Statement of Work - Attachment 1.pdf

Beaumont Reserve Fleet

Medical Surveillance Program Examinations

Statement of Work

1. INTRODUCTION:

1.1. Under the provisions of the Maritime Administration’s (MARAD) “Action Plan for the Control of Asbestos Exposure in MARAD Programs,” MARAD is entering a contract with an Occupational Health Medical Facility (FACILITY), employing an Occupational Health Physician (PHYSICIAN), Nurses and Certified Medical Technicians to provide occupational medical/physical examinations to designated MARAD employees assigned to the Beaumont Reserve Fleet (BRF), Beaumont, Texas.

2. ABSTRACT:

2.1. The health risks of occupational exposures to asbestos and hazardous materials are becoming well known. To limit preventable illnesses and to provide medical surveillance to the BRF employees who may have been exposed to potentially hazardous materials and chemicals in the past, MARAD’s Occupational Medical Surveillance Program provides medical/physical examinations and laboratory tests to these employees.

3. SCOPE OF WORK:

3.1. Occupational medical health surveillance shall be provided to designated BRF employees who have been, are, or will be exposed to potentially hazardous material and conditions (for example asbestos, lead, excessive noise) as outlined in 29 CFR 1910.1001. For this contract, asbestos includes chrysotile, amosite, crocidolite, tremolite, asbestos, anthophyllite asbestos, actinolite asbestos, and any of these minerals that have been manufactured or chemically treated or altered. The FACILITY shall be responsible for providing and performing the following occupational medical/physical examination types unless otherwise specified in this Statement of Work:

3.1.1. Basic Periodic Examinations: Asbestos/Occupational Health Medical

Examinations are to be provided to detect early or subclinical effects because of accidental or inadvertent overexposure to potentially hazardous substances, and to monitor for unanticipated effects of long-term low-level exposure to specific biological, chemical, and physical agents. These examinations shall be given to all designated BRF employees authorized to participate in this Surveillance Program, and will consist of the following:

3.1.2. Hands-on Physical Examination conducted by a qualified Occupational Health Physician by current and acceptable medical practice (including basic vision screening, height/weight measurements, blood pressure reading, etc.).

3.1.3. Medical Laboratory Tests as follows:

Blood Chemistries:

CHEM 6=Glucose Sodium Chloride BUN (Blood Urea Nitrogen) K+ (Potassium Carbon Dioxide HDLT=High Density Lipid Triglycerides CBC =Complete Blood Count PSA =Prostate Specific Antigen (To male employees age 40 Years and over)

Urinalysis =Dip w/micro (dipstick + microscopic exam for WBCs, RBC’s Bacterial, casts, crystals, Trichomonas, yeast, and epithelial cells (transitional, renal, squamous)

Hemoculture Test =Three (03) stool specimens Lead Testing=Blood sample and analysis which determines blood lead level and the ZPP test

3.1.4. Audiometric Hearing Test administered in a sound-attenuated booth based on guidelines established in 29 CFR 1910.95. The audiometric hearing test shall also be performed in compliance with specifications prescribed by the American National Standards Institute, S3.6-1969, Specifications for Audiometers (or the latest revision thereof), and in a room whose background noise meets the requirements of the American National Standards Institute S3.1-1977, Criteria for Permissible Ambient Noise During Audiometer Testing (or latest revision thereof).

3.1.5. Pulmonary Function Test - Spirometry test consists of simple lung ventilation measurements, including Forced Expiratory Volume in one second (FEV) and Forced Vital Capacity (FVC), which meets, as a minimum, the OSHA/NIOSH standards/requirements. Such tests shall be performed, calculated, and interpreted by the current NIOSH standards.

The FACILITY’s technician/nurse who administers the pulmonary function test shall be a certified technician/nurse and/or supervised by a licensed physician.

3.1.6. Electrocardiogram (EKG) - An electrocardiogram, consisting of a Standardized 12 lead testing shall be administered to the BRF employees. A record of the electric potentials associated with electric currents that traverse the heart, which can be used to diagnose heart disease, shall be maintained.

3.1.7. A Comprehensive, Occupational History detailing prior exposure to potentially harmful chemical or physical respiratory hazards, particularly asbestos, is to be developed. Any adverse effects related to the exposure are to be recorded. A respiratory history, with emphasis on the presence of respiratory symptoms and smoking, is to be recorded.

3.1.8. A Judgment of the Employee’s Ability to Use Respiratory Equipment shall be made. The PHYSICIAN shall provide the BRF with a certification of fitness for respirator use.

3.1.9. Any Additional or Follow-up Occupational Health Related Examinations.

/Medical Laboratory Tests deemed appropriate/necessary by the PHYSICIAN, must be PREAPPROVED by BRF.

3.1.10. Additional or follow-up occupational health-related examinations, medical laboratory tests, consultations, and training may be authorized by BRF if deemed appropriate/necessary by the PHYSICIAN.

