36C26124Q0164.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

593-24-1-771-0005

36C26124Q0164 12-04-2023

Austin Mitts - Austin.Mitts@va.gov 559-225-6100 x 6584 12-22-2023

12:00 PST PST

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21

855 M. Street, Suite 1020 Fresno CA 93721

X 100

X

621112

$13.5 Million

N/A

X

VA Southern Nevada Health Care System

6900 North Pecos Road North Las Vegas NV 89086

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21

855 M. Street, Suite 1020 Fresno CA 93721

Department of Veterans Affairs FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

This is a Request for Quote for pre-employment and annual police psychological assessments services for the Police Service within VA Southern Nevada Health Care System.

Please carefully read the Addendum to FAR 52.212-1 Instructions to Offerors - Commercial Items and VAAR 852.273-73 Evaluation - Health Care Resources to ensure quotes submitted are complete and conforming to the solicitation's requirement.

Point of Contact: Austin Mitts Email questions regarding RFQ to Austin.Mitts@va.gov by 12/12/2023 by 12:00pm PST

Ordering Period 1: 02/16/24 - 02/15/25 Ordering Period 2: 02/16/25 - 02/15/26 Ordering Period 3: 02/16/26 - 02/15/27 Ordering Period 4: 02/16/27 - 02/15/28 Ordering Period 5: 02/16/28 - 02/15/29

See CONTINUATION Page 593-3640152-771-840700-2580 010040700

X

Maricela Berrones Gauger Contracting Officer

36C26124Q0164

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PEFORMANCE WORK STATEMENT

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (NOV 2021)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) 36

C.8 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.11 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.12 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.13 VAAR 852.211-72 TECHNICAL INDUSTRY STANDARDS (NOV 2018)

C.14 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

C.15 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JAN 2023) (DEVIATION)

C.16 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.17 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.18 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.19 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019) . 51

C.20 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.21 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.22 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.5 VAAR 852.273-70 LATE OFFERS (NOV 2021)

E.6 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (NOV 2021)

E.7 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer Maricela Berrones-Gauger Department of Veterans Affairs Network Contracting Office (NCO) 21 Maricela.Berrones-Gauger@va.gov

Contracting Specialist Austin Mitts Department of Veterans Affairs Network Contracting Office (NCO) 21 Austin.Mitts@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

mailto:Maricela.Berrones-Gauger@va.gov

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

62.00 EA __________________ __________________

Periodic Annual Assessments Contract Period: Ordering Period 1 POP Begin: 02-16-2024 POP End: 02-15-2025 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric Consultation

MANUFACTURER PART NUMBER (MPN): N/A

30.00 EA __________________ __________________

Initial Pre-Employment Assessments Contract Period: Ordering Period 1 POP Begin: 02-16-2024 POP End: 02-15-2025 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

5.00 EA __________________ __________________

Fit For Duty Assessments Contract Period: Ordering Period 1 POP Begin: 02-16-2024 POP End: 02-15-2025 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 2 POP Begin: 02-16-2025 POP End: 02-15-2026 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 2 POP Begin: 02-16-2025 POP End: 02-15-2026 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 2 POP Begin: 02-16-2025 POP End: 02-15-2026 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 3 POP Begin: 02-16-2026 POP End: 02-15-2027 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 3 POP Begin: 02-16-2026 POP End: 02-15-2027 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 3 POP Begin: 02-16-2026 POP End: 02-15-2027 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists

PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 4 POP Begin: 02-16-2027 POP End: 02-15-2028 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 4 POP Begin: 02-16-2027 POP End: 02-15-2028 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 4 POP Begin: 02-16-2027 POP End: 02-15-2028 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 5 POP Begin: 02-16-2028 POP End: 02-15-2029 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Initial Pre-Employment Assessments Contract Period: Ordering Period 5 POP Begin: 02-16-2028 POP End: 02-15-2029 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

