36C24818Q0628-001.pdf

STATEMENT OF WORK

Police Psychological Testing

1) Definitions

a) CO: Contracting Officer

b) COR: Contracting Officer’s Technical Representative

c) WPB VAMC: West Palm Beach VA Medical Center

2) PURPOSE

The purpose of this contractual agreement is to acquire psychological evolutions and testing for VA Police Officers at West Palm Beach Florida VA Medical Center to determine an officer suitability to perform the duties of a police officer and to carry a firearm.

3) BACKGROUND

The Department of Veterans Affairs requires VA Police Officers to carry firearms. It was also mandated that all current Police Service employees and new hires shall undergo an initial psychological evaluation as well as an annual evaluation. Officers’ encounters are often with mentally ill, irrational or disturbed persons who, although assaultive or destructive, must be handled with understanding, full control of force, and unimpeded judgment. Any emotional or mental condition which could cause the applicant/officer to be a hazard to others or self during stressful situation and physical altercations will disqualify.

4) DESCRIPTION OF SERVICES:

Contractor shall provide initial and annual psychological evaluation of all VA Police Officers. All

VA Police Officers, Detectives, Criminal Investigators, Assistant Chief, and Chief of Police shall be reexamined annually to determine their continued emotional suitability to perform the duties of a VA Police Officer.

a) The psychological evaluation is to include a verbal interview utilizing the Human

Reliability Structured by Neil S. Hibler, PhD, FAClinP.

b) VA guidelines do not permit the routine use of written psychological testing for incumbent’s police officers. These officers only receive the one oral interview with the emphasis on a functional assessment of psychiatric symptoms directly relevant to job duties. Current law and regulations preclude the use of any psychological testing as a tool during the psychological evaluation.

c) Police Officer applicants must be fully screened by the verbal interview process as well as the following battery of test:

1) Inward Personality Inventory (IPI)

2) Vulnerability to Stress Scale (VSS)

3) State Trait Anger Expression Inventory (STAXI-2)

4) Fundamental Interpersonal Relations Orientation (FIRO-B)

5) Sentence Completion Test (SCT)

6) Shipley Institute of Living Scale (SILS)

7) Minnesota Multiphasic Personality Inventory-2 (MMPI-2)

d) Re-test if during the psychological evolution for incumbents’ police officers the psychologist has an articulable reason to doubt that the officer is capable of performing the duties of a police officer (including the use of a firearm) he/she should make a formal recommendation for psychological testing to the Employee Health Physician

(EHP) at the West Palm Beach VA Medical Center. In such a situation the EHP may approve such a recommendation and suggest utilizing the PAI and MMPI and /or other test deemed appropriate.

e) The Contractor shall provide results/reports in the form of a one-page letter to

Employee Health Physician at the West Palm Beach VA Medical Center. The report will indicate Pass/Fail, Recommended/Not Recommended for use of a firearm for the VA

Medical Center. A second copy will be sent to the Chief of Police at the Medical Center, within five (5) business days of evaluation.

f) Privacy Act Notification – Any reports, as well as any internal working documents generated by the Contractor, are the property of the West Palm Beach VA Medical

Center and shall be kept confidential from the officer. The Contractor and/or staff are not authorized to disclose any information pertaining to a VA employee to any source.

Any request for information shall be forwarded to the Employee Health Physician.

g) All results/reports shall be discussed with the Employee Health Physician and mailed to:

VA Medical Center 7305 North Military Trail West Palm Beach, Florida 33410 Attn

548/07, Phone 561 422 6945.

h) A second copy will be mailed to the Chief of Police, 7305 North Military Trail West Palm

Beach, Florida 33410. Attn 548/07, Phone 561 422-5514.

5) STAFF QUALIFICATION/CREDENTIALING:

The Contractor shall provide a licensed professional psychologist who has the appropriate qualifications, experience and licensure commensurate with the particular job responsibilities as required to perform this service. The individual must at a minimum hold a PhD in Psychology and a license to practice independently in the State of Florida. Only VA credentialed psychologists are to provide service. Credentialing will take approximately eight (8) weeks.

6) SCHEDULING:

Service will be provided at the Contractor’s office. Contractor will be notified by the COR for the purpose of scheduling of a new Police Officer applicant or for annual evaluation.

7) PAYMENT:

a) The WPB VA will verify provision of service as to a new Police Officer applicant evaluation or annual police office evaluation. Payment will be made by the VA to the

Contractor within thirty (30) days of submission and verification.

b) Vendor to be located within a 20 mile radius of the VA Medical Center.

c) Any discrepancies in payment shall be address, in writing to the COR at the following address:

VA Medical Center

Police Service (07)

7305 North Military Trail

West Palm Beach, Florida 33410

Attn: Don Prosser, 548/07

8) TERM AND TERMINATION:

The term of this contract shall be effective for a twelve-month period of performance. Contract shall have four (4) options of one year renewals, which may be exercised at the Government’s discretion.

