SOW_Occ Med - FY27 (ao 19AUG26) (003).docx

STATEMENT OF WORK

FOR

Occupational Medicine Services

75th Operational Medical Readiness Squadron 75th Medical Group Hill Air Force Base, Utah 19 Aug 2026

1.0. DESCRIPTION OF SERVICES.

1.1. The Contractor shall provide Occupational Medicine Services (OMS) for the Ogden Air Logistics Center (OO-ALC), its subordinate commands and tenant organizations at Hill Air Force Base (HAFB), Utah. This includes furnishing all labor, transportation, consultation, teaching, reports, equipment, and clinical oversight, except as outlined in Appendix D. Performance shall be according to the requirements contained in this Statement of Work (SOW). The Contractor (Corporate President) or senior company representative for the contract will be available to meet with local contract staff and HAFB Contracting Officer (CO), 75 Medical Group (MDG) Logistics, Contracting Specialist and the Functional Requirements Evaluator Designee (FRED). The Contractor shall staff and provide occupational medicine services for government employees, require occupational health services, in accordance with (IAW) all applicable laws, regulations, and Department of Defense (DoD), Air Force (AF) and HAFB Instructions (see Appendix E). The OMS is a Flight under the 75th Operational Medical Readiness Squadron (75 OMRS). The 75 OMRS is a component of the 75 MDG, an Air Force ambulatory care clinic that provides care to approximately 33,000 TRICARE beneficiaries. The beneficiary population of the OMS clinic is approximately 18,500 federal, Non-Appropriated Fund (NAF), and tenant unit employees as well as Active Duty (AD) receiving annual Occupational and Environmental Health Medical Examinations (OEHME). Approximately 8,500 federal and military members work in industrial work areas with approximately 2,500 receiving annual physicals.

1.2. FUNCTIONAL REQUIREMENTS EVALUATOR DESIGNEE (FRED). The Installation Occupational and Environmental Medicine Consultant (IOEMC) and/or Chief of Medicine (COM) are the FREDs and have over-site responsibility for OMS. These individuals are residency-trained, occupational medicine physicians who are government employees, either AD or federal civil service. The IOEMC and/ or COM is assigned as the lead contract FRED. The IOEMC and/or COM is also appointed as the consultants for OMS IAW DAFI 48-145.

1.3. CONTRACTOR REQUIREMENTS. The Contractor will provide Occupational Medicine providers, nursing staff (Registered Nurse (RN), Licensed Practical Nurse (LPN)), clinic management support, medical administration and scheduling, records management, non-count coding, and respiratory fit testing. The Contractor staff will integrate into a combined government/contract Occupational Medicine clinic which works collaboratively to care for all occupational health beneficiaries.

2.0. OMS STAFF

The Contractor will at minimum, staff the OMS as follows:

PERSONAL SERVICES

See comments Option to add these FTEs during the Base or Option Years of the contract.

NON-PERSONAL SERVICES

MRC Front Desk x 2 MRC Data Entry x 1 MRC Schedulers x 2 MRC Audiology Clerk x 1

2.1. Performance. When the contractor experiences any delays in accomplishing the specific tasks identified in subparagraphs (a), (b) and (c) below, the contractor shall notify the Contracting Officer Representative (COR) immediately. The COR will evaluate the situation to determine if an extension of the dates is appropriate. If an extension is not approved, the Government may terminate the task order for default or seek other remedies as appropriate.

2.1.1. Submit resumes of qualified individuals being considered for employment to the Logistics Contracting Specialist at the Medical Treatment Facility (MTF) within 30 calendar days of Period of Performance. Period of Performance is considered to be performance by the contractor rather than the contracted Health Care Worker. This performance includes the recruiting and qualifying portion of the Task Order. The government reserves the right to interview in person or telephonically and approve or disapprove all candidates.

2.1.2. Credentialed Health Care Worker(s) shall physically begin performance 60 calendar days from the initial period of performance date or the date specified in the Task Order which shall not be less than 90 calendar days from the initial period of performance date. Health care workers may begin performance earlier than 90 calendar days if an earlier date is mutually agreed upon between the CO and the contractor. A Task Order modification will be accomplished to adjust the date performance begins.

2.1.3. Non-Credentialed Health Care Worker(s) shall not be less than 60 calendar days from the initial period of performance date. Health care workers may begin performance earlier than 45 calendar days if an earlier date is mutually agreed upon between the CO and the contractor. A Task Order modification will be accomplished to adjust the date performance begins.

2.1.4. Staffing positions will not be vacant for more than a period of 45 days, especially provider positions. If a position remains vacant or is anticipated to be vacant for 46 days or more, the contractor will provide an interim or locum tenens staff with appropriate credentials and qualifications to temporarily work in the position until such position is filled with a candidate. The interim staff shall be in place and functional in their respective role within 2 weeks (60 days from initial vacancy). Additionally, over 60 days vacancy will be cause for consideration of termination of the contract. Exceptions to these stipulations may be allowed when approved by the Flight Commander and/or Chief of Occupational Medicine with the primary goal of finding the best fit candidate.