Contract Period: Ordering Period 5 POP Begin: 02-16-2028 POP End: 02-15-2029 PRINCIPAL NAICS CODE: 621112 - Offices of Physicians, Mental Health Specialists PRODUCT/SERVICE CODE: Q526 - Medical - Medical/Psychiatric

GRAND TOTAL __________________

B.3 PEFORMANCE WORK STATEMENT

Performance Work Statement

Psychological Evaluation

VA Southern Nevada Healthcare System

VA Medical facilities are protected by Police Officers who have arrest authority, as defined by 38 U.S.C. Chapter 9. They protect life and property on VA owned or operated land and buildings, and must regularly make decisions on the appropriate application of force, the use of a firearm, police baton, or Oleoresin Capsicum (OC) spray. Applicant and incumbent VA Police Officers must meet certain functional requirements. In order to meet the specific behavioral functional requirements for the successful police officer, individuals must:

a. Possess a high level of personal integrity

b. Be able to maintain control of anger and emotions

c. Be compassionate towards others, especially those who cannot care for themselves

d. Be able to quickly respond to emergency situations

e. Have respect for authority and rule of law

f. Be emotionally able to apply physical and possibly lethal force as needed, and to recognize when such force is necessary, but in strict accordance with training and policy requirements

g. Be able to often work independently, but within a regimented group

2. General Requirements:

a. VHA Directive 0730(1), dated December 8, 2020, establishes responsibilities related to the psychological evaluations of VA Police Officer applicants and VA Police Officers.

Contractor shall provide all required psychological assessment services for incumbent VA Police officers employed by the VA Southern Nevada Healthcare System (VASNHS).

The psychological assessments shall be performed in accordance with the guidelines designed to determine an officer’s emotional and mental stability of conducting designated functional requirements essential to the duties of a VA Police Officer and an officer’s suitability to carry a firearm. These guidelines are consistent with VA Handbook 0720, Procedures to Arm Department of Veterans Affairs Police, dated January 24, 2000. These standards are based on 5

C.F.R. § 339.301. See:

http://www.va.gov/vapubs/viewPublication.asp?Pub

Continuum of Force, Training Units, other law enforcement standards and position descriptions are also available in VA Police Units at each of the participating facilities.

b. VHA Directive 0730 (1) dated December 8, 2020 paragraph 6 specifies Psychological evaluations for VA Police Officers in that the primary focus of the evaluation is to assess the applicant’s or employee’s psychological fitness to meet the functional requirements of the position. VA regulations require an initial psychological assessment for VA Police http://www.va.gov/vapubs/viewPublication.asp?Pub

Officer applicants, which shall include a structured interview and written psychological testing. The regulations also require an annual psychological assessment for incumbent VA Police Officers, which are limited to a verbal interview covering only job-related factors, unless concerns arise during the psychological evaluation. The initial and annual psychological examination of the applicant/officer’s emotional and mental stability shall be performed by a psychologist with recognized expertise in performing the specifically focused exams.

While not required by regulation, the ability of a contractor to conduct face to face (rather than telephone) interviews with applicants/officers within shall be a factor in this award.

Police officer duties include personal encounters patients, visitors, and other employees.

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 judgement. Any emotional or mental conditions which could cause the officer/applicant to be a hazard to others or self during stress situations and/or physical altercations will disqualify.

c. The primary objectives of psychological screening for VA police officer applicants and incumbent police officer are to screen out emotionally unstable individuals and to identify positive psychological characteristics associated successful job performance. Emotional instability, in this context, refers to symptomatology of such severity that the individual’s ability to meet the functional requirements of the position, including the carrying and use of firearms, would be impaired. A mental health diagnosis, on its own, cannot be used as a basis for a determination of instability. Suitability, in the psychological screening context, refers to personality characteristics pertinent to an individual’s performance in the job and includes interpersonal skills, judgement, decision-making and integrity. The evaluating psychologist will determine, based upon his / her clinical judgement, the exact subset of dimensions to be assessed while adhering to the police officer functional requirements.

