2.1.1- ATTACHMENT 1- FINAL SOW_Medical_Services - March 2026.docx

Medical Services Recompete March 2026 CBP/HRM/Medical Support Services

U.S. DEPARTMENT OF HOMELAND SECURITY

U.S. CUSTOMS AND BORDER PROTECTION

March 2026

STATEMENT OF WORK

FOR

Medical Support Services

For

Human Resources Management

National Programs Division and

CBP Hiring Center

Table of Contents

1.0 BACKGROUND

As a Federal law enforcement agency, U.S. Customs and Border Protection (CBP) is responsible for ensuring that certain personnel are fully qualified to safely and effectively perform the essential job duties without undue risk or hazard to self or public. This involves, but is not limited to, developing and the implementation of the Office of Personnel Management approved job-related medical standards, facilitating medical examinations and consultations, and managing and implementing the Federal Drug-Free Workplace Program to deter illegal drug use.

1.1 This statement of work is for medical services to support two program offices within CBP’s Office of Human Resources Management (HRM): National Programs Division’s (NPD) Medical and Fitness Branch (MFB) and CBP Hiring Center (CBP HC).

1.2 CBP National Programs Division is located in Washington, D.C, and for the purposes of this SOW, is responsible for the Drug Free Workplace Program, Independent Medical Examinations, reviews of medical documentation, and general examinations.

1.3 CBP Hiring Center (CBP HC) is located in Bloomington, MN, and for the purposes of this SOW, is responsible for the coordination of the pre-employment candidate medical examinations and fitness tests for positions with medical standards and physical requirements, and for the scheduling of specimen collection services for the drug testing of candidates selected to occupy safety sensitive positions.

1.4 Services will be delivered to all CBP locations, nationally and internationally. Requests for pre-employment testing are initiated by CBP HC. For current CBP employees, examinations and testing are initiated by MFB. The contractor must be available to accept notification of the need for drug or alcohol testing via telephone 24-hours a day, 7 calendar days a week.

1.5 When CBP standard operating procedures change, the Contractor shall adjust processes as needed. CBP shall make a good faith effort to keep the Contractor informed of any anticipated changes.

1.6 The Contractor is responsible to pay all postage and fees relating to requirements in this SOW unless otherwise stated. For example, the Contractor shall pay all postage and fees relating to information submitted to the CO and COR including forms, reports, medical examinations and recommendations, etc. The Contractor shall also pay postage for shipping to Specimen Collectors and facilities items necessary to perform drug tests, etc.

1.7 CBP will be in contact with the Contractor daily. The Contractor shall be prepared to be responsive to all inquiries and status requests.

Applicable Law, Regulation, and Policy

The applicable law, regulation, and policy for this SOW are listed below. The Contractor is expected to comply with these documents, and the Contractor must use the most current version of these applicable documents.

· 41 Code of Federal Regulations (CFR) Chapters 300-304, Federal Travel Regulation, most current version.

· 42 CFR Chapter 1, HHS Mandatory Guidelines for Federal Workplace Drug Testing Program – Authorized Testing Panels, most current version.

· The Department of Health and Human Services Urine Specimen Collection Handbook, most current version.

· Public Law 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA) - The Office for Civil Rights enforces the HIPAA (August 21, 1996) Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety. The Contractor shall comply with the most recent version of HIPAA found at the U.S. Department of Health and Human Services website.

· CBP Medical Standards, approved by the Office of Personnel Management, most current version

· Collective Bargaining Agreements, most current version.

· HHS, Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs, most current version.

· The Department of Health and Human Services Mandatory Guidelines for Federal Workplace Drug Testing Programs, most current version.

· The Department of Health and Human Services Mandatory Guidelines for Federal Workplace Drug Testing Programs-Oral/Fluid, most current version.

· CBP Drug-Free Workplace Plan, most current version.

· HHS SAMHSA list of certified laboratories, most current version.

· 5 CFR 339 Medical Qualification Determinations, most current version.

· Title 5 CFR § 630 Subpart L - – Family and Medical Leave, most current version.

· The Department of Health and Human Services Collection Site Manual, most current version.

· The Department of Health and Human Services Oral Fluid Specimen Collection Handbook, most current version.

· The Department of Health and Human Services Collection Site Manual for the Collection of Oral Fluid Specimens, most current version.

· DHS Handbook for Safeguarding Sensitive Personally Identifiable Information, Privacy Policy Directive 047-01-007, Revision 3, most current version.

· DHS Sensitive Systems Policy Directive 4300A, most current version.

· DHS Non-Disclosure Agreement (NDA), most current version.

· DHS/CBP Standards of Conduct - Applicable to NPD only, most current version.

· The National Archives and Records Administration, General Records Scheduled 1: Rule 36 - Applicable to Post-Employment only, most current version.

· Federal Workplace Drug Testing Program Files; and Rule 30 - Administrative Grievance, Disciplinary, and Adverse Action, most current version.

