Statement of Work Occupational Medical Surveillance 2023 07 17.pdf

U.S. General Services Administration Public Buildings Service National Capital Region

Statement of Work (SOW) for

Occupational Medical Surveillance Program Services

1. General

1.1. Scope

Provide Occupational Medical Surveillance Program (OMSP) services to the General Services Administration for forty-four (44) White House Service Center employees. The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in section 3.6 Government Furnished Property, to perform OMSP services as described in the requirements of this statement of work and in accordance with applicable regulations.

1.2. Objectives

The purpose of the Occupational Medical Surveillance Program services is:

● To provide job-related Occupational Medical Surveillance to approximately forty-four (44) White House Service Center (WHSC) full-time employees who are exposed to OSHA Permissible Exposure Limits (PELs) health hazards in the work environment.

● To supply examination results and/or medical records to the individual employee and retain medical records for historical reference.

● To provide any necessary work clearance forms to the individual employee and GSA manager.

1.3. Background

The OMSP is provided to authorized employees considered for assignment or presently assigned to work that includes exposure to OSHA Permissible Exposure Limits (PELs) health hazards in the work environment. The General Services Administration (GSA) Occupational Safety and Health (OSH) Program for internal GSA agency operations is established by the Administrative Directive Memorandum (ADM) 5940.2 and contains the requirements for this program.

1.4. General Information

1.4.1. Period of Performance

The anticipated period of performance is 365 days from the Award date.

National Capital Region

1.4.2. Place of Performance

The place of performance shall be at the contractor’s facility within a thirty

(30) mile radius of 725 17th St NW Washington, DC 20506-0200.

1.4.3. Scheduling

Individual employees will schedule appointments in adherence with policies set forth at GSA.

2. Requirements

2.1. Overview

2.1.1. The contractor must provide the following Medical Surveillance Examinations to White House Service Center (WHSC) employees that are exposed to toxic workplace hazards that exceed the PELs set forth by OSHA for their respective job series and based on employee provided information during the physical examination. The OMSP is designed for the detection of occupationally significant medical anomalies. The limited medical procedures performed are not intended, and should not be construed, to substitute for the care provided by the employee's personal physician.

2.1.2. The following specifications are designed to provide the maximum flexibility in tailoring the OMSP for each employee according to their medical background and specific workplace exposures. The Contractor shall provide a fee schedule based upon the OSHA requirements and risk associated with each job series. Each employee shall receive a basic physical examination and a risk assessment. Employees shall then receive additional medical examinations and testing as medically indicated and based on their occupational hazards.

2.1.3. The workforce identified for potential OMSP at the WHSC is structured as follows:

Job Title Job Series # of Employees

Mechanical Engineering Technician 802 9

Construction Control Representative 809 3

Plant Operations Manager 1101 1

Building Manager Specialist 1176 11

Equipment Facilities Specialist 1603 1

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Facility Operations Specialist 1640 1

Mason 3603 5

Painter 4102 6

Wood Crafter 4605 6

Maintenance Worker 4749 1

TOTAL 44

2.2. Examinations

The descriptions of the examinations and testing shall not be construed as medical advice or complete requirements. Due to the highly individual requirements, the General Services Administration is reliant upon medical professionals with experience in occupational medical surveillance to provide recommendations. If other potential examinations are identified based upon the job series information provided above, please include them in the fee schedule and proposal.

2.2.1. Physical Examination

The physical examination shall be required for all employees to identify other potential risks. This physical examination is for the purpose of identifying risks to the and actionable PELs of the individual employee and does not replace the physical examinations by the employee’s personal physician.

2.2.2. Respiratory Medical Clearance (non-SCBA Type)

If employees require respiratory protection for their job function they must have a medical evaluation and release stating their ability to wear respiratory protective equipment. The employee must also have the fit of their respirator qualitatively or quantitatively evaluated. The Contractor shall provide examinations and written certification as specified by OSHA in 29 CFR 1910.132 and 134. This may include Respirator questionnaire review, and if medically indicated, spirometry, chest x-ray, and/or limited physical examination.

2.2.3. Audiometry Program

The Contractor shall provide a sound shielded facility in which any loss of hearing may be determined for each ear. Each ear shall be tested at the frequencies of 500, 1000, 2000, 3000, 4000, 6000, and 8000 HZ.

International Standards Organization (ISO) standards apply. Hearing loss

National Capital Region shall be identified and categorized by probable cause. This may include Audiogram and Audiogram Comparison - OSHA Mandated.

