Performance Work Statement_Rev 4.pdf

Attachment 1

PERFORMANCE WORK STATEMENT (PWS)

NASA/Armstrong Flight Research Center

Occupational Health Services

Performance Work Statement

Revision 4: March 13, 2025

DRAFT

1.0 BACKGROUND

1.1 This Performance Works Statement (PWS) describes Occupational Health Services to be performed at the National Aeronautics and Space Administration (NASA) Neil A.

Armstrong Flight Research Center (AFRC), located on Edwards Air Force Base (EAFB) in Edwards, California (CA) and its associated site in Palmdale, CA. The specific services covered are Occupational Medicine to include Occupational Medical Clinic and Health Education and Wellness Program, as well as Environmental Health (EH) to include Industrial Hygiene and Health Physics (Ionizing and Non-Ionizing Radiation) and oversight of the AFRC Food Safety Program. Services specifically EXCLUDED from this PWS are: Employee Assistance Program (EAP), Workplace Drug-Testing (including Specimen Collection and/or Medical Review for drug testing), Workers’ Compensation Case Management, and Environmental Management.

1.2 AFRC, formerly known as the NASA Hugh L. Dryd n Flight Research Center, is located approximately 80 miles northeast of Los Angele CA. An AFRC component facility (Building 703) supports the AFRC S ience Mission Directorate aircraft, and is located in Palmdale, CA, approximately 50 miles northeast of Los Angeles, CA and 32 miles from EAFB. Overall, AFRC conducts eronautical research and testing, along with airborne science operations, in ac ordance with NASA’s strategic mission, utilizing about 1,100 on-site pers n el— to inc ude Civil Servants, Contractor personnel and other visitors.

1.3 The Contractor’s primar req iremen under this contract is to ensure the safety and health of workers thr ugh compliance with all applicable laws, regulations, policies standards as well as NASA’ and ter Procedural Requirements. NASA has defined the requirements or an Occupational Health Program under NASA Procedural R quirem nt (NPR) 1800.1, entitled, “Occupational Health Program Procedure . Many of t ese requirements reflect or expand upon other Federal requirements as promulgated through the Occupational Safety and Health Administration (OSHA), the Federal Aviation Administration (FAA), the Federal Motor Carrier Safe Administration (FMCSA), and various other organizations responsible for establishing industry standards such as the American Conference on Governmental Industrial Hygienists (ACGIH), American National Standard Institute (ANSI) and Institute of Electrical and Electronics Engineers (IEEE) The PWS outlines what objectives the Contractor shall accomplish to fulfill the specific elements of NPR 1800.1 and related Center documents. For the purposes of this requirement, the term ‘Occupational Medicine’ shall include the Occupational Medical Clinics and the Health Education and Wellness Program, unless otherwise noted. The term “Environmental Health” Program shall include Industrial Hygiene and Health Physics (Ionizing and Non-Ionizing Sources), unless otherwise noted.

2.0 OBJECTIVES

2.1 OCCUPATIONAL MEDICINE

The objectives of the Occupational Medicine function are accomplished through primary (e.g., job certification, fitness center or travel medical examinations), secondary (e.g.

medical surveillance examinations) and tertiary (e.g. illness and injury management, medical emergency response) prevention activities. The Occupational Medicine function also promotes the health of the AFRC workforce through the operation and management of an on-site Fitness Center and wellness campaigns (e.g., flu vaccinations, blood pressure checks). The Contractor’s Occupational Medicine staff shall provide services and materials to meet requirements in the following functional areas:

2.1.1 Job Certification Medical Examinations (e.g., Respirator Use, Crane/Equipment Operation, Aircrew Medical Examinations, etc.)

2.1.2 Federal Aviation Administration (FAA) Medical Examinations (to include First-Class medical certification)

2.1.3 Department of Transportation (DOT) Medical E aminations, i.e. Federal Motor Carrier Safety Adminis ration (FMCSA) Medical Examinations

2.1.4 Travel Clearances and Travel Med cal Examinations

2.1.5 Medical Surveillance Examina i s (e.g. Audiometry, Lead Exposure Monitoring, Laser Eye E ams, Methylene Chloride medical surveillance, etc.)

2.1.6 Occupation l Illness and Injury Examinations

2.1.7 P eventive Health Examinations

2.1.8 Fi ess Cent r Medical Clearances

2.1.9 Health Promotion Activities, such as didactic educational events, blood pressure screenings, staffing a health promotion booth at Safety Day, Vaccination campaigns, etc.

2.1.10 Health-Related Education and Training (e.g. Hearing Conservation, Blood-Borne Pathogens, etc.)

2.1.11 Infection Control

2.1.12 Medical Emergency Response, to include Basic Life Support (BLS) and the initial steps of Advanced Cardiovascular Life Support (ACLS)

2.1.13 Automated External Defibrillator (AED) Program Management. See section 4.1.12 and 4.1.15.

2.1.14 Fitness Center Management (Formal class instruction and/or personal training services are EXCLUDED). See section 4.1.11.

2.1.15 Medical support to the crew and support staff of a commercial space vehicle during simulation exercises and test landings at Edwards AFB, conducted in coordination through NASA AFRC.

2.1.16 Performance of NASA Pilot medical examinations and determination of medical qualification for flight in accordance with NASA and FAA standards.

2.1.17 Performance of FAA First, Second and Thi d Class Medical Certification examinations.

2.1.18 Identification of medical condition requiring aiver, and preparation of the aeromedical documentation o support a waiv r request (if justified) or for FAA Medical Certifica on exam cases will follow FAA requirements for FAA Special Is uance.