· National Institute of Standards and Technology guidance and requirements, most current version.

· Selected Occupational Safety and Health Standards, 29 CFR 1910.38 and 1910.157, most current version.

· 29 CFR Part 1910.1030, Occupational Safety and Health Standards, most current version.

The Government will provide the most current version of CBP documents to the Contractor upon award. These documents include:

· Medical standards by Position Description

· Position Descriptions

· Position Medical Requirements

· Collective Bargaining Agreements

· Medical Reassignment Internal Operating Procedure

· Candidate Medical History and Physical Examination form (Attachment #9)

· Candidate Fitness Test Administrator Manuals and Audio Files (Attachments #17A – #17H)

· Medical Examination and Medical Document Review Templates

· Testing Designated Positions List

· Candidate Vision Consult Cover Letter (Attachment #21)

· Candidate Psychiatric Consult Cover Letter (Attachment #20)

· Candidate Non-Psychiatric Consult Cover Letter (Attachment #19)

· Candidate Auditory Testing Requirement and Hearing Aids (Attachment #18)

· Candidate CBP Fitness Test Standards and Scoring Tables (Attachment #17I)

· Candidate Non-Mental Health Consult MRO Template (Attachment #22)

· Candidate Mental Health Consult MRO Template (Attachment #23)

· Candidate Mental Health Screening Recommendation Template (Attachment #24)

· NPD Nurse Consultant Medical Services Request

· NPD - Authorization for Release of Medical Records – FFDE

· General Authorization for Release of Medical Records form

· FFDE Release of Medical Records form

· NPD – Management Request for Medical Services form

· Candidate Medical Requirements and Essential Job Tasks for various CBP Positions (Attachments #10A – #10G)

· NPD - Employee Medical Examination and History Report

· Specialized Test List

· Medical Examination and History Report

· Candidate Medical Examination Rating Sheet (Attachment #11)

· Candidate Non-Psychiatric Medical Consultation Request Form (Attachment #12)

· Non-Psychiatric Consult MRO Template

· Psychiatric Consult MRO Template

· CBP Leave Handbook

National Program Division’s Medical and Fitness Branch

Section A of this SOW is for the comprehensive provision of a Medical Services Contractor (hereafter referred to as the “Contractor”) to provide professional services which support MFB within NPD. These services shall include Contractor’s Lead Reviewing Physician Consultants to review and form an opinion of the actual examination findings of the independent medical examinations (IME) performed by physicians and/or healthcare practitioners.

Additional performance activities include: medical psychiatric, and functional capacity evaluations of employees; consultation services for the development, verification, and validation of job-related medical and physical requirements; medical consultations for clinical opinions; authoring detailed written reports of the examination and diagnostic findings, and consultation to assist with creation of medical and physical requirements and standards.

In addition, this SOW includes services to support CBP’s Drug-Free Workplace Program (DFWP) to include Health and Human Services (HHS)-certified clinics for specimen collection; HHS-certified collection staff, and the analysis of the collected specimens by an HHS-certified forensic laboratory. The Contractor’s HHS-certified forensic laboratory reports all drug test results only to the Contractor’s designated Medical Review Officer (MRO). The MRO conducts a final review of all drug testing results and reports only verified results to the Contracting Officer’s Representative (COR).

In support of the DFWP, the Contractor shall provide specimen collection supplies and shipping of these supplies to approximately 600 duty stations, located nationally and internationally. During the life of this contract, this may include locations such as Canada, the Caribbean, Abu Dhabi, United Arab Emirates, and Ireland.

The Site Coordinator, a separate contractor, coordinates specimen collection events at CBP duty stations in concert with CBP management and the Contractor. The Blind Sample supplier is a separate contractor to ensure quality measures.

The Contractor shall maintain a secure, web-based data system, accessible remotely from any internet ready personal computer with a high-speed connection, by CBP personnel per the Web Services and reporting requirements in this SOW.

The Government will consider technology related methods for interaction, such as virtual attendance. When feasible, the Agency may implement practices including virtual examinations. All virtual examination scheduling must be approved, in writing, by the COR.

1.8 EMPLOYEE MEDICAL SERVICES – Examinations and Consultations

Employee medical services include the following: employee fitness for duty evaluations, return to work reviews after an injury or illness, medical documentation review, medical consultation for clinical opinion, and specialists to assist in the development of vision and hearing requirements portion of medical standards specific to certain positions.

Fitness for Duty Evaluations

A fitness for duty evaluation (FFDE) may be conducted when there are job performance or behavioral issues. Federal employees undergo FFDEs in accordance with 5 CFR § 339.301 - Authority to Require an Examination. Under 5 CFR § 339.301(b)(3), an employee who is in a position with medical or physical requirements, may be required to undergo an FFDE whenever there is a direct question about an employee’s continued capacity to meet the physical or medical requirements of a position. For those positions without medical standards, management may offer an FFDE under 5 CFR § 339.302.

