Attachment 1 - PWS_Amendment 0002.pdf

PERFORMANCE WORK STATEMENT (PWS)

October 14, 2020

Defense Civilian Personnel Advisory Service (DCPAS) Occupational Health

Services and Medical Case Review Services

1. GENERAL: This is a non-personnel services contract to provide occupational health services for a network of qualified private medical providers, and medical case review services. The Government shall not exercise any supervision or control over the contract service providers performing the services herein.

Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1. Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and non-personal services necessary to establish a network of qualified Occupational Health services medical providers and medical case review services, as defined in this Performance Work Statement, except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.2. Background: The Department of Defense is a world class employer seeking to hire and retain exceptional quality employees by offering a variety of programs and services. The overall intent is to ensure that the

Department can meet mission goals and objectives by ensuring the safety and welfare its employees. The

Defense of Defense (DoD) requires a network of qualified medical providers to deliver occupational health services within the continental United States (CONUS) as well as outside the United States

(OCONUS), to include the Virgin Islands, Guam, Puerto Rico, Hawaii and Alaska. Providers will perform services at a variety of Private Provider facilities and may also conduct outreach services at mobile testing sites. Providers will perform medical examinations to ensure employees meet job specific medical standards. These exams may be required to meet requirements for compliance withthe standards set by the

Occupational Safety and Health Administration (OSHA) or other regulatory bodies in addition to medical standards developed according to 5 CFR 339. The examinations may be performed prior to employment for applicants, for periodic medical surveillance of incumbents, before return to work after an injury, or to determine an incumbent’s ongoing fitness for duty when a change in health status has caused concern about the worker’s or others’ safety. The DoD also requires consultation and medical case reviews for occupational medical matters that directly affect the health and safety of the Department’s workforce.

Reviews ensure that both applicants and employees can safely perform work that is arduous, involves a high degree of sensitivity toward the public or sensitive national security concerns, or puts employees at risk of hazardous exposures while performing essential job duties. Assignments will require an expert level of technical knowledge regarding occupational health and safety issues. Provider will also furnish administrative and clerical support, as well as medical records review, conversion of records, and data entry.

1.3. Objectives:

a. Provides, manages and schedules a network of qualified private medical network of physicians assigned to provide occupation health services, when requested.

b. Provides private provider services within driving distance of 25 miles for all major cities from the requested service location and 50 miles for rural locations.

c. Provision of treatments prescribed by a personal physician such as periodic bed rest, blood pressure monitoring, glucose monitoring and allergy immunotherapy.

d. Private provider Walk-in care and first aid.

e. Health screenings (e.g. cancer, diabetes, blood pressure, Post Deployment health assessments, vision, and

COVID-19)

f. Preventive health, medical surveillance

g. Administration of immunizations (e.g. Hepatitis A, Hepatitis B, Anthrax, Smallpox, etc.)

h. Provide medical screenings, exams, testing and clearance related to medical surveillance, deployments and/or specific job requirements (e.g. audiometry, spirometry, EKG, vision testing, laser eye mapping, Beryllium Blood Testing)

i. Maintains medical records confidentiality and ensures that records are properly managed and stored in accordance with 5 U.S.C. 552A, the Privacy Action of 1974, and other applicable Government policies.

The contractor may also be required to convert historical records.

j. Ensures Board Certified physicians for a variety of specialty areas. These specialties include but are not limited to the following:

Allergist

Audiologist

Cardiologist

Dermatologist

Endocrinologist

Functional Capacity Examinations

Gastroenterologist

Hematologist

Infectious Disease

Nephrologists

Neurologist

Neurosurgery

Oncologist

Ophthalmologist

Otolaryngology (E.N.T)

Physical Medicine & Rehabilitation

Psychiatrist

Psychologist/Pscyhological examinations

Pulmonologist

Rheumatologist

Urologist

k. Reviews medical records using agency specific work orders to ensure completeness (ensures required signatures and documents are legible) before sending.

l. Provides expert advice and consultation to the Government and Federal Government Agencies on

Occupational Medicine matters such as partial physical exams, Psychological pre-placement exams, Psychological Security Clearance Services, Psychological Assessments and Testing, Psychological Fit-for-Duty, Psychological Pre-Placement, Psychological Security Clearance, Neuropsychological

