Statement of Work (SOW) HQ Wellness Center Draft.pdf

70SBUR20F00000224

Attachment A- 1 of 10

U.S. CITIZENSHIP AND IMMIGRATION SERVICES

STATEMENT OF WORK

FOR

CLINICAL HEALTH SERIVCES: ONSITE OCCUPATIONAL HEALTH CENTER

Revised 9/4/2024

1.0 GENERAL

1.1 BACKGROUND AND PURPOSE

The United States Citizenship and Immigration Services (USCIS) will be operating an Onsite Occupational Health Center (HQ Wellness Center) at the Camp Springs, Maryland location.

Health center services will support and maintain a healthy and maximally productive workforce for USCIS Headquarters (HQ) employees.

1.2 SCOPE

The onsite health services for the HQ Wellness Center will be provided by a licensed, Basic Life Support (BLS) certified, registered nurse (RN) and include emergency medical response for life-threatening conditions which may require basic life support, the use of an automated external defibrillator (AED), or administration of emergency medications while awaiting the arrival of local Emergency Medical Services (EMS).

In addition to emergency care, the HQ Wellness Center will provide convenient onsite care for minor illness and injury to minimize unnecessary absences that may otherwise result in basic preventive health services and education to allow workers to maintain or improve their health to prevent the development or progression of chronic disease.

Physician services are needed to support the on-site Wellness Center (Health Clinic) contractor to review/and or develop standing orders for clinic procedures, workflows, and responsibilities including but not limited to the coordination of services for walk-in-care for minor illnesses and injuries, vaccinations/immunizations, health screenings, routine labs and administration of medication and emergency medical care for the onsite occupational health clinic.

1.3 OBJECTIVE

To secure a contractor to manage the onsite HQ Wellness center for 3,800+ employees located in Camp Springs, Maryland.

To obtain a staff physician for virtual physician services to support a contractor that manages the onsite HQ Wellness center for 3,800+ employees located in Camp Springs, Maryland.

1.4 PERFORMANCE REQUIREMENTS SUMMARY

The HQ Wellness Center will minimally include:

file://hqnas/SHARED/G-A/G-ACS/CAAT%20Team/TOOLBOX/SCOPE%20PARAGRAPHS.doc

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• Walk-in care for minor illnesses and injury that may be work or non-work related;

• Routine adult immunizations according to the guidelines from the Center for Disease

Control (CDC): including Tetanus-diphtheria (Td), Tetanus-diphtheria-acellular pertussis (Tdap), Influenza, and pneumococcal (pneumonia) vaccines;

• Destination specific travel information from the CDC to include RN consultation for questions about the information provided;

• Consultations of general health concerns;

• Care prescribed by an employee’s personal physician including administration of medications, blood pressure and glucose (blood sugar) monitoring, wound care, and periodic bedrest;

• Health screenings including vision, blood pressure, diabetes, cholesterol, and other risk factors for heart disease;

• Management of designated lactation space located within the clinic space to include regular cleaning of the room and any agency provided equipment.

• Participate in annual Wellness Expo and Benefits Fairs. The Wellness Expo is a local event for USCIS within the Washington D.C. Metropolitan Area. The RN staff will host an information table to highlight wellness and preventative information on lifestyle illness.

• Provide monthly one hour health and wellness trainings either in person or a combination of in-person and virtual on topics related to the prevention of lifestyle illness, wellness and preventative services in consultation with the USCIS Program Manager (PM).

• Clinic staff participation in occupant emergency planning;

• Annual program review to assist management in identifying basic safety, health and wellness opportunities.

• Provide an operational guideline to outline Wellness Center operational overview.

• The RN staff shall be available for in-person services during business hours outlined in the SOW.

The HQ Wellness Center will minimally need physician services (virtual or in person, as needed) to include the initial and annual review of standing orders. Services will include:

• Review and/or develop standing orders for clinic procedures, workflows, and responsibilities including but not limited to coordination of services for walk-in care for minor illnesses and injuries, vaccinations/immunizations, health screenings, emergency medical care and administration of medications.

• Respond to and assist with adverse and emergency issues requiring physician’s expertise, including the patient’s current condition, the status of any acute episodes of illness, test results, medications, other actual or high-risk potential medical problems that are affecting the individuals functional, physical or cognitive status.

• Respond to and review abnormal laboratory and other diagnostic test results within 48 hours or sooner if an immediate need exists.

• Maintain confidentiality and complete health records of the services provided.