2.2. Retain. The continuity of high-quality health care workers is a vitally important component in maintaining quality of care to OMS beneficiaries. The Contractor shall maintain a minimum of 99% of all HCW positions filled at any given time. The provider’s fill rate shall be maintained at a minimum of 85%. All absences will be coordinated/scheduled.

2.3. In-processing. All new OMS personnel shall in-process through the 75 MDG Commander’s Support Staff (CSS) office within two duty days of start of work and complete a 75 MDG checklist for the purpose of in-processing. This must be turned in, completed, and sent back to CSS within 30 days after start date.

2.4. Normal Hours of Operation. OMS staff will perform the services required under this contract during the following hours: Mon – Fri 0700-1600, except Federal Holidays. Extended hours may be requested with prior approval, to ensure timely completion of work at no additional cost to the government. The government may request the Contractor to execute surge operations of the clinic to support national emergencies. The Contractor may anticipate reduced patient volume every other Friday and training day and use these days for required training, in-services, etc. The clinic must remain open, however.

2.4.1. Alternative Work Schedule (AWS). With prior approval from the contract program manager, OMS leadership may implement an AWS when it better aligns with mission requirements/capabilities and customer support.

2.4.1.1. OMS leadership and may implement a traditional AWS known as a 5/4/9 schedule, where the employees work a total of 80 hours per pay period. An example of this is working 36 hours one week, then working 44 hours the following week; and having every other Friday off. The Friday off would be staggered among contract staff to ensure coverage on the day others are off.

2.4.1.2. Another example of an AWS is a 5/4/9 under which OMS staff would perform the services under this contract Mon – Thu 0630 – 1630. And Fri 0630-1530 with the work week ending halfway through the workday on Friday. Under this AWS, each work week would consist of exactly 40 hours and contract staff would have every other Friday off.

2.4.1.3. The utilization of an AWS is not an entitlement and remains strictly subject to ongoing operational requirements and mission needs. Individual employee flexibility would be allowed so long as overtime is not incurred. OMS Leadership has the rights and options to revert contract employees back to normal hours of operation as described in paragraph 1.4. Any changes to work schedules will be coordinated to the contract company through the COR. Under any approved AWS arrangement, contractor personnel shall not exceed 80 hours of work per pay period unless required by surge or contingency operations, and only on prior approval as stated in paragraph 1.4

2.5. Recognized Holidays and Planned Closures. The Contractor is not required to provide service on the following days: New Year’s Day, Martin Luther King Day, Presidents Day, Memorial Day, Juneteenth Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, and Christmas Day. If the holiday falls on Saturday, it is observed on Friday. If the holiday falls on a Sunday, it is normally observed on Monday; if it does not, the Contractor will take the holiday on the federally observed day.

2.6. Unplanned Closures. During unplanned closures due to unusual and compelling circumstances such as natural disasters, military emergencies, severe weather or by executive order, etc., the contractor will only be compensated for the actual hours the HCW provided. If the clinic is closed and no services can be rendered due to an unplanned closure, the contractor will not be compensated and the contractor will not be able to bill for services not rendered.

2.7. Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR). All OMS employees will show proof of required BLS. This must be maintained throughout the duration of employment.

2.8. Base Access/ID Card. New personnel may be escorted by a current OMS employee to the 75 MDG Logistics, Contracting Specialist, who will initiate an application for DoD Common Access Card (CAC) to access HAFB.

2.9. Background Investigation. Since the healthcare workers under this contract have access to and/or process information requiring protection under the Privacy Act of 1974, these positions are designated as Automated Data Processing III (ADP-III) / Information Technology Level III (IT-III) positions. Compliance with DoDI 8500.01 (Cybersecurity), DoDM 5200.02_AFMAN 16-1405 (Air Force Personnel Security Program), and AFMAN 17-1301 (Computer Security) is mandatory. Therefore, a Tier 1 (T1) background investigation (formerly known as a National Agency Check with Inquiries (NACI) is required for each healthcare worker under this contract. The Contractor shall fully adhere to the provisions of these referenced publications by ensuring each employee performing under this contract coordinates through the COR and or Security Manager to schedule an appointment with the installation's designated security organization.

2.9.1. To obtain a background check, each contractor will complete the following:

2.9.1.1. Fill-out Standard Form 85 (SF-85), Questionnaire for Non-Sensitive Positions. Upon in-processing with the 75 MDG, the contract employee will meet with the 75 MDG’s Security Manager and the contract employee will be directed to submit the information provided on their SF-85 via an electronic application on the National Background Investigation Services online website.

2.9.1.2. Fingerprints. 75 MDG Security Manager will assist in scheduling fingerprint appointments. Fingerprints appointments generally take place on base (unless otherwise directed by the base security office).

2.9.2. The Contractor shall advise their employees that a favorable suitability determination is a condition of employment under this contract. The Contractor shall initiate the security vetting process prior to the start of performance for each healthcare worker.

2.9.3. The Contractor understands that while the MTF Commander may grant interim network access to allow healthcare workers to temporarily occupy nonsensitive (ADP-III) positions pending the final outcome of the Tier 1 background investigation (NACI), the healthcare worker shall be immediately removed from the position and have all government network access revoked if the background investigation receives an unfavorable adjudication or any other adverse or unfavorable security information becomes known that would negatively affect the investigation or suitability determination.