Testing, Pre/Post-Deployment Health Assessment Support, COVID-19 testing (molecular (swab) and serology (IgG)), COVID vaccines, audiometric testing, cardiovascular stress tests, cholesterol checks, chest x‐rays, colorectal cancer screening, electrocardiograms, mammography, pulmonary function testing, vision screenings, respiratory fit testing, vaccine administration (Influenza), and independent medical evaluations.

m. Ensures all professional licenses, certifications, and are registrations are valid and appropriate.

n. Reviews charts of applicant and/or incumbent employees, making medical determinations asto their medical qualifications relative to job standards.

o. All Providers are proficient in Microsoft Applications and basic computer use.

p. Provides comprehensive reports to employers and employees attending agency meetings.

q. Provides expert witness testimony in support of medical recommendations regarding reasonable accommodations, when requested by the Government.

r. Performs general office work such as mail distribution, photocopying, faxing, records management, file conversion, telecommunications management, facility usage and space issues, supply distribution, preparation analysis, assisting in procuring equipment, materials and services.

s. Utilizes the medical records database to track missing medical information and contacts appropriate provider to obtain missing documents.

t. Reviews, records and archive data using automate data entry system filing the Medical Records

Archiving Policies and Procedures. The archiving of records may require conversion from a paper document to an electronic system.

u. Records, creates transfers, convert files and prepares medical records and x-rays for processing of shipping.

v. Processes requests for medical records and x-rays from OHC, agencies or employees.

1.4. Scope: The contractor shall provide private provider occupational health services within the continental

United States (CONUS), as well as outside of the United States, to include the Virgin Islands, Guam, Puerto Rico, Hawaii and Alaska (OCONUS), and international services in Canada. Additional international sites may also be required, if the need for such services may arise. The contractor will also maintain Occupational Health support to meet the occupational medical cases review and management needs of the DoD. To meet the DoD’s requirements the contractor will:

1. Provides expert Occupational Medicine consultation services

2. Medical Records Management duties

3. General Administrative duties

4. Data Entry

1.5. Period of Performance: The Single Award Indefinite Delivery Indefinite Quantity (IDIQ) contract will have a five (5) year ordering period.

1.6. General Information:

1.6.1. Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirementof the contract. The QCP shall be delivered via electronic mail within 30 days of contract award.

Amendments/changes to the QCP shall be delivered to the COR and KO within three business days following any change.

1.6.2. Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the

Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.6.3. Recognized Holidays: The contractor is not required to perform service on holidays New

Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

1.6.4. Hours of Operation: The contractor is responsible for conducting appointments, between the DoD core hours of 9:00 AM to 3:00 PM, for the applicable time zone in which the services are performed, Monday thru Friday except Federal holidaysThe Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential..

1.6.5. Place of Performance: The work to be performed under this contract will be performed at a

Private Provider office space or via telehealth.

1.6.6. Type of Contract: The government will issue a Single Award Indefinite Delivery Indefinite Quantity (IDIQ) hybrid contract consisting of firm-fixed-priced (FFP), labor hours (LH), and time and material (T&M) contract line item numbers (CLINs).

1.6.7. Security Requirements: Contractor personnel performing work under this contract must be cleared with a

National Crime Information Center (NCIC) check for issuance of a Common Access Card (CAC) and must maintain the level of security required for the life of the contract. The Contractor must be a US citizen, and have received a favorable National Agency Check with Inquiries (NACI) as well as a favorable response to an Federal Bureau of Investigation (FBI) fingerprint check. The contractor shall immediately notify the Department of Defense of any data breaches, and will be required to provide 1 year of credit protection for each DoD employee who PII or PHI has been compromised by the breach.

1.6.8. Special Qualifications: Contractor personnel will be required to sign a Non-Disclosure Agreement.

1.6.9. Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with

Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative

(COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues.

These meetings shall be at no additional cost to the government.

