S02_SOW Respiratory Fit Testing (FINAL).docx

A. Statement of Work

1. Title of Project:

Industrial Hygiene Program Support for our Washington D.C. VA Medical Center (DCVAMC).

2. Background:

In accordance with the Occupational Safety and Health (OSHA), code of federal regulations CFR 1910.134 some Washington DC, VAMC employees are required to be included in a comprehensive respiratory protection program. All are entitled to a safe workplace.

3. Scope:

The Department of Veterans Affairs Washington, D.C. Veterans Affairs Medical Center (VAMC) intends to use the services of a Contractor to provide supplemental industrial hygiene support to assist with the high demand of fit testing at the DC VAMC.

All work shall be conducted in accordance with Occupational Safety and Health (OSHA) Act of 1970, OSHA respirator standard 29 CFR 1910.134 and ANSI/ASHRAE/ASHE Standard 170-2021, Ventilation of Health Care Facilities. Title 40, Code of Federal Regulations (40 CFR) Protection of Environment. OSHA’s General Duty Clause, Section 5(a)(1).

Respiratory Fit Testing

The fit testing schedule shall be in accordance with a schedule determined by the Safety Office and a population based on 3000 employees (NTE 3000). Testing days shall be scheduled on Tuesdays and Thursdays from 6:30 am - 3:00 pm to cover all shifts. Safety reserves the right to adjust schedule and give contractor at least a weeks’ notice.

Fit Tester shall use an OSHA-Accepted Fit Test Protocol (i.e., QLFT or QNFT), per OSHA 1910.134 for each test subject fitted, tested, and issued a NIOSH Approved respiratory device. Contractor shall ensure the test subject conducts a user seal check, either the negative and positive pressure seal check as described in OSHA Standard Appendix B-1 or those recommended by the respirator manufacturer which provides equivalent protection to the procedures in Appendix B-1. The Contractor shall discontinue or not fit test a test subject, if any of the following are detected:

Fit tester shall follow OSHA requirements for fit testing and train each employee on the respirator they will be wearing. The contractor shall insure each employee has been medically cleared to wear a respirator within the past 6 months.

Fit test will ensure the following documentation:

· The name of each employee’s to be fit tested.

· Service and Department

· The date an employee’s medical questionnaire was approved by the LHCP.

· The type of respirator each employee was fitted with, results, fit tester identification and the date trained on the respirator.

· Employee signature and the date of testing

The contractor shall complete fit testing notification cards (supplied by the VA COR; this card lists the respirator the employee is to wear, and the date fit testing was completed) and provide this card to each employee upon the completion of fit testing. A minimum of one fit tester will be provided during each session.

APPROVED RESPIRATORS: The Approved Respirators List is representative of typical respiratory devices used by wearers of a respiratory device in this facility are listed below.

3M 1860, 3M 1870

All fit testing materials will be supplied by the DC VAMC Occupational Safety & Health Service. The contractor shall keep the COR informed of the level of supplies needed for the week. The contractor shall be required to periodically clean the fit testing equipment to ensure that saccharin is flowing through the nebulizer.

Place of Performance: Work will be performed on DCVAMC main campus in Washington, DC. Under Occupational Safety & Health Office.

Location: Washington DC, VAMC 50 Irving ST NW Washington, DC 20422

*NOTE* - The DC VAMC Occupational Safety & Health Service Program Manager/COR will escort all contracted staff to the police badging area to receive contractor badging while working on the DC VAMC campus for fit testing.

Type of Contract: Firm-Fixed-Price Contract.

Performance Period:

The period of performance is one year from contract date of award with 4 option years. Work at the government site shall not take place on Federal holidays or weekends.

In accordance with 5 U.S.C. 6103, Executive Order 11582 and Public Law 94-97 the following national holidays are observed and for the purpose of this contract are defined as “Legal Federal official holidays”

**When a holiday falls on a Sunday, the following Monday will be observed as a National Holiday. When a holiday falls on a Saturday, the preceding Friday is observed as a National Holiday by U.S. Government Agencies.

B. CHANGES TO STATEMENT OF WORK

Any changes to this SOW shall be authorized and approved only through written correspondence from the CO. A copy of each change will be kept in a project folder along with all other products of the project. Costs incurred by the contractor through the actions of parties other than the CO shall be borne by the contractor.

C. PROOF OF BUSINESS LICENSES:

Contractor is responsible for acquisition of all applicable business licenses and permits required by laws applicable to the State. Contractor shall certify that it acknowledges and is in possession of all required business licenses and permits.

CONTRACTOR'S RESPONSIBILITIES: In accomplishing any work under this contract the contractor is fully responsible for his/her full compliance with all applicable, federal, state, and local government policies, regulations, procedures, specifications, etc., that apply to work of this nature. In addition, the contractor must obtain and keep current all licenses, OSHA training, permits, etc., that may be required by the above-mentioned agencies to accomplish the work. The contractors shall ensure the Program Administrator or COR is sent electronic documentation in Microsoft Excel or Access, that will categorize and track healthcare personnel who have been fit-tested and trained during the contract period. The VA will supply all testing equipment and tools. Contractor will notify COR when supplies are needed.