2.9.4. Contracted personnel retain the right to obtain a copy of their background investigation and to challenge the accuracy and completeness of the information contained therein. Because background investigations are federal records governed by the Privacy Act, employees must request copies of their records directly from the investigating agency, typically the Defense Counterintelligence and Security Agency (DCSA)—via a Privacy Act/Freedom of Information Act (FOIA) request. The 75 MDG Security Manager or CSS can provide the employee with the current contact information and instructions on how to submit this request to the appropriate federal agency.

2.9.5. If a contracted employee has previously undergone a federal background investigation, the Contractor shall provide verifiable proof of the favorable adjudication to the COR to establish reciprocity. A previously adjudicated investigation shall be accepted reciprocally, provided that:

2.9.5.1. The previous investigation meets or exceeds the Tier 1 (NACI / ADP-III) standard

2.9.5.2. There is no new derogatory or unfavorable information since the last adjudication

2.9.5.3. There has not been a break in service to the Department of Defense (DoD) or Federal Government exceeding two (2) years (24 months). If a break in service exceeds two years, a new Tier 1 investigation must be initiated. Local security re-verification or credentialing checks shall be accomplished every five (5) years in accordance with local installation security policy.

2.9.6. Payment of fees incurred in the conduct of any criminal history background check is the responsibility of the Contractor.

2.9.7. If needed, selected contract employees maybe issued a restricted area badge (line badge) through the 75 MDG Security Office to conduct mandatory shop and industrial workplace visits. The Contractor shall ensure that the designated personnel meet and maintain all base security requirements necessary to hold a restricted area badge.

2.9.8. Contracted personnel are strictly prohibited from accessing, viewing, or handling any Secret or otherwise classified documents or materials. If a mandatory shop visit requires access to a classified or secure area where classified information cannot be shielded, the Occupational Medicine Services (OMS) FRED or designated military/government personnel shall conduct the shop visit instead of the contract physician.

2.10. English Language Requirement. All contracted workers shall read, write, understand, and speak English fluently.

2.11. Appearance. While at the 75 MDG on a regular workday, OMS staff shall be neat and clean, well groomed, and in appropriate clothing. OMS staff shall not wear clothing made of “see through” material, cut-offs, tank tops or clothing that displays offensive slogans or pictures. Open-toed shoes or lounge wear shall not be worn by the OMS staff. No facial or tongue piercing, other than one piercing per ear, is allowed. Facial hair, including beards, mustaches, sideburns, shall be controlled, restrained, or trimmed so as to not interfere with professional, modest appearance in keeping with normally accepted community standards of dress for the work being performed. Any visible tattoos must not be offensive.

2.12. Employee Identification. The OMS staff shall wear the 75 MDG identification badge; which will be worn on the outside layer of clothing between the neck and the waist. All staff will be required to maintain a current CAC. Personnel issued a restricted area badge (line badge) will adhere to instructions regarding its use.

2.13. Health Requirements. In accordance with applicable Air Force Instruction (AFIs), Department of Defense Instructions (DODIs), all health care workers shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report (MMWR), and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard.

2.13.1. Before start of work, health care workers shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The health care worker shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray and/or QuantiFERON Gold test results within 12 months) prior to start of work. After start of work, the Government will provide post blood borne exposure protocols according to applicable AFIs, DODIs.

2.13.2. In those areas where there is a higher risk of transmission of tuberculosis, health care workers will be tested as frequently as directed by the MTF policy. This test will be provided by the MTF.

2.13.3. Immunization information will be tracked in DoD computer systems for all health care workers.

2.13.4. No medical tests or procedures required by the contract may be performed at the MTF (with the exception of Tuberculosis testing and recurrent immunizations required periodically after start of work). Expenses for all required tests and/or procedures (e.g., respirator fit testing where required) shall be borne by the health care workers at no additional expense to the Government.

2.13.5. Health care workers must be immunized annually with the influenza vaccine. Unless vaccinated by the Government, the health care worker shall be required to show proof of the vaccination. Immunizations that require booster or recurrent vaccination will be furnished by the MTF.

2.14. Out-processing. On the employee’s last duty day, the employee will report to the 75 MDG CSS to initiate the out-processing action application and relinquish his/her CAC card to the 75 MDG Logistics, Contracting Specialist. Parking pass and building keys will be turned into facilities personnel. All actions will be completed by close of business this day.

2.14.1. Non-working Employees. The 75 MDG COR shall be notified by the Contractor of any contractor personnel no longer working at 75 MDG OMS clinic. The Contractor will ensure all employees complete the 75 MDG out-processing. Any contract personnel re-assigned by the Contractor to work after 120 days from the last day of work during the previous work period shall be treated as a new employee for the purpose of training requirements.

2.15. Conflict of Interest. The Contractor shall not employ any person who is an employee of the United States Government. The Contractor shall not employ any person who is an employee of the AF, Defense Health Agency (DHA), AD or civilian, unless such person seeks and receives approval IAW applicable AFIs/DODIs.