Psychiatric examinations must begin with a general examination before proceeding with the psychiatric examination.

1.8.1 Return to Work for Non-Workers’ Compensation Cases

Medical documentation submitted by the employee and/or management that is submitted to obtain a recommendation of whether the employee is fit to return to the assigned job series.

1.8.2 Medical Documentation Review

Medical documentation submitted by the employee and/or management requires a recommendation which meets the provisions set forth in the following:

1.8.2.1 The Family and Medical Leave Act (FMLA), Title 5 CFR § 630, is an entitlement law that allows eligible federal employees to take up to twelve (12) weeks of unpaid leave per year.

1.8.2.2 Medical Hardship Reassignment (Collective Bargaining Agreement between CBP and the National Treasury Employees Union (NTEU), most current version): a recommendation based on the analysis of the hardship-circumstance specifics to the health-related documentation submitted in support of reassignment at another duty station in an expedited manner. This is specific to NTEU members.

1.8.2.3 Medical Reassignment Program (U.S. Border Patrol Internal Operating Procedure Medical Reassignment Program, most current version): a recommendation based on the analysis of medical documentation submitted when medical care is not readily available to the employee and/or immediate family members regularly residing in the same household. This is specific to USBP non-bargaining unit employees and bargaining employees that are represented by the National Border Patrol Council (NBPC).

1.8.2.4 Various medical documentation submitted by employees and CBP management officials.

The chart below summarizes the number of employee examinations and consultation reviews conducted during Fiscal Year (FY) 2021 - 2025. This is historical information only and the Government does not guarantee a minimum or maximum number of reviews or examinations.

Table I - Employee Medical Examination Historical Trends

Exams and Reviews Conducted by Contractor FY 2021 – FY 2025

* Not all Medical Reassignment and Medical Hardship Reassignment Cases are sent to the Contractor.

1.9 Medical Standards and Programs

In compliance with 5 C.F.R. Part 339, CBP develops job-related medical requirements based on the essential job functions and physical requirements identified by conducting job analyses.

1.9.1 Development of Vision and Hearing Medical Requirements

This effort is intended to develop job-related vision and hearing requirements, as well to provide medical consultation related to medical and physical requirements and medical policies. The request for contractual support to develop the vision and hearing requirements of the medical standards for certain positions within CBP is subject to the needs of the Government.

1.10 Federal Drug-Free Workplace Program

NPD administers and implements the Federal Drug-Free Workplace Program (DFWP) in accordance with the U.S. Department of Health and Human Services (HHS), DHS Directive, and DHS CBP Drug-Free Workplace Plan (most current version). CBP conducts drug testing under the following circumstances:

1.10.1.1 Random – employees who occupy safety sensitive positions considered as testing designated positions (TDPs);

1.10.1.2 Reasonable suspicion drug testing;

1.10.1.3 Post-accident;

1.10.1.4 Voluntary;

1.10.1.5 Return to Work;

1.10.1.6 Follow-up Drug Testing; and

1.10.1.7 Pre-employment (coordinated by CBP Hiring Center).

1.10.2 Testing Designated Positions

CBP workforce is comprised of TDPs within the transportation industries. The Department of Transportation (DOT) regulations issued in 1988 and those issued under the authority of the Omnibus Transportation Employee Testing Act of 1991, require drug and alcohol testing of employees in “safety-sensitive” positions in aviation, trucking, mass-transit, pipeline, and other transportation industries. Therefore, in compliance with DOT regulations at Title 49 CFR Part 40, during the life of the contract, CBP may implement alcohol testing for covered employees under the following circumstances: random, reasonable suspicion, and post-accident.

1.10.3 The table below summarizes the number of employee drug tests conducted during Fiscal Years (FY) 2021 through FY 2025.

Table 2 – Employee Specimen Collected Historical Trends

POST-EMPLOYMENT SPECIMEN COLLECTIONS FY 2021-FY 2025

The Contractor must comply with HHS Mandatory Guidelines and HHS Collection Handbooks and Manuals for the Collection of Urine and Oral Fluid Specimens for Federal Agency Workplace Drug Testing Programs, hereafter referred to as “HHS Guidelines,” and the “HHS Collection Handbook,” respectively.

The Contractor shall identify and establish facilities capable of performing candidate medical examination, and fitness testing within a sixty (60) mile radius of the candidate's home address. If a candidate is located in an area where facilities capable of performing these services are scarce and the Contractor has existing facilities in their network located outside of the sixty (60) mile radius, the Contractor may request that the Contracting Officer (CO) or Contracting Officer's Representative (COR) authorizes a candidate to be examined or tested at the existing facility in the Contractor's network. Drug testing services must be within a thirty (30) mile radius unless the employee is in a rural area. If the employee is in a rural area, the services must be within a sixty (60) mile radius.

