14-Specifications and Requirements, GEN2130705B1, Occupational Medical Srvcs-Drug Alcohol Testing.docx

SPECIFICATIONS AND REQUIREMENTS

Occupational Medical Services/Drug & Alcohol Testing

1. PURPOSE: The purpose of the agreement is to contract a vendor to provide the County with general and special Occupational Medical Services and with Drug and Alcohol Testing Program Services. The County recognizes that the goal of its occupational health program is to detect any occupational medical conditions which would place Broward County employees at increased risk of health impairment from work exposures or work practices.

2. REGULATIONS: The occupational health services are provided to the County in accordance with requirements outlined in OSHA Regulations, National Institute on Drug Abuse (NIDA) regulations, the Omnibus Transportation Employee Testing Act of 1991 and U.S. Department of Transportation regulations, including but not limited to those promulgated by the Federal Transit Administration, the Federal Highway Administration, the National Highway Traffic Safety Administration, the Federal Aviation Administration, and the Florida Administrative Register and Florida Administrative Code Chapter 14-90, "Equipment and Operational Safety Standards for Bus Transit Systems." It should be noted that there are NIDA/DOT and NON-NIDA/DOT regulations that are to be adhered to in the contract.

3. OCCUPATIONAL HEALTH SERVICES: Vendor will provide occupational medical surveillance, epidemiological analyses, and occupational medical consultation, supplementing Broward County’s Risk Management Division in its efforts to anticipate, identify, evaluate, and control exposure to occupational hazards.

4. EPIDEMIOLOGICAL ANALYSES: Vendor will, on an annual basis, provide a retrospective epidemiological report appropriate to the time period, type of exam, employee population(s) and other factors which may provide useful information to the COUNTYS occupational health program. The content of such exam is left to the discretion of the VENDOR, in consultation with the COUNTY, and is intended to highlight trends, commonalities and statistically significant events or conditions.

5. EMPLOYMENT PHYSICALS: Employment physicals include, but are not limited to, occupational health questionnaires, swimmer’s certifications (See Attachment A), diver’s physical (See Attachment B), hands on examinations, blood work and assorted testing. The parties agree and acknowledge that the content of the occupational health examinations may vary depending on the anticipated hazards of the job. Therefore, the County agrees to assess the risk groups of various positions including essential job functions (where available) and provide such information to the Vendor. Vendor shall annually review occupational medical protocols to ensure standardization, precision and a sound match with employee exposure. Medical certificates issued shall meet standards outlined in the synopsis of medical standards listed in Exhibit A and preemployment physicals for bus operators must follow F.A.C. 14-90 preemployment physical guidelines listed in Exhibit C.

A. EXPANDED TESTING: Recognizing that the protocols developed for employee occupational health examinations will not meet the needs of all employment situations, Vendors may deem expanded testing to be required. Vendor shall refer employee to his/her Primary Care Physician (PCP).

B. Vendor must be capable of verifying employee weights up to 500lbs.

6. DRUG AND ALCOHOL SCREENS: The Vendor will provide drug and alcohol testing services and will perform all such testing services in full accordance with the U.S. Department of Transportation Regulation 49 CFR Part 40, "Procedures for Transportation Workplace Drug and Alcohol Testing Programs," Federal Transit Administration Regulation 49 CFR Part 655, "Prevention of Prohibited Drug Use and Alcohol Misuse in Transit Operations" and "Prevention of Alcohol Misuse in Transit Operations," Federal Highway Administration Regulation 49 CFR Part 382, 'Controlled Substance and Alcohol Use and Testing" respectively, and Florida Administrative Code Chapter 14-90, "Equipment and Operational Safety Standards for Bus Transit Systems".

A. All locations for collections of specimens shall conform to Section 2 and applicable regulations.

B. In the event of an accident requiring the transport of an employee who must be transported to a non-Vendor medical facility, the Vendor shall make all reasonable efforts to conduct drug and alcohol tests at the receiving facility. The County will notify the Vendor as soon as possible after the accident.

