OSFLO-393-2023-0036 SOW for Med Fit Testing Services.docx

STATEMENT OF WORK

FOR

Medical Clearance and N95 Respiratory Protection Testing Program 07/28/2023

I. SCOPE

The contractor shall provide medical clearance screening services and N95 respirator fit testing for the Center for Clinical Standards (CCSQ) site surveyors throughout the 48 contiguous states.

A. Introduction/Background The Centers for Medicare & Medicaid Services (CMS), Office of Security, Facilities and Logistics Operations (OSFLO) is responsible for the agency’s Respiratory Protection Program and ensuring individuals are properly fit tested and medically cleared to wear N95 respirators as part of their official duties. OSFLO serves as the coordinator for the Center for Clinical Standards and Quality (CCSQ) site surveyors.

The CCSQ site surveyors conduct mission critical quality audits, surveys and inspections to providers such as nursing homes, acute care centers and long-term care facilities to ensure all quality safety standards, practices and procedures are met for the protection of beneficiaries. As such, CCSQ Surveyors are required to wear N95 respirators to enter into high-risk environments to conduct surveys and inspections set forth by law and regulations. OSHA requirements dictate that employees wearing N95 respirators annually complete a medical clearance and have fit testing completed on the model of N95 respirator they will be wearing.

B. Purpose Purchasing of these services by CMS will provide medical clearance and N95 respirator fit testing services for our site surveyors located throughout the country. This comprehensive Respiratory Protection Program will ensure the CMS site surveyors can perform their site inspection duties in a safe manner, limiting their risk of contracting airborne disease. Comprehensive testing will include online medical clearance screening, medical provider follow-up if needed, OSHA-accepted Qualitative Fit Test (QLFT) or Quantitative Fit Test (QNFT) on multiple mask models, and instruction on proper mask wearing. CMS allows employees remote designation, allowing them to live within the 48 contiguous states. The contractor must have the ability to perform services within the 48 contiguous states.

II. REQUIREMENTS

A. Appointment Capabilities

· Contractor shall allow CMS surveyor employees to schedule their annual N95 respirator fit test and medical evaluation at a location within the 48 contiguous United States and the District of Columbia accessible by the public between the hours of 8 am to 5 pm (local time zone) Monday through Friday. Additionally, if services are available, medical evaluations can be completed online.

· Contractor, within 15 days of the award of contract, shall make available to CMS Respiratory Protection Program participants the ability to enroll themselves into the portal for appointment scheduling. Contractor shall also provide written confirmation that access has been granted.

· Contractor, within 15 days of contract award, shall provide user access accounts and instructions for CMS Respiratory Protection Program participants to utilize the portal.

· Contractor, within 30 days of the award of contract, will be able to start N95 fit testing services as outlined in the SOW for CMS staff.

· Contractor shall conduct fit testing on multiple models of N95 masks. These mask models will be determined by CMS Health and Safety in conjunction with CCSQ. The models used will include, but not be limited to, 3M 1860, 8210R, 8210V, and 9205+.

· The fit test shall be administered using an OSHA-accepted QLFT or QNFT protocol.

· CMS Surveyor employees who do not require an annual fit test but do require an annual medical evaluation will be able to complete the process online or schedule their evaluations at a location within the 48 contiguous United States and the District of Columbia accessible by the public between the hours of 8 am to 5 pm (local time zone) Monday through Friday

· CMS Surveyor employees whose medical evaluation requires further review by a medical professional will be contacted directly by a medical professional for discussion and to work through the process to determine ability to wear a respirator.

· CMS Surveyor employees will have the ability to schedule appointments independently, and they will be provided the address and contact information for the location at which services will be provided prior to scheduling the services.

· CMS Surveyor employees will have the ability to cancel and reschedule fit testing with 24-hour notice without CMS incurring a fee.

· The contractor shall provide education during fit testing appointments on proper personal protective equipment (PPE) utilization, sanitation protocols, and storage of each type of N95 mask model determined by CMS Health and Safety in conjunction with CCSQ.