The Contractor shall provide medical examination, fitness testing, and drug testing services to include specimen collection supplies and shipping of these supplies to collection sites all CBP locations, nationally and internationally. The Contractor, upon request, shall also provide pre-employment medical examination, fitness testing, and drug testing services throughout the seven continents. The sixty (60) mile radius requirement does not apply to services being performed outside the contiguous United States.

1.11 CBP Hiring Center

Section B of this SOW provides the specific tasks and requirements for pre-employment medical services, medical consultation services, pre-employment fitness testing services, and pre-employment drug testing services for CBP.

The services under this contract are subject to the needs of the Government and to the availability of funds; the volume of tests ordered is contingent upon the number of new hires approved by Congress and specific hiring requirements. CBP shall make a good faith effort to keep the Contractor informed of anticipated or impending needs for services. The volume of requests sent by CBP to the Contractor may vary widely by day – CBP may send up to several thousand requests in one day which will need to be completed within the timelines specified in this SOW.

Candidates for the Customs and Border Protection Officer (CBPO), Border Patrol Agent (BPA), Air Interdiction Agent (AIA), Marine Interdiction Agent (MIA), and Aviation Enforcement Agent (AEA), CBP Agriculture Specialist (CBPAS), Criminal Investigator (CI), and Detection Enforcement Officer (DEO) positions receiving a conditional offer of employment are required to undergo a Pre-Employment Medical Examination and/or Fitness Test (PFT) to ensure that they are medically and physically prepared to meet the demands of the Academy, and capable of performing the required tasks of the position.

The Contractor shall have the ability to provide automated self-scheduling capabilities to allow candidates to elect date, time, and location for medical examination, fitness test, and drug test appointments.

The Government will consider technology related methods for interaction, such as virtual attendance. When feasible, the Agency may implement such practices.

1.12 PRE-EMPLOYMENT SERVICES

Pre-employment services include the following: pre-employment medical examinations, medical consultations, pre-employment fitness tests, and pre-employment drug test collection, laboratory, and Medical Review Officer.

1.12.1 Pre-Employment Medical Examination Services

1.12.1.1 Services performed under this SOW are for the purpose of providing medical information and recommendations for CBP's programs; however, final medical determination and hiring decisions are the responsibility of CBP.

1.12.1.2 The Contractor shall provide all medical examination facilities and personnel, electronic communications of all medical examination data, and all equipment necessary for completion of the medical examinations nationwide, as well as overseas upon request.

1.12.1.3 The Contractor shall provide an IT platform accessible to CBP personnel, Contractor personnel, and candidates. The platform shall provide the ability to collect, share, and transmit candidate information, including but not limited to medical examinations and consultations, candidate responses to medical follow-up, and provide candidates with the ability to review and provide required follow-up information.

1.12.1.4 Schedule candidates to take the medical examination and psychiatric evaluation (if applicable) in coordination with the CBP HC as requested by the Contracting Officer’s Representative (COR).

1.12.1.5 Administer the medical examination to candidates receiving conditional offers of employment for relevant positions, such as BPA, CBPO, CBPAS/AGS, AIA, CI, and DEO Ground.

The chart below summarizes the number of pre-employment medical examinations requested and completed during Fiscal Years (FY) 2021-2025.

Table 1 – Pre-Employment Medical Examination Historical Trends

Pre-Employment Medical Examination Historical Trends

1.12.2 Medical Consultative Services

The Contractor shall provide medical consultative services to the CBP, Office of Human Resources Management (HRM), located at the CBP HC. The Contractor shall be responsible for providing medical consultations and recommendations for all medical issues, including mental health and vision. The recommendations shall relate to the vendor’s opinion on the ability of the candidate to perform CBP job functions.

The chart below summarizes the number of pre-employment medical consultations requested and completed during Fiscal Year (FY) 2021- 2025.

Table 2 – Medical Consultation Historical Trends

Pre-Employment Medical Consultation Historical Trends

FY 2021

1.12.3 Pre-Employment Fitness Test (PFT) Services

1.12.3.1 The Contractor shall provide all fitness testing facilities, all fitness testing personnel, electronic communications of all fitness test data, and all equipment necessary for completion of the PFT nationwide, as well as overseas upon request.

1.12.3.2 Schedule candidates to take the PFT in coordination with the CBP HC as requested by the Contracting Officer’s Representative (COR).

1.12.3.3 Administer the PFT to candidates receiving conditional offers of employment for the relevant positions.

1.12.3.4 The chart below summarizes the number of pre-employment fitness tests requested and completed during Fiscal Year (FY) 2021- 2025.

Table 3 – Pre-Employment Fitness Test Historical Trends

Historical Volume of Candidate Fitness Tests Requested – PFT

1.12.4 Pre-Employment Drug Test Services

1.12.4.1 Federal Drug-Free Workplace Program

1.12.4.1.1 Pre-employment drug testing is coordinated by CBP HC, while NPD administers the Drug-Free Workplace Program.

1.12.4.2 The chart below summarizes the number of pre-employment drug tests requested and completed during Fiscal Year (FY) 2021-2025.