3. Qualifications:

a. Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in a State, Territory, Commonwealth of the United States, or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. The qualifications of such personnel shall also be subject to review by the VA Chief of Mental Health Services or Chief of Psychology Service to ensure contract psychologists or psychiatrists are privileged in accordance with VHA Handbook 1100.19, Credentialing and Privileging, dated October 15, 2012. Office of Occupational Safety and Health and Mental Health Services staff must be involved to ensure that contractors have the requisite qualifications and training commensurate with their assigned responsibilities.

b. The work of psychologists who conduct psychological evaluations of Police Officers is complex and demanding. Evaluations shall be conducted only by licensed psychologists and psychiatrists who are qualified by their education, training, and experience to conduct psychological assessments. These individuals must have expertise in clinical assessment as well as the assessment of normal personality characteristics relevant to personnel selection. Examiners must be familiar with VA policies relevant to the evaluation and selection of Police Officers. Examiners must also be knowledgeable in employment law impacting the administration of these types of personnel evaluations, including but not limited to the Americans with Disabilities Act As Amended (ADA/ADAAA), Uniformed Services Employment and Reemployment Rights Act (USERRA}, Genetic Information Nondiscrimination Act (GINA), Age Discrimination in Employment Act (ADEA), Health Insurance Portability and Accountability Act (HIPAA), the Rehabilitation Act of 1973 and The Privacy Act of 1974.

4. Types of VA Police Officer Evaluations:

a. Pre-employment Psychological Evaluation. The pre-employment psychological evaluation focuses on the functional requirements for the position of a VA Police Officer, as well as suitability and stability for the role. It must consist of a standardized interview and standardized objective psychological testing with symptom validity scales. At least two psychological tests must be administered. The psychological evaluation must also include exploration of substance abuse and symptoms of other mental health disorders that may be considered an impediment to effective functioning as a VA Police Officer.

b. Periodic Evaluations. Periodic or annual evaluations focus on functional requirements for maintaining the position of a VA Police Officer. To initiate the evaluation, VHA Human Resources must provide a written request for the periodic evaluation and provide a documented reason to the employee when ordering the exam. A standardized interview must be conducted, and psychological testing should only be conducted when concerns are raised about the psychological fitness of the Police Officer during the psychological evaluation.

Screening instruments, such as the Personal Health Questionnaire 2 (PHQ2), PTSD Screen for Primary Care (PC-PTSD), Alcohol Use Identification Test (AUDIT) or other standardized instruments, may be used if additional testing is needed. A positive response on any screening instruments is an indication that further testing is required and cannot, in and of itself, be used as grounds for the final recommendation. If the interview or the screening and assessment tools raise concern for functional ability, stability, or suitability, further psychological testing may be done. NOTE: Periodic psychological evaluations of Police Officers recur every 12 months.

c. Directed or Special Examination. Incumbent VA Police Officers may be referred for a directed or special examination when there is objective evidence as determined by VHA Human Resources to indicate the employee’s ability to perform essential job functions may be compromised. A directed or special psychological examination may be required when it appears that the incapacity is due to a mental or psychological disorder. This must be done in the context of an occupational health evaluation outlined in VA Handbook 5019 to ensure that medical conditions that may manifest with psychological, mental, or behavioral disturbance are identified. VHA Human Resources must provide a written summary articulating the reason that the employee’s ability has come into question and provide the reason to the employee when ordering the exam.

5. Evaluation Components.

The psychological evaluation is composed of several components, to include:

(1) Authorization Form. Prior to conducting any psychological evaluation of an applicant or VA Police Officer, the VA or contracted psychologist or psychiatrist must obtain an Authorization Form from the applicant or employee in writing. At a minimum this consent must include the nature and objectives of the evaluation and must identify the intended recipient(s) of the information, the probable uses of the evaluation information, and the limits of confidentiality. It is best practice to review the key elements of the authorization form with the applicant or employee prior to conducting the psychological evaluation. NOTE: See Appendix A for an Authorization Form template for VA Police Officer psychological evaluations.