3.1.11. Chest X-Rays (Posterior and Anterior): By OSHA Standard 29 CFR 1910.1001, and the “Frequency of Chest Roentgenograms, 14" x 17" posterior and anterior chest x-rays shall be taken. It will be the responsibility of the FACILITY to screen the employee’s prior medical records and compare the information with the following chart to determine whether the employee is due for a chest x-ray. The x-ray films shall be locally screened for clarity and quality. It will be the FACILITY’S responsibility to have the x-ray films interpreted by Board Certified “B” Reader, Radiologist. It will be the FACILITY’S responsibility to provide the x-ray films (current and previous year) to the Radiologist for comparison and interpretation.

3.1.12. If an employee’s previous medical examination results indicate an asbestos health problem, x-rays shall be taken on an annual basis. The PHYSICIAN may recommend that an employee be x-rayed if, in his/her opinion, and by current and acceptable medical practices, the employee’s health situation dictates the need for additional x-rays.

3.1.13. All the above medical examinations should include a physical examination of all systems with an emphasis on the respiratory system, cardiovascular system, and digestive tract with specific emphasis on the chest, particularly the presence of persistent “dry rales” or “crackles” at the lung base. In addition, the presence or absence of “clubbing” of the fingers and signs of bronchitis and emphysema will also be noted. The FACILITY shall perform periodic occupational health medical/physical examinations and will also provide pre-placement, fitness for/return to duty, and pre-separation examinations as requested.

3.2. The medical examinations shall be conducted in THREE PARTS:

3.2.1. All lab tests and x-rays (if required) are conducted.

3.2.2. The PHYSICIAN conducts the hands-on physical examination by

Standard Medical Practice and discusses the results of all lab tests, x-ray interpretations (if required), and hands-on examination with the employee.

3.2.3. The LICENSED PHYSICAL THERAPIST conducts the Functional Capacity Test, IF REQUIRED, for Pre-placement/Fitness for Duty examinations.

4. ITEM LOCATION:

4.1. Physicals are to be conducted at a designated facility with the capability to perform all requirements listed in this statement of work.

5. DEFINITIONS:

5.1. NA

6. PERFORMANCE CRITERIA/DELIVERABLES:

6.1. Under the terms of this contract, the FACILITY shall be responsible to:

6.1.1. Ensure that all medical examinations are conducted by the PHYSICIAN and that all lab tests and procedures are performed by or under the supervision of a PHYSICIAN by current and acceptable medical practices, and the FACILITY shall provide a professional staff, administrative support, and other services necessary to perform the occupational health medical/physical examinations professionally. The PHYSICIAN shall be a graduate of an accredited school of medicine and shall meet the licensing requirements of the State of Texas. At a minimum, two years of experience in occupational health medicine is required for the PHYSICIAN who will conduct the medical examinations.

All nurses shall be graduates of an accredited school of nursing, shall be registered, and shall be legally qualified to practice nursing in the State of Texas.

6.1.2. Ensure that the examining PHYSICIAN reviews all occupational medical information, medical examination data, and lab test results and compares results, including the x-ray interpretations and written summary reports from the Board Certified “B” Reader Radiologist, and validates the conclusions of the medical examinations by OSHA’S requirements and professional medical procedures. Also, the PHYSICIAN shall compare the employee’s current occupational health medical/physical examination results (PFT, hearing test, etc.), with the employee’s previous medical examination test results and any health changes shall be noted in the examining PHYSICIAN’s written opinion/report.

6.1.4. Provide a written opinion/report signed by the examining PHYSICIAN.

This report shall be available to BRF and shall be placed in the employee’s asbestos medical folder within fourteen (14) days of the employee’s hands-on physical examination. This opinion/report shall contain the current occupational health medical examination results and any occupational health changes because of the comparison of the current test with the employee’s previous year’s occupational health test results. As a minimum, the PHYSICIAN’s written opinion/report shall contain the following:

6.1.5. Examining PHYSICIAN’s opinion as to whether the employee has detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos, tremolite, anthophyllite, actinolite, or any other occupational hazardous substances. The examining PHYSICIAN shall identify any occupational health abnormalities and shall state his/her recommendations. The judgment of the PHYSICIAN concerning the adequacy of the diagnostic information to support the impression of asbestos-related disease should be entered in the medical report/opinion.

6.1.6. Any recommended limitations on the employee or upon the use of personal protective equipment, such as clothing or respirators, etc. The PHYSICIAN shall complete the “Medical Determination for Respirator Use” (Attachment b2). The PHYSICIAN shall complete the “Respirator Approval Card,” for each employee. The completed forms shall be provided to the Fleet within seven (7) days after completion of Part II of the employee’s medical exam. Forms should be forwarded by FEDEX to BRF once a week.