Table 4 – Pre-employment Drug Test Historical Trends

Historical Volume of Candidate Drug Tests

SECTION A: Employee Services - National Programs Division

Post-Employment Medical Services and Drug Free Workplace Program

All requirements outlined in SECTION A of this SOW apply to employee services for NPD.

2.0 SPECIFIC TASKS FOR EMPLOYEE MEDICAL SERVICES

2.1 TASK 1: GENERAL MEDICAL EXAMINATION SCHEDULING

2.1.1 The COR or the assigned Nurse Consultant will submit the request for an appointment to the Contractor via electronic secured transmission. The documentation submitted with the request may include, but is not limited to the following:

· Nurse Consultant Request for Medical Services;

· Authorization for Request of Medical Records;

· CBP Management’s supporting documentation;

· Medical supporting documentation provided by the employee, if available; and

· Management Request for Medical Services Form.

2.1.1.1 The COR or Nurse Consultant will provide to the Contractor, at the time of the request for an appointment, a copy of the documents listed below that are specific to the employee’s essential job duties. All document transmittals will be conducted by electronic secured transmission.

2.1.1.2 Medical Standards, Physical Requirements, and Essential Job Task Lists specific to the employee’s position, if available;

2.1.1.3 Medical supporting documentation provided by the employee, if available;

2.1.1.4 Documents submitted by management, including work observations;

2.1.1.5 The employee’s Position Description; and

2.1.1.6 Employee’s Signed Authorization for Release of Records form

2.1.2 The Contractor shall utilize the documents listed in this SOW as tools for objectively determining fitness for duty opinions.

2.1.3 The Contractor shall receive the request, by secured electronic transmission, for FFDE and coordinate an appointment for a medical examination to be performed by a healthcare provider selected by the Contractor based on the specifics of the COR/Nurse Consultant’s request documented in the Nurse Consultant Request for Medical Services form.

2.1.4 The following timeframes and record transmittal conducted by secured electronic transmission will apply:

2.1.4.1 Review of the FFDE: The Contractor shall review the provided FFDE request package for completeness within two (2) business days of the initial request for FFDE.

2.1.4.2 The Contractor shall contact the COR or Nurse Consultant by e-mail for an FFDE package that is incomplete to process, to request additional documentation, and for clarification of the request within two (2) business days of the initial receipt of the FFDE request.

2.1.4.3 The Contractor shall schedule appointments for the general examination within two (2) business days of the receipt of the complete FFDE request package. The appointment date shall not exceed more than fifteen (15) business days from the date of the COR/Nurse Consultant’s request.

2.1.4.4 The Contractor shall forward the completed FFDE request via secured electronic transmission e-mail messaging to the selected General Examination Physician or Practitioner at least seven (7) calendar days prior to the scheduled appointment for FFDE. It must be sent using a secure method, such as secure web portals, password-protected emails, emails using end-to-end encryption, or zero-trust file links.

Appointment Details: The Contractor shall schedule appointments for the general medical examination at healthcare facilities that are located within a sixty (60) mile radius of the employee duty station.

2.1.5 The appointment for the FFDE general examination shall include the following details:

· Name of the medical facility;

· Address to include street address, city, state, and zip code;

· Telephone number;

· Appointment date and time; and

· Name of point of contact at the medical facility

2.1.6 At the time the appointment is scheduled by the Contractor, the Contractor shall provide to the COR or Nurse Consultant, all information pertinent to the examination and any special instructions that must be communicated to the employee prior to the appointment. The Contractor shall provide the appointment details via secured electronic transmission.

2.1.7 The Contractor shall provide written confirmation to the COR or Nurse Consultant via secured electronic transmission at least 24 hours prior to the scheduled appointment that the subcontractor healthcare provider’s office is expecting the employee at the documented time and location and has accepted the Contractor’s terms of the scheduled appointment.

2.2 TASK 2: EMPLOYEE MEDICAL EXAMINATIONS PROCESS

2.2.1 Employee General Medical Examination Documentation and Appointment

The General Medical Examination findings shall be measured against the Medical and Physical Requirements, Position Description, and Essential Job Tasks for various CBP Positions, when applicable. The medical screening shall include a thorough assessment of the employee's medical history and shall determine the following:

2.2.1.1 Whether the employee has a history of a particular medical condition in which recurrence cannot medically be ruled out;

2.2.1.2 The etiology of any disease or condition;

2.2.1.3 The level/degree of stability of an existing or past disease/condition;

2.2.1.4 The level/degree of severity of conditions identified; and

2.2.1.5 The existence and extent of any new findings not identified in the history.

2.2.1.6 The General Medical Examination Physician or Practitioner shall complete all questions for each body system and base findings for each system reviewed on the provided Medical Examination and History Report form.

2.2.1.7 Within seven (7) business days after the examination of the employee, the General Medical Examination Physician or Practitioner shall review all medical examination records, ensuring thoroughness and completeness of requirement before forwarding paperwork by secured electronic transmission to the Contractor.

