2.2.1 - RFP Attachment 1 - PWS Apr 2024_IAD - Amendment 1.docx

Department of Homeland Security, U.S. Immigration and Customs Enforcement, Office of Human Resources Operations Center

Medical Service Support (MSS)

Performance Work Statement (PWS)

5 April 2024

TABLE OF CONTENTS

MSS PWS

Part 1 - Overview and Contract Requirements

Introduction

The primary mission of the U.S. Department of Homeland Security (DHS) is to lead the unified national effort to secure the country and preserve our freedoms. While the Department was created to secure our country against those who seek to disrupt the American way of life, our charter also includes preparation for and response to all hazards and disasters. U.S. Immigration and Customs Enforcement (ICE) is responsible for the protection of the security of the American people and homeland by vigilantly enforcing the nation’s immigration and customs laws.

Scope

This PWS encompasses pre-employment and post-employment medical, psychological, fitness, and drug testing services for ICE personnel. Pre-employment medical services include selectee medical, fitness, and drug testing in accordance with U.S. Department of Health and Human Services (HHS) regulations. Post-employment medical services include support for the Drug Free Federal Workplace Program, independent medical examinations, reviews of medical documents, and ancillary testing for ICE employees.

Potential locations where services will be delivered include all 50 U.S. states, plus locations in Puerto Rico, the Virgin Islands, the Mariana Islands to include Guam, and possibly any location throughout the seven continents. Requests for pre-employment testing will originate from the ICE Office of Human Capital (OHC) Human Resources Operations Center (HROC) Dallas Pre-Employment Clearance (PEC) Unit. For ICE employees, examinations and testing will originate from the ICE OHC Fitness for Duty Coordinator (FFDC) or Drug Program Coordinator (DPC). A capability to accept notification of the need for drug or alcohol testing in reasonable-suspicion cases must be available via telephone 24-hours a day, 7 calendar days a week.

Due to the complex and technical nature of the requirements in this PWS, the Government shall be in contact with the Contractor daily. The Contractor shall be prepared to be responsive to inquiries and status requests.

Applicable Law, Regulation, and Policy

The applicable law, regulation, and policy for this PWS are listed below. The Contractor is expected to comply with these documents and the Contractor must use the latest version of these applicable documents. Government documents will be provided to the Contractor upon request but no later than before the commencement of services.

· 41 Code of Federal Regulations (CFR) Chapters 300-304, Federal Travel Regulation, http://www.gsa.gov/portal/content/104790

· HHS Mandatory Guidelines (latest version available on the Substance Abuse and Mental Health Services Administration (SAMHSA) website

· HHS, Urine Specimen Collection Handbook for Federal Agency Workplace Drug Testing Programs

· 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 http://www.hhs.gov/hipaa

· ICE Medical Standards, approved by the Office of Personnel Management

· HHS, Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs

· ICE Drug-Free Workplace Plan

· HHS SAMHSA list of certified laboratories

· 5 CFR 339 Medical Qualification Determinations

The Government will provide the following to the Contractor upon award:

· Medical standards by position description

· Medical History and Physical Examination (MHPE) form

· Fitness examination DVD

· Fitness examination audio file

· Medical Examination and Medical Document Review Templates

· Testing Designated Positions List

Hours of Operation

Working days are defined as Monday through Friday, excluding federal holidays.

Juneteenth

The Contractor’s testing facilities and clinics shall remain open to allow scheduling 5 working days a week and collection 5 working days a week.

In the event of post-accident scheduling (see Section 4), the Contractor’s testing facility and clinic must be made available within 8 hours of post-accident notification, 7 calendar days a week.

Geographic Locations

The examining medical/fitness/collection facilities must be located within the potential delivery destinations of all 50 U.S. states, plus locations in Puerto Rico, the Virgin Islands, and the Mariana Islands to include Guam. The examining medical/fitness/collection facility selected should be located within 50 miles of the employee’s home or work.

Personnel Requirements

Medical Review Officer

The HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs (“Mandatory Guidelines”) define a medical review officer (MRO) as a licensed physician holding either a Doctor of Medicine or Doctor of Osteopathy degree who has:

A. Knowledge regarding the pharmacology and toxicology of illicit drugs.

B. Training in: collection procedures used to collect federal agency specimens; interpretation of test results reported by laboratories; chain of custody, reporting, and recordkeeping requirements for federal agency specimens; the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs; procedures for interpretation, review, and reporting of results as specified by the federal agency or agencies for which the individual may serve as MRO; and the requirement to notify the Agency of cases where individuals in safety-sensitive positions are taking legitimately prescribed medications that creates a safety risk, primarily those ICE employees in law enforcement positions.