6.1.8. A statement that the employee has been informed by the examining PHYSICIAN of the results of the occupational health medical/physical examination and of any occupational health conditions resulting from asbestos, tremolite, anthophyllite, or actinolite exposure that requires further explanation or treatment, or from any other occupational health-hazardous substances.

6.1.9. The employee’s original occupational health medical examination results/records which shall include results/records of the medical/physical examination tests identified in Section III of this Statement of Work, and the examining PHYSICIAN’s written medical opinion/report as to the employee’s occupational health status.

6.1.10. The examining PHYSICIAN SHALL NOT REVEAL in the written opinion/report given to the BRF specific findings of diagnoses unrelated to occupational health exposure to asbestos, tremolite, anthophyllite, or actinolite, or other occupational hazardous substances. The written opinion/report shall state that the examining PHYSICIAN has informed the employee of any personal health problems and has instructed the employee to see his/her physician for any necessary definitive care or follow-up treatment for these personal health problems. The employee shall be required to sign this statement.

6.1.11. Utilize standard occupational health medical history and physical examination report forms provided as attachments to this Statement of Work.

6.1.12. The FACILITY shall be responsible for all medical records. Records shall be handled by the requirements of the Privacy Act of 1974 (5 U.S.C. 552a). The confidentiality of all employee medical information shall be protected.

6.1.13. Provide the services of a Board Certified “B” Reader, Radiologist, to independently interpret the BRF employees’ x-ray films (P/A) by ILO International Classification of Radiograph of Pneumoconiosis.

6.1.14. The radiologist will compare the employees’ current x-ray films with the employees’ last x-rays taken under this program.

6.1.15. Complete Pneumoconiosis Radiograph Interpretation Form.

6.1.16. Provide a detailed written summary report stating the Radiologist’s professional findings, opinions, and recommendations.

6.1.17. All Medical Surveillance Program medical/physical examination opinions/reports/lab test results and x-rays of BRF employees shall be maintained in a secure file at the FACILITY, by prescribed Federal and Medical record-keeping requirements/practices and Privacy Act requirements. The Beaumont Reserve Fleet is responsible for assuring compliance with OSHA Standard 29 CFR 1910.20, “Access to Employee Exposure and Medical Records.”

6.1.18. Upon receipt of a written request by the employee, the FACILITY shall provide a copy of the current occupational health medical/physical examination results to the employee and/or the employee’s physician.

6.1.19. Maintain professional liability insurance in an amount not less than $1,000,000. Indemnify and hold harmless and defend the United States, MARAD, and its officials and employees against all claims and demands (including costs and attorney fees in defending such claims or demands, whether the claims or demands are found to be valid) for injury or death arising out of the medical/physical examination and testing activities of the occupational health medical facility for BRF employees under the Medical Surveillance Program.

6.1.20. The FACILITY shall immediately notify the Fleet Program Manager, or his/her designee if an employee refuses a portion of the occupational health medical examination.

6.1.21. The FACILITY shall immediately notify the employee, upon discovery of a health problem that would restrict the employee from safely performing job duties.

6.1.22. All occupational health medical/physical examinations shall commence as agreed upon by the Fleet Superintendent or his/her designee.

6.1.23. The FACILITY’s liaison for the administration of this contract with the BRF shall be a full-time employee, experienced in occupational medicine requirements and contract administration, with complete comprehension of this statement of work, and the authority to authorize, accept and sign for changes to this contract.

6.1.24. The FACILITY shall ensure that examinations are scheduled for completion during the normal FLEET working hours, Monday- Friday, 7:00 a.m. to 3:30 p.m.

7. SITE VISIT:

7.1 Arrangement can be made with COR or ACOR, listed below, at any time during the solicitation period to schedule a site visit. From 07:30 to 1400 Monday thru Thursday.

8. POINTS OF CONTACT:

8.1. COR Kevin Champagne Safety and Occ. Health Specialist.

Kevin.Champagne@dot.gov.

8.2. ACOR Mike Pattison Environmental Specialist.

9. GOVERNMENT-FURNISHEDHED MATERIAL:

9.1. None.

10. GOVERNMENT-FURNISHED SERVICES:

10.1. None.

11. GENERAL SPECIFICATIONS/SAFETY AND WORK REQUIREMENTS:

11.1. The contractor/vendor shall perform work during the hours of 7:00 am and 3:30 pm Monday-Thursday. Excluding National Holidays

11.2. The FACILITY shall ensure that BRF employees will not be required to travel more than twenty-five (25) miles one way to a single location from the BRF worksite to obtain a complete occupational health medical/physical examination. This is required to minimize employee time away from the job.

11.3. Upon thirty (30) days written notice to the FACILITY, this contract may be terminated at any time at the discretion of the Maritime Administration.

12. Safety:

12.1. The Contractor is responsible for providing their employees and subcontractors with all safety equipment.

12.2. The Contractor is responsible for the cleanliness of the worksite and cleaning and restoring all areas disturbed by the work outline in the specification(s) as the original.