2.0 GOVERNMENT FURNISHED EQUIPMENT

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The facilities department will provide the following furniture items:

• (1) workstation with task chair

• (2) task chairs for Wellness Center Office

• Waiting room table and chairs

• Privacy curtains

• Medical equipment and supplies (Section 6.6)

• Network connection

2.1 CONTRACTOR MANAGED GFP

(a) The Government’s Property Administrator/COR shall collaborate with the appropriate Government’s Property Custodian (PC) to facilitate the administrative process of providing Government property to the contractor. The Government’s Property Custodian will update Sunflower Asset Management System (SAMS) to reflect that the property has been provided to the contractor.

(b) The Contractor shall create and maintain records of all government property accountable to the contract, including Government-furnished and Contractor-acquired property. Property records shall enable a complete, current, auditable record of all transactions and shall, unless otherwise approved by the Government’s Property Administrator/COR, contain the following:

(1) The name, part number and description, manufacturer, model number, and National Stock Number (if needed for additional item identification, tracking and/or disposition);

(2) Unit acquisition cost;

(3) Barcode number;

(4) Contract number (including modification number of equipment added by modification);

(5) Physical location;

(6) Disposition;

(7) End user identification; and

(8) Date placed in service.

(c) The Contractor will provide property record data updates to the Government’s Property Administrator/COR as changes occur to any items listed above. The Government’s Property Administrator/COR shall provide these updates to the Government’s Property Custodian, who will update SAMS.

(d) The Contractor shall perform and record physical inventory results annually. Inventory shall be submitted within 30 days of 1) initial receipt of equipment, and 2) the beginning of each option period. For equipment added or replaced between annual inventories, inventory submitted need only reflect the affected inventory records. The contractor shall disclose physical inventory results to the Government’s Property Administrator/COR. The Property Administrator/COR shall provide inventory results to the Government’s appropriate Property Custodian who will update SAMS. A final physical inventory shall be performed upon contract completion or termination.

(e) The Government’s Property Administrator/COR shall have access to the Contractor’s premises and all government property, at reasonable times, for the purposes of reviewing, inspecting and evaluating the Contractor’s property management plan, systems, procedures, Attachment A- 4 of 10 records, and supporting documentation pertaining to government property. The Government’s Property Custodian may accompany the Property Administrator during any and all reviews and/or inventories.

(f) The Government’s Property Administrator/COR and the Contractor’s project manager (working with the Accountable Property Officer) will ensure that all GFP is returned to USCIS upon the conclusion of contract performance.

Description of Government Property - Include the level of detail required at FAR 45.201(a)

Date/Event Indicate when the GFP will be furnished

Date/Event Indicate when the GFP will be returned

Unit Cost (Each)

Unit Quantity iPhone 11 (iPhone 13 currently) Upon execution of modification P00004

Contract end date

$699.00 1

3.0 CONTRACTOR FUNISHED EQUIPMENT

The contractor shall provide all computer equipment. The computer equipment required should include a laptop or desk computer and a printer. This computer equipment will not be made the property of the Government after services are concluded.

4.0 REPORTING

The contractor shall maintain employee health records for services provided per Health Insurance Portability and Accountability Act (HIPPA) guidelines. This information shall not be shared with the agency outside of utilization. The contractor shall provide service specific utilization reports as detailed below.

Type of Report

Report Elements (minimum requirements) Date Delivered

Quarterly Report

• Aggregate metrics:

• Presenting issue

• Services rendered

• Outcome

• Utilization

• Written Narrative:

• Trends observed

• Program risks/ challenges

10 days after the close of the fiscal quarter

Annual Report • Same data elements as Quarterly report with a year-end summary of trends and recommendations for

30 days after the close of the fiscal year

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Type of Report

Report Elements (minimum requirements) Date Delivered program enhancements and improvements.

• Annual program review to assist management in identifying basic safety, health and wellness opportunities.

Emergency Medical Services (EMS)/ Event Service Report

• Provide a report for all EMS services that require ambulance transport.

• Written Narrative:

• Type of incident/ event service provided

• Relevant background of incident/ event

• Outcome

Five days after the service is provided

5.0 CONTRACTOR PERSONNEL

5.1 QUALIFIED PERSONNEL

The Contractor shall provide qualified personnel to perform all requirements specified in this SOW. The services must be provided by a licensed, BLS certified, Registered Nurse holding a Bachelor of Science in Nursing (BSN) degree, with a minimum of 3 years’ experience. The Government requires Registered Nurses to provide 1,960 hours of onsite services for each period of performance.

