A23_RFQ_Attachment_1_-_Statement_of_Work.pdf

RFQ ATTACHMENT #1

PUBLIC SAFETY OFFICERS' BENEFITS (PSOB) OFFICE

BUREAU OF JUSTICE ASSISTANCE

PUBLIC SAFETY OFFICER'S BENEFITS PROGRAM INDEPENDENT

MEDICAL EXAMINATION (IME) SERVICES

STATEMENT OF WORK

1. INTRODUCTION

Enacted in 1976, the Public Safety Officers' Benefits (PSOB) Act assists in the recruitment and retention of qualified public safety officers in America; establishes the value communities place on the contributions of those who are willing to serve their communities in potentially dangerous circumstances; and offers peace of mind to men and women seeking careers in public safety. A unique effort of the US Department of Justice; local, state, tribal, and federal public safety agencies; and national organizations, PSOB provides benefits including death, educational assistance, and disability to those eligible for the Program.

The PSOB Office at the Bureau of Justice Assistance (BJA), Office of Justice Programs (OJP), US Department of Justice is responsible for implementing the PSOB Program. In addition to reviewing and processing more than 1,000 cases each year, the Office works with national law enforcement, firefighter, and other first responder groups, educating public safety agencies regarding the Program and offering support to families and colleagues of fallen law enforcement officers, firefighters, and other first responders. Additionally, PSOB appeals, at the Hearing Officer, BJA Director, and U.S. Court of Appeals for the Federal Circuit level have reached unprecedented numbers.

2. SCOPE

The Contractor shall secure the services of a licensed Medical Specialists in order to provide the PSOB Office with a formal written report of the medical findings and conclusions regarding the public safety officer's injury and/or death. Because death claims may require medical determinations, BJA may submit such claims to the Medical Specialist for an expert medicolegal review prior to determining whether or not a public safety officer's death is compensable under the PSOB Act.

BJA will make the final administrative determination for each death or disability claim as to whether a PSOB benefit is to be paid.

For death and disability claims, based on specific case information provided by the PSOB Office, the Medical Specialist will review the public safety officer's medical profile which will include the medical records that resulted in a line of duty injury and / or death. BJA may also submit medical evidence, testimony, and other information provided at the appeal level on death or disability claims to the Medical Specialist for expert medicolegal review. The Medical Specialist agrees not to disclose the medical opinion or release any medical records or information pertaining to PSOB cases to anyone other than the representatives of the PSOB Program. Medical Specialists may conduct research and draft documents and memoranda related to the PSOB Program, law, regulations, and related issues as requested by the BJA Director.

All Medical Specialists will complete a review of the relevant PSOB law and regulations as provided by the PSOB Office.

The work shall be performed on an as needed basis, however the estimated volume of these programs, per fiscal year, is as follows: Death: 350 claims; Disability: 100 claims.

The PSOB Act and Regulations are available online at https://psob.bja.ojp.gov/law-and-regulations/.

3. TASKS

The Contractor shall provide the following Independent Medical Examination services including:

TASK AREA 1 - Record Reviews:

The Contractor shall review all medical and medical-related records provided by the claimant, physicians, and/or representative(s). A Record Review generally takes 4 hours of service under Medicare CPT (Current Procedural Terminology) / HCPCS (Healthcare Common Procedure Coding System) Code 99358 "Prolonged Evaluation and

Management Service before and/or after Direct Patient Care", and is performed by either a General Physician or a Neurologist.

TASK AREA 2 - Independent Medical Examinations:

The Contractor shall review all medical records as well as conduct an in-person examination (at an agreed upon location between the medical specialist and the claimant) of a claimant. The location shall be accessible and conducted within a reasonable distance to the claimant. An Independent Medical Examination generally takes 4 to 5 hours of service under Medicare CPT/HCPCS Code 99455 "Work-Related or Medical Disability Evaluation Services", and is performed by either a General Physician or a Neurologist.

TASK AREA 3 - Vocational Assessments:

The Contractor shall provide in-person examinations, at an agreed upon location between the medical specialist and the claimant, which assesses whether or not a claimant is able to perform any type of gainful work. A Vocational Assessment generally takes 2 to 3 hours of service under Medicare CPT/HCPCS Code H2014 "Skills Training and Development", and is performed by either a General Physician or a Neurologist.

TASK AREA 4 - Functional Capacity Examinations:

The Contractor shall provide in-person examinations (or review of the records) at an agreed upon location between the medical specialist and the claimant, which determines if claimant is able to function or perform in everyday life need(s).

A Functional Capacity Examination generally takes 4 hours of service under Medicare CPT/HCPCS Code 97750 "Physical Medicine and Rehabilitation Tests and Measurements", and is performed by a General Physician, an ENT (Ear, Nose, and Throat Specialist Doctor, or a Rheumatologist.

TASK AREA 5 - Legal Nurse Reviews:

The Contractor shall provide reviews of all medical records by a licensed legal nurse. A Legal Nurse Review generally takes 1 to 2 hours of service under Medicare CPT/HCPCS Code G0299 "Direct Skilled Nursing Services of a Registered Nurse (RN)".