(2) Interview. All evaluations must incorporate an individual interview by a VA or contracted psychologist or psychiatrist for all evaluations of applicants and incumbent Police Officers.

The interview must be conducted in a consistent, comprehensive manner that focuses on the collection of information relevant to the purpose of the evaluation and adheres to professional and industry standards.

(3) Psychological Testing. A written psychological test battery relevant to the purpose of the evaluation must be utilized in accordance with the guidance provided in this Directive. For new-hire evaluations, at least two psychological tests must be administered: one broadband measure of normal-range personality traits and the other a broadband measure of psychopathology and personality problems. For annual or special evaluations, testing should only be used if the interview or the screening and assessment tools raise concern for functional ability, stability, or suitability. NOTE: Instruments, such as the PHQ2, PC-PTSD, AUDIT or other standardized instruments, may be used for screening; A positive response on any screening instrument is an indication that further testing may be necessary and cannot, in and of itself, be used as grounds for a final recommendation.

(a) The Mental Health Assistant (MHA) software tool must not be used to administer or score psychometric instruments for Police Officer applicants or incumbents. Since the MHA is accessed through the Electronic Health Record (EHR)-either the Computerized Patient Record System (CPRS) or Cerner Millennium Power Chart, MHA should be not used for Human Resource personnel evaluations. Keeping personnel evaluations outside the EHR will protect the confidentiality of VA Police Officers. VA medical facilities should work with local fiscal teams to purchase test licenses or single test administrations direct from the test publishers, taking care to protect employee privacy when using online testing platforms.

(b) To ensure security and privacy, examiners must not enter employees’ Protected Health Information (PHI) or Personally Identifiable Information (PII), even temporarily, into a test publisher’s online platform. Please note that any document connecting VA employees to simulated identification data must be kept securely within VA’s encrypted firewall, in keeping with VHA’s records policies.

6. Required Evaluation.

a. The psychological evaluation shall focus on the functional requirements for the position of VA Police Officer, as well as suitability and stability for the role. Information about the required duties, responsibilities, working conditions, and other psychologically relevant job characteristics should be obtained from Human Resources or the VA medical facility EOH prior to beginning the psychological evaluation. The psychological evaluation should focus on identifying skills, behaviors, attributes and other personal characteristics associated with effective and counterproductive job performance.

b. The evaluation of VA Police Officer applicants and employees must include a review of the individual’s history that is pertinent to the purpose of the evaluation.

c. The evaluation of the functional requirements for the position of VA Police Officers must be done using the constructs provided by the ten empirically derived psychological screening dimensions developed by the California Commission on Peace Officers Standards and Training (POST) Psychological Screening Manual. The POST manual is recognized as the leading best practice in the field of psychology evaluations of Police Officers. These dimensions, described in detail in the Evaluation Report Template in Appendix C, are: social competence, teamwork, adaptability/flexibility, conscientiousness/dependability, impulse control/attention to safety, integrity/ethics, emotional regulation/stress tolerance, decision-making/judgment, assertiveness/persuasiveness and avoiding substance abuse/other risk-taking behavior.

Details on the development, definitions, and use of these psychological screening dimensions are available in the California POST Officer Psychological Screening Manual, which can be obtained at no cost at https://post.ca.gov/peace-officer- psychological-screening-manual.

d. VA or contracted psychologists or psychiatrists should submit a recommendation report with discussion of the issues to be included in the Employee Medical Folder. The VA medical facility EOH Agency Medical Officer is responsible for providing the final fitness for duty recommendation to VHA Human Resources.

e. For pre-employment evaluations, the written history review in the recommendation report is comprehensive in nature and must include but not be limited to: education, work history, financial record, legal history, substance use and mental health concerns. In all cases the information obtained must be based on the information necessary to assess the individual’s ability to perform requirements of the position and role.