2.1.19 Preparing aeromedical umm ries for presentation to the NASA Aerospace Medicine Bo rd, 2) preparing occupational medicine FMCSA NASA e uivalen case summaries (Doctor and NP), 3) presenting ases fo FMCSA to NASA HQ Occupational Medicine Board (D ctor an NP) and 4) presenting cases to the NASA Aerospace Me icine Board (Doctor and Doctor for NP). AFRC Chief Medical Office shall approve documentation format and contents for NASA Aer space Medicine Board (AMB) presentation narrative summaries.

2.1.20 Revie o flight medical questionnaires of qualified non-crewmembers to determine medical qualification for flight.

2.1.21 Review of occupational audiograms to determine work-related hearing loss and OSHA recordability.

2.1.22 Medical direction and quality assurance review of the clinical activity of the Nurse Practitioner.

2.1.23 Serve as a technical expert in answering medical questions posed by NASA Center management.

2.1.24 Provide pharmacy services of a California Board licensed medical doctor who serves as the lab’s director, including any required signatures, as well as the requisitioning or purchase, storage, safeguarding, accountability, and dispensing of all pharmacy supplies, drugs, and medicines necessary for the operation of the medical services facilities at AFRC Main Campus.

2.2 ENVIRONMENTAL HEALTH (EH)

The objectives of Environmental Health (EH) are accomplished through the anticipation (e.g. document reviews and permits), recognition (e.g. workplace exposure assessment), evaluation (e.g. appropriate sampling, surveillance and analysis of workplace hazards) and control (e.g. recommendation of workplace controls, as well as education, training and certification) of workplace health hazards. Controls generally include: 1) Elimination or substitution; 2) Engineering controls to prevent or minimize exposure to workers; 3) Administrative or work practice controls to prevent or minimize exposure to workers; and/or 4) Appropriate use of personal protective equipment by the worker. The Contractor’s EH staff shall provide support and services b sed on NPR 1800.1 and other Federal and NASA Requirements such as the following unctional areas:

2.2.1 Hazard Communication/ Global H rmonizatio System (GHS)

2.2.2 Control of Hazardous Substan es

2.2.3 Asbestos

2.2.4 Heavy Metals such as: Hexa alent Chromium (Chromium VI), Lead, Cadmium, Be ylli m, Me cury, etc.

2.2.5 Benzene

2.2.6 Fo maldehyde

2.2.7 Methylene c oride

2.2.8 Blood B rne Pathogens and Biosafety

2.2.9 Additive Manufacturing

2.2.10 Reproductive and Developmental Health

2.2.11 Hearing Conservation

2.2.12 Ergonomics

2.2.13 Indoor Air Quality

2.2.14 Thermal Stress

2.2.15 Local Exhaust Ventilation

2.2.16 Respiratory Protection

2.2.17 UV Safety Program

2.2.18 Ionizing Safety Radiation

2.2.19 Radiofrequency and Microwave Safety Radiation

2.2.20 Laser and Non-Laser Optical Radiation Safety

2.2.21 Vector Related Disease (e.g. hantavirus, histoplasmosis)

2.2.22 Silica Dust

2.2.23 Food Safety Program

2.2.24 Cryogen Safety

2.2.25 Illumination

2.2.26 Water Quality

2.2.27 Hydrazine safety

3.1 SCOPE

3.2 OCCUPATIONAL MEDICINE (OM)

3.2.1 Size - The medic l facility at AFRC is referred to as the “Health Unit” bldg. 4822) The AFRC Health Unit is located on the main campus.

A ditionally the AFRC Fitness Center (bldg. 4877) is a 4,350 square foot facility, which has two large fitness areas (one primarily for equipm nt, the other for stretching, aerobics and group exercise); the facility includes men’s and women’s locker rooms and shower facilities, as well as an administrative office. On average, 25-30 employees (Civil Servant and Contractor) utilize the facility each workday.

3.2.2 Job Certification Physical Examinations: Job certification physicals address the question of whether an employee is medically qualified to perform a specific job or function. These examinations assure the employing organization (as well as the individual and the individual’s Supervisor) that the individual is medically qualified to perform the job, or a specific aspect of the job (e.g. respirator use). Job certification examinations are provided by NASA at no cost to the employee (Civil Servant or Contractors). Many of these exams are accomplished in accordance with guidance from OSHA, NASA, or other regulatory authorities. Communication of the assessment is made to the responsible parties (usually the Supervisor and employee) in written format (e.g. the AFRC “Request for Medical Clearance” form).

3.2.3 Medical Surveillance Examinations: Medical surveillance exams address the question of whether the work or its environment is producing deleterious health effects on the employee. As such, medical surveillance examinations are a type of monitoring tool for health and safety in the workplace. At AFRC, various environmental health programs include requirements for medical surveillance, such as Hearing Conservation Program, Respiratory Protection Program, Bloodborne Pathogen Program, Confined Space Program, OSHA specific chemical hazards (e.g. Lead and methylene chloride), Laser Safety Program and Radiation Safety Program. A communication of certification examinations is made to the responsible parties in written format.

3.2.4 Periodic Health Maintenance Examinations Preventive Health

Examinations (also referred to as “Execu ve Physicals”) consist of screening observations or tests to det ct dis ase in an early, more treatable phase, before symptoms manifest nd are mor detrimental. Periodic health maintenance examinations are offered to C vil Servants as a benefit of their employment; howeve these xams are voluntary. The scope and frequency of the exam is specifi d n NPR 1800.1.

3.2.5 Fitness Center Management: Contract r will manage the operation of the Fitness Center and pro ide medical clearance for use of the Fitness Center

3.2.6 Travel Cl rance NASA Civil Servants who are traveling overseas shall receive a medi al evaluation and clearance performed in accordance with NPR 18 0 1. When requested or when the Health Unit recognizes the need, the O cupational Health Contractor shall perform travel medical evaluations and provide recommended travel preventive medicine ser ices, meeting the United States Centers for Disease Control recom endations, to other NASA resident contractors traveling outside the United States.