2.16. Complaints. Validated by the FRED/IOEMC/COM and/or SGH, shall be reported in writing to 75 MDG Logistics, COR and the Contractor for action. Failure of the Contractor to correct validated complaints submitted by the 75 MDG staff will be considered a failure to perform. Communication from the Contractor for action back to the COR should take no longer than 14 days.

2.16.1. Personnel receiving complaints validated by the FRED/IOEMC/COM and/or SGH shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing services under this contract.

2.17. Incidents. Report any near miss and/or incidents i.e. medication error, patient fall, encountered using the correct documentation and process IAW the 75 MDG Instructions regarding the use of the Patient Safety Reporting (PSR) tool.

2.18. In-Service training. Document in-service and training attended in his/her Competency Assessment File (CAF) Folder.

2.19. Surge. Expect surges in patient care to occur during or following contingency operations to meet military unique mission requirements. This may include pre-deployment medical processing.

3.0.

SCOPE OF MEDICINE.

3.1. The Contractor shall provide initial and follow up care for injury and illness of government employees and equal tenant unit employees that occur on the job during OMS clinic hours. Medical care provided by the Contractor shall be within the scope of this OMS contract. The quality of medical practice shall meet or exceed the standards of care established by the 75 MDG Executive Council of Medical Staff (ECOMS) and Executive Council.

3.2. Evaluation of Patients. Patients shall be evaluated IAW their medical condition or medical injury. When a PA does the initial injury/illness evaluation for a work-related incident, all documentation will be co-signed by a physician and all appropriate oversight to all care given will be maintained during monthly peer reviews.

3.3. 2.3. Refusal of Services. No civilian or qualified tenant unit employee shall be refused the right to see a provider if requested for care that is under the scope of this contract and the responsibility of OMS. If the condition allows, the employee may be scheduled for the following day’s appointment. Except in emergency situations where immediate medical care will save life, limb or eyesight, all contract or non-approved tenant personnel working at HAFB will be referred to an off-base emergency treatment facility.

3.4. 2.4. Chaperone Assistance. Contractors will abide by the 75 MDG’s Chaperone policy and guidelines.

3.5. Accreditation Association for Ambulatory Health Care (AAAHC) and Health Services Inspection (HSI). All applicable AAAHC standards shall be met pertaining to the performance of this contract. Self-inspection (Management Internal Control Toolset) MICT, or current process, checklist will be reviewed and updated as required by the AF and 75 MDG.

4.0. PHYSICALS

4.1. Occupational Safety and Health Administrations (OSHA) Expanded Standard Baseline, Periodic, and Termination Examinations. The Contractor shall conduct baseline, periodic, and termination examinations for AD, civilian, and qualified tenant employees, as per each unit’s tenant agreement, IAW Comprehensive Occupational Health Exam Reviews (COHER). The Bioenvironmental Engineering Flight (SGXB) will provide a Similar Exposure Group (SEG) to the OMS one month prior to the designated block month. The Contractor shall work closely with the point of contact (POC) of each SEG, the SGXB and the Public Health Flight (SGXM) to ensure that all employees in a SEG are identified and required examinations are completed. To maintain currency within the SEGs for baseline and termination. A good rapport must be maintained with the POCs of each SEG. All abnormal findings suspected to be due to occupational factors will be reported to SGXM and SGXB via SF-190 and OSHA Form 301/AFMC Supplemental (OSHA 301). The Contractor will follow up on abnormal findings with the employee within five duty days of clinic notification. The provider will discuss with the employee implications of continuing to work in his/her assigned area. The goal for completion rate is 95% at the end of the block month as SEG employee deployments, school, leave, physical qualifications, and Temporary Duties Yonder (TDY) allow. Forms needed for physicals will include COHER form, Occupational Environmental Exposure Data OEHED form, Occupational Environmental Health Medical Exam (OEHME) form, Physician’s Written Opinion (PWO), and questionnaires as required. See section 15.0. Forms, for more information.

4.2. Other Periodic Physical examinations. OMS providers shall conduct other periodic physicals on civilian, AD, or qualified tenant employees to ensure the employee meets specific physical and mental standards necessary to meet the functional requirements and environmental factors of the job. Other physical exams include, but are not limited to:

4.2.1. Immunization Requirements in Conjunction with Exams. A list of personnel requiring these examinations will be provided to the OMS clinic by the 75 MDG Infection Control. Civilians who are candidates for overseas positions and civilians traveling under official orders to overseas locations shall receive any necessary serological tests and immunizations/medical disease prophylaxis required for travel to those countries. The immunizations may be given at the 75 MDG immunization clinic or at the OMS clinic as available.

4.2.2. Physically Disqualified Program (PDP). 25-30 exams per year result in disqualifying an employee from his/her current position and having him/her placed in the PDP program.

4.2.3. 3.2.3. PDP Medical Record, Position Description (PD), and Optional Form (OF) 178 and the Memorandum in Lieu of OF178 will be reviewed for Job Placement. While the HAFB employee is in the PDP, he/she will be actively looking for a full-time position. When a potential job is found by the PDP administrator, the OMS provider will review the employee’s permanent restrictions, the new OF 178, and PD to see if the PDP employee medically qualifies for the proposed position. If the job requirements are amenable to his/her medical condition, then the employee will be scheduled for a PDP physical. If the job requirements are not amenable, then the OMS provider will write “not medically qualified” on the Memorandum in Lieu of OF-178. The original is scanned and e-mailed to the PDP administrator then scanned and uploaded in the employee’s medical record. See section 15.0. Forms for more information.