C. Satisfactorily passed an examination administered by an HHS-approved organization (i.e., a nationally recognized entity that certifies MROs or a subspecialty board for physicians performing a review of federal employee drug test results). HHS publishes an annual list of approved organizations in the Federal Register.

Reviewing Physician(s)

A Reviewing Physician must be a licensed physician with demonstrated experience in performing reviews of medical examinations to determine if a selectee or employee meets an agency’s medical standards or is medically qualified under federal regulatory standards such as Department of Transportation’s Federal Motor Carrier Safety Administration medical standards or the Federal Aviation Administration’s medical standards for Airline Transport Pilots. The Reviewing Physician must have demonstrated an ability to clearly articulate the type of additional medical documentation needed to further evaluate the risk associated with a medical condition and its impact on the safe and effective performance of the job. The Reviewing Physician(s) will perform reviews of the medical examination and/or any additional medical documentation submitted, as requested, to support meeting the agency’s medical standards. Reviewing Physician(s) must be well versed in federal regulations, case law, and Equal Employment Opportunity Commission guidance regarding the type of medical information that can be required in order to provide sufficient evidence that a past or current medical condition presents no increased risk of causing a sudden or subtle, partial or total, incapacitation presenting a hazard, or risk, to the employee, coworker, or the mission of the Agency. Reviewing Physicians deemed qualified following quality review by the Agency must review and correct the medical reviews of any new or additional Reviewing Physicians employed by the Contractor.

Program Manager

The Program Manager must have at least 5 years of experience managing programs of the same complexity and scope of this PWS. The Program Manager should be a subject matter expert in the medical services industry. The Contractor shall provide a Program Manager to act as the central point of contact (POC) with the Government for all program-wide technical issues and who will represent the Contractor at all post-award status meetings. The Program Manager shall be responsible for all issue resolution, program management, and other administrative support including providing comprehensive support for the contract. The Program Manager shall be a single POC for the indefinite delivery indefinite quantity (IDIQ) contracting officer and the IDIQ and task order contracting officer’s representative (COR).

The Program Manager shall be available to the COR(s) via telephone between the hours of 8 a.m.-5 p.m., EST, Monday through Friday, and shall respond to a request for discussion or resolution of technical problems within 24 hours of notification.

Contractor’s Responsibilities

The Contractor’s responsibilities shall include, but are not limited to:

A. Providing all labor, materials, and equipment necessary for the selectee/employee medical examination services, fitness assessments, and for the collection and transportation of all specimens.

A. Paying all fees and postage related to information submitted to the Government, including forms, reports, shipping to collectors, etc.

B. In support of random drug testing, identify and arrange facilities for examination services, specimen collection and ensure the facilities are equipped with the appropriate supplies and materials within 5 working days of the Government’s request. Should the Contractor have problems or issues with a particular subcontractor or facility, the primary Contractor shall notify the Government via the designated COR within 2 working days and shall note any corrective action taken.

C. The Government shall not be invoice for selectees/employee’s specimens that are rejected or lost due to collection errors.

D. Invoices for independent medical examinations shall only occur after all the Agency’s questions have been addressed to the satisfaction of the government.

Security Procedures

The Government reserves the right to require a full-field background investigation of any Contractor employee assigned to perform services. The Contractor is responsible for ensuring that all information and medical records obtained are maintained in a strictly confidential manner. The records must be stored either in locked, fireproof metal filing cabinets or in a secured room that is not accessible to the public or visitors.

Release of Information

All records are subject to the Privacy Act, 5 U.S.C. 552a. The information and records shall be maintained and used with the highest regard for selectee and employee privacy. Selectees and employees may review the information obtained from the physical/medical exam. However, they shall not be allowed to have unsupervised access to their medical records. Individuals may obtain a copy of their medical examination results by sending an original notarized letter authorizing release of the information, to whom the information is to be released, and the address of where the information is to be mailed.