f. For periodic evaluations of incumbent Police Officers, the written history review must focus on the employee’s recent job performance and any behaviors and events that could potentially indicate the presence of emotional or psychological symptoms that would interfere with the employee’s ability to perform the essential functions and role of a Police Officer. (7) For directed or special examinations, the written history review must focus on the behaviors or events precipitating the evaluation, as described in the written summary from VHA Human Resources, and any information needed to assess the employee’s ability to perform the essential functions of the job as a Police Officer. It is recognized that in these types of evaluations a comprehensive history review is often required to assess the nature and severity of any psychological concerns that may be identified.

g. If relevant to the evaluation of the applicant’s or employee’s psychological stability and suitability, mental health records may be requested from treating health care providers in accordance with VA Handbook 5019 and paragraph 9, Records Management, of this directive, and reviewed before a final determination is made. Obtaining these records requires written authorization from the applicant or employee for the release of the records.

h. When no background medical records have been submitted by the applicant or employee, VA or contracted psychologists or psychiatrists must make note of this in the report and indicate that all reported history is based on the applicant’s or employee’s self- report and could be subject to reconsideration based on subsequent submission of additional medical records by the employee.

i. VA or contracted psychologists or psychiatrists must not conduct any type of background investigation independently, such as, but not limited to, an internet search or a search using social media.

j. The psychological recommendation report will include only the minimum level of disclosure regarding functional requirements for the job and only the level of detail necessary for medical clearance by the EOH Agency Medical Officer. See Appendix B for an evaluation template and Appendix C for a report template.

k. The detail in the recommendation report must be adequate for the EOH Agency Medical Officer to understand the rationale, make a determination of qualification or disqualification, and explain the decision to the applicant or employee, should they ask. The rationale for this is the psychological evaluation is one component part of the overall

EOH medical examination and thus should be discussed in the context of the whole evaluation.

l. Medical disqualifications for a position are made by the EOH Agency Medical Officer based on all the evidence provided (including the medical examination and psychological evaluation). Psychological evaluation is one piece of information in the context of the entire fitness for duty evaluation to ascertain the applicant’s or employee’s ability to meet the functional requirements of the job, and the psychological test results alone cannot be used as evidence for medical disqualification. Similarly, a mental health diagnosis itself cannot be used as evidence of medical disqualification for a position. If a clinical diagnosis is made by the examining psychologist or psychiatrist and certain other factors exist such that the symptoms associated with the diagnosis impair the individual’s ability to meet the functional requirements, the functional impairment, not the diagnosis, would be the disqualifying reason.

NOTE: If a diagnosis is made, it must be made using the most current version of the Diagnostic and Statistical Manual of Mental Disorders currently utilized in VA at the time of the evaluation.

m. Recommendations made by VA or contracted psychologists or psychiatrists to the EOH Agency Medical Officers must be unequivocal (i.e., the applicant or employee does or does not meet the functional requirements). In the case of a negative recommendation, any functional requirements that are compromised must be documented. In the case that the findings of an evaluation are not sufficient to provide an unequivocal determination, the reasons of insufficiency must be described in the report.

7. Telehealth Considerations.

a. For evaluations conducted remotely through video communication technology, administration procedures should be kept as close as possible to the traditional, in-person procedures and documented in the written report.

b. Remote audio-visual monitoring of the test administration, even with self-administered instruments, is essential. Select a non-public facing video teleconference platform that is compliant with Health Insurance Portability and Accountability Act (HIPAA) Rule requirements and apply administrative, physical, and technical safeguards to protect information.

c. Consult publishers for guidance on video technology adaptation of specific psychological assessment measures.

d. Notify persons being assessed that video applications potentially introduce privacy risks and enable all available encryption and privacy modes when using such applications.

8. 6500.6 SECURITY CLAUSES

Appendix B

The contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract.

Appendix C

1. RECORDS MANAGEMENT LANGUAGE

Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. Chapters. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a).

These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C.

552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

In accordance with 36 CFR 1222.32, the contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

The VA Southern Nevada Healthcare System (VASNHS) and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of VASNHS or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701.

In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, the contractor must report to VASNHS. The agency must report promptly to NARA in accordance with 36 CFR 1230.