3.2.7 Qualifying Non-Crew Member (QNC) clearance: for AFRC personnel

(Civil Servants and Contractors) who perform QNC duties, contractor will perform in-person examinations and ensure appropriate occupational health needs of these QNC workers.

Non-AFRC workers who request QNC clearance will be cleared by review of QNC medical questionnaires and further clarifying medical information will be requested from the worker when needed based on the responses to the questionnaire.

3.2.8 Occupational Illnesses & Injuries: The Occupational Medical staff shall treat and manage the occasional work-related injury or illness. All AFRC personnel (Civil Servants and Contractors) with occupational illnesses or injuries may be initially treated within the capabilities of the AFRC Health Unit. There is no on-site X-ray or laboratory capability, so more complicated or serious injuries and illnesses are referred to the patient’s private medical provider off-site. Both Civil Servants and Contractor employees have a choice as to who their treating doctor (Medical Doctor- Doctor of Medicine or DO-Doctor of Osteopathic Medicine) will be for an occupational illness or injury, i.e. the employee is encouraged, but not required, to go to the AFRC Health Unit for their illness or injury.

Contractors may have their own “preferred providers” for injured or ill employees, separate from the AFRC Health Unit. More detailed procedures for addressing workplace (occupational) injuries, illnesses, and communicating such information to the employer (i.e. the Supervisor) are provided in specific NASA and AFRC guidance.

3.2.9 Non-Occupational Injuries & Illnesses: The NASA Occupational Health

Program dictates that Health Unit staff WILL NOT act as the employee’s personal medical doctor (PMD) or prima y care provider. The AFRC Health Unit generally does not addres , trea or dispense medications for non-occupational illnesses and injuries. When n the best interests of NASA, the Health Unit may address and treat—o a one-time basis— non-occupational illnesses an injurie of AFRC Civil Servants, (e.g.

respiratory infections, gastroent it s or non-work-related injuries). All follow-up or ongoing care shall be provided by the employee’s PMD.

Contractor employees must s e the PMD for all non-occupational medical needs u less it is an urgent or emergent condition (e.g. heart attack, stroke, etc.)

3.2.10 Medical Em r ency Response: Although the AFRC Health Unit does not op rate forma ambulance service, Health Unit staff shall respond to medical em rgenc es during regular duty hours that occur at AFRC main ampus. On main campus, the staff shall use the Medical Emergency

Res onse V hicle (MERV). The scene may be an industrial area such as an airc af hangar, or elsewhere within a building. The Health Unit staff shall NOT proceed into an area or structure unless it is safe. The determination of an area’s safety, when not obvious, will be made by the On-Scene Commander (e.g. Fire Chief, Safety, Health and Environmental Officer, Protective Services, etc.). Contractor personnel shall NOT drive the AFRC MERV off the confines of Edwards Air Force Base.

3.2.11 NASA Mishap Information System (NMIS): NASA has various safety reporting systems. The contractor’s Occupational Health staff shall ensure all occupational medical related incidents be entered into NMIS following NASA’s NPR 8621.1C- NASA Procedural Requirement for Mishap and Close Call Reporting, Investigating, and Record Keeping.

3.2.12 Administrative and Medical Record/Document support: The AFRC

Health unit (HU) medical services and Clinic Director require the support of a technical/clinical documents/medical records information specialist.

This specialist will do at minimum the following:

3.2.6.3 Coordinate with AFRC civil servant and contract employees to set-up appointments for visits to the HU in support of required occupational health certifications/approvals.

3.2.6.4 Updating clients’ medical records in the NASA

Occupational Health electronic health record system.

3.2.6.5 Updating clients’ training records for required occupational health trainings.

3.2.6.6 Coordinating appointments for AFRC civil servants’

executive medical examinations.

3.2.6.7 Assisting Nurse Practitioner/Physician Assistant/or Doctor (MD or DO) with the coordination of Wellness Campaigns and management of the Fitness Center.

3.2.6.8 Compiling metrics data from everal Occupation health

programs, including partici ation in activities or use of the AFRC Fitness Center.

3.2.6.9 Assisting and managing with the coordination and Center logistics of all Oc upational Health udit visits, including the tri-annual O HMO udit (rooms, phones, computers, and setting up of C n er Management meetings/ presentations in supp rt of the audit visit).

3.3 ENVIRONMENTAL HEALTH (EH)

3.3.1 Size: The AFRC m in cam us occupies approximately 880 acres, and consists o buildin s with approximately 900,000 square feet of structural floor space. Overall, AFRC structures include cafeteria, gift shop, aircraft hangars, indust ial shops, fuel stations, a motor pool, research engineering orkshops, flight imulation facilities, fabrication shop, research aircraft platforms, fi er optics labs, material testing lab, ejection seat maintenance sho comm nication and telemetry facilities, a mirror coating facility, an airbor e s ience integration facility, an occupation health clinic, and office space. AFRC has a workforce composed of approximately 533 Civil Servants and 786 on-site contractors, as well as a few visiting researchers and investigators.

3.3.2 Hazardous Operation review/evaluation and permitting: Various work processes and hazardous operations may have a need for Environmental Health reviews and evaluations, and in some cases, formal permitting.

Various workgroups throughout the Center will often utilize regulated chemicals or have other hazardous operations. These may require the issuance of an Evaluation and Recommendation/Requirements Report, as well as formal permits/authorizations (e.g. Class IIIb or 4 lasers, Ionizing Radiation and Radio Frequency Devices, nuclear gauge permits). In addition, Changes to the infrastructure, facilities or work processes can potentially expose workers to health hazards not previously identified or mitigated (e.g. new chemicals, unforeseen ergonomic challenges, increases in power of radiation devices, etc.) and these will require Environmental Health evaluations. There are also isolated incidents (e.g.

foul smell in the work area, unusual taste to the drinking water, etc.) that occasionally require prompt IH evaluations and recommendations.