1.6.10. Contracting Officer Representative (COR): The (COR) will be identified by separate letter. The

COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance:

maintain written and oral communications with the Contractor concerning technical aspects of the contract:

issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of

Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.11. Key Personnel: The personnel listed below are considered essential to the work being performed under this contract. Before removing, replacing, or diverting any of the listed or specified personnel or facilities, the Contractor shall (1) notify the Contracting Officer reasonably in advance and (2) submit justification (including proposed substitutions) in sufficient detail to permit evaluation of the impact on this contract. The Contractor shall make no diversion without the Contracting Officer's written consent;

provided that the Contracting Officer may ratify in writing the proposed change, and that ratification shall constitute the Contracting Officer's consent required by this document.

Program Manager

Minimum Qualifications: Employees must demonstrate that they have successfully completed a master's or equivalent graduate degree OR have successfully completed two full years of progressively higher graduate level education leading to a master's degree in business, health care administration or related field or equivalent education. 5 years of experience in project management, including such areas as budget reconciliation, data management, billing, accounting and customer service. Proficient in Microsoft applications, specifically Word, Excel and web-based applications.

Program Management Assistant – Operations Supervisor

Minimum Qualifications: A Bachelor’s degree in Business Management or Business Healthcare, and at least two (2) years experience working under a Private Provider Network contract.

Physician - Occupational/Case Review/Private Provider Network

Minimum Qualifications: Incumbent must be a licensed physician (MD or DO) board certified in Preventive

Medicine/Occupational/Internal/Family Medicine with a minimum of five (5) years’ experience working in a private provider occupational health clinic. At least two (2) years should include experience as medical consultant to upper management on issues of worksite hazards, medical surveillance, worker accommodation, and/or fit-for-duty/employability/ADA issues. The successful candidate will have an expert understanding of Federal government safety and health regulations. A Master’s in Public Health is desired.

This position serves in a high profile role supporting the medical and consultative needs to THE

GOVERNMENT and/or Federal government agency upper management. Incumbents will have a mixture of administrative and consultant responsibilities. All assignments require an expert level of technical knowledge regarding occupational health and safety issues. Key to this position is the ability to work and communicate effectively in high stress situations and work collaboratively with other members of the occupational health team that supports the Federal government agency.

Physician - Medical Case Review

Minimum Qualifications: One (1) year of medical administrative experience in a physician’s office, clinic, or other health care facility.

Medical Records Specialist

Minimum qualifications: High school diploma/GED required with two years data entry experience. Must demonstrate through CV, fast and accurate data entry skills and be familiar with medical, science and technology terminology. Must be proficient in Microsoft applications, basic computer and website use.

1.6.12. Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious tothird parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor personnel will be required to obtain, use, and display a Common Access Card in the performance of this service.

1.6.13. Contractor Travel: In According with FAR 31.205-46-Travel Cost, the Contractor shall provide travel in support of the DoD 4th Occupational Health and Medical Case Review requirement.

1.6.14. Other Direct Costs: This category includes travel (outlined in 1.6.13), reproduction, and shipping expenses associated with training activities and visits to contractor facilities.

1.6.15. Data Rights: N/A

1.6.16. Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational

Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting

Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such

OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the

Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.17. Phase In/Phase Out Period: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have personnel on board, during the sixty (60) day, phase in/phase out periods. During the phase in period, the Contractor shall become familiar with performance requirements in order to commence full performance of services on the contract start date.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.6. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7. PHYSICAL SECURITY. Actions that prevent the loss or damage of Governmentproperty.

2.1.8. QUALITY ASSURANCE. The government procedures to verify that services being performed by the

Contractor are performed according to acceptable standards.

2.1.9. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.12. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.12. WORK WEEK. Monday through Friday, unless specified otherwise.

2.2. ACRONYMS:

ACOR Alternate Contracting Officer's Representative

BCTF Boards, Commissions, and Task Forces

CFR Code of Federal Regulations

CONUS Continental United States (excludes Alaska and Hawaii)

COR Contracting Officer Representative

COTR Contracting Officer's Technical Representative

COTS Commercial-Off-the-Shelf

DD Form 254 Department of Defense Contract Security Requirement List

DFARS Defense Federal Acquisition Regulation Supplement

DMDC Defense Manpower Data Center

DOD Department of Defense

EM Enterprise Management Directorate

FAR Federal Acquisition Regulation

HIPAA Health Insurance Portability and Accountability Act of 1996

KO Contracting Officer

OCI Organizational Conflict of Interest

OCONUS Outside Continental United States (includes Alaska and Hawaii)