The contractor shall immediately notify the appropriate Contracting Officer (CO) upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the contract documents. The contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity.

When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to VASNHS control or the contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the CO or address prescribed in the contract documents.

Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

The contractor is required to obtain the CO's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The contractor (and any sub-contractor) is required to abide by Government and VASNHS guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

The contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with VASNHS policy.

The contractor shall not create or maintain any records containing any non-public VASNHS information that are not specifically tied to or authorized by the contract.

The contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the FOIA.

VASNHS owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which VASNHS shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

Training. All contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take VHA-provided records management training.

The contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

Flowdown of requirements to Subcontractors:

The contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this contract document, and require written subcontractor acknowledgment of same.

Violation by a subcontractor of any provision set forth in this clause will be attributed to the contractor.

B.4 IT CONTRACT SECURITY

VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY

1. GENERAL

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

c. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.

d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S.

may be an evaluation factor.

e. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor's employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

3. VA INFORMATION CUSTODIAL LANGUAGE

a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor's information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA's information is returned to the VA or destroyed in accordance with VA's sanitization requirements. VA reserves the right to conduct on site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

c. Prior to termination or completion of this contract, contractor/ subcontractor must not destroy information received from VA, or gathered/ created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

g. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements.

Absent an agreement to use or disclose protected health information, there is no business associate relationship.

h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

i. The contractor/subcontractor's firewall and Web services security controls, if applicable, shall meet or exceed VA's minimum requirements. VA Configuration Guidelines are available upon request.

j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations:

(i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA's prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

k. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

l. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COR.

4. INFORMATION SYSTEM DESIGN AND DEVELOPMENT

a. Information systems that are designed or developed for or on behalf of VA at non-VA facilities shall comply with all VA directives developed in accordance with FISMA, HIPAA, NIST, and related VA security and privacy control requirements for Federal information systems. This includes standards for the protection of electronic PHI, outlined in 45 C.F.R. Part 164, Subpart C, information and system security categorization level designations in accordance with FIPS 199 and FIPS 200 with implementation of all baseline security controls commensurate with the FIPS 199 system security categorization (reference Appendix D of VA Handbook 6500, VA Information Security Program).

During the development cycle a Privacy Impact Assessment (PIA) must be completed, provided to the COR, and approved by the VA Privacy Service in accordance with Directive 6507, VA Privacy Impact Assessment.

b. The contractor/subcontractor shall certify to the COR that applications are fully functional and operate correctly as intended on systems using the VA Federal Desktop Core Configuration (FDCC), and the common security configuration guidelines provided by NIST or the VA. This includes Internet Explorer 7 configured to operate on Windows XP and Vista (in Protected Mode on Vista) and future versions, as required.

c. The standard installation, operation, maintenance, updating, and patching of software shall not alter the configuration settings from the VA approved and FDCC configuration. Information technology staff must also use the Windows Installer Service for installation to the default "program files" directory and silently install and uninstall.

d. Applications designed for normal end users shall run in the standard user context without elevated system administration privileges.

e. The security controls must be designed, developed, approved by VA, and implemented in accordance with the provisions of VA security system development life cycle as outlined in NIST Special Publication 800-37, Guide for Applying the Risk Management Framework to Federal Information Systems, VA Handbook 6500, Information Security Program and VA Handbook 6500.5, Incorporating Security and Privacy in System Development Lifecycle.

f. The contractor/subcontractor is required to design, develop, or operate a System of Records Notice (SOR) on individuals to accomplish an agency function subject to the Privacy Act of 1974, (as amended), Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Privacy Act may involve the imposition of criminal and civil penalties.

g. The contractor/subcontractor agrees to:

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies:

(a) The Systems of Records (SOR); and

(b) The design, development, or operation work that the contractor/ subcontractor is to perform;

(1) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the redesign, development, or operation of a SOR on individuals that is subject to the Privacy Act; and

(2) Include this Privacy Act clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a SOR.

h. In the event of violations of the Act, a civil action may be brought against the agency involved…