A.02 PWS (Expanded) (26-Q-4001).pdf

5.0 Requirements: The contractor shall: provide job-related medical surveillance examinations and occupational health services to approximately 70 Wyoming Army National Guard full-time support and temporary personnel who are potentially exposed to health hazards in the work environment or who are assigned to positions requiring specific standards of physical fitness.

5.1 Medical Surveillance Examination/ Occupational Health services:

5.1.1 Physical Examination/Assessment/Consultation. Physical examination, assessment and consultation to be performed by a Board Certified Occupational Health Physician (Preferred) or a Physician’s Assistant.

5.1.2 Examination to include assessment of individual's work/health history, current occupational exposure, pulmonary, cardiovascular, gastrointestinal, neurological, dermatological and related systems associated with exposures.

5.1.3 Based on individual's current job description and medical evaluation, the contract physician must submit a written summary of employee's health status, recommendations to the employer regarding any physical limitations/restrictions, additional monitoring, follow-up and or referral.

5.1.4 The contract physician must obtain approval from the Wyoming Army National Guard COR prior to performing exams/testing outside the scope of this contract.

5.2 Medical Record Keeping:

5.2.1 Employee Medical Records. The Wyoming Army National Guard COR will ensure individual medical records are available at each site for review by the contact physician.

5.2.2 Supplemental Forms. Employees will be instructed to complete all supplemental forms provided by the contractor, including a form for signature/consent and Privacy Act Statement.

5.2.3 Contract Medical Records. At a minimum, all medical records are to be identified by the contractor with the employee's name, social security number, and gender.

5.3 Exams

The numbers below are estimates. We reserve the right to adjust what exams are administered based on the exams listed below. Only the COR can authorize what exams are provided to the patients.

Estimated for April/May 2026 (Initial)

Physical

Exam Vision Exam

Chem 20 Lab

Tests

Blood Lead, ZPP, Cadmium, CHRO

(Heavy Metals)

Pulmonary Function

Test (when individual identified)

Chest Xray (as needed)

FIT

Testing

Number of exams

Required 70 70 70 1 50 0

Estimated for Option Year 1

Vision Exam

Chem 20 Lab

Tests

Blood Lead, ZPP, Cadmium, CHRO

(Heavy Metals)

Pulmonary Function

Test (when individual identified)

Chest

Number of

Estimated for Option Year 2

Vision Exam

Chem 20 Lab

Tests

Blood Lead, ZPP, Cadmium, CHRO

(Heavy Metals)

Pulmonary Function

Test (when individual identified)

Chest

Number of

Estimated for Option Year 3

Vision Exam

Chem 20 Lab

Tests

Blood Lead, ZPP, Cadmium, CHRO

(Heavy Metals)

Pulmonary Function

Test (when individual identified)

Chest

Number of

Estimated for Option Year 4

Vision Exam

Chem 20 Lab

Tests

Blood Lead, ZPP, Cadmium, CHRO

(Heavy Metals)

Pulmonary Function

Test (when individual identified)

Chest

Number of

5.3.1 Physical Exam:

5.3.1.1 Vitals: Contractor will provide vital signs to include height, weight, blood pressure, pulse and respirations for all scheduled Government personnel.

5.3.1.2 Job Function Analysis: Contractors will provide a Job Functional Analysis or KrausWeber that includes back strength and flexibility for all scheduled Government personnel. Note any pain or recommended lifting limitations if less than 50 lbs.

5.3.1.3 Dermatological Examinations: Contractor shall ensure dermatological examinations are performed on all scheduled Government personnel. Examinations must be performed by a physician and include an inspection of the entire integumentary system with emphasis on areas most likely to be affected by the employee’s occupational (i.e. radiation) exposures. Documentation will include the presence of any dermatomes or lesion of the skin.

5.3.2 Vision Exam:

5.3.2.1 Vision Screenings: Contractor will ensure that vision screenings are in accordance with DA PAM 40-506 using multiphasic vision screening equipment to measure the following primary skills.

5.3.2.2 Visual acuity for distance and near

5.3.2.3 Lateral phorias for distance and near

5.3.2.4 Vertical phorias for distance and near

5.3.2.5 Depth perception

5.3.2.6 Color perception

5.3.2.7 Peripheral vision

5.3.3 Reserved Hearing

5.3.4 Pulmonary Function Test (when individuals identified)

5.3.4.1 Contractor shall ensure Pulmonary Function Tests (PFTs) Performed by a licensed physician, Certified Pulmonary Functional Technologist, or Registered Respiratory therapist in accordance with 29 CFR 1910.1001. Contractor will provide quantitative fit test in accordance with 29 CFR 1910.134 appendix A.

5.3.4.2 Screenings will only be conducted on employees exposed to respiratory hazards that will require a respirator to mitigate their hazards that are above the action level.

5.3.4.3 Respiratory Evaluation and Respirator Fit testing. Quantitative and Qualitative Respirator fit testing will be conducted on each individual with their own personal respirator. Testing using surrogate respirators will not be accepted.

5.3.4.4 Test will include as a minimum Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), comparison with recognized normal’ s for the individual’s height and weight, sex, race, age and a documented interpretation by a pulmonologist or certified Occupational Health physician.