3.3.3 Exposure Assessments: Exposure assessments are a proactive method by which the IH staff evaluate a functional work area with regards to the hazards and programs identified in Section 2.2. In this on-going process the presence, or absence, of the specific hazard for a given work area is documented, and if present, its potential hazard to workers is assessed in a quantifiable manner. Workers potentially exposed to the hazard(s) are identified, and mitigation steps are developed. These steps may include required training, medical examination, engineering or administrative controls, and/or the use of personal protective equipment (PPE).

3.3.4 Sampling and Surveillance: AFRC utiliz s two common sampling techniques: a) surveys and monitoring of exposure conducted with direct reading instruments or passive samplers and b) sampling of specific substances, with subsequent shipping to an appropriate laboratory for processing and analysis. The arious quipment and instruments used for surveying and sampling must be maintained on a regular basis, bump-tested on a regular schedule and cal brated to established standards.

Environmental Health ontra t staff shall maintain such equipment and instruments according to established standard operating procedures, and ensure items a ump tes d and calibrated on the prescribe schedule per standards a d NASA requi ements. Contractor shall also maintain associate logs, r o ds and databases. NASA will provide the actual equipment o i struments. NASA will also perform and/or coordinate the calibrati n Contract staff will coordinate the with NASA AFRC’s Calibration roup. NASA will provide any additional costs of maintenance beyond normal inspection and care of the equipment or ins ument.

3.3.5 Dosimetry and Direct Readers for Radiation Exposure: The AFRC

Radiation Safety Program provides Optically Stimulated Luminescent (OSL) dosimeters to all applicable radiation workers as designated by the RSO. The Environmental Health contractor shall coordinate and implement the OSL program, which consists of processing new program participant requests, “Safe Use of OSL” training, quarterly OSL exchanging, retrieving OSLs from employees leaving the OSL program, and providing each employee with their individual annual exposure reports.

3.3.6 Reports: A variety of reports or other methods of documentation are produced by the Environmental Health group. These include: survey reports, evaluations, exposure assessments, annual program self-assessments, data analysis, trending analysis, deficiencies within regulatory requirements, document reviews, mishap reports, progress and metric reporting, improvement and recommendation/requirements reporting, and detail requirements for mitigation and control of the potential hazard(s). In addition, the Radiation Safety Program has an annual requirement for a report based on a comprehensive review of the ionizing and non-ionizing radiation program.

3.2.6.1 The contract Environmental Health personnel shall provide the appropriate draft reports (information, requirements and recommendations) to the responsible NASA AFRC Program Manager for IH or HP for their review and concurrence thus facilitating informed decisions that minimize health risk of center personnel. NASA will provide the contractor with any required templates and/or format for these reports.

3.2.7 Implementation and Coordination of Hazard Controls:

There may be the need for the coordination and implementation of hazard controls based on surveys assessments, a d evaluations. The Environmental Health Contra tor shall provide the IH and HP PM with viable options for the coordinat on nd/or implementation of EH controls. For example, training, signage, permits and engineering controls. The contractor sh ll suppor the implementation of these controls.

3.2.8 Education and Trai ing: T e AFRC workplace safety and health program requires s ecific training to e accomplished by the worker. Some training can be accomplished online through the NASA-provided online learning syst Howe er, some training must be accomplished in-person (e.g.

r spirator u e and fit-testing).

3 2 8.1 The Environmental Health staff shall provide required training, as defined within their areas of responsibility, in accordance with nationally recognized standards. In addition, the contractor staff shall coordinate two annual awareness training campaigns for Center employees. Campaign subject will be coordinated with the AFRC EH Program Managers. One of these may be in conjunction with the AFRC Safety Day Activities.

3.2.8.2 The Environmental Health Staff will track and document training.

3.2.9 Recordkeeping:

The AFRC EH Program requires accurate and updated record keeping information. NASA has a prescribe Record Management Program for these functional areas. The contractor is to ensure that all EH records are kept in accordance with NASA Record Management requirements NPR 1440.6I.

3.2.10 Database Development and Management System

The EH program is intensively regulated with very prescribe requirements that may have prescribed schedules. The Environmental Health Contract Staff is to develop a management scheduling database for the EH Program that may include, among its functional components: EH equipment maintenance, bump-test and calibration schedules, regular exposure surveys and assessments (e.g. x-ray cabinet annual surveys, x-ray producing devices, x-ray vault annual survey, noise surveys, and chemical surveys), area radiation surveys, leak tests, annual radiation areas and devices inspections, exposure assessment schedule, dosimetry schedule, AFRC permit schedules, updating of AFRC’s radiation devices inventories (RF, Laser and Ionizing Radiation), training schedule, annual awareness trainings (RF, lasers, asbestos, lead) and EH facility inspections.

3.2.11 Utilize various methods (e.g., educationa presentations, awareness information [e.g., AM3 notes, promot onal material, SharePoint], health fairs, screenings, and individual counseling services) to ensure, annually, at least four health and wellness topic-specific ac ivities are conducted.

3.2.11.1 A minimum of 1-2 he lth clinics are conducted per year. (e.g., Vaccination clinics, blood pressure screening, diabetes screening, et )

3.2.11.2 Activities and i f rmation materials shall be planned throughout the year and not ll in one quarter.

3.2.11.3 P omo ion of e ercises and fitness Center usage for health bene it shall be at least one of these activities.

3.2.11.4 Al activities covered by this section, shall be approved by the

COR.

4.0 Requirements

4.1.Occupational Medicine (OM), the Contractor shall:

4.1.1. Operate the AFRC Health Unit at Edwards campus in accordance with the operational hours and work schedule for AFRC, provided under the Section entitled, “Standard Work Hours”.