2.2.1.8 The General Physician or Practitioner shall not make any recommendation(s) verbally, or in writing, to the employee concerning the ability of the employee to perform the essential job duties, return to work letter, prescriptions, or work schedule. In the event that the Contractor is approached by an employee for a follow up note and/or an appointment, the Contractor shall refer the employee to the COR or Nurse Consultant.

2.2.2 Actions Post-General Examination

2.2.2.1 The Lead Reviewing Physician Consultant shall be responsible for:

2.2.2.1.1 Ensuring the documents submitted by the General Examining Physician or Practitioner are complete, accurate, and legible.

2.2.2.1.2 Use the findings from the General Examination and other documentation to create a written recommendation whether:

2.2.2.1.2.1 The employee is Fit for Duty,

2.2.2.1.2.2 The employee is Not Fit for Duty, or

2.2.2.1.2.3 Further evaluation should be conducted with an IME Specialist; and/or

2.2.2.1.2.4 Additional documentation and/or medical documentation needed to augment the IME.

2.2.2.1.3 In the majority of cases, an IME will be required to complete a FFDE. In the rare circumstances where the Lead Reviewing Physician Consultant believes there is sufficient information to make a recommendation on the employee’s Fitness for Duty without an IME, the Lead Reviewing Physician Consultant will use the General Examination findings in conjunction with the Medical Standards, Physical Requirements, Essential Job Task List, Position Description, and supporting documentation to create a Medical Report regarding the employee's current medical fitness for the specific position (including a description of current health status, stability of condition, use of medication that may affect safe and efficient job performance, and the rationale for the opinion).

2.2.2.1.4 This report shall answer all questions on the Nurse Consultant Request for Services form and make a recommendation of whether the employee is Fit or Not Fit to perform the essential duties of their position. The COR or Agency Nurse Consultant may request an IME even when the Lead Reviewing Physician Consultant believes there is sufficient information to make a recommendation on the employee’s fitness after the General Examination.

2.2.2.1.5 The Lead Reviewing Physician Consultant shall review all examinations, diagnostic findings, and laboratory results and provide the recommendation to the COR or Nurse Consultant within seven (7) business days of the Contractor’s receipt of the examination documentation from the General Examining Physician or Practitioner.

2.2.2.1.6 For abnormal laboratory test results and diagnostic study findings that would generally be considered urgent or life threatening per the American Medical Association, the Lead Reviewing Physician Consultant is required to contact the employee via telephone within 24 hours of receipt of the findings and advise the employee of the results.

2.2.2.1.7 The Lead Reviewing Physician Consultant shall notify the COR or Agency Nurse Consultant assigned to the case via telephone and follow the call up with an email within twenty-four (24) hours of the notification to the employee.

2.2.2.1.8 The Contractor shall draft a courtesy letter for any abnormal laboratory findings. The letter should be addressed to the employee and include any abnormal findings. The courtesy letter must be drafted within seven (7) days of receipt of the examination findings from the General Physician or Practitioner.

2.2.2.2 All documents provided to the COR or Nurse Consultant shall be placed on official letterhead and shall be typed and legible.

2.2.2.3 The Contractor shall provide the original copies of the General Examination final report to the COR or Nurse Consultant within 7 business days.

2.2.2.4 All reports submitted by the Contractor shall be complete, accurate, void of typographical errors, and decisive in opinion.

2.2.3 Independent Medical Examinations

2.2.3.1 Once the COR or Nurse Consultant requests the Contractor schedule an IME, the Contractor shall provide tentative appointment details (potential date(s), location, and provider) within ten (10) business days of the request. The final IME appointment details should be provided within two (2) business days of the COR or Nurse Consultant’s approval of the IME appointment details.

The Contractor shall provide the COR or Nurse Consultant with appointment details via secured e-mail at least fifteen (15) business days in advance of the IME appointment. IMEs will be fixed price per examination to include a thorough review and summary of the medical records, scheduling fees, all nursing support, examination, and a comprehensive report.

2.2.3.2 Provider locations: The examination shall take place in a medical facility or office space. Establishments (e.g., hotels) that provide accommodations, meals, and other services for travelers and tourists are not acceptable examination locations.

2.2.3.3 Provider locations outside of 60-mile radius: The Contractor shall notify the COR to get approval before scheduling

2.2.3.4 Cancellations: The cancellation fees for the IME must be incorporated in the price of the IME. The Government will not be billed for cancelled IMEs.

2.2.3.5 Reschedule: The fee to reschedule an IME must be incorporated in the price of the IME. The Government will not be billed for rescheduled IMEs.

2.2.3.6 No shows: The Contractor shall notify the COR and designee by telephone and follow up with an email that same day when an employee does not attend his/her scheduled medical appointment and the Contractor shall be paid the IME "no show" fee.