TASK AREA 6 - Psychological Testing:

The Contractor shall perform psychological testing at an agreed upon location between the licensed psychologist / psychiatrist and the claimant, which assesses whether or not a claimant is able to perform any type of gainful work. A Psychological test generally takes 2 hours of service under Medicare CPT/HCPCS Code 90791 "Psychological Diagnostic Evaluation", and is performed by either a licensed Psychologist or a licensed Psychiatrist.

TASK AREA 7 - Medical Diagnostic Testing by Current Procedural Terminology (CPT) costs:

The Contractor shall perform medical diagnostic testing at an agreed upon location between the licensed medical practitioner and the claimant. A Medical Diagnostic Test carries with it a less specific determination of the type of test performed, and is to be considered a 1 unit hour of service under the Medicare CPT/HCPCS Code which best matches the type of testing performed. This service is provided by the type of doctor both available and approved to provide services by the COR on a case-by-case basis.

Deliver electronic medical reports to the PSOB Director, COR and the Point of Contact identified by the COR.

4. QUALIFICATIONS

Medical Specialists must have a medical degree from an accredited medical school and be certified by an appropriate medical board in one of the following specialties or subspecialty: forensic pathology, orthopedics, neurology, psychology, psychiatry, pulmonology, cardiology, internal medicine, or other specialty or subspecialty as required by BJA. All doctors shall submit their resumes or curricula vitae indicating such qualifications to BJA prior to the IME or record review.

Medical Specialists will participate in all required training related to their appointment, and will maintain a working knowledge of the PSOB Act and its implementing regulations.

5. TECHNICAL REQUIREMENTS

All communication regarding a claim, including any communication between the Medical Specialist and Claimant (or Claimants' representatives), will be processed through BJA. All requests for information made to the Medical Specialist from Claimants (or Claimants' representatives) or from any third party will be referred back to BJA by email to the COR and PSOB Director.

Claim information, while in the possession of the Medical Specialist, shall be treated as Privacy Act information under the administrative management of BJA, and/or as protected health information under 45 C.F.R. Part 164. The Medical Specialist shall ensure, by use of appropriate provisions, to safeguard the information pursuant to the standards for Privacy Act and protected health information.

When a death or disability claim is denied, the Claimant has the right to an administrative and judicial appeal, according to PSOB's implementing regulations. On appeal, the Claimant has the right to present new evidence or testimony in support of the original claim. At the request of BJA, the Medical Specialist will review information presented through the appeal process and issue written findings.

6. DELIVERABLES AND DELIVERY SCHEDULE

Upon completion of the IME, the Contractor shall provide the PSOB Office with the medical specialist's written medical evaluation within 30 days after the initial examination. Upon completion of a record review of a death claim, the Contractor shall provide the PSOB Office with the medical specialist's written medical analysis within 30 days of the case review, unless otherwise specified. The Contractor must ensure that all written reports contain the correct grammar, accuracy in the identification of proper names and places, and to ensure that the record is discernible. Financial reports are required in accordance with OJP 2852.242-74 "REPORTS".

7. TRAVEL

Travel costs are to be paid under this order in accordance with Federal Travel Regulations. Local travel is included in travel costs with the exception of meals and per diem.

8. PERIOD OF PERFORMANCE

The period of performance shall be comprised of a one (1) twelve (12) month base period and four (4) twelve (12) month option periods.

9. SECURITY

Contractor will comply with all required security. All personnel must be United States Citizens and meet the DOJ Residency Requirement. The Residency Requirement states that, for three of the five years immediately prior to applying for a position, the individual must have: 1) resided in the United States; 2) worked for the United States overseas in a Federal or military capacity; or 3) be a dependent of a Federal or military employee serving overseas. Systems that the Contractor shall support or may develop are presently categorized as Unclassified - Moderate Risk.

Contractor staff performing under this task order shall be assigned to positions that are considered moderate risk public trust positions. Contractors in moderate risk public trust positions must possess or undergo a Minimum Background Investigation (MBI).

10. PLACE OF PERFORMANCE

The work performed under this task order will take place nationwide in field locations assigned by the COR and PSOB Office. The Contractor shall provide qualified personnel throughout OCONUS in an acceptable timeframe, both in rural and metropolitan areas. OCONUS is defined as the contiguous United States, which includes Alaska, Hawaii, and U.S.

Territories and Possessions, such as Puerto Rico, Guam, and the Northern Mariana Islands.

11. HOURS OF OPERATION

The typical OJP Hours of Operations is between the hours of 9:00 AM Eastern Time and 5:30 PM Eastern Time, Monday through Friday. Work shall not be required on the following Federal holidays or on days observed in lieu thereof, unless emergency support is required:

New Year's Day Birthday of Martin Luther King, Jr.

Washington's Birthday Memorial Day Independence Day Labor Day Columbus Day Veteran's Day Thanksgiving Day Christmas Day Inauguration Day (When Applicable)

In addition to the days designated as holidays, the Government observes the following days:

Any other day designated by Federal Statute Any other day designated by Executive Order Any other day designated by the President's Proclamation

It is understood and agreed between the Government and the Contractor that observance of such days by Government personnel shall not be a reason for an additional period of performance, or entitlement of compensation except as set forth within the task order. In the event the Contractor's personnel work during the holiday, they may be reimbursed by the Contractor; however, no form of holiday or other premium compensation shall be reimbursed either as a direct or indirect cost, other than their normal compensation for the time worked.