7. OCCUPATIONAL MEDICAL CONSULTATION: Vendor will, on an as-needed basis, function as an ad-hoc member of the County’s Risk Management staff, providing occupational medical advice with regard to occupational health issues.

8. SUBSTANCE ABUSE SERVICES: Vendor will provide breath, oral fluid, and urine specimen collection, and drug and alcohol testing services in accordance with Section 2, other applicable regulations and County policy. Such services shall include but are not limited to, provision of collection sites, Medical Review Officer services, laboratory services, and random drug and alcohol testing services.

9. FEES: All services will be provided by Vendor at the cost set forth in the Bid Sheet in this agreement.

10. RESULTS: Results of evaluations and testing shall be reported by Vendor to the County through its Human Resources representative located at 115 South Andrews Avenue, Fort Lauderdale, Florida. All results from employee evaluations and testing will be made available to the County within 3 business days or 72 hours of the Employee/Applicant’s appointment, via secure email to HRMSP@BROWARD.ORG of qualification sheet or through a secure digital format approved by the County. Vendor shall inform, in writing, all employees undergoing an occupational medical exam and/or substance abuse testing how to obtain a copy of their results in accordance with County policy and directives.

A. RESULTS: “Not Qualified” results of evaluations and testing shall be reported by the Vendor to County within 24 hours.

B. If Applicant/Employee is requested to provide additional documentation from their private Physician, the Applicant/Employee has three (3) business days in which to comply. If Applicant/Employee is non-compliant with this request, the Vendor shall deem Applicant/Employee “NOT QUALIFIED”.

C. DEPARTMENT OF TRANSPORTATION (DOT) POST-OFFER PRE-EMPLOYMENT RESULTS: Applicants must meet the medical standards for one (1) year or longer to be deemed “QUALIFIED” on a Post-Offer Pre-Employment Examination.

11. RECORDS: The results of all evaluations and testing conducted pursuant to this Agreement shall be provided to County by Vendor as specified in Section 10.

12. STORAGE: Vendor shall maintain all occupational medical records for County employees. Vendor will ensure security and retention of the records in accordance with all applicable laws. Furthermore, Vendor will preserve doctor-patient confidentiality according to the current Federal HIPAA laws and best management practices. Vendors shall forward to County, or designated Provider, all County employees’ occupational medical records no later than thirty (30) days after termination of this Agreement.

13. ACCESS: Vendor shall comply with all written requests from County employees requesting access to their medical records. Vendor shall allow access to a County employees’ medical records by employees’ designee(s), upon receiving employee’s written authorization to release such records to such designee(s).

14. HOURS OF SERVICE AND LOCATIONS

A. Vendor will provide occupational health, and the collection services described herein to County employees at a minimum of Three (3) Vendor physical locations, one centrally located in Broward County; one location in North Broward County and one location in South Broward County.

a. Broward County prefers two (2) Vendor locations of the three (3) physical Vendor locations to be between the Turnpike and US 1; one location North of Broward Blvd. and one location South of Broward Blvd.

b. Broward County prefers one (1) of the three (3) physical Vendor locations to be between the Turnpike and I75/Sawgrass Expressway south of Commercial Blvd north of Griffin Rd.

c. Broward County prefers one (1) vendor locations of the three (3) physical locations to host hours of operations from 7:00 am to 7:00 pm. Broward County prefers one (1) of the three (3) physical vendor locations to host a minimum of four (4) operational hours on each Saturday and Sunday.

The three (3) minimum locations are to be identified and submitted by the Vendor in the enclosed Exhibit B.

After award of the contract, the submitted location(s) may be subject to change, and additional location(s) may be requested and agreed to, in writing, by the County’s Contract Administrator and the Vendor.

B. MOBILE ON-SITE TESTING SERVICE: Vendor will provide an option for two (2) mobile on-site collection units at each of the County’s main locations (3201 West Copans Road, Pompano Beach, FL 33069; and 5440 Ravenswood Road, Fort Lauderdale, FL 33312) at a minimum of two 24-hour days per week to provide on-site collection for random or post-accident Crashworthiness Data System (CDS) testing in accordance with Section 2, Regulations, and all other applicable regulations.