The Contractor can submit up to six qualified PRN nurses to perform all requirements specified in this SOW to ensure the clinic has operational coverage.

The Contractor shall provide qualified personnel to perform all requirements specified in this SOW. The services must be provided by a licensed, BLS certified, physician with the following experience and qualifications:

Experience:

Five years of residency training or equivalent experience and training in Emergency

Medicine or Occupational Medicine (i.e., three years Residency and two years fellowship and/or experience).

Resume must reflect sufficient level of expertise in Emergency Medicine or Occupational Medicine to perform core responsibilities to include providing medical consultations, evaluations and treatment for both initial and follow-up of work-related injuries or diseases.

Physician Qualifications:

Education/Degree: Doctor of Medicine, Doctor of Osteopathic Medicine or equivalent from a school in the United States or Canada. This degree must have been accredited by the Council on Medical Education of the American Medical Association, Association of American Colleges, Liaison Committee on Medical Education, Commission on Osteopathic

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College of Accreditation on the American Osteopathic Association or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained.

Degree from Foreign Medical School: A Doctor of Medicine or equivalent degree from a foreign medical school must provide education and medical knowledge equivalent to accredited schools in the United States. Evidence of equivalency to accredited schools in the United States is demonstrated by permanent certification by the Educational Commission for Foreign Medical Graduates, a fifth pathway certificate for Americans who completed premedical education in the United States and graduate education in a foreign country, or successful completion of the U.S. Medical Licensing Examination.

Licensure: The contractor must possess a current, active, full, and unrestricted license or registration as a physician from a state, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Board Certification: Board Certified by the American Board of Internal Medicine, the American Board of Family Practice, the American Board of Emergency Medicine and the American Board of Occupational Medicine.

Basic Life Support (BLS): Have and maintain a current American Red Cross or American Heart Association BLS certification.

Professional Medical Malpractice Insurance: The contractor shall provide their own professional medical malpractice insurance.

5.2 MEDICAL PROVIDER CREDENTIALING

If the medical provider doesn’t have a multistate compact license (a license to practice in multiple states) or will be working in a state, territory or District of Columbia are not covered by the compact, they must have a license in the state/ territory where they work. Medical Providers who utilize his/her medical credentials (license, certification, and/or registration) as the basis for providing medical advisement, expertise, or direct medical care to, for, or on behalf of DHS.

1. Contractor will email and submit DHS 5207 Form, license verification, National Practitioner Data Bank (NPDB) and Basic Life Support (BLS) to DHS Medical Credentialing and cc Lisa.Williams@hq.dhs.gov.

2. DHS Medical Credentialing will review documents and provide a credential verification letter for each applicant.

3. All medical personnel are responsible to provide updated credentials as they expire to medicalcredentialing@hq.dhs.gov.

4. Nurses that have an active email address using a computer on the USCIS intranet will receive notification/reminder that their professional license and/or certification is due to expire within the next 90/60/30 days. Additionally, the employee will receive step-by-step instructions on how to use the Credentialing Health and Medical ServiceNow Application to manage and update their credentials. The nurse will also need to upload the supporting credential documents in the portal. Questions can be addressed by sending an email to medicalcredentialing@hq.dhs.gov.

5. PRN nurses and Physicians that don’t have access to DHS computers can email the updated credential documents to medicalcredentialing@hq.dhs.gov and cc Lisa.Williams@hq.dhs.gov.

mailto:MedicalCredentialing@hq.dhs.gov mailto:MedicalCredentialing@hq.dhs.gov mailto:Lisa.Williams@hq.dhs.gov mailto:MedicalCredentialing@hq.dhs.gov mailto:medicalcredentialing@hq.dhs.gov mailto:medicalcredentialing@hq.dhs.gov mailto:medicalcredentialing@hq.dhs.gov mailto:Lisa.Williams@hq.dhs.gov

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5.3 EMPLOYEE IDENTIFICATION

Contractor employees working on-site at Government facilities shall wear a temporary Government issued identification badge. All Contractor employees shall identify themselves as Contractors when their status is not readily apparent (in meetings, when answering Government telephones, in e-mail messages, etc.) and display the government issued badge in plain view above the waist at all times.

Contractor’s employees who have terminated their employment with the Contractor must return their government issued badge to the USCIS Program Manager within 3 business days of their termination.

5.4 EMPLOYEE CONDUCT

Contractor’s employees shall comply with all applicable Government regulations, policies and procedures (e.g., fire, safety, sanitation, environmental protection, security, “off limits” areas when visiting or working at Government facilities). The Contractor shall ensure Contractor employees always present a professional appearance and that their conduct shall not reflect discredit on the United States or USCIS. The program manager shall ensure Contractor employees understand and abide by USCIS established rules, regulations and policies concerning safety and security.