SPECIAL CONTRACT REQUIREMENTS

Under the authority of Public Law 104.262 and 38 USC .8153 the contractor agrees to provide services, recommendations and testing in accordance with the Statement of Work (SOW), terms and conditions herein. Contractor to furnish to the Dept. of Veteran Affairs Medical Center, 7305 N. Military Trail, West

Palm Beach, FL 33410-6400, hereafter called the “VA”, the services and prices specified in the section entitled. “Schedule of Supplies/Services” of the contract.

1. SERVICES:

a. The services specified in the section entitled Schedule of Supplies/Services and Special

Contract Requirements may be changed by written modification to this contact. The modification will be prepared by the VA Contracting Officer. The awarded Contractor is advised that only the Contracting Officer, acting within the scope of the contact and his/her duties and responsibilities and, after advice and consultation with the Contracting Officer’s Technical

Representative (COR), has the authority to make changes which effect contract prices, quality, quantity, delivery terms and conditions, or term of the contract. In no event shall any understanding or agreement, contract modification, change order, or other matter in deviation from the terms of the contract, between the Contractor and person other than the Contracting

Officer, be effective or binding upon the Government.

b. Contractor’s place of performance for this contract, must be within a twenty five (25) mile radius of the VA Medical Center located at 7305 N. Military Trail West Palm Beach, FL

33410.

c. The services to be performed by the Contractor will be performed in accordance with

VA policies and procedures and the regulations of the medical staff by-laws of the VA facility.

d. Term of this contract shall be the base period, with (4) option years to renew. The contractor, as defined herein, shall furnish the services covered by this contract. This contract is entered into by and between the Contractor and the VA to set forth the understanding for both parties with respect to the terms and conditions under which the Contractor will provide services in the capacity of psychological evaluation to the VA, in accordance with all the terms, conditions, and Statement of Work.

2. QUALIFICATIONS:

Contractor must possess a Florida License for Psychology. The contractor performing these services must comply with the VA’s credentialing and privileging process. Contractor shall be compliant with relevant regulatory and accrediting standards with respect to general environmental safety including, but not limited to, Office of Safety and Health Administration (OSHA), National Fire Protection

Association (NFPA) and all JCAHO standard including demonstration of a process for compliance with

JCAHO required analysis of reviewable sentinel events and JCAHO Human Resource standards.

3. PERSONNEL POLICY:

General: The Contractor shall assume full responsibility for the protection of the personnel furnishing service under this contract, in accordance with the personnel policy of the Contractor, such as providing workman’s compensation, professional liability insurance, health examination, income tax withholding and social security payments. The parties agree that such personnel shall NOT be considered VA employees for any purpose and shall be considered employee of the Contractor.

4. EVIDENCE OF COVERAGE:

Before commencing work under this contract, the contractor shall furnish certification to the VA

Contracting Officer that the coverage required has been obtained and such policy shall state: THIS

POLICY SHALL NOT BE CHANGED OR CANCELLED WITHOUT WRTTEN NOTICE TO THE VA.” Said policy must bear an appropriate “loss payable clause” to the United States as its interest may appear. Such evidence of insurance shall not be waived.

5. CONTRACTING OFFICER’S TECHNICAL REPRESENTATIVE:

Prior to award, the Contracting Officer will designate a VA Medical Center employee as Contracting

Officer’s Technical Representative (COR). All work coordination shall be made through the COTR. The

Contractor shall be provided a copy of the letter of delegation, authorizing the COTR at the commencement of the term of this agreement. No other person shall be authorized to act in such capacity unless appointed in writing by the Contracting Officer.

6. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE:

Contractor is required to submit with their quote, their Indemnification and Medical Liability Insurance

Certificates as required by VAAR Clause 852.237-7.

7. CONTRACTOR COMPLIANCE:

Contractor represents and warrants that it is in compliance with Medicare, Medicare, and any other related federal, state, statues, regulations, rules, polices and that neither they nor their agents, officers, employees, assigns or successors in interest are exclude from participation in the Medicare, Medicaid, or related federal, state programs. Further Contractor shall immediately notify the Contracting Officer of the exclusion form such programs of any of its agents, officers, employees, assigns or successors in interest. Such exclusion shall be grounds for immediate termination of the contract.

8. Upon receipt of Notice of Award, Contractor will commence credentialing and privileging process for all personnel assigned to perform under this contract. A minimum of eight calendar weeks is required for VA credentialing and privileging after the package, including VetPro electronic application, has been completed and received from the Contractor. VA will designate a Credentialing Verification Office (CVO) to credential Contracted ore subcontracted personnel at University of Miami. No other credentialing service will be utilized. Contractor is responsible for timely submission of completed credentialing package to CVO. The designated CVO must completed credentialing process through VetPro in order to meet VHA credentialing guidelines. Contractors are responsible for all fees for credentialing services rendered by CVO. Once a CVO completes credentialing of personnel, the VA Medical Staff Coordinator will proceed with privileging process. The credentialing service will be reviewed and verified by the VA

Medical Staff Coordinator to ensure compliance with VHA Handbook 1100.19 and JCAH guidelines.