ODC Other Direct Costs

PIPO Phase In/Phase Out

POC Point of Contact

PRS Performance Requirements Summary

PWS Performance Work Statement

QA Quality Assurance

QAP Quality Assurance Program

QASP Quality Assurance Surveillance Plan

QC Quality Control

QCP Quality Control Program

TE Technical Exhibit

WHS Washington Headquarters Services

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: Not applicable

3.2. Facilities: Not applicable

3.3. Equipment: Not applicable

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2. Facility Clearance: No facility clearance required. Contractor personnel performing work under this contract must be cleared with a National Crime Information Center (NCIC) check for issuance of a

Common Access Card (CAC) and must maintain the level of security required for the life of the contract.

The Contractor must also have received a favorable National Agency Check with Inquiries (NACI) as well as a favorable response to an Federal Bureau of Investigation (FBI) fingerprint check.

4.3. Materials: Any and all materials required to deliver Occupational Health Service and Medical case review will be provided by the Private Provider Network.

4.3.1 All medical and other records, including DoD MIS data, and all records/data added by the contractor shall remain the property of the Federal government. Neither the original records, nor copies, may be removed by the contractor; and may be used for any purpose not intended by this contract. Contractor must assure that all staff understand the Privacy Act, rules of confidentiality, and related requirements and provide assurance that privacy and confidentiality of medical and fitness records are maintained according to DoD policy and the Privacy Act.

4.4. Equipment: Any equipment required to deliver Occupational Health Service and Medical case review will be provided by the Private Provider Network.

PART 5

SPECIFIC TASKS

5. Specific Tasks: The contractor shall provide services for Occupational Health Services and Medical case reviews to support the DoD 4th Estate.

5.1. Task 1 - Program Management Support Services: The Contractor shall provide oversight of the performance of its vendor employees, quality of deliverables, and support the government with current and emergent requirements for Occupational Health Services and Medical case reviews. These activities may include any, or any combination of, the following Sub-Tasks:

5.1.1. A dedicated Program Manager (PM) to work with the DoD/WHS Office of Civilian Human Resources to support all aspect of this PWS including: demographics of the workforce, employee work schedules, and geographic distribution of employees, employee insurance coverages, specific job performance issues, current disciplinary policies and procedures, and types of personal problems already known to be of concern to employees.

5.1.2. The PM shall develop and recommend guidelines and procedures concerning the identification and referral of employees who need help with personal health problems.

5.1.3. The Contractor shall review the overall functioning of the program on a monthly basis and coordinate needed adjustments with the COR. The contractor shall review all monthly invoices for accuracy and submit by COB of the first working day following day of receipt, through the

Wide Area Workflow e-business suite. The invoices must distinguish which specific DoD

Component received or utilized the services. Invoices shall also indicate service type by CLIN and any associated sub-CLIN.

5.1.4. The Contractor shall provide a continuous quality improvement program that measures the following: Quarterly reports will be emailed to agency at the end of following month after quarter ends o Number of Employees Served o Method of Referral (self-informal supervisory, formal supervisory) o Incidence of Presenting Problems o Demographic Profile of Employees Utilizing the Occupational Health and Medical Case review services o Case resolution o Satisfaction Surveys result (confidentiality not compromised) o Quarterly reports will be emailed to agency at the end of the following month after quarter ends

5.1.5. The contractor shall make recommendations to the COR and Program Manager to ensureoptimum counseling staffing levels and placement based on agency geographic dispersion, program utilization, affiliate counselor accessibility and other relevant factors to maintain program quality and access. The contractor shall track staff counselor capacity and affiliate counselor assignment utilization. The contractor shall conduct an analysis of staff placement for all service areas and coordinate status with agency.

5.1.6. The contractor shall administer and manage the private provider network. This requirementincludes the location and procurement of services from a network of private providers in designated locations who meet occupational health services requirements.

5.1.7. The contractor shall receive work orders, review them, and schedule services as identified inwork orders at clinics able to provide the requested occupational health services.

5.1.8. The contractor shall prepare and ship laboratory kits and examination packets to private providers. The kits will include instructions on laboratory testing and examination and testing requirements, including the requirements of specified form completion.