4.2.4. Comparison physicals are used to qualify a current employee to a new position with different job requirements than his/her current position.

4.2.5. Courtesy physicals are used to qualify for a new position an applicant who will not be working at HAFB but another AF base/DoD facility. Physical exam data that is part of the courtesy physical shall be scanned, faxed, or mailed per the OMS Medical Records Clerk (MRC) scheduler into the computer and sent via encrypted e-mail to the requesting Base or Facility.

4.2.6. TDY physicals are used to qualify a civilian or qualified tenant employee to travel and work temporarily at another site.

4.2.7. Permanent Change of Station (PCS) physicals are used to qualify a civilian or qualified tenant employee who is transferring to a different home base.

4.2.8. Civilian Deployments physicals are used to qualify a civilian employee or qualified tenant employee who is deploying for a determined length of time to complete mission essential functions.

4.3. Pre-Placement Examinations. OMS providers shall perform pre-placement exams for applicants referred by Civilian Personnel Office (CPO), to determine if the applicant’s general health is compatible with the job assignment requirements. The schedule will be on a shared public folder of SHAREPOINT for the Pre-Employment Team (PET), Drug Demand Reduction (DDR) staff, fingerprinting staff, and OMS pre-placement MRC. All laboratory components, exam requirements and other necessary information are received then the determination is made by the OMS provider after his/her exam for the applicant to work with or without restrictions for the safety of the individual and worksite. The OMS provider does not decide if the employee is employable or not employable. The OMS clinic shall obtain, from the applicant, additional medical information, when necessary to make a decision. The applicant is responsible to furnish all required additional information at the applicant’s expense to the OMS provider when the applicant’s medical qualification is in question. See section 15.0. Forms, for more information.

4.3.1. Pre-Placement/Increased/New Workload. The Contractor will be advised when HAFB has increased requirements for pre-placement physicals. This may be an increased workload but will not be considered an actual surge.

4.4. Audiology Referrals and Hearing Exams. The Contractor's Occupational Medicine Services (OMS) physician shall evaluate referred civilian, Active Duty (AD), and qualified tenant employees presenting with job-related hearing issues. Referrals will be received from the 75th Operational Medical Readiness Squadron (75 OMRS) Audiology Flight after the appropriate workplace fitness and risk assessment evaluations have been completed and a specialist consultation is required to consider temporary/permanent duty limitations or removal from hazardous noise environments. The Contractor shall provide clinical consultation and medical documentation to support the audiologist’s administrative actions in accordance with: AFI 48-127 (Occupational Noise and Hearing Conservation Program) DAFMAN 48-146 (Occupational Health Program Management) DoDI 6055.12 (Hearing Conservation Program). At a minimum, this clinical consultation shall include a comprehensive history, a physical visual examination of the external ear canals and tympanic membranes, and cerumen management as clinically indicated. The resulting documentation must provide sufficient objective medical evidence to justify necessary workplace removals or to controvert federal/civilian workers' compensation claims when medically warranted.

4.5. Fitness-for-Duty (FFD) Examination. The Contractor’s OMS physicians shall perform FFD examinations for civilian employees when authorized. The examining physician shall provide a written, objective medical assessment regarding any employee who displays performance or behavioral issues that are suspected to stem from a physical or mental medical deficiency. Supervisors seeking to initiate an FFD must first coordinate with the civilian personnel flight and the OMS representative to review the regulatory requirements, qualifying criteria, and available resource materials. Once the supervisor completes all required documentation, including obtaining the necessary signatures from the Squadron Commander (CC) or Director, the OMS clinic shall schedule the employee for the FFD examination. All FFD evaluations must be fully justified and conducted in strict accordance with 5 Code Federal Regulation (CFR) Part 339, Sections 339.301 through 339.304 (Medical Evaluation Programs). When a specialty consultation is medically necessary to complete the FFD evaluation, the OMS physician shall refer the employee to an outside specialist. Prior to scheduling any specialty consult, the OMS clinic shall coordinate funding authorizations through the employee's unit of assignment and the 75 MDG Resource Management Office (RMO).

4.6. Impaired Employee Evaluation. OMS providers should see workers referred by his/her supervisor for an assessment for safely working in current condition without harm to self or others and make a recommendation regarding duty limitations after the supervisor has contacted the unit Employee Relations Specialist (ERS) and the employee has been to DDR. At the time of such a visit, an OMS provider should determine if referral for treatment is appropriate. When non-urgent treatment is indicated, the worker will be referred to the clinical psychologist. When work limitations are given or the worker is sent home, and driven by another person, arrangements for a follow-up assessment should be made to clear the worker to Return to Work (RTW). When a diagnosis of alcohol/substance abuse or dependence is made, and the worker performs hazardous duties, he/she should not be returned to perform those duties until appropriate treatment and compliance with aftercare is verified through the clinical psychologist. If the worker has a security clearance; similar evidence of resolution and compliance should be documented prior to return to duties requiring that clearance.