2.2.3.7 The IME Specialist shall perform the examination and form an opinion, “Fit” or “Not Fit” based on the examination findings, employee’s Position Description, and all provided information and form a recommendation whether the employee can safely and efficiently perform all of the duties of the specific position without restrictions.

2.2.3.8 The IME Specialist’s final report must answer questions listed on the Nurse Consultant request form, which may be modified, but currently requests responses to the following questions:

1. State the employee’s diagnosis(s) – using International Classification of Diseases (ICD) Codes (most updated version), Diagnostic and Statistical Manual (DSM) (most updated version), severity, and the prognosis of the condition(s).

a. Is the condition in question itself disqualifying?

b. Can the condition’s recurrence be ruled out?

c. Are the duties of the position such that a recurrence would pose a reasonable probability of substantial harm to self or others?

2. Is there a history of violence and/or abuse (E.g. domestic)? If yes, please provide the details.

3. Is there a medical or psychological condition in question that affects the employee’s ability to perform the essential job functions safely and efficiently?

4. Does the employee pose a direct threat to self or others, and/or the vulnerability of business operations and information systems? If yes, please provide your opinion regarding why the employee poses a possible threat.

5. Can the employee safely and efficiently perform all of the duties of the position, including but not limited to, responding to emergencies in a law enforcement capacity (e.g., restraining suspects)?

6. Are the restrictions / limitations, if any, or requested accommodation short, long term, or permanent?

7. If the employee is unable to perform all the duties of the position without restrictions, please explain and list the task(s) and the rationale for the inability to perform.

8. Is the employee fit or not fit to perform the full duties of the position without restrictions? Please indicate a Fit for Duty or Not Fit for Duty status.

2.2.3.9 The IME providers shall submit the report findings and opinion to the Contractor as set forth in this SOW within ten (10) business days of the IME appointment.

2.2.3.10 For non-psychiatric IMEs, the Lead Reviewing Consultant shall review all documentation provided by the IME Physician(s) for adequacy, consistency, and credibility. For Psychiatric IMEs, this will be done by the Mental Health Reviewing Consultant. Any discrepancies or other issues shall be communicated between the IME provider and the Lead Reviewing Physician Consultant or Mental Health Reviewing Consultant.t.

2.2.3.11 The Lead Reviewing Physician Consultant or Mental Health Reviewing Consultant must use all provided information, including the IME Report, to create a Final Report that includes the recommendation of whether the employee is Fit or Not Fit for Duty to perform the essential duties of their position. This report must be submitted to the COR or Nurse Consultant via secured electronic transmission within ten (10) business days of receipt of the IME Specialist’s report.

2.2.3.12 The recommendation made by the Lead Reviewing Physician Consultant or the Mental Health Reviewing Consultant shall be the definitive recommendation.

2.2.3.13 Psychiatric and Non-Psychiatric IMEs shall be billed under separate CLINs.

2.2.3.14 All reports submitted by the Contractor shall be complete, accurate, void of typographical errors, and decisive in opinion.

2.3 TASK 3: OTHER EMPLOYEE MEDICAL SERVICES

2.3.1 Employee Specialized Medical Tests

2.3.1.1 The COR may add “Specialized Medical Tests” (additional laboratory tests and/or diagnostic studies) to the employee’s examination. The COR may occasionally request that the Contractor complete the additional specialized test outside of an employee examination. For example, based on the initial clinical findings of the employee examination, the COR may then request additional tests to support a definitive diagnosis and opinion.

At the time of the final scheduling of the examination and/or evaluation, the Contractor shall provide to the COR, via secured electronic transmission, the cost of both the Independent Medical Examination(s) and the specific cost(s) of any Specialized Medical Tests as set under the terms of the contract.

2.3.1.2 The Contractor shall order Specialized Medical Tests based upon the presentation of the employee. For example, for diagnoses related to substance use disorder and based on the standard of care and professional judgement, the Contractor shall order FFDE Drug Testing for drugs of abuse. The Contractor shall complete the scheduling of FFDE Drug Testing within two (2) business days of the receipt of the request from a COR or Nurse Consultant.

2.3.1.3 FFDE Drug Testing must comply with Federal authorities for the Federal Drug Testing programs using strict chain of custody. Note: The FFDE Drug Test is independent of the Agency’s Drug-Free Workplace Program.

2.3.2 No Shows, Rescheduled, and Canceled Appointments

The Contractor should anticipate that no-show or canceled appointments may occur up to six percent of the time, however, this is merely an estimate and may be higher. A no-show appointment is when the employee does not show up for the appointment and the Contractor was not notified at least 24 hours in advance that the employee will not attend the appointment.

For general examinations, no show and/or cancelled appointments are not separately priced and therefore, not billable under this effort. The successful offeror must be sure to include the expected cost, if any, of no show and/or canceled general examination appointments in the price of the services as outlined in the SOW.

Cancellation and rescheduling fees for IME appointments are not billable. The successful offeror must be sure to include the expected cost, if any, of canceled or rescheduled IMEs in the price of services as outlined in the SOW. No-shows for IMEs shall be billed to the Government at a fixed price rate and in accordance with the terms contained herein.