4.1.2. The AFRC Edwards Campus will operate with a minimum of one (1) Licensed Medical Professional (LMP) between the hours of 07:00 - 07:30 AM, and 4:00 – 4:30 PM (3:00 – 3:30 PM on working Fridays) on workdays.

4.1.3. The AFRC Edwards Campus will operate with a minimum of two (2) licensed Medical Professionals (LMP) required on working weekdays

Monday - Thursday (8:00-4:00pm):

1. (e.g. A Nurse Practitioner/ Physician Assistant and one Registered Nurse or one Paramedic/Rescue Specialist (Military trained USAF PJ, USA 18D, USN Seal Medic, USMC Marsoc Medic) with a doctor available for consultation when needed.

or

2. A doctor (MD or DO) and one Registered Nurse or

3. A doctor (MD or DO) and one Paramedic/ Rescue Specialist (Military trained USAF PJ, USA 18D, USN Seal Medic, USMC Marsoc Medic)

4.1.4. A doctor (MD or DO) shall be the Medical Director of the Health Unit and shall perform, as needed, aviation medical xaminations including NASA First, Second, and Third Class Aviation Medi al Exams, FAA First, Second, and Third Class medical certificati n exams (i.e. must be a FAA Senior Aviation Medical Examiner), and NASA Qualified Non-crewmember certification, in addition to other dutie consistent with required qualifications for the doctor (MD or DO) position

4.1.4.1. Contractor espon ilities at BLDG 703 will continue for the

AED program until BLDG 703 is closed and AEDs are etriev d.

4.1.5. Prepare a var ty of medical presentations such as: aeromedical summaries for p se tation o the NASA Aerospace Medicine Board, 2) occupational medicine FMCSA NASA equivalent case summaries (Doctor and NP/PA), 3) pr senting cas s for FMCSA to NASA HQ Occupational Medicine Board (Doc or and NP), and 4) presenting cases to the NASA Aerospace Medicine Board (Do tor and Doctor for NP).

4.1.6. Coordinate the disposal of regulated medical waste and expired pharmaceuticals with a disposal contractor. The government will pay all costs associated with disposal.

4.1.7. Perform work-related medical examinations in accordance with NPR 1800.1 and other applicable regulatory agencies. The Contractor shall provide staff who possess the knowledge, skills and abilities to perform medical examinations, to include:

4.1.7.1. Vital Signs (i.e. height and weight measurement, blood pressure measurement using an automated sphygmomanometer, oral temperature using an automated oral probe, respiratory rate and heart rate);

4.1.7.2. Pure-Tone Audiometry;

4.1.7.3. 12-lead Electrocardiography (EKG);

4.1.7.4. Phlebotomy;

4.1.7.5. Intravenous (IV) Line Insertion and Maintenance;

4.1.7.6. Spirometry (Pulmonary Function Testing);

4.1.7.7. Vision Testing (Using a standard Optec® or Titmus® Vision Testing Machine provided by NASA);

4.1.7.8. Urine Dipstick Analysis;

4.1.7.9. Finger stick glucose sample collec on and analysis as well as:

4.1.7.10. FMCSA Medical Certifi ation;

4.1.7.11. FAA Avia io Medical ertification, to include First-Class, Second-Cla s and T ird-Class Medical Certifications (FAA Senior Aviat o Medical Examiner is required to perform First- Class exams a d certifications).

4.1.7.12. NASA First, Second, and Third-Class Aviation Medical Exam

Cer ifications (FAA Senior Aviation Medical Examiner is equired to perform NASA First Class exams and certifications)

4.1 7 13. Qualified Non-crewmember Certifications [A doctor (MD or DO) is required to perform these certifications].

4.1.8. Review appropriate tests and laboratory results required by such exams (e.g.

hearing tests, pulmonary function tests, laboratory tests, etc.), and direct appropriate follow-up as indicated.

4.1.9. Assess, treat and manage workplace illnesses and injuries within the purview of the Health Unit (i.e. there is no "STAT" lab capability except for dip urinalysis and finger stick glucose, no radiology capability, and no inpatient capability on-site).

4.1.10. Assess and treat (within the Clinician’s scope of practice and within the purview of the Health Unit) urgent or emergent conditions, such as acute coronary syndrome, acute myocardial infarction, or cerebrovascular accident

(stroke) on an initial (i.e. urgent or emergence) basis. The staff shall immediately arrange urgent/emergent transport of the patient to higher levels of care via ambulance when the need is identified.

4.1.11. Respond immediately to 911 emergency calls in accordance with the Center’s

Emergency Preparedness and Response Plan. The response shall specifically include:

4.1.11.1. The cessation of all current activities (assuming they are not themselves life-saving activities);

4.1.11.2. Acquiring the necessary emergency information for response;

4.1.11.3. Loading the MERV with pre-determined bags and equipment (NASA will determine the medications and equipment in these bags);

4.1.11.4. Driving the MERV in an emergen y manner (i.e. emergency lights and siren, if indicated—with due regard for safety) to the scene of the emergency;

4.1.11.5. Stabilizing the patient(s) to the extent possible in accordance with standa d BLS d/or ACLS protocols;

4.1.11.6. Ensuri g patients needing further care are transported to an off-site hospital using the paramedic ambulance service, i.e. the Ed ards Air Force Base Paramedic Ambulance Service (AFRC Main Campus), as outlined in AFRC guidance.

4.1.12. R spond to all Center Mass Casualty Emergencies following AFPL8710.1-

001-Emergen y Management.

4.1.13. Assess non-work-related illnesses. The Clinician shall not prescribe or furnish medications unavailable in the Health Unit.