4.7. OEHME Completion Reporting. The OMS clinic’s goal is to complete all exam requirements for the HAFB employees within the scheduled block month as able. The clinic shall strive to maintain a minimum 12-month rolling average of 90-percent completion rate for all OEHMEs. Major Command (MAJCOM) reviews the completion rates in Aeromedical Services Information Management System (ASIMS) which includes OEHME completion and audiogram only SEG completion. The Contract is responsible for OEHME completion rates only. The completion rate is routed to the 75 MDG Executive staff via Occupational and Environmental Health Working Group (OEHWG) and the Aerospace Medical Counsel (AMC).

4.8. Other Exams. Exams with specific components may be required by other federal agencies through written agreement with the 75 MDG, e.g., Department of State, Peace Corps, teachers for DoD overseas dependent schools, etc.

4.8.1. Medical Records Review Programs. The OMS providers conduct professional reviews of medical records. Examples of medical records review programs are: Security clearance; PRP/Sensitive Compartmented Information (SCI); assignment to positions of special trust, request for review of suicides, security investigations, PDP, etc.

5.0. INJURY/ ILLNESS EXAMS

5.1. Tuberculosis (TB) Patients. OMS does not treat TB patients. When an employee has a positive reaction to the TB skin test placed in the OMS clinic, the patient will be referred to 75 MDG Public Health, and to either his/her primary care provider and to the County Health department as appropriate for diagnosis and treatment.

5.2. Work Related Injuries and Illnesses. OMS providers shall evaluate and offer to treat all civilian and qualified tenant employees with occupational injuries or illnesses associated with employment by the DoD. Civilian employees may exercise their right to seek treatment from a civilian source rather than from the OMS clinic. At the time of the OMS visit, the injured/ill employee will fill out an OSHA 301 or approved equivalent. Emergent patients will be triaged and seen prior to scheduled patients.

5.2.1. Injury and Illness Documentation. All injury/illness exams and treatment given at the OMS clinic shall have appropriate and defensible medical documentation entered into the medical record. Additional items that should be included relate to the medical condition of the employee’s work environment or to his/her work. The documentation shall reflect accepted standards of care.

5.3. Occupational Illness Referral. OMS providers shall refer an employee to PH when the employee has a new occupational illness. This is for the PH investigation of work relatedness. This referral will be conducted while the patient is in the OMS clinic if PH personnel are available. PH personnel enter their investigation information into the Air Force Safety Automated System (AFSAS) which automatically notifies SGXB to complete a work site evaluation. PH’s conclusion of the investigation is brought to the OMS referring provider for signature and the report is scanned and uploaded in the patient’s medical record.

5.4. Return-to-Work (RTW) Examinations. OMS providers shall determine whether an employee is fit to RTW after an illness or injury, occupational or non-occupational. Any employee who is placed, or is working light/limited duty, or is sent home will be followed by the OMS clinic every 30 days IAW HAFB Light Duty Guidance. The RTW exams are documented by the OMS provider in the electronic medical record and the RNCM enters the appointment information into the OMS Injury/illness database for tracking purposes. Workers are informed of how to contact the Office of Workers Compensation Program (OWCP), NAF, or qualified tenant unit’s workman’s compensation liaison for assistance at the time of their initial appointment for this injury/illness.

5.5. 4.5. Life Threatening Situations. OMS providers or RNs shall triage and stabilize all patients with life threatening injuries or illnesses per BLS standards and within the capabilities and equipment maintained in the clinic prior to or at the same time as activating the Emergency Medical System (EMS) system. EMS will be contacted by dialing 911 with a LAN line.

5.5.1. E-mail notification to Executive Staff at 75 MDG. As the patient is being taken to the ambulance, the RNPM will send an e-mail to the 75 MDG /CC, director of Medical Staff (SGH), director of Nursing Staff (SGN), 75 OMRS/CC, and the IOEMC and/or COM to inform them of the EMS transport.

5.5.2. If a supervisor or co-worker calls OMS regarding a patient emergency, either physical or mental, the OMS staff will advise that person to call 911 for faster response of the EMS team to the employee.

5.5.3. The LAN line is directly linked to the HAFB Fire Department dispatch. HAFB paramedics will respond and transport to the nearest Emergency Department.

5.6. Injuries/Illnesses Occurring Outside OMS Clinic Hours. Civilian and qualified tenant employees who sustain work related injuries/illnesses when the OMS clinic is closed shall be referred by the employer to off-base resources, preferably to the nearest emergency facility.

6.0. SHOP VISITS

6.1. Scheduling Annual Shop Visits. The Administrative Support Technician (AST) shall provide a schedule of annual shop visits in January to OEHWG for coordination and approval. The shop visit list will contain all SGXB designated Category 1 critical shops that receive OEHME. Category 1 shops will be visited by an OMS provider. OMS providers shall comply with the established schedule from January to December each year.

6.2. Shop Visit Preparation. The AST shall arrange shop visits with appropriate shop supervisors/POC. The AST shall obtain a personnel listing of employees from ASIMS. The OMS provider will compare the employee list of the scheduler and the POC and review the list on site. OMS providers should review the shop folder (both SGXB and Tab F), any relevant Injury/Illness data from the database, the COHER form, OEHED form and last years shop visit prior to the visit. The AST invites Flight surgeons, PH, optometrist, RN, and Audiologist to attend the shop visit.