For requests concerning pre-employment examinations, the Release of Information Authorization and request should be addressed to:

Entry Level Hiring Unit, PEC Office of Human Capital-Irving U.S. Immigration and Customs Enforcement 8222 N. Belt Line Road, 2nd Floor Irving, TX 75063

For requests concerning fitness for duty examinations (FFDE), the Release of Information Authorization and request should be addressed to:

Medical Officer Office of Human Capital U.S. Immigration and Customs Enforcement 500 12th Street Washington, D.C. 20536-5008 Billing

Invoice submission shall be monthly via email to the ICE Finance Center (invoice.consolidation@ice.dhs.gov), COR, and alternate COR (for the respective task order). The invoice cover sheet shall include the following (PDF format):

• Contractor business name

• contract/task order

• invoice number

• bill to

• remit to

• billing period

• amount billed

• current amount

• cumulative amount

• invoice total

• electronic funds transfer information (bank name, ABA routing, and account name/number)

• UEI number

• Contractor POC information

The invoice detail spreadsheet shall include the following (.xls format):

• Contractor business name

• contract/task order

• invoice number

• patient information (per exam) - (invoice date, facility, patient name, last 4 digits of social security number, exam date, appointment date, category, exam type, exam procedure/exam name, price billed, invoice total).

Travel / Other Direct Costs

The Contractor shall coordinate specific travel arrangements with the COR to obtain advance, written approval for the travel to be conducted. The Contractor’s request for travel shall be in writing and contain the names of individuals traveling, dates, destination, purpose, and estimated costs of the travel. The Government will not reimburse for local travel, which is defined as travel within a 50-mile radius of the Contractor personnel’s permanent performance location.

If any travel arrangements cause additional costs to a task order that exceed those previously negotiated, modification to the task order by the task order contracting officer is required prior to undertaking such travel.

The Contractor shall, to the maximum extent practicable, minimize overall travel costs by taking advantage of discounted airfare rates available through advance purchase. Charges associated with itinerary changes and cancellations under nonrefundable airline tickets may be reimbursable if the changes are driven by the work requirement. Travel performed for personal convenience or daily travel to and from work at the Contractor’s facility or local Government facility (i.e., designated work site) shall not be reimbursed. Costs associated with Contractor travel shall be in accordance with Federal Acquisition Regulation (FAR) Part 31.205-46 - Travel Costs and Federal Travel Regulations prescribed by the General Services Administration for travel in the contiguous United States.

All overhead, including Other Direct Costs (ODCs), should be included in the Firm-Fixed-Price (FFP) line items of this contract.

No Shows and Canceled Appointments

It should be noted that the Government anticipates that there will be no show and/or canceled appointments during the contract. However, no show and/or canceled 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 appointments in the price of the services as outlined in the PWS. The Contractor should anticipate that no show or canceled appointments may occur up to six percent of the time. The exception to this is independent medical examinations, which will be billable to the Government at a fixed price rate.

Additional Services

If the medical requirements change, within either ICE’s pre-employment, post-employment, or Drug Free Work force program, the Government may negotiate additional services to this IDIQ. These additional services must fall within the scope of Medical, Psychological, Fitness, and Drug Testing Services as stated in Section 1.1.

Part 2 - Mobile One-Stop Hiring Event(s)

Description

As required during the term of the contract, the Contractor shall provide all required medical, fitness (if applicable), and drug testing services in support of Agency hiring events designed to compress the traditional employee hiring process. A fixed price order may be placed under the Mobile One-Stop Event CLINs. Any services provided under a Mobile One-Stop Hiring Event order will count toward any quantity designated in the schedule as the “minimum.”

All One-Stop Hiring Events will be held in major metropolitan areas. The Government will provide the venue and travel costs will be reimbursed in accordance with Section 1.10. The task orders will be awarded at one fixed price per event (plus travel) for a minimum of 30 (maximum of 55) selectees per day, for 3 to 4 calendar days, likely including a weekend. All costs will be included in the fixed price to include on-site labor, equipment, supplies, shipping, drug test collections, drug test lab analysis, tuberculosis bloodwork lab analysis, and any other direct costs incurred by the vendor.

The Government will provide a venue (typically a hotel) that meets the following specifications.

· 1200-1300 square feet meeting space:

· Three tables outside of meeting space for check-in

· 10 chairs for selectees to fill out paperwork near check-in

· Two water stations with cups

· 12 to 15 chairs for medical staff to use as needed

· 12 to 15 tables for medical staff to use as needed

· One exclusive restroom for drug testing

The Contractor’s duties are as follows:

A. Set up pipe and drape for medical exams.

B. Perform all necessary administrative, medical, fitness (if applicable), and drug testing services in accordance with all contract requirement(s) set forth in this PWS.