5.1.9. The contractor shall prepare and ship vaccines, if indicated. Shipment of vaccine should meet or exceed

CDC requirements for vaccine shipment.

5.1.10. The contractor shall monitor and manage the private clinic performance. If the clinic is not able to complete the requirements of the work order request adequately, the contractor may be requested by the

Government to complete a corrective action plan and present it to the COR.

5.1.11. The contractor shall maintain and ship medical records to specified locations as identified in the work order or recipient plan.

5.2. Task 2 – Occupational Health Services: The contractor shall provide private provider Occupational

Health Services and medical case reviews within the continental United States (CONUS), as well as outside of the United States, to include the Virgin Islands, Guam, Puerto Rico, Hawaii and Alaska (OCONUS), and international services in Canada. Additional international sites may also be required, if the need for such services may arise. The requirements extends to all of the Agency's law enforcement (covered) positions and includes both incumbents and applicants in pursuit of a covered position.

5.2.1. The contractor shall provide private provider occupational health services within the continental

United States (CONUS), as well as outside of the United States, to include the Virgin Islands, Guam, Puerto Rico, Hawaii and Alaska (OCONUS), and international services in Canada.

5.2.2. The contractor shall receive and process the completed clinical documentation from the private providers and shall review all materials for completeness, adequacy of testing and accuracy according to components and instructions of the work order and/or as specified in Government policies.

5.2.3. The contractor shall store all active medical records for the PPN, including those records created by incumbent contractor. All testing and services should meet United States occupational health industry standards.

5.2.4. The contractor shall assist the Government in assessing the quality, timeliness and accuracy of services through standard as well as innovative continuous quality improvement techniques.

5.2.5. The contractor shall provide available private provider services within a driving distance of 25 miles from the requested services location within the city, and up to 50 miles diving distance for rural locations. In some instances, requests may be made for the provision of private provider services within a driving distance of less than 25 miles from the requested service location. This requirement may be waived in some rural areas, with the approval of the COR.

5.2.6. When implementing new accounts, the Government will notify the contractor of expected examination locations, types, and quantities, so that the contractor can verify whether or not the existing provider network will satisfy the new account. If areas are identified that are not covered by the provider network, the contractor shall identify and contact providers, so that services are available as soon as possible to ensure that the contract timeline can be met.

5.2.7. Private provider service appointments shall be scheduled at one location and shall require one visit for each service request, unless otherwise stated in the work order or recipient plan. Advance approval from the COR must be obtained if the services will be performed at more than one location, or if a second service visit at the same private provider clinic is required. In some instances, arrangements will be made by the contractor for specialized service modalities and medical waste disposal. These may include mobile testing sites in remote areas or where a fixed private provider site is unavailable. The contractor shall notify the COR regarding the need for such services prior to entering into a subcontracting arrangement with the provider.

All outreach services and mobile testing sites will require the completion by the contractor of a Government

Outreach Form. This form must be submitted to the COR for approval before mobile testing sites or other outreach services can be completed.

5.2.8. Occupational health services that may be requested of the contractor include, but are not limited to, comprehensive or partial physical exams, pre-placement exams, Psychological Assessments and

Testing, Psychological Fit-for-Duty, Psychological Pre-Placement, Psychological Security Clearance, Neuropsychological Testing, Pre/Post-Deployment Health Assessment Support, COVID-19 testing

(molecular (swab) and serology (IgG)), audiometric testing, cardiovascular stress tests, chest x‐rays, colorectal cancer screening, electrocardiograms, mammography, pulmonary function testing, vision screenings, laser eye mapping, respiratory fit testing, vaccine administration, and independent medical evaluations. This also includes medical screenings for pre-employment, deployment, post-deployment

Deployers and Overseas permanent change of station exams.

5.2.9. Outreach services may include blood pressure checks, immunizations, Influenza vaccines, cholesterol checks, and phlebotomy services. Physical examinations and other types of occupational health services may also be required via outreach. All physical examinations will be completed by a licensed health care provider whose knowledge, skills, and abilities are commensurate with the scope of practice per the state or territory requirements in which the service is performed. Specialty services may be required, that may include, but are not limited to, phlebotomy services, chest x‐ray B‐reads, electrocardiogram over‐reads, or other specialtyservices.

