Appendix_C_Medical_Evaluation.doc

APPENDIX C

MEDICAL EVALUATIONS AND OTHER MEDICAL ISSUES

1. Pre-assignment Medical Evaluation:

a. No contract employee shall perform health care services under this contract unless a pre-assignment medical evaluation has been performed not more than 30 calendar days prior to submission of credentials. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others.

b. As a minimum, the individual shall be free of physical defects or medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement of performance of health care services under this contract by any employee, the Contractor shall provide to the Public Health (Employee Health) Flight certification that such employees have completed the medical evaluation requirements identified below, or as directed by AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military Significance.

c. Initial documentation is required for: HIV, MMR (immunization or titer levels for Rubella and Rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity), TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with contractor’s physician and a chest x-ray.

d. A physician must provide documentation of “no active respiratory disease”, Hepatitis B vaccination/series are required for all personnel with occupational risk of exposure (declination are not acceptable, this is a condition of employment) and if the employee will be involved in exposure-prone procedures (ex: dentist, dental hygienist) they will have their HbsAg status determined. This is to be done by providing documentation of the HbsAb. If the HbsAb is positive, they will be referred to the MTF Credentials committee to determine scope of practice.

e. If the physician finds the candidate is fit for employment, the physician will complete the certificate. It shall include the date on which the examination was completed, the physician’s name that performed the examination, and the following statement:

“(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a (insert job title). He/she has documented proof of immunization against/immunity to rubeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk.”

f. If, in the opinion of the evaluating physician, the candidate does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain state the following:

“For medical reasons, (NAME OF EMPLOYEE) is not qualified for employment as a (insert job title).” Certification shall be provided to the CO, who will forward to the MTF Employee Health Office.

2. Annual Medical Evaluations: All contract employees performing health care services under this contract shall complete annual medical evaluations as required by the MTF hospital employee health program. The contractor shall provide to the QAP a certificate, as described above, documenting the results of this evaluation.

3. Preventative Prophylactic and Follow-Up Procedures: The contractor shall ensure that his/her employees are in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF and IAW AFI 91-301, Air Force Occupational and Environmental Safety, Fire Protection and Health (AFOSH). Required preventive, prophylactic and follow-up procedures will be provided by the Government to contract employees in the military MTF. The Contractor shall reimburse payment for these services if received in the MTF. If care is received elsewhere, the Contractor shall provide written verification of treatment.

4. The Contractor and contractor employees shall comply with all Occupational Safety and Health Act (OSHA) requirements that apply to a health care worker.

5. The contractor shall report to the Primary Care Flight Commander, all information necessary to assure hospital records can be maintained correctly, and therefore comply with the AAAHD, OSHA, and Center for Disease Control (CDC) health record requirements.

APPX C