C. Provide service for a guaranteed minimum of 30 pre-employment medical, 30 physical fitness tests (if applicable), and 30 drug testing exams at major metropolitan locations.

D. Provide all labor, materials, and equipment necessary for the selectee’s pre-employment medical, fitness (if applicable), and drug testing services to include collection and transportation of all specimens.

E. Provide a booth meeting Occupational Safety and Health (OSHA) testing requirements for the hearing tests.

F. Set up each event to be ready for selectees by 7 a.m. Each event shall continually run throughout the day and the last selectee will normally be accepted by OHC staff no later than 2:30 p.m. each day to allow for all tests to be completed by 8 p.m.

G. Record test findings using the MHPE developed by the Government to be used for examination purposes. OHC staff will email fillable MHPE forms to each selectee prior to each one-stop. Additional copies of the MHPE forms must be available onsite in the event a selectee is unable to bring the previously provided forms. Input test results into the Customer Access Portal for each selectee as follows:

· Blood test, or PPD test, will be used for the tuberculosis test.

· Date and time of scheduled appointment.

· Drug results within 4 working days of actual test.

· Medical results, laboratory test results, chest x-ray reports, and ancillary test results within 10 working days of actual test.

· Physical Fitness Test (PFT) Score Sheet fitness results (if applicable) within 10 working days of actual test.

H. Send a completed MHPE in PDF file format for each selectee within 10 working days of actual exam.

I. Furnish all personnel and all medical equipment necessary for screening during each event.

Part 3 - Pre-Employment Medical Services

Federal agencies are responsible for ensuring that their employees are fully qualified to perform the essential duties of their respective positions safely and efficiently. In law enforcement and other safety-sensitive areas, this mandate takes on extraordinary significance in that certain positions require the employee to engage in activities that are strenuous, hazardous, and carry a high degree of responsibility to the public. These areas are generally, but not exclusively, weapon carrying positions. Because of this, and in accordance with 5 CFR 339, federal agencies have the authority to require:

· Selectees to undergo a pre-employment medical examination and provide specific documentation related to their medical histories; and

· Employees to demonstrate their continued medical qualification for the position based on previously established medical guidelines, physical requirements, and critical tasks specific to each position.

Federal agencies are also authorized to perform drug testing and fitness testing for certain designated positions.

If a selectee has a history of a mental health disorder, a chronic condition with an expectation for relapse or recurrence, or a medical condition with a potential for residual impairment once at maximum medical improvement, then copies of treatment records should be requested by the Agency to further assess the status of the mental health disorder or medical condition.

The Government will inform the Contractor of the selectee’s need for a medical examination. Once the Government has contacted the Contractor, the Contractor has 10 working days to contact the employee for scheduling the examination. The examination shall be scheduled within 30 calendar days once the selectee is contacted. The completed medical examinations package, MHPE, PFT Score (as applicable) and all other test results, must be provided to the Government within 10 working days following completion of Contractor-provided testing.

When requested as part of an FFDE, the request will describe the services requested. A “virtual face-to-face” evaluation via videoconferencing, or telemedicine, is not acceptable for either a pre-employment examination or FFDE.

Pre-Employment Drug Screening

All pre-employment drug test collection must occur at a clinic within 50 miles from the selectee’s recorded address and be performed in accordance with HHS guidelines.

Drug Screening Process/Scheduling

Daily, or as needed, ICE will order a drug screening for its selectees. Within 3 working days of initial notification from the Government of the need to schedule a screening, the Contractor shall be responsible for coordinating the scheduling of the services with the selectee. The Contractor shall make three attempts to contact the selectee, via telephone and/or email, to notify the examinee of the appointment date, time, address, and contact person. Upon successfully notifying the selectee of the need for a urine specimen, the Contractor shall make provisions to ensure the selectee provides such a specimen within 2 working days of the selectee being notified. The MRO will notify OHC within 2 working days after receiving the results of the test. It is the responsibility of the MRO to report positive and irregular results to OHC as they are identified. It is the responsibility of the MRO to contact the ICE Medical Officer via email for any law-enforcement officer with a non-negative test result. A non-negative result is defined as when a tested substance is detected, but a current, valid prescription for that substance is provided, therefore, the final result is reported as negative.

Procedure in the Event of Selectee Unavailability or No Shows

In the event the selectee is unable to schedule a drug screening within 2 working days of the Contractor contacting the selectee, the Contractor must refer the examination request back to OHC for further guidance on how to proceed with the selectee’s case.