5.2.10. Specific parameters for individual tests and procedures will be delineated on the work order. Certain tests must always meet or exceed specified parameters (unless the contractor receives electronic notification from the COR). These tests include, but are not limited to, Pulmonary Function testing (NIOSH standard), Audiometric testing (CAOHC standard), Vision screening, mapping and EKGs. Certain agencies will require specialized testing services; examples include functional hearing testing, bone density screening, and cardiology diagnostic testing. All tests will need to be performed utilizing accurate, properly calibrated and maintained testing equipment and properly trained and credentialed personnel familiar with the required occupational health standards for testing and services. The tests and exams must be reviewed for the quality and accuracy of examination and testing, and will include accurate, legible, and complete documentation.

5.2.11. The contractor is responsible for ensuring that necessary training and instructions are given to all

PPN staff providing testing and services. Tests may be requested individually or included as part of customized physical exam requests. The request for private provider services shall be initiated by the authorized Government program staff member and then sent to the COR for approval. The individual requests for services shall then be submitted to the contractor’s authorized staff member electronically, via a work order or electronically. Only those services specifically outlined on the work order or requested electronically by a Government representative will be reimbursed.

5.3. Task 3 – Independent Medical Examinations (IME): Independent Medical Examinations (IME) may be requested by the Government. The provider requirements are for Board Certified physicians. These may include, but are not limited to the following specialties:

Allergist

Audiologist

Cardiologist

Dermatologist

Endocrinologist

Functional Capacity Examinations

Gastroenterologist

Hematologist

Infectious Disease

Nephrologists

Neurologist

Neurosurgery

Occupational Health

Oncologist

Ophthalmologist

Orthopedist

Otolaryngology (E.N.T.)

Physical Medicine & Rehabilitation

Psychiatrist

Psychologist/Psychological examinations

Pulmonologist

Rheumatologist

Urologist

5.3.1. The primary focus of Psychological reviews are fitness‐for‐duty, but other requests may be received with specific concerns that need to be addressed. Psychologists may also provide; Mental and psychological evaluation to determine if an employee has a mental defect that would preclude them from continued access to classified sensitive information, Pre-placement services, Neuro Psychological testing, and Post deployment health assessment services. According to 5 CFR 339, a federal agency may require an employee who has applied for or is receiving continuation of pay or compensation as a result of an on‐ the‐job injury/disease to report for a fitness for duty (FFD) exam to determine medical limitations that may affect placement decisions. As a result of a FFD exam, a more detailed assessment by a physician specialist. Certain DoD agencies, such as the Office of Inspector General, require that a provider who administers the under cover Psychological examinations for law enforcement officers cannot be one of the providers that administers the normal psychological fit-for-duty exams. Also, the exams cannot be in person; it must be a teleconference.

5.3.2. All available medical records will be forwarded and required to be reviewed including current records, previous treatment records, job description and previously completed diagnostic testing along with a list of questions to be answered by the provider in his/her report. Supplied medical records should be considered in the medical determination. The Government will provide copies of any medical records to the contractor.

The contractor shall send the medical records to the provider.

5.3.3. The contractor shall purge those medical records after submission of the IME report.

5.3.4. The contracted private provider physician shall provide a well summarized report to the Government, answering the questions that were communicated to their office.

5.3.5. The Psychological Security Clearance Evaluation is performed by a psychologist and includes a clinical interview, mental status exam and behavioral observations, review of relevant records – including the SF-

86 Questionnaire for National Security Positions which has been completed by the employee – and objective psychological testing. The following tests are included: MMPI-2 RF, Personality Inventory, and

Biographical Questionnaire.

5.4. Task 4 – Independent Medical Reviews: Independent Medical Reviews (IMR) are occasionally required.

These services require a specialist in the required field to perform a review of medical records and answer questions posed by the customer, to ascertain the extent of a claimed condition or to obtain knowledge for reasonable accommodation of the claimed condition. These requests do not require a face to face exam with the examinee. The timeframe for delivery is the same as the independent medical exams.

