Attachment 0005 - PWS 05 RFAAP Occupational Health.pdf

DRAFT

RADFORD ARMY AMMUNITION PLANT

PERFORMANCE WORK STATEMENT (PWS)

PWS – 5: OCCUPATIONAL HEALTH

1. OBJECTIVE: The Contractor shall maintain and operate an occupational health, Industrial Hygiene (IH), and safety program in accordance with (IAW) applicable Army, Federal, State, and Local regulations. The Contractor shall provide all legally required occupational health related care to Contractor employees and subcontractor employees located on the installation. The Contractor shall support audits, inspections, or information requests as required by the government.

2. LEGAL APPLICABILITY OF STANDARDS: The Contractor and its employees shall comply with the federal regulatory standards distributed by Occupational Safety and Health Administration (OSHA) in Title 29, Code of Federal Regulations at all nonmilitary-unique operations and workplaces, and with regulatory requirements of part 20 of Title 10, CFR, part 1040 and sections

1040.10 and 1040.11 of Title 21, CFR, IAW DA PAM 40-503.

2.1. The Contractor shall submit an annual certification statement verifying they are complying with Federal, State, and local statutes and regulations, directives, and guidance governing occupational and environmental health per Army Regulation 385-10, Chapter 2, Responsibilities (CDRL A05-01).

3. EXPOSURE STANDARDS: The (OSHA) Permissible Exposure Limits (PEL) shall be used as exposure standards except where the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLVs) are more stringent. Exposure standards and criteria will be used to determine the need for medical monitoring, occupational health screening and the need for protective equipment and/or reducing the exposure through design engineering.

The Contractor shall provide results of direct monitoring to the Medical Director who shall establish the appropriate bio-surveillance program for affected employees and subcontractors of any discovered occupational or environmental exposure risk. The Contractor shall, as described in DA PAM 40-11, paragraph 5, be transparent when communicating the risk of chemical, physical, biological, and radiological exposure to government employees and inspectors who enter the contractor-operated workspaces. The contractor will follow OSHA standards for reporting of monitoring results.

3.1. The goal is to protect workers from known and emerging hazards as determined from the best science available. The exposure standards, as defined above, define when an exposure is significant enough to warrant continued medical surveillance, appropriate medical monitoring, and worker protection methods. Elimination of the hazard through improved design engineering is always the preferred hazard reduction method, but it is recognized that this is not always feasible. When that is the case, approved administrative and personal protective measures shall be used.

4. CLINICAL QUALITY MANAGEMENT PROGRAM (CQMP): Occupational Health programs (The Program) delivering health care shall establish and maintain a CQMP per Title 5, CFR, Parts 293 and 339 (CDRL A05-02). Program elements which shall be addressed in the CQMP are listed below:

4.1. The Program that delivers health care shall have a Medical Director with the degree of M.D. or D.O., who is currently licensed to practice medicine in the State, is board certified in a medical discipline, and has at least 5 years of experience in an occupational medicine physician position or training in Occupational Medicine equivalent to phase 1 and 2 of the Fundamentals of Occupational Medicine Course, 6H-F20.

4.2. The Program shall establish and maintain Medical Directives and/or Standard Operating Procedures (SOPs) that shall be reviewed and updated annually by the Medical Director. These Directives and/or SOPs shall cover at a minimum:

• A peer review process for all providers at a minimum rate of 10 encounters per quarter or more if required by State Law. A peer is defined as someone from the same professional discipline/specialty as the individual undergoing review.

• System(s) for ensuring appropriate credentialing/certification and licensure for medical providers.

• System(s) for ensuring that medical equipment is properly maintained and calibrated.

• All clinical staff providing patient care shall maintain appropriate professional certification, licensure, credentialing and privileging, and training requirements.

• Medication inventory and reconciliation, storage, security, and dispensing.

• Protocols for treatment by non-physician providers.

• Bio-surveillance protocols tailored to specific exposures IAW OSHA PELs and ACGIH TLVs, whichever is more stringent, which are described in DODI 6055.05-M, Occupational Medical Examination and Surveillance.

• Fitness for duty exams, pre-placement, periodic, and termination exams, and employer notification procedures for accommodations.

• Medical records management and privacy and security of patient records IAW Title 5, CFR, part 297, Privacy Act of 1974.

• Urgent care protocols for job-related illness and injury to include procedures for activating emergency services.

• Hearing Conservation Program protocols IAW 49 CFR 227 and 29 CFR 1910.95.

• Vision Conservation Program protocols IAW 29 CFR 1910.133

• Respiratory Protection Program protocols IAW 29 CFR 1910.134.

• Infection Control/Bloodborne Pathogen Program protocols IAW 29 CFR 1910.1030.

4.3. Drug testing shall be performed IAW all Federal, Department of Transportation (DOT) 49 CFR Part 40, and State requirements. A trained and U.S. DOT certified Medical Review Officer, who is a licensed physician knowledgeable in substance abuse disorders and drug testing procedures, shall interpret and evaluate all positive drug test results. The Occupational Health Physician may perform this duty, if certified, or it may be contracted to another qualified party.