4.1.13.1. Medications will only be furnished from the AFRC Health Unit in accordance with Health Unit policies and protocols.

Medications shall be furnished in dosages routinely prescribed, when indicated and appropriate for the patient. No prescriptions shall be written by the Contractor Clinician. Drug, strength and directions for use shall be documented in the electronic health record system, and patients shall be provided with the appropriate educational information regarding furnished drugs or devices. The medications available in the Health Unit will be determined by NASA. The Contractor shall be provided access to NASA Occupational Health Databases used in the performance of these requirements (e.g. Electronic Health Record System).

4.1.14. The Contractor will support the operations of the AFRC’s Fitness Center by performing the following:

4.1.14.1. Conduct a walk-through each morning of the Fitness Center during the regular workweek to check on AEDs, 911 phones and general facility.

4.1.14.2. Evaluate employees’ medical clearances required to use the

Fitness Center facility. Clearances are valid for one year.

4.1.14.3. Grant card reader access via NAMS to the Fitness Center, only to participants that hold a cu ent medical clearance.

4.1.14.4. Coordinate with AFR Code 220 Facility) for any custodial or maintenance issue egarding the Fitness Center building.

Provide the AFRC Fitne s Center Program Manager (FC PM) with information reg ding:

• Any new existing, equipment placement and/or rear angement within the facility;

• Routi e quarterly AFRC safety inspections, weekly fitness center visual inspection using the OCHMO che klist and coordinating the maintenance and service equipment inspections.

Participate, as part of the Fitness Center Safety Team, and providing feedback to the AFRC FC PM on any safety issues to include any acquisition recommendations for new equipment or the removal of any malfunctioning, recalled or broken equipment. These will be as-hoc meetings, only call upon when needed.

4.1.14.4.1. NASA will review, approve, and procure (when

feasible) any required purchase or maintenance services.

4.1.14.4.2. The Contractor shall be responsible for notifying the

FC PM if/when equipment is not functional and place a “OUT OF ORDER” sign at the site of the equipment.

• If equipment is deemed unfeasible to maintained or repair and needs to be excessed or disposed, the contractor will coordinate the excessing and disposal process.

• If the equipment is deemed to need repair services, the contractor will request approval, from the FC PM, and coordinate the service call and visit. For issues identified in the regular safety inspection or any other audit, the contractor will coordinate, with the FC PM, the resolution of any finding or issues.

4.1.14.5. The contractor will ensure appropriate safety/health signage is posted at the Fitness Center.

4.1.14.6. The Contractor shall be responsible for notifying the Government if/when equipme t is not functional.

4.1.14.7. The Fitness Center is open 24 hours for employee use.

However, the contrac or is NOT required to supervise hourly activities at the fitness center.

4.1.14.8. Ensure all new Fitnes Center participants get a tour of the facility and understand the general safety rules for the safe use of the equipment nd the basic Fitness Center Etiquettes. The cont actor wi l provide a list to the FC PM of needed bathro m/lock r NPR 1800.1 requirement deficiencies to ensur locker/bathroom area is safe and functional. Contractor will coordinate with facilities/housekeeping to ensure these are properly installed. It is the Government responsibility to cover ll expenses required to maintain bathroom/locker r quirements, per NPR 1800.1. AFRC Housekeeping will perform the required routine cleaning of the facility.

4.1.14.9. Obtaining data from AFRC Security on the Fitness Center usage and analyze trends. These will be presented during the monthly OHM3 meetings.

4.1.15. The Contractor will provide an Automated External Defibrillator (AED)

Coordinator to manage the AFRC AED Program in accordance with NPR

8100.1. Specifically, the AED Coordinator shall:

4.1.15.1. Document the location of each AED on site;

4.1.15.2. Develop an inventory of all devices and their warranty expiration dates, dates of regular inspections, maintenance and any other required information;

4.1.15.3. Ensure each AED is checked on a periodic basis (no less frequently than quarterly) to determine if the signal light is blinking normally;

4.1.15.4. Document the lot number and expiration date of the batteries, the pads and the replacement pads (when applicable) to each defibrillator;

4.1.15.5. Coordinate with the designated point-of-contact for each defibrillator and alert that individual within three months of an expiration date of either the batteries or the pads. The point-of-contact shall be notified if there is a recall by the manufacturer of either the batteries or the pads. This notification shall be documented;

4.1.15.6. The Contractor shall be r spons ble for notifying the designated point-of-contact for each defibrilla or if the defibrillator is no longer usable (e.g ignal light not blinking, service alarm sounding, batterie or pa s expired, etc.). Such notification shall be documented he designated point-of- contact is responsible f r replacing the batteries and/or removing the defibrillato from vice; the Contractor is not responsible for ensuring the defibrillator is physically removed from service ntil it s again usable;

4.1.15.7. Co rdinate an Annual AED AFRC Committee composed of m mbers from Code 720 (Safety), Code 240 (Security) and the AED Coordinator;

4.1 15.8. Coordinate the acquisition and/or exchange of AEDs in designated areas. Contractor will not be responsible for funding the acquisition of the AEDs. AED Coordinator will provide suggested list to Chief Medical Officer for review and approval.

4.1.15.9. Provide AED/First Aid/CPR training in support of AFRC occupational requirements, missions and projects.

4.1.16. Emergency, Pandemic and Disaster Response

The Contractor will provide Emergency, Pandemic and Disaster Response utilizing policy guidance from the NASA:

• Emergency Preparedness and Response- AFOP-8715.3 and Center Mishap Preparedness- AFPL-8621.01. In addition, the Contractor will also follow all guidance provide by NASA’s Office of the Chief Medical Officer (OCHMO) regarding any emergency, pandemic and/or disaster response.