5.4.1. Specialty Examinations with the certain specialists may be required. These may include, but are not limited to: Cardiologists (Cardiology Exams), which in some cases could also be completed by an Internist with a sub‐specialty in cardiology; Otolaryngologists; and Pulmonologists (Pulmonary Exams).

5.5. Task 5 – Mobile Outreach Support: Outreach services (including mobile vans and/or mobile testing sites) will be requested by an individual work order or by electronic notification. The COR will provide the Government Outreach Form to the contractor to provide the costs to perform the outreach service.

Upon completion of the form by the contractor, the COR will be required to review and approve the outreach request before any services can be scheduled.

5.5.1 Mobile Outreach services may include blood pressure checks, immunizations, and phlebotomy services. Physical examinations and other types of occupational health services may also be required via outreach. All physical examinations will be completed by a licensed health care provider whose knowledge, skills, and abilities are commensurate with the scope of practice per the state or territory requirements in which the service is performed. Specialty services may be required, that may include, but are not limited to, phlebotomy services, chest x‐ray B‐reads, electrocardiogram over‐reads, or other specialtyservices.

5.6. Task 6 – Medical Case Reviews: Primary duties and competencies include but are not limited to, reviewing medical records using agency specific work orders to ensure completeness to include each sheet of patient information contains appropriate identifying information, ensures the presence of examinee and provider signatures, ensures all components are received and legible before forwarding to the Medical

Records Technicians and Reviewing Medical Officer (RMO). Maintains and utilizes medical records data base for tracking missing medical information, utilizes tracking systems for checking off medical exam components as received for purposes of end of month reviews by Team Leads. Operates computer to process, store and retrieve health information. Coordinates moderately complex activities on assigned team to ensure service delivery is met. Communicates with Private Provider case coordinator to request medical documentation missing from medical exams to ensure client expectations are met or exceeded.

5.6.1. Provide administrative and clerical support employees. Maintains office files for assigned work, and ensures information is readily available for retrieval. Types a variety of memorandums, letters, reports, and other documents, as requested, utilizing Microsoft applications, basic computer and website use. Contractor shall coordinate and implement a broad range of duties vital to the operations of THE GOVERNMENT.

These services include but are not limited to secretarial and receptions, clerical, office equipment management and operations, administration, conference and meeting planning, travel support, information and data processing including generating reports, mail distribution, photocopying, faxing, records management, telecommunications management, facility usage and space issues, supply distribution, preparation, analysis, review and implementation of activities related to the procurement of equipment, materials, supplies, products and services (following procurement regulations). Oversight of day-to-day operations of smoking cessation program which includes organization of phone interviewers, ordering and mailing of supplies, resource contact for OHC's, performing phone interviews, keeping handouts and related documents up to date, tracking quit rate statistics, renewing agreements from year to year. Assists

OHC with obtaining materials for education programs.

5.6.2. The contractor shall treat all records containing employee medical information as confidential and maintain them in accordance with 5 U.S.C. 552a, the Privacy Act of 1974, and other applicable

Government policies.

5.6.3. The disposition of medical records for each agency shall be based on agency directives detailed in each work order or recipient plan. The contractor shall receive results and/or documentation of all requested services. Upon receipt of each completed exam or service, the contractor shall perform a quality assurance function to assure that the examination components are in agreement with the work specified on the work order or recipient plan, and that the examination results are accurate and thorough. A copy or original of the exam, test, or procedure shall be sent to the medical records routing address, as specified on each work order or recipient plan. The Government will reimburse the costs of medical records shipment.

5.6.4. Requests for retrieval of a completed medical record housed at the contractors’ facility will be made through the COR. The request will be accompanied by a release of information form to the contractor.

Approximately 100 such requests for retrieval of employee medical records are made annually. The contractor will be responsible for any clerical costs associated with preparing the medical record for shipment. The Government will be responsible for all costs for customized forms not available on the contractor website. If the work order or recipient plan indicates the need for long‐term, on‐site record storage, the contractor must comply with Government guidelines. The contractor must maintain an appropriate facility for storage and retrieval of records, in compliance with HIPAA policies. The contractor’s facility shall have adequate storage space for medical records, and the contractor shall ensure that medical records stored in their facility will be safe from fire, theft, and other hazards. Records will be readily available for tracking and retrieval of information, in accordance with industry standards.