· Fit testing and medical evaluations will be conducted per the requirements of 29 CFR 1910.134.

B. Data Storage Capabilities

· Contractor shall have the ability to store surveyors’ medical evaluations indefinitely on a HIPAA compliant client portal for access by the Centers for Medicare & Medicaid Services and immediately available for review and download once medical clearance is completed.

· Fit test results shall be maintained for one year on a HIPPA compliant client portal and immediately available for review and download by the Centers for Medicare & Medicaid Services.

· Contractor, within 15 days of the award of contract, will make available to CMS access to a secure portal to track medical clearance/fit testing results for CMS staff. Contractor shall provide user access accounts and instructions for using the portal.

· CMS will have the ability to activate/deactivate employees and edit profiles.

· CMS will have the ability to download information from the portal for storage on local computer systems. CMS will have the ability to view/download medical clearance evaluation and fit testing reports to include:

· employee name and location

· number of employees that have been medically cleared and fit tested.

· number of employees that are unable to be medically cleared due to requiring a follow up examination or documentation

· number of employees that still need to be medically cleared

· number of employees that are unable to wear a N95 masks

· number of employees that need to be fit tested

· make and model of the N95 Masks that each employee is authorized to wear

· ability to run summary reports based on above data

· Routinely coordinate with CMS to reconcile and resolve any medical clearance and fit testing information/issues.

C. Monthly Reporting

· Contactor shall provide fiscal reports, due 5 business days after the end of each previous month, that reflect total amount of medical clearances/fit tests billed during the contract period, monthly charges against the account, and the balance remaining on the contract to CMS as requested.

D. Technical Knowledge and Capabilities

· Contractor shall maintain the proper staff and business relationships to insure continued competency and high-quality design. Specifically, skills and a strong knowledge of OSHA requirements as they relate to Respiratory Protection Programs, medical clearance screening and exams, and respirator fit testing.

III. Period of Performance:

The base period of performance for this effort will be September 30, 2023 to September 29, 2024. The notice of proposed contract extension or termination will be provided in writing to the contractor a minimum of 60 days prior to the end of the existing performance period.

IV. Services Selected for Procurement

The contract vendor shall provide all medical clearance and N95 respirator fit testing services listed above. No test substitutions will be considered without consultation and acceptance by CMS.

Base Year:

CMS will enter the base year of the contract receiving the services provided above with 4 Option Years requested. Any subsequent services will be included in a new contract.

Subsequent Option Years:

OSFLO may enter into 4 Option Years continuing the same service that is provided in the base year.

V. Section 508 Requirements All electronic and information technology (EIT) procured through this Task Order must meet the applicable accessibility standards at 36 CFR 1194, unless an agency exception to this requirement exists. 36 CFR 1194 implements Section 508 of the Rehabilitation Act of 1973, as amended, and is viewable at https://www.access-board.gov/ict/. The Contractor shall indicate for each line item in the schedule whether each product or service is compliant or non-compliant with the accessibility standards at 36 CFR 1194. Further, the proposal must indicate where full details of compliance can be found (e.g., Contractor’s Web site or other exact location).

VI. ITEMS TO BE FURNISHED AND DELIVERABLE SCHEDULE

Deliverable due dates are identified as business days unless otherwise indicated. In addition, Federal holidays are not used in the calculation of deliverable due dates. If a deliverable due date falls on a federal holiday, the deliverable is due on the following business day.

The contract vendor shall provide the following deliverables at minimum when requested as part of the contract. No substitutions will be considered without consultation and acceptance by CMS.

The following acronyms are used in the deliverables schedule:

COR = Contracting Officer’s Representative GTL = Government Task Lead IAW = In Accordance With

DUE DATE

Contracting Officer Representative (COR):

Jeff Foster Jeffrey.foster@cms.hhs.gov 410-786-9458

Government Task Leader (GTL):

Christina Short Christina.short@cms.hhs.gov