(1) This pricing should be provided as an Alternate Item and for a daily flat rate.

(2) The anticipated number of samples that will be collected on-site weekly is estimated at a quantity of 10 – 20 but may vary. Vendors should account for this variance when submitting daily flat rate pricing and note that variance in total number of samples collected will not impact price.

C. A Vendor physician will be available to the County staff 24/7. Vendor physician shall be a Doctor of Medicine or Doctor of Osteopathy, refer to section 19, Staffing, for more information. Vendor will provide the County with a contact number for after-hours emergencies.

D. AFTER HOURS: For testing to be performed after business hours at one of the Vendor’s locations listed on the bid sheet, the County, through its Primary County Contact or his/her designee, shall call VENDOR's 24-hour telephone number provided in the Bid Sheet. Vendor's medical technician will speak to the Primary County Contact directly and inquire about the specific testing circumstances and decide which location would be most appropriate to meet to conduct the testing. The employee to be tested shall meet the qualified Vendor technician at the agreed-upon testing site, and testing shall be conducted in accordance with this Agreement, Section 2 and all applicable regulations.

A Vendor medical technician shall be available 24/7, must make every reasonable effort to respond to the County’s call within fifteen (15) minutes of the County’s call, and must take all steps reasonably necessary to ensure testing is accomplished in accordance with all applicable regulations.

15. Waiting Times: If the employee exam is not completed within one hour of the scheduled appointment, then the Vendor waives its fee for the visit unless Vendor can demonstrate to the County’s Contract Administrator’s satisfaction that there were extenuating circumstances beyond the Vendor's control. Vendor’s factual written description or explanation of the extenuating circumstances shall be provided to the County’s Safety and Occupational Health Manager or designee within five (5) days of occurrence. The determination by Contract Administrator on whether or not extenuating circumstances existed beyond Vendor’s control shall be final and binding on the parties.

A. Waiting Times: The Vendor shall see Employee/Applicant within 30 minutes of their appointment/arrival time for medical evaluations. All efforts will be made to see Employee/Applicant promptly. However, should an emergency occur, the Vendor will notify the County in an attempt to eliminate any undue waiting times.

16. SCHEDULING: All requested appointments shall be scheduled to occur within the time specified by the County.

17. OUT OF AREA: When a candidate(s) for County employment resides outside the tri-county area, Vendor agrees to coordinate post-offer occupational medical exams within a reasonable distance to the candidate’s place of residence. These exams should contain elements appropriate to the candidate's proposed job duties, as determined by the County.

A. Vendor agrees to coordinate with external providers, review external providers’ results and provide the County with results as described previously.

B. Vendor shall be responsible for making payments to the third-party occupational health providers. Payments made by Vendor to third-party occupational health providers shall be billed by Vendor to the County as specified in the Bid Sheet of this Agreement with no more than a fifteen percent (15%) markup above the actual cost of the exam as reflected on the external provider’s invoice. Copies of actual invoices for such services incurred shall be provided to the County with the monthly billing.

C. Vendor agrees that other facilities owned and/or managed outside the tri-county area and within reasonable distance to the applicant’s place of residence may be used to conduct post-offer occupational medical exams. Any Vendor facility used to conduct such exams will accepts fees as set forth in the Bid Sheet of this Agreement.

18. REFERRALS: The Vendor will notify the County in the event that an Employee/Applicant is referred to his/her PCP for any additional services.

19. STAFFING:

A. Vendor shall, at the Vendor’s Broward locations, have on FULL TIME STAFF the following personnel licensed or certified by the State of Florida:

Doctor of Medicine, OR Doctor of Osteopathy, and Physician Assistant, OR Advanced Registered Nurse Practitioner Vendor must possess Certifications and Licenses at time of bid and submit within three business days of County’s request.