PART 6

APPLICABLE PUBLICATIONS

6. APPLICABLE PUBLICATIONS:

6.1. The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures. A brief summary of relevant regulations and federal requirements follows below. This summary is not exhaustive.

Occupational medical examinations based on DoD 6055.05-M, Occupational Medical Examinations and Surveillance Manual, satisfy the basic medical surveillance requirements in DoDI 6055.05, Occupational and

Environmental Health.

Occupational medical examinations are conducted to determine if: workers are medically and physically able to perform the assigned duties without substantial risk of harm to themselves, others, or the mission (fitness for duty examinations) and whether the workplace is causing workers injury or illness due to an occupational exposure (medical surveillance examinations).

The following Tables identify the

DoD requirements for the specific types of occupational examinations or medical treatment that are required.

Table 1: Requirement for Preplacement/Initial/New Hire Examinations

Legal or Regulatory

Source

Preplacement/Initial/New Hire Examinations

DoD 6055.05-M These exams are performed before placement in a specific job to medically assess if the worker will be able to perform the job safely. They may be combined with occupational medical surveillance to record a baseline of values for future comparison. These medical examinations should be done before the worker commences work. However, if the individual has already started work, these examinations shall be completed within 60 days of assignment, unless more stringent requirements exist.

Table 2: Requirements for Personnel Policy Enforcement Examinations

Personnel Policy Enforcement Examinations

DoD 6055.05-M These exams medically assess workers to determine if they meet established standards and conditions of employment. Examples of these types of examinations are drug use screening and fitness for duty examinations. Other types of personnel policy examinations may include work related injury/illness evaluations, return to work examinations, and impairment evaluations.

DoDI 6055.01 In support of injury compensation claims administration, qualified SOH personnel must provide claims administrators with an assessment of the work-relatedness of reported injuries and illnesses. In support of return-to-work programs, qualified

SOH personnel must provide the personnel office with a professional opinion on workplace conditions and worker practices appropriate for light-duty assignments.

DoD, DoD 6055-05-M Occupational Medical Examinations and Surveillance Manual, p. 9.

DoD, DoD 6055-05-M Occupational Medical Examinations and Surveillance Manual, p. 10.

IDA did not include a table for Ergonomics as there is currently no Occupational Health and Safety

Agency regulations establishing ergonomic requirements or standards. In 2001, Congress passed Joint

Regulation 6 disapproving rules relating to ergonomics, which was approved by the President.

Subsequent revisions of DoD 6055.01 have not contained ergonomic requirements.

Table 3: Requirement for Medical Certification Examinations

Medical Certification Examinations

DoD 6055.05-M These determine if an individual meets specific medical fitness standards, such as those promulgated by the Federal Aviation Administration and Department of

Transportation for aviators and commercial drivers, respectively. Additionally, the examination should determine if the individual can perform the essential duties of the position without endangering self or others. The individual is either within all standards and thus medically qualified, or fails to meet one or more standards and thus is not medically qualified.

Table 4: Requirements for Medical Surveillance Examinations

Medical Surveillance Examinations

DoDD 6200.04 Provide appropriate, periodic occupational health assessments for those potentially exposed to chemical, biological, and physical hazards in the course of their duties in accordance with DoDD 4715.01E, DoDI 6055.1, DoDI 6055.5, DoDI 6490.03, and

DoD Directive 6490.5.

DoD 6055.05-M Medical Surveillance Examinations or occupational health examinations, provide baseline and periodic assessments or measurements to detect abnormalities in workers exposed to work-related health hazards. These examinations are effective for the individual if useful screening techniques (history questionnaires, medical exams, or lab tests) are available to identify abnormalities in the target organ system at a stage when modifying exposure or providing medical treatment can arrest progression or prevent recurrence. These exams include Baseline Surveillance exams and Periodic Surveillance Exams.

DoD 6055.05-M Several occupational groups require special consideration because of their unique exposures, specific health risk considerations, or otherwise regulated medical surveillance requirements. This includes medical surveillance of surety

(chemical/biological/nuclear) workers, firefighters, police officers and security guards, workers in their reproductive years, pregnant workers, breastfeeding workers, laser workers, and workers who require DOT examinations.