4.1.16.1. Participate in Emergency and Disaster Response Exercises

4.1.16.1.1. Arrange and participate in emergency response

exercises (i.e. “Mock Codes”), on a quarterly basis at a minimum. These “Mock Codes” shall ensure the Health Unit staff is proficient at:

4.1.16.2. Identifying the location of an emergency (when outside the

Health Unit);

4.1.16.3. Retrieving the required emergency response supplies;

4.1.16.4. Conducting Basic Life Support (BLS);

4.1.16.5. Calling for, and ensuring ollo on response, e.g. paramedic ambulance response s rvice, is ini iated; and

4.1.16.6. Conducting the in tial ste s of Advanced Cardiovascular Life

Support (ACLS), su h as applying oxygen, starting an intravenous line, placing a cardiac monitor, and recognizing “shockable” from “non-shockable” cardiac rhythms.

4.1.17. Participate in other xercise (e.g. aircraft mishap exercises, earthquake drills, mass casualty exercise etc.) when scheduled, or as directed by the COR. Health Uni staff sh l participate in After-Action Reviews, or other such p forman e review mechanisms (e.g. monthly staff meetings) as required, or s dire ted by the Chief Medical Officer.

4.1.18. Con ractor wi provide training required to AFRC personnel and contractors in Card opu monary Resuscitation (CPR) and First-Aid/Automated External Defibrillation, in accordance with the standards of the American Heart Association to all employees required by their position and job related activities (e.g. Employees within the Blood Borne Pathogen Program, Safety, Security, etc.). Training will be scheduled and provided at the AFRC Main Campus, on a regular basis. In addition, the contractor will also provide CPR/AED/First Aid training to other AFRC personnel and contractors monthly at AFRC.

4.1.18.1. The Government shall provide the materials, e.g. books, and the equipment, e.g. manikins, to be used in the training. The Government shall also provide the supplies for cleaning the manikins after use.

4.1.18.2. The Government shall provide (i.e. pay for) the course completion cards for those successfully completing the course.

4.1.19. Participate in a structured Medical Quality Assurance and Peer Review program in which at least 10 selected charts between all LMPs, with a target of 3 charts per provider, to include the contract physician as well as the AFRC’s CMO charts, are reviewed every quarter for accuracy (i.e. “Chart Reviews”) and overall quality of care (i.e. “Peer Review of the contracted Health Unit Medical Director’s charts may be performed by another physician on the contract and/or AFRC’s Chief Medical Officer and a contract physician will review the AFRC CMO charts). All provider categories (physician, nurse practitioner/physician assistant/ nurse) must be represented as part of the 10 peer reviews per quarter.

4.1.20. Provide a designated “Infection Control Officer” (ICO) to implement the

AFRC Infection Control Plan and provide tra ning to members of the Infection Control Workgroup.

4.1.21. Document all patient contacts in the NASA-pro ided electronic health record system (EHRS) and shall compl te all required forms in accordance with standard practice and specific NASA guidance.

4.1.22. Attend meetings at the AFRC as re uired, or as directed by the COR.

4.1.22.1. Develop sp cific itten standing orders and protocols for the Contractor Health Unit staff (to include the Nurse Practitioner nd th Regis red Nurses) to address medical examinations/operations from NPR 1800.1 Appendix Cand OCHMO-STD-1880 requirements. These standing orders and pro ocols shall be a “living document” in that revisions shall be done ny time NASA OCHMO and the center CMO provides new policies regarding examinations or clearances to the Center or a new NPR is in place. The initial standing orders and protocols as well as any revision or modification shall be drafted and signed by the Health Unit Medical Director and shall receive the written concurrence of the AFRC Chief Medical Officer (CMO) prior to contract implementation. An approved copy shall be provided to all LMPs and nursing staff.

If during the course of the contract, there is a change in contract Health Unit Medical Director or NASA Chief Medical Officer, the Standing Orders/Protocols shall be re-submitted for concurrence to the CMO within 60 calendar days of the new CMO and/or contract Health Unit Medical Director start date.

The Health Unit Director will ensure staff understanding and compliance to the orders.

4.1.22.2. Support simulation tests and landing when required by NASA

AFRC. Specific Industrial Hygiene support measures will include those functions previously described in this Performance Work Statement. The exact amount and types of services (e.g. the type of staff and the hours required) required will be determined as needed; reimbursement to the Contractor will be accomplished a separate reimbursement mechanism.

4.2.Health and Wellness

4.2.1. Contractor shall ensure All OCHMO Health and Wellness requirements, based on NPR

1800.1 and OCHMO Fitness Center audit questionnaire requirements are implemented. Managing informative poster and brochures throughout the Fitness Center regarding current health and wellness campaigns and general safety guidance.

4.3.Environmental Health (Industrial Hygiene and Health Physic ), the Contractor shall:

4.3.1. Develop an Environmental Health Program Orientation Ha dbook with the intent to help new EH contract personnel understa d the different elements of the AFRC EH programs. Draft versions of the EH Progr m O ientation Handbook shall be submitted to the EH program manager for review and approval.

4.3.2. Conduct Environmental Health sur eilla ce ( g. “exposure assessments”, surveys) of facilities, work process, p oj cts and health hazard generating equipment (e.g. ionizing and non-ionizing radiation, no se, etc. materials using standard IH/HP equipment/instrumen s and d rd IH sampling/surveillance techniques. NASA AFRC will provide equi ment and supplies to support environmental surveillance. The Contractor shall prep re, review and/or modify all standard operating procedures for conductin environmen al health surveillance based on approved consensus standards and NASA r quirement .