The Vendor’s medical examiner(s) will be certified, registered, and remain compliant and up to date with the requirements of the National Registry of Certified Medical Examiner’s and Federal Motor Carrier Safety Administration (FMCSA). Proof of certification, registry, and updates to be provided to the County upon request.

B. MEDICAL REVIEW OFFICER: The Medical Review Officer (MRO) shall be a licensed physician who has knowledge of substance abuse disorders and has appropriate occupational medical training to interpret and evaluate the Employee/Applicant's confirmed positive result together with his or her occupational medical history and other relevant biomedical information. The MRO shall not be an employee, officer, director, partner, or proprietor of, nor have a financial interest either direct or indirect, in the lab used for drug screening analysis. The MRO shall be located in Broward County, Florida and available during all operating hours. The MRO shall appoint another qualified MRO in the event of his/her absence and notify in writing the Broward County contract administrator and Designated Employer Representative (DER).

C. The Vendor shall be staffed during all operating hours with an MRO, as well as qualified Breath Alcohol Technicians (BATS) and trained collectors who are proficient in conducting testing in accordance with Section 2 and applicable regulations.

20. SERVICE STANDARDS FOR DRUG AND/OR ALCOHOL TESTING:

A. The Vendor shall make all reasonable efforts to commence the required drug and/or alcohol testing within 30 minutes of arrival of an employee subject to such testing at the testing site. If testing does not commence within 30minutes of the employee's arrival, then the Vendor waives its testing fee for testing that employee, unless the Vendor can demonstrate to Contract Administrator's satisfaction that there were extenuating circumstances beyond the Vendor's control. Vendor's factual written description or explanation of the extenuating circumstances shall be provided to County's Safety and Occupational Health Manager, or designee, within five (5) days of occurrence. The determination by Contract Administrator on whether or not extenuating circumstances existed beyond Vendor's control shall be final and binding on the parties.

B. The Vendor shall immediately notify the County designee about an Employee/Applicant’s breath alcohol test result of 0.02 BAC or above. The Vendor representative shall convey to the employee the County’s instruction that the employee is not to drive upon departure but is to arrange alternative transportation.

C. The Vendor shall notify in writing the County Program Manager, or designee, of any positive drug screen results in accordance with Section 2 CFR Part 40, and applicable regulations.

D. The Vendor shall maintain records in accordance with federal regulations, and shall provide monthly, quarterly, and annual reports as requested by the Contract Administrator. The reports which are generated in order to fulfill Federal Regulatory reporting requirements must be provided on the forms prescribed in the regulations. All records are the property of the County and shall be submitted within ten (10) business days of request.

E. The Vendor shall be available 24/7 to report as needed to accident scenes, emergency collection site locations, and non-Vendor medical facilities for on-site random testing, when an accident prevents the employee from reporting to the Vendor testing site. Such staff shall have with them the necessary supplies and equipment to conduct drug and alcohol testing in accordance with Section 2 and applicable regulations.

F. The Vendor shall provide a list of all Breath Alcohol Technicians (BATS) who will perform services under this Agreement and will certify that those BATS have successfully completed training in operating the Evidential Breath Testing (EBT) device employed, and that the training has been determined by the National Highway Traffic Safety Administration (NHTSA) to be equivalent to the NHTSA Model Course. The list and certification required by this paragraph must be provided to the County prior to commencing alcohol testing services. Only such certified BATS may conduct alcohol testing pursuant to the Agreement. The certification must be updated as BATS or EBT devices or both are added or changed.

G. The Vendor shall use only EBT devices which are on the most current conforming products list issued by NHTSA. Further, the Vendor shall maintain and calibrate such equipment in accordance with the manufacturer's quality assurance plan and 49 CFR Part 40. In the event, an EBT device fails a calibration check, it shall be taken out of operation until serviced in accordance with the manufacturer's quality assurance plan and 49 CFR Part 40, and the County shall be notified.

H. NOTIFICATIONS: Immediate notification is defined as acknowledgment by the County designee of receipt of the test results, which then will be followed up by written documentation within 24 hours.