2.3.3 Agency requested IME addendum:

In the event and upon notification that additional information is available and/or the Agency has additional questions to be addressed by the IME physician after the recommendation is rendered, the Contractor shall provide the addendum to the COR or Agency Nurse Consultant within 15 business days of the receipt of the request.

2.3.4 Lead Reviewing Physician Consultant requested IME addendum:

The Lead Reviewing Physician Consultant shall review all IME report findings. In the event that a Lead Reviewing Physician Consultant determines that an addendum is necessary in order to make a FFDE recommendation, then the Lead Reviewing Physician Consultant shall provide, via secured electronic transmission, the addendum questions to the Contractor’s examining IME physician within one (1) business day of the recommendation. The Contractor shall provide the revised IME report via secured electronic transmission within seven (7) business days of notification of deficiency.

2.3.5 The Contractor’s Mental Health and Vision Reviewing Consultants

The Contractor shall manage all Psychiatric and Vision IME reviews by Specialists, including Board-Certified Psychologists, Board-Certified Psychiatrists, Board-Certified Addiction Specialists, and Board-Certified Optometrists or Ophthalmologists. The Mental Health Reviewing Consultant shall review all psychiatric IME reports. The Vision Reviewing Consultant shall review vision IME reports. All Reviewing Consultants shall review examination finding reports as set forth in this SOW. The Contractor shall provide all available records to the respective Reviewing Consultant within seven (7) business days of receipt of the report from the IME provider.

The Contractor shall provide the Government with a written report within fifteen (15) business days of the receipt of each request.

2.4 TASK 4: EMPLOYEE PSYCHIATRIC CONSULTATIONS

2.4.1 At the request of the COR/Nurse Consultant, the Mental Health Reviewing Consultant shall review medical documentation provided by the employee. The scope of Mental Health Reviewing Consultant shall include, but is not limited to, the following medical review services:

2.4.2 IME Report Reviews: The Contractor shall provide all available records to the Contractor’s Mental Health Reviewing Consultant for review within seven (7) business days of the receipt of the report from the examining psychiatric IME Provider. The records shall be provided via secured electronic transmission. The Mental Health Reviewing Consultant shall ensure that the examining Provider addressed all questions posed in the “Nurse Consultant Medical Services Request form” in the report to the Agency, as described in Section 2.2.

2.4.3 Return to Work for Psychiatric Cases: Physician reviews of medical documentation and physician issuance of a written, comprehensive opinion as to whether an employee can safely and efficiently resume the full range of duties of his/her position.

The Contractor shall create a written report within fifteen (15) business days of the receipt of each request.

2.5 TASK 5: MEDICAL REVIEW CONSULTATION SERVICES – LEAD REVIEWING PHYSICIAN CONSULTANT

2.5.1 At the request of the COR/Nurse Consultant, the Lead Reviewing Physician Consultant shall review medical documentation provided by the employee. The scope of Lead Reviewing Physician Consultant shall include, but is not limited to, the following medical review services:

2.5.1.1 Review of all FFDE General Examination, IME, and Final Reports. All reports should be reviewed for completeness, accuracy and consistency.

2.5.1.2 Review of documentation concerning general medical issues and questions concerning medical standards and physical requirements of CBP positions.

The Contractor shall create written reports within fifteen (15) business days of the receipt of each request and provide a response via electronic transmission to the COR or Nurse Consultant.

2.5.1.3 Review of medical cases to prepare for legal proceedings to advise CBP's Office of the Chief Counsel (OCC).

2.5.1.4 Return to Work: Physician reviews of documentation to create a written, comprehensive opinion as to whether an employee can safely and efficiently resume the full range of duties of his/her position.

The Contractor shall create a written report within fifteen (15) business days of the receipt of each request. Provide a response via electronic transmission to the COR or Nurse Consultant.

2.5.1.5 Family and Medical Leave Act (FMLA) requests: Physician reviews and physician issuance of a written, comprehensive opinion as to whether the provided information meets the medical criteria for leave under FMLA (5 CFR Part 630).

The Contractor shall create a written report within fifteen (15) business days of the receipt of each request. Provide a response via electronic transmission to the COR or Nurse Consultant.

2.5.1.6 Position Description Reviews: Physician is provided a Position Description and medical and management documentation about an employee. The physician uses the Position Description requirements and medical documentation to create a written comprehensive opinion as to whether the employee meets criteria for the position.

The Contractor shall create a written report within fifteen (15) business days of the receipt of each request. Provide a response via electronic transmission to the COR or Nurse Consultant.

2.5.1.7 Employees with leave issues: Occasional physician reviews in cases of medical related leave issues.

The Contractor shall create a written report within fifteen (15) business days of the receipt of each request. Provide a response via electronic transmission to the COR or Nurse Consultant.

2.5.1.8 Consultations with OCC on any…