6.3. SEG Trend Analysis. The RNCM shall search the OMS database and report to the OEHWG any adverse injury/illness trends detected on each Category 1 SEG. The OMS provider will review all lab work completed for the OEHME. The trend analysis is reviewed again prior to the shop visit, approximately three months after the shop physical examination block month.

6.3.1. Reporting Trend Analysis Findings. The purpose of the trend analysis is to identify and determine possible causality between clinically significant laboratory abnormalities in employees during their OEHME and potential exposures to occupational hazards. All positive trends shall be reported at OEHWG and discussed with the POC/supervisor of the shop.

6.3.2. Request for SEG Survey. The OMS provider shall initiate an SF-513, Consultation Form, or two-way memo, to request from SGXB a workplace survey or evaluation whenever a question arises regarding the effectiveness of workplace controls as it relates to health.

6.4. On-Site Shop Visit Report. This report identifies findings/recommendations from each shop visit of the health/medical aspects of the work environment. The on-site shop visit report will include observations, conclusions, and recommendations. Safety concerns should be reported immediately to 75 ABW Ground Safety or to a representative of the OO-ALC Environmental, Safety, and Occupational Health (ESOH) office. Exposure concerns should be reported immediately to SGXB and to PH. The onsite shop visit form is scanned and uploaded the shop visit folder. Abnormal findings are reported at OEHWG.

6.5. Documenting Shop Visits. The OMS provider shall complete the on-site shop visit report. The AST will document the shop visit on the shop visit scheduled spreadsheet. A courtesy copy of the shop visit report will be forwarded to 75 OMRS/CC, SGXB, PH, and the shop supervisor.

6.6. Shop Folder Control. The AST will comply with the shop visit folder control procedures established jointly with SGXB and PH. Procedures will be developed jointly to ensure positive control. This will be documented in the OMS records management log and in the OMS File Plan.

7.0. TESTING

7.1. Laboratory Specimens. OMS LPN shall obtain all appropriate laboratory specimens and ensure their timely and safe transportation to the 75 MDG laboratory.

7.1.1. Laboratory Reports. Laboratory results shall be reviewed and appropriately dispositioned in the EHR (Electronic Health Record) by an OMS provider.

7.1.2. Laboratory Accreditation. The OMS LPN will maintain on-going communication with the 75 MDG Laboratory Officer regarding operations of the OMS laboratory, IAW the College of American Pathologists (CAP) standards. The OMS laboratory area is a satellite of the 75 MDG Laboratory, thus susceptible to all accreditation standards by the CAP. Failure to maintain the OMS Lab area IAW to the CAP standards will result in termination of laboratory services at the OMS clinic.

7.2. Radiology. X-rays will be obtained through the 75 MDG Radiology department. Digital Image Radiographs will be interpreted by the consulting radiologist. The OMS providers will have access to the x-ray’s images on the 75 MDG current radiology image viewer software and will render initial interpretations where necessary.

7.2.1. Radiology Reports. Radiology results shall be followed up on appropriately and documented in the EHR. If a patient needs a copy of the x-ray, a CD will be made and can be picked up by the patient at the Radiology Clinic in Bldg. 570.Radiology Services. Advanced imaging services (i.e. MRI, CT, and U/S) are not available in the 75 MDG; these services should be arranged for through the appropriate OWCP liaison if related to an occupational injury or illness by referral and managed by the RNCM.

7.2.2. Laboratory and Radiology Results. The LPN will follow up on all laboratory and radiology results. Once results are obtained the lab LPN will have an OMS provider review. All results are also sent to the OMS RNPM for the abnormal lab work report. Once the results are initialed by the OMS provider it is filed into the employee’s medical record.

8.0. CODING

8.1. Coding. Coding is accomplished by the OMS providers through the EHR. RN and LPN will complete their own encounter coding through MHS Genesis.

8.2. Ambulatory Data. The coding contract staff contacts the OMS providers for needed information or if the electronic medical chart doesn’t show completed in the Automated Data System (ADS). This could mean the transfer from the Standard Ambulatory Data Record (SADR) Daily Outpatient Workload Report (DOWR) did not process correctly; the coding clerk will code per the electronic medical record note. OMS providers will provide feedback when required to the coding contract staff. The OMS clinic will maintain the AF’s 72 hour electronic medical records completion compliance.

9.0. CHARTING

9.1. Documentation. The OMS providers shall document all patient encounters in the EHR, on the Memorandum in Lieu of OF178, and/or on the SF-600 overprint as required. The OMS provider shall address all pertinent positive findings on the employee’s health history questionnaire. Each encounter will conclude with the provider completing a RTW form or an OEHME form. These will include permanent or temporary work restrictions and/or qualification for OSHA expanded standard clearance. All RTW/OEHME forms are signed by the employee to acknowledge a copy is to be given to his/her supervisor.