21. CERTIFICATIONS: Vendor’s proof of each collectors training must be provided to the County prior to commencing testing services. Upon the County’s request, the MRO must be available to testify concerning any dispute involving MRO services provided pursuant to this Agreement.

22. LABORATORY SERVICES:

A. The Vendor shall use only substance abuse analytical laboratories certified by the U.S. Department of Health and Human Services. Proof of such certifications shall be provided to the County prior to use of any laboratory pursuant to this Agreement. All such laboratories used by the Vendor shall have a quality control program in accordance with 49 CFR Part 40.

B. Vendor shall be responsible for assuring that laboratories performing other or additional analytical work maintain appropriate accreditation. Vendor shall provide the County with documentation of its laboratories’ current accreditation annually and prior to using any new laboratory.

C. Representatives of the County shall be entitled to visit, conduct periodic assessments, audit testing records on-site, and examine the Vendor’s facilities and laboratories performing services under this Agreement. Vendor is required to submit corrective action plan to remedy identified problems within ten (10) business days.

D. The Vendor shall administer a random testing program for all County employees subject to testing under Section 2, Regulations, standard NIDA/DOT and NON-NIDA/DOT regulations, and all applicable regulations. This shall include maintenance of separate testing pools, as requested by the County and required by law, randomly selecting dates and individual for testing, notifying the County in order to arrange for the employees to report to testing, and ensuring that the required percentage of each pool is randomly tested annually consistent with the Federal Regulations. The County will provide initial lists of covered employees and will provide updates to those lists as often as necessary as determined by the COUNTY. Within each pool there may be two separate random selections, one for controlled substance testing and another for alcohol testing.

23. REFUSAL TO TEST: Shy Bladder, failure to provide an adequate amount of saliva, and Shy Lung. The Vendor shall be knowledgeable of and following the procedures listed below:

i. 49 CFR Part 40, Section 193 – for situations in which an employee does not provide a sufficient amount of urine to permit a drug test (i.e., 45 mL of urine), also referred to as Shy Bladder;

ii. 49 CFR Part 40, Section 263 – for situations in which an employee is unable to provide sufficient saliva to complete a test on a saliva screening device (e.g., the employee does not provide sufficient saliva to activate the device) and;

iii. 49 CFR Part 40, Section 265 – for situations in which an employee does not provide a sufficient amount of breath to permit a valid breath test, also referred to as Shy Lung.

The MRO, BAT/STT (Screening Test Technician) and/or Collector shall immediately notify the Designated Employer Representative (DER) by any means (e.g., phone or secure fax) that ensures that the refusal notification has been immediately received. The DER, upon notification that an employee has not provided a sufficient amount of breath, saliva or specimen, will consult with the MRO, and direct the employee to obtain, within 5 days, an evaluation from a license physician, acceptable to the MRO, who has expertise in the medical issues raised by the employee’s failure to provide a sufficient amount of breath, saliva or specimen. (The MRO may perform this evaluation if the MRO has an appropriate expertise). Upon completion of the evaluation, the MRO shall immediately report his or her conclusions to the DER in writing.

24. SUPPLIES: The Vendor shall provide all necessary supplies (including but not limited to, chain of custody and reporting forms, and collection supplies), equipment, and facilities necessary to the provision of services pursuant to the Agreement.

A. The Vendor shall provide all necessary supplies for respiratory fit testing (including but not limited to, approved disposable respirators, fit-test probe kits, alcohol wipes), equipment, supplies, and facilities necessary to the provision of services pursuant to this Agreement.

25. INVOICE REQUIREMENTS:

A. Vendor must ensure all invoices contain, at a minimum, the following:

a. Date of Invoice

b. Invoice Number

c. Current and valid County purchase order number (“PO#”), if applicable

d. The date and type specimen drawn

e. Contract line number and Description of test Cost for each test

B. Invoices shall be submitted in excel spreadsheet format.

C. Payment will be made by the County after products/services have been received, accepted, and properly invoiced. Failure to provide proper invoice(s) may cause payment delays.