11-RLI 25004JD Questionnaire - FINAL.pdf

RLI # 25004JD | PRE-EMPLOYMENT MEDICAL EXAM AND DRUG TESTING FOR BSO APPLICANTS

QUESTION/REQUEST

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

Can your firm guarantee a waiting time that does not exceed 30 minutes (from the arrival time) for Pre-employment medical and drug testing?

How many certified licenses physicians in your office are

Medical Review Officers?

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

What is the estimated time for

Pre- Employment medical examinations and drug tests results to be available for the agency?

Do you currently perform

Independent Medical

Examinations (IME) in conjunction with Workers’

Compensation evaluations?

Do you currently perform ADA

(American with Disabilities Act)-related physicals for any agencies?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

What is the estimated time for written Fitness for Duty results, including a return to work assessment, to be provided?

What is the estimated time for written Clarification of Medical

Certification results to be provided?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

Does your facility have access to a secure portal (password protected) for BSO to retrieve medical exam and drug testing results?

Do your physicians currently handle Fitness for Duty

Examinations for other employers? If yes, how long have you been providing this service?

Do your physicians currently handle Clarification of Medical

Certifications for other employers? If yes, how long have you need providing this service?

DRUG TESTING – Please provide responses to the following general questions.

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

Can your firm guarantee a waiting time that does not exceed 20 minutes (from the arrival time) for random drug testing?

Can your facility administer

Hepatitis B Vaccines?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

Is your firm open for business

7 days a week/ 24 hours, including holidays?

List your days of operation, number of locations, complete location addresses and hours of operation for Pre-

Employment Drug Testing and

Random Drug Testing.

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

On a confirmed drug test, does your reporting structure allow for details on requisite specificity, sensitivity and quantitative accuracy?

Do you have an on-call policy?

If so, what is the response time outlined in your policy?

Per Section 3.6.3.2.3.4. Please advise if your firm can provide a primary and after-hours

Certified Collector and/or a

Breath Alcohol Technician at a designated NIDA collection location within two (2) hours of request from BSO?

Does your facility perform the second analytical method (split specimen) test from a specimen that was positive on initial screening?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

Do you have facilities available operational at 6:00 AM to process random drug testing?

Is your facility capable of performing Phosphatidylethanol

(PEth) Testing?

As specified in Section

3.6.2.3.5.1.1, is your facility capable of performing Fourteen

(14) Panel Drug Screen testing?

What is your average time to provide electronic results for random drug testing?

Is your facility capable of performing steroid drug testing?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

Is your facility capable of performing Audiometric

Testing?

26 Is your facility capable of performing Zinc Testing?

Is your facility capable of performing Lead

Testing?

Do you have a certified collector to perform on-site collection at a pre- determined

BSO location?

27 Can your facility perform alcohol testing?

*YES,

Proposer currently provides.

***Indicate under response/explanation how

Proposer meets this criteria.*

*NO,

Proposer does not currently provide.

***Indicate under response/explanation how

Proposer can meet this criteria.*

RESPONSE/EXPLANATION

RLI 25004JD | PROPOSAL QUESTIONNAIRE AND CHECKLIST

If your response exceeds the maximum number of characters accepted, upload a separate document titled RLI 25004JD | Proposal Questionaire and Checklist. List the question number, restate the question, and provide the supplemental information and or detailed response.

Additional items uploaded shoud refer to the corresponding number within the Questionaire.

*** Please note that ALL responses to this Questionnaire will form part of the Proposer's Submittal for Scope of Services. The Selection Committee will review these responses, and they may, at BSO's discretion, be incorporated into the contract for services. ***

MEDICAL EXAM / MEDICAL CERTIFICATION – Please provide responses to the following general questions.

List Chain of Custody handling procedures currently in place that provide accountability for specimens at each stage of the handling, testing, and storing process. Do you have written policies that can be provided to

BSO?

Do you have the capable software that will allow you to generate an electronic random list of names and CCN #’s based on data provided by BSO? Yes or No.

Please explain in detail briefly.