5.5 REMOVING EMPLOYEES for MISCONDUCT or SECURITY REASONS

The Government may, at its sole discretion (via the Contracting Officer), direct the Contractor to remove any Contractor employee from USCIS facilities for misconduct or security reasons.

Removal does not relieve the Contractor of the responsibility to continue providing the services required under the contract. The Contracting Officer will provide the Contractor with a written explanation to support any request to remove an employee.

6.0 OTHER APPLICABLE CONDITIONS

6.1 SECURITY

Contractor access to classified information is not currently required under this SOW. See Attachment B- Security Requirements for information and requirements related to security.

6.2 PERIOD OF PERFORMANCE

The period of performance for this task order includes a 12-month base period and 4 twelve-month option periods.

Base Period: 9/30/2025 – 9/29/2026 Option Period 1: 9/30/2026 – 9/29/2027 Option Period 2: 9/30/2027 – 9/29/2028 Option Period 3: 9/30/2028 – 9/29/2029

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Option Period 4: 9/30/2029 – 9/29/2030

6.3 PLACE OF PERFORMANCE

The primary place of performance is a government facility located at 5900 Capital Gateway Drive, Camp Springs, MD 20529.

During times of early dismissal or building closures, remote work from home to support tele-health appointments as needed is authorized.

6.4 HOURS OF OPERATION

Contractor employees shall perform all work between the hours of 8am and 5pm EST, Monday through Friday (except Federal holidays).

6.5 KICK-OFF MEETING

No later than seven (7) business days after contract award, key members of the contractor’s staff who will be assigned major responsibility for carrying out the tasks of the contract shall meet with the Contracting Officer, Contracting Officer Representative (COR) and other interested government personnel within USCIS at a location to be determined at a later date. This meeting will ensure the Contractor, and the Government have a common understanding; in addition, they will discuss the project’s objectives, planned course of action, milestones and deliverables. The Contractor shall first conduct a briefing (i.e. 30–60 minutes) describing the firm’s planned approach. The Contractor shall be prepared with appropriate briefing materials.

6.6 MEDICAL EQUIPMENT AND SUPPLIES

The Contractor shall provide a list of medical equipment and necessary supplies to perform all tasks required in the SOW, which shall be furnished by USCIS. The Contractor shall notify the PM and COR at least 30 days in advance when additional supplies are required. This deliverable shall be submitted prior to the kick-off meeting.

7.0 GENERAL REPORT REQUIREMENTS

The Contractor shall provide all written reports in electronic format with read/write capability using applications that are compatible with DHS workstations (Windows XP and Microsoft Office Applications).

DELIVERABLES / MILESTONES AND DELIVERY SCHEDULE

7.1 Deliverables / Milestones

The contractor shall deliver those items to USCIS as outlined in the table below.

DELIVERABLE TITLE DUE DATE/ FREQUENCY RECEIVING

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PARTY(s) The Contractor shall provide a list of medical equipment and necessary supplies to perform all tasks required in the SOW

Initial list provided prior to kick-off meeting.

USCIS PM, COR

Contractor will provide monthly one hour health and wellness trainings either in person or a combination of in-person and virtual on topics related to the prevention of lifestyle illness, wellness and preventative services in consultation with the USCIS

PM.

Initial monthly topics for the first three months will be provided by the contractor and topic selection thereafter will be presented and confirmed with the USCIS PM.

USCIS PM

Submit quarterly and annual utilization reports.

See section 4.0 USCIS PM

Emergency Medical Services (EMS)/ Event Service Report

•Provide a report for all EMS services that require ambulance transport. The report shall be provided within five days after the services is provided.

•Written Narrative:

•Type of incident/ event service provided •Relevant background of incident/ event •Outcome

USCIS PM

The Contractor shall provide a list of medical equipment and necessary supplies to perform all tasks required in the SOW.

This deliverable shall be submitted prior to the kick-off meeting (see section 6.6)

USCIS PM, COR

Develop operational guidelines

Provide an operational guideline to outline Wellness Center operational overview.

Hard copy and electronic copy provided at kick-off meeting to

USCIS PM.

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8.0 PROTECTION OF INFORMATION

Contractor may hear information protected under the Privacy Act in the course of patient discussion. Contractor employees shall safeguard this information against unauthorized disclosure or dissemination in accordance with the law and Government policy and regulation.