4.3.2.1. Contractor shall update individual branch codes exposure assessment summaries, annually. Initial exposure assessment summaries include a list of similar exposure groups (SEGs), what hazards each SEG is or may be exposed to, and the required training and medical surveillance programs associated with each hazard. Updates shall reflect the current EH department’s understanding of the hazards in each branch code. Updates may include (but are not limited to) adding new hazards identified, removing SEGs from certain medical monitoring programs, and an updated reproductive and development hazard chemical list. Contractor shall work with each respective branch manager, or designee, to verify all SEGs listed are current and identified and to verify if they know of any other hazards or concerns not already listed in the exposure assessment summary. The branch code exposure assessment summary format will be provided by the NASA EH program managers. Updated exposure assessment summaries shall be approved by the NASA EH program managers prior to sending them out to the respective branch managers and other applicable personnel (e.g. other contractor safety representatives).

4.3.3. Surveillance shall be conducted on a regular schedule, as well as ad-hoc in support of specific AFRC missions or projects. Approved Survey protocols must be used by the contractor. Survey information and results will be documented using official AFRC survey forms. Upon direction by the COR, conduct or coordinate surveying or sampling of potential worksite health hazards. Routine requests shall be accomplished within thirty (30) calendar days; urgent requests shall be accomplished within one (1) business day.

4.3.3.1. Final Reports are due five (5) business days from the day the results are received at NASA AFRC. Reports will include the sampling results, analysis and recommendations, and will e provided to the HP and/or IH Program Manager for review and approval prior to providing information to AFRC customers.

4.3.4. The Contractors shall accomplish the follow g tasks, as applicable:

4.3.4.1. Sample various med a ( e air, soil and/or water) for analysis;

4.3.4.2. Perform noi e s rveys nd dosimetry. This also includes investigating non-age orrected standa d threshold shifts (STS), temporary threshold shifts (TTS), a d ag orrected STS;

4.3.4.3. Perform entila ion surveys;

4.3.4.4. P rform illumination surveys;

4.3.4.5. Perform ionizing radiation surveys;

4.3.4.6. Perform non-ionizing radiation surveys (to include RF and UV surveys);

4.3.4.7. Monitor and report heat stress conditions (if necessary);

4.3.4.8. Reproductive and Developmental hazard surveys;

4.3.4.9. Perform Ergonomic surveys;

4.3.4.10. Indoor Air Quality Survey; and

4.3.4.11. Compliance surveys.

4.3.5. Conduct internal reviews (i.e. “program self-assessments”), within twelve (12) months of being scheduled. The self-assessments shall include the following areas:

4.3.5.1. Asbestos;

4.3.5.2. Hearing Conservation and Noise;

4.3.5.3. Cryogens;

4.3.5.4. Hexavalent Chromium;

4.3.5.5. Lead;

4.3.5.6. Hazard Communication (Global Harmonizati n System);

4.3.5.7. Non-Ionizing (Radiofrequen y and Microwave) Radiation);

4.3.5.8. Ionizing Radiation;

4.3.5.9. Laser and High adiant Optical Device Safety;

4.3.5.10. UV Safety P ogram;

4.3.5.11 Respirato y Protection;

4.3.5.12. Lo al Exhaust Ventilation;

4.3.5.13. Blood-Borne Pathogens;

4.3.5.14. Thermal Stress;

4.3.5.15. Ergonomics;

4.3.5.16. Heavy Metals (as appropriate);

4.3.5.17. Reproductive and Developmental Hazard program;

4.3.5.18. Hydrazine Program; and

4.3.5.19. Any other OSHA specific health hazard that may be present in the AFRC workplace.

4.3.6. Maintain an inventory of all IH/HP sampling/surveillance equipment. Contractor will ensure associated equipment logs are completed and maintained.

4.3.6.1. Perform routine field calibration, and ensure all instruments receive respective calibration in accordance with the manufacturer’s recommended schedules.

4.3.6.2. Perform check source test for all ionizing radiation survey equipment.

4.3.6.3. Record all bump test.

4.3.6.4. Contractor will coordinate with NASA met ology and/or vendor for instruments that will require o tside calibratio s. Including shipment of instruments.

4.3.7. Coordinate with NASA and outsi vendors to rovide health, and environmental analytical laboratory services for s mpled items. Contractor will coordinate with NASA’s logistics for the shipment f such samples. These services will be at the Government’s expense and s all be oordinated through the COR.

4.3.8. Food Safety Program- The contractor will also evaluate and support all other food related programs a identified in the NPR 1800.1. Documentation of such review will be placed in the AFRC I driv . EH Contract will perform the OCHMO required annual self-review and will pa ticipate in the AFRC Tri-annual OCHMO audit.

4.3.9. Provide technical c nsultation services, including reviewing and commenting on various technical documents (e.g., Chemical Purchase Reviews, project plan reviews) concerning proposed construction projects, aircraft research projects, or other projects, for compliance with applicable IH/HP requirements. These reviews shall be accomplished within 10 business days of request submitted to AFRC Environmental’ s chemical license coordinator.

4.3.10. Support the implementation, compliance and requirements of the AFRC Radiation

Safety Programs to include: Ionizing Radiation Safety, Laser and Optical Safety, UV safety and Radio Frequency Safety Programs with NPR 1800.1, NRC and California Title 17. Contractor employee shall become the AFRC’s alternate RSO, LSO and RfSO.

4.3.11. The contractor shall:

4.3.11.1. Obtain the required certifications to become Radiation Safety Officer

(RSO), Laser Safety Officer (LSO) and Radio Frequency Safety Officer (RfSO) Certifications.

4.3.11.2. Develop and implement the required Radiation safety Training to all ionizing and non-ionizing radiation workers at AFRC.

4.3.11.3. Perform exposure Surveys and Leak tests on any rad source on site.

Exposure Survey data will be used to calculate potential annual exposures and a report provided to operators.

4.3.11.4. Perform radiation exposure surveys on the source material packages when received at NASA AFRC logistics or via any other transportation mode.

4.3.11.5. Perform a radiation exposure s rvey on the…