4.4 Government Safety Staff shall be given unrestricted read only access to review the Operating Contractor/subcontractor databases, archived records, and information repositories of all data related to past and present RFAAP / NRU Operations related to PWS 1 thru 18. Access includes, but is not limited to blueprints, drawings, operating procedures, maintenance procedures, management manuals, reports, letter log/correspondence files, and plant protection standards. Hard copies and/or electronic copies shall be made available upon request.

5. Government Provided Vaccines: Contractor employees, subcontractors and tenants performing or supporting DoD operations of the Radford Army Ammunition Plant under the facility use contract are permitted to receive government provided vaccines.

6. INDUSTRIAL HYGIENE (IH): The services of an Industrial Hygienist shall be used to evaluate and monitor workplace exposure hazard. An Industrial Hygienist is a person who has, at a minimum, the following educational qualifications: four year Bachelor’s Degree from a regionally-accredited college or university in

Biology, Chemistry, Physics, or Engineering; or a four year Bachelor’s Degree in IH or Safety from an Accreditation Board for Engineering and Technology (ABET) accredited college or university; or with at least 60 semester hours of science, math, engineering, or science-based technology (15 hours at the junior, senior, or graduate level). The Industrial Hygienist shall be currently or actively pursuing certification as a Certified Industrial Hygienist (CIH) through the Board for Global EHS Credentialing, or currently or actively pursuing certification as an Occupational Hygiene and Safety Technician (OHST) through the Board of Certified Safety Professionals. The CIH/OHST requirement shall be obtained within 5 years of hiring/contracting an Industrial Hygienist. Such training shall have qualifying experiences that involve the recognition, evaluation, corrective actions, and elimination of environmental conditions in the workplace that causes sickness, impaired health, or illness. This experience shall demonstrate a professional knowledge of the theory and application of the principles of industrial hygiene and closely related sciences such as physics and engineering controls.

Such work shall have involved experience in all of the following areas: the acquisition of quantitative and qualitative data and the measurement of exposures for a variety of chemical, physical, and biological stresses; the analysis of the data acquired and the prediction of probable effects of exposures on the health and well-being of workers; and the selection and recommendation of appropriate controls, including management, medical, engineering, education or training, and personal protective equipment per DOD 6055.05-M; Army Regulation 385-10, Chapter 2; 29 CFR Part 1910; 29 CFR Part 1926 (CDRL A5– 03).

6.1. Industrial hygienists shall conduct comprehensive evaluations of all potential health hazards in each workplace and ancillary facilities NLT 6 months after operational control. Should working conditions change or a new process implemented, the Contractor shall have 30 days to ensure that workers are not exposed to recognized physical, chemical, or biological hazards that could cause death or illness (29 CFR 1910). For each health hazard in each workplace, a professional judgment shall be made as to the health risk associated with its use.

In many cases, this judgment can be made by reviewing the chemical and physical characteristics of a material and the way it is being used. In certain instances, sampling may be necessary to ascertain potential exposures.

Regardless of the techniques used, the result shall be a definite determination as to the presence, absence, or degree of health hazard from the use of that chemical, biological, or physical agent. Only industrial hygienists, qualified occupational health personnel, or technicians under the supervision of industrial hygienists, shall perform those workplace evaluations. Monitoring shall meet the requirements of applicable OSHA standards or approved DoD alternate or supplemental standards. Affected DoD personnel or civilian employee representatives shall be advised of the monitoring procedures and have access to the results.

6.2. The results of those efforts should form the basis for an overall assessment of the health hazards in each workplace. This assessment can be used to assign priorities for abatement actions, to schedule future surveys, to require personal protective equipment, and to provide a basis for determining the requirement and scope of periodic medical surveillance of workers.

7. KPI Tracking:

7.1 In addition to any KPIs specified in this PWS, the Contractor shall identify a minimum of three (3) KPIs that measure performance, effectiveness, timeliness, and/or efficiency of Occupational Health efforts at RFAAP. These additional KPIs shall be included in a PWS 5 KPI report (INSERT CDRL). The initial submission shall be submitted to the Government for approval 30 calendar days after transitioning as the Operating Contractor and monthly thereafter.

7.2 The Contractor shall define the calculation method for each KPI and any sub- KPIs in the first submission of the PWS 5 KPI report ACA for Government approval.

7.3 The PWS 5 KPI Report shall provide targets for improvement for each KPI, with justification as to why the target was determined. Targets may be based on industry standards or baseline data acquired in the first quarter of performance tracking. Targets may be adjusted on an annual basis or sooner, if necessary, with Government approval.

7.4 When KPIs are trending negative or consistently below target (for at least three consecutive months), the Contractor shall provide a plan or strategy adjustment to work back towards the target. The plan and/or strategy shall include details on actions to be performed, timeline for improvement and personnel responsible to achieve the target.

7.5 While the government reserves the right to assess contractor compliance with specific requirements of this PWS, the primary measure of the contractor’s success in performing the PWS will be determined by KPI goal attainment.