5.3.4.5.0 Follow NIOSH and ATS-ERS standard requirements:

5.3.4.5.1 Continue testing individual when the patient is improving until improvement is <30ml.

5.3.4.5.2 Test results are acceptable with a minimum if three acceptable maneuvers that are free from a leak, obstructed mouthpiece, hesitation, false starts, cough, glottis closure, early termination, and have a good curve of at least 6 seconds duration.

5.3.4.5.3 Test results are reproducible in that they have the same result from the individual (two largest FVCs are within 0.150 L of each other and two largest FEV1’s are within 0.150 L of each other) when the test is repeated several times. Testing is continued until criteria are met or 8 trials are attempted, or the employee being tested cannot or should not continue.

5.3.4.5.4 If three (3) acceptable and two (2) repeatable tests cannot be obtained, the technician performing the PFT must document the reason the standard could not be met.

5.3.4.5.5 Always use measured height not reported height by the nearest half inch without footwear.

5.3.4.5.6 Always indicate source of reference value on the report by the nearest half inch without footwear.

5.3.4.5.7 No smoking within 1 hour prior.

5.3.4.5.8 No cold, flu or allergies within two weeks.

5.3.4.5.9 No inhaler use prior to test that would still be in the patient’s system.

5.3.4.6 Specifications regarding equipment guidelines and calibration, test administration, and test interpretation must meet applicable OSHA and ANSI standards.

Supporting documentation will be provided to this office daily or annually depending on manufacturing guidelines or spirometer.

5.3.4.7 Respiratory clearance documented and a copy given to employee at time of visit.

5.3.4.8 Test Results/Patient Disposition:

5.3.4.8.1 The contractor will ensure that all copies of the test results and any written recommendations are provided to the Wyoming Army National Guard COR for proper disposition (e.g., placement in the individual's health records). Each patient will have a separate sheet i.e. no grouping results in a book format with multiple patients data on the same page. The Wyoming Army National Guard COR will be responsible for the final disposition of all employees requiring additional follow-up monitoring audiometry, audiologic and/or otologic examinations.

5.4 CHEM 20 Lab Tests

5.4.1 Contractor shall ensure laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology. The supporting laboratory will provide employee instruction and equipment necessary for tests requiring special methods and/or containers. Document that employee has been counseled by examining provider about laboratory results. Provide a copy lab results to employee for their primary care physician. Fasting is required.

Tests include:

5.4.1.1 Lab Analysis:

a) Occ Health Profile (Bundle: CBC, liver function test, BUN, Creatinine, Urinalysis) Each

b) CBC (HGB, HCT, WBC, MCV, MCH, MCHC) with diff Each

c) CBC (HGB, HCT, WBC, MCV, MCH, MCHC) without diff Each

d) Liver Function Test (AST, ALT, ALB, ALK PHOS, dBil, TBil, Protein) Each

e) BUN /Creatinine Each

f) Urinalysis with Micro Each

g) Urinalysis without Micro Each

h) Blood Glucose Each

5.5 Blood Lead, ZPP, Cadmium, CHRO (Heavy Metals)

a) Cadmium Profile (Per Lab Corp)

b) Human Chorionic Gonadotropin HCG beta

c) Chromium (Blood)

d) Lead, industrial whole blood

e) ZPP, Blood Protoporphyrins, zinc

5.5.1 Contractor shall ensure laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology. The supporting laboratory will provide employee instruction and equipment necessary for tests requiring special methods and/or containers. Document that employee has been counseled by examining provider about laboratory results. Provide a copy lab results to employee for their primary care physician. Fasting is required.

Tests include:

5.5.1.1 Lab Analysis:

(1) Blood Lead/ZPP

(2) Heavy metals, Chromium 3 and Chromium 6. Chromium 3 & 6 levels must be reported on the lab analysis for each employee, regardless of measurable detectable level.

5.6 Contractor Manpower Reporting Application (CMRA):

5.6.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Wyoming Army National Guard via a secure data collection site.

5.6.2 The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2018. Contractors may direct questions to the help desk at http://www.ecmra.mil.

http://www.ecmra.mil/ http://www.ecmra.mil/

TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS)

This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

Performance Objective

Performance Standard Acceptable Quality Levels (AQL)

Surveillance Method / By Whom

5.1.1 The contractor shall

provide a Board Certified Occupational

Health Physician (Preferred) or

Physician’s Assistant.

The contractor provided a board certified occupational health physician (preferred) or physician’s assistant

Deviation from COHP or PA must be cleared with

OccHealth Nurse prior to conducting exams.

Provide licensure

On time performance Contractor will adhere to military technician schedule of 0700 MST start time.

Completion of the day will be based on the last patient seen by provider.

Acceptable 5 minute late start times.

COR

TECHNICAL EXHIBIT 1

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

5.1.3 submit a written summary of employee's health status, recommendations to the employer regarding any physical limitations/restrictions, additional monitoring, follow-up and or referral

Upon completion of medical surveillance exam, the contractor will submit within fifteen (15) working days

1 Paper Safety Specialist / Government

5.3.4.7 Respiratory

clearance documented and a copy given to employee

At time of visit. 1 Paper Employee receiving pulmonary test

5.3.4.8.1 Copies of

the test results and any written recommendations

Provide within 20 calendar days after employee completes surveillance exam

1 Paper Safety Specialist / Government