2.2.4. Asbestos Exam

If there is a risk of exposure to Asbestos that is above the PELs, the Contractor shall provide an asbestos questionnaire, full physical examination and if medically indicated, chest x-rays and/or B Reader.

2.2.5. Chest X-rays

When medically indicated, the Contractor shall provide a full size chest x-ray of the employee. Films will be interpreted by board certified radiologists. Those employees occupationally exposed to asbestos containing material as specified in current OSHA Standards (29 CFR 1910 and 29 CFR 1926 as applicable) shall be X-rayed as noted above.

2.2.6. EKG

When medically indicated, the Contractor shall provide the employee with EKG testing.

2.2.7. Lead Exposure Tests

If there is a risk of exposure to Lead that is above the PELs, the Contractor shall provide Blood Lead and ZPP, CBC w/ Diff, BUN - Creatinine, and/or Urinalysis.

2.2.8. Pesticide Baseline Exam

If there is a risk of exposure to Pesticides that is above the PELs, the Contractor shall provide pesticide physical examination and RBC and Plasma Cholinesterase.

2.3. Personnel

Administration of the medical surveillance services should be under the supervision of a licensed doctor of medicine (MD) or doctor of osteopathy (DO).

In addition, at a minimum, the MD/DO should be Board Certified in Occupational Medicine or Board Certified in Internal Medicine. If a person with these credentials is not available, then an MD/DO who is Board Eligible in Occupational Medicine or Internal Medicine would be an acceptable alternative. In either case, a physician with experience and interest in occupational medicine is preferred.

The physician will note irregularities and abnormalities, which would jeopardize the health status of the employee via the performance of their normal work duties. Life threatening anomalous conditions will be reported expeditiously and directly to the employee's personal physician.

National Capital Region

2.4. Deliverables

2.4.1. OSHA Required Medical Surveillance

Complete Medical Surveillance for required employees per OSHA Medical Surveillance Standards and based on individual risk factors.

2.4.2. Medical Records

Medical records, including but not limited to, test results, examination results, and findings shall be provided to the individual employee and medical records should be retained by the provider. Any work clearance forms, as required, should be filled out and given to the individual employee.

3. Additional Information

3.1. Applicable Publications

● OSHA Medical Surveillance Standards -https://www.osha.gov/medical-surveillance/standards

● Medical Screening and Surveillance Requirements in OSHA Standards: A Guide OSHA 3162 01R Published 2014 https://www.osha.gov/sites/default/files/publications/osha3162.pdf

● OSHA Medical Screening and Surveillance -https://www.osha.gov/medical-surveillance/screening

● Federal Acquisition Regulation (FAR) - https://www.acquisition.gov/far

3.2. Nonpersonal Health Care Services

This contract is for Nonpersonal Health Care Services, as defined in Federal Acquisition Regulation (FAR) part 37.101. In accordance with FAR part 37.4 the Government may enter into nonpersonal health care services contracts with physicians, dentists, and other health care providers under authority of 10 U.S.C.

chapter 221 and 41 U.S.C. chapter 33.

1. The contract is a nonpersonal health care services contract, as defined in FAR 37.101, under which the contractor is an independent contractor.

2. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

3. The contractor is required to indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

4. The contractor is required to maintain medical liability insurance, in a coverage amount acceptable to the contracting officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned.

https://www.osha.gov/medical-surveillance/standards https://www.osha.gov/sites/default/files/publications/osha3162.pdf https://www.osha.gov/medical-surveillance/screening https://www.acquisition.gov/far

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5. The contractor is required to ensure that its subcontracts for provisions of health care services, contain the requirements of the clause at 52.237-7, including the maintenance of medical liability insurance.

3.3. Communication

The contractor shall reply to correspondence from the General Service Administration (GSA) and GSA contractors within 3 calendar days. The Contracting Officer Representative (COR)/Project Manager (PM) shall be included on all correspondence.

3.4. Security Requirements

The Contractor shall ensure that all Personal Identifiable Information (PII) is kept confidential when transferring medical records and documentation within the Contractor’s facility and when sending to the Government.

3.5. Invoices

Invoices shall be submitted through Pegasys for payment. All invoices shall include but is not limited to:

● Contract Award Number (PIID):

● Last Name, First Initial of Employee(s) examined

● Work Location(s) of Employee(s)

● Date of Examination(s)/Testing(s)

● Type of Exam/Test(s) performed

● Unit Cost of Exam/Test(s) performed

3.6. Government Furnished Property

There is no Government Furnished Property for this statement of work. The contractor is required to provide all personnel, equipment, tools, materials, supervision, and quality control necessary.