9.2. Provider Charting. All patient encounters including telephonic health visits accomplished by OMS providers shall be adequately documented to record pertinent medical and occupational history, clinical findings, related lab or x-ray results, diagnoses, whether the medical condition or significant abnormality is believed to be job related, treatment and disposition. Each employee seen for a new injury/illness will have pertinent history and circumstances of occurrence, a statement explaining how the injury/illness is related to the position, diagnosis, and treatment recommended. Confidentiality shall be maintained IAW the applicable OPM regulations, AFIs, the Privacy Act of 1974, and Health Insurance Portability and Accountability Act (HIPAA) of 1996.

9.3. Interpretation. The interpretation of the individual’s health status and disposition shall be made by the OMS provider and shall be related to the established job requirements and workplace environment. \

9.4. 8.4. Guidance. The Contractor shall ensure that every patient encounter is thoroughly and properly documented by the examining OMS provider within the individual’s official medical record. Clinical and administrative record-keeping workflows shall adhere to the following directives: Record Maintenance Standards: The Contractor’s OMS MRCs shall ensure a complete, accurate, and secure medical record is maintained for each employee in strict accordance with DHA-PM 6025.02, Volume 2 (DoD Health Record Lifecycle Management) and DAFMAN 48-123 (Medical Examinations and Standards). Electronic Health Record (EHR): Each clinical encounter must be documented in the designated government Electronic Health Record (EHR) system (e.g., MHS GENESIS) by the end of the duty day on which the service was rendered. Quality and Clinical Guidelines: The examining provider is bound by all clinical quality, credentialing, and administrative guidelines in accordance with DAFI 44-119 (Clinical Quality Management) and all local 75 MDG instructions.

9.5. Validating Medical Documents. OMS providers shall indicate responsibility and validate the content and correctness of all of his/her medical records documentation when he/she attaches his/her digital signature to the encounter.

9.6. 8.6. Depression Screening. A depression screen can be completed as per the 75 MDG depression screening guidance. Under this guidance universal screening (for every patient) is only required in primary care clinics and thus is not required in the OMS specialty clinic. Providers and staff should still implement depression screening where it is deemed appropriate for individual patients.

9.7. Written Replies. The Contractor shall prepare written replies for requests other than medical information e.g., union grievances, Equal Employment Opportunity (EEO) complaints, OWCP, official investigations, labor law requests for administrative actions, or congressional inquiries. If needed, these replies shall be coordinated and forwarded through the appropriate chain of command to the 75 MDG/CC for review and approval prior to release within required suspense assigned by the FRED upon receipt of the request.

9.8. Provider Peer Review. Peer review will be conducted via the designated peer review software IAW the 75 MDG/SGH policies. Procedures performed in the OMS treatment room will be reviewed separately and tabulated monthly as required by the 75 MDG.

10.0. DATA ENTRY

10.1. Aeromedical Services Information Management System (ASIMS). The OMS data entry MRC must become familiar with and use computerized occupational health information surveillance system (currently ASIMS) including any upgrades as provided by the government.

10.1.1. ASIMS data entry must be completed in conjunction with the physical exams. The data entry clerk will receive training and approval from the 75 MDG ASIMS staff.

10.2. Occupational and Environmental Health Medical Exams (OEHMEs). All OEHME elements (e.g. lab, pulmonary function test (PFT), electrocardiogram (ECG), vision, and questionnaires) must be tracked, completed, and entered into the EHR by ancillary staff and OMS providers. This includes ASIMS data entered by MRC and Defense Occupational and Environmental Health Readiness System (DOEHRS) data entered by the respiratory protection fit tech.

10.3. Data Entry MRC. The data entry MRC shall enter all OEHME data. All daily patient scheduling encounters and EOD processing data will be entered into EHR, ASIMS, DOEHRS. Patient care data includes the OMS provider’s physical exam, lab/x-ray, PFTs, EKG, vision results, and a “yes” response to any of the questions of any of the questionnaires. EOD EHR processing shall be completed daily to meet AF requirement of 100% daily compliance.

10.4. OMS Database. The RNCM enters all data regarding injury or illness visits into the OMS database.

11.0. SCHEDULING

11.1. 10.1. Scheduling OEHMEs. The OMS clinic shall schedule all OEHMEs, associated Hearing Conservation Program Exams (HCPE), and Occupational Medical Services using EHR as provided by the 75 MDG. The AST shall create appropriate provider appointment templates. These schedules will be for each OMS provider, PA, and RN staff. Schedules will also be maintained for the Flight Commander and the COM. The AST shall maintain a minimum of 180 calendar days open in the EHR schedule for patient appointments. Appointments are scheduled for physicals, illness or injury follow-up, FFD, RTW, PDP physicals, and others as required. Emergency situations shall have priority over the routine services listed above.

11.2. Hearing Referrals. OMS providers will evaluate DoD civilian or qualified tenant employees when referred by the 75 OMRS Audiologist. This appointment will be made by the MRC.

11.3. Appointments for the Psychologist. Microsoft Outlook will be used as a schedule template for the EHR. and patients will be scheduled accordingly. These appointments may be made for evaluation of distressed employees, RTW evaluations, security clearances, drug/ETOH evaluations, after work absences for mental illness, and FFD evaluations.

11.4. Appointments for Supervisors.