If a selectee does not appear for the scheduled examination, the Contractor shall notify the OHC Drugfree-Workplace Program Coordinator (DPC) via email or fax, with or without a telephone call, within 4 hours of the scheduled appointment. “No show” fees will not be billed to the Government. The Government reserves the right to cancel or reschedule a screening up to 24 hours before the scheduled appointment without any additional fee.

Pre-Employment Medical Examinations

When contacting the selectee to schedule a medical exam (and fitness assessment), the Contractor shall advise the selectee that medical records related to current or past medical conditions must be copied and brought by the selectee to the medical examination. This includes any Veterans Affairs Disability Rating Decision Letters and any form of disability compensation that the selectee may be receiving. The Contractor must make the selectee aware that the selectee is required to provide these records to the examining physician at the time of their appointment.

Pre-Employment Medical Examination Process

Medical examinations performed under the requirements of this PWS must be consistent with established medical guidelines for weapon-carrying positions. Specifically, the medical screening must include a thorough assessment of the selectee’s medical history and must determine the following:

· The selectee’s current and forecasted future medical qualification for fulfilling the duties of the advertised position.

· If the individual has a history of a particular medical problem in which recurrence cannot be medically ruled out based on the information available at the time of the examination.

· The etiology of any disease or condition.

· Whether there is a discrepancy in the reported medical history.

· The level/degree of stability of an existing or past disease/condition.

· The level/degree of severity of conditions identified.

· The existence and extent of any current concern that is not identified in the medical history, but which may be present during the exam.

Forms to be used in the recording of the medical history and examination’s physical findings have been developed by the Government and will be used for examination purposes. These forms also serve as guidelines as to what information is salient to the exam process. The Contractor must ensure that all questions on the form are answered by the selectee. In addition, the Contractor must ensure that the examining physician provides factual comments on any positive answers from selectees, fully performs any diagnosis-specific physical examination tests, and records all data required for the exam on the examination form. The required data points include:

· Vital signs

· Height and weight

· Vision:

· corrected and uncorrected visual acuity (near and distant) correctly illuminated according to manufacturer recommendations.

· peripheral vision

· visual depth perception

· Hardy, Rand and Rittler (HRR) pseudo isochromatic plate test for color vision testing, illuminated by International Commission on Illumination (CIE) Class C, or equivalent lighting.

· Pure tone audiometry (500; 1,000; 2,000; 3,000; 4,000; 6,000; 8,000 frequencies)

· ICE pre-employment Tuberculosis symptom screening questionnaire.

· Chest x-ray for all selectees who have a positive tuberculosis skin test or blood test.

· Medical doctor’s review and interpretation of 12-lead electrocardiogram (EKG) (upon review of the EKG, the reviewing physician must sign or otherwise initial the EKG) and interpretation of the chest x-ray when the selectee has a positive tuberculosis questionnaire.

· On-site quality review to confirm that all required information has been collected and entered on the form.

· Examiner comments on all positive medical history findings, as well as detailed collection and recording of physical examination findings directed by the medical history.

· Examiner comments as to whether the medical treatment records provided by the selectee sufficiently address the selectee’s past medical history.

The Contractor is responsible for obtaining, at their expense, any data, specified above, or information not collected during the medical examination process.

Selectees being currently treated for medical conditions who fail to provide necessary medical treatment records shall have their medical examination postponed until the selectee obtains the necessary documentation. The selectee shall be given 15 calendar days to notify the Contractor that the treatment records have been obtained. In such cases, the Contractor shall notify the Government of the delay in processing the medical examination, or if the selectee fails to obtain the necessary treatment records within the 15 calendar days.

Scheduling

The Contractor shall have 10 working days from the date of OHC notification to contact selectees to schedule medical tests (and physical fitness tests (PFT), if applicable). Upon successfully notifying the selectee of the need for medical and/or fitness testing, the selectee is given 30 calendar days to be appointed for the examination.

If a selectee does not appear for the scheduled examination, the Contractor shall notify OHC via email, with or without a telephone call, within 4 hours of the scheduled appointment. “No show” fees will not be billed to the Government. OHC reserves the right to cancel or reschedule appointments up to 24 hours prior to the scheduled appointment without any additional fee.

The Contractor shall make a total of three attempts within 10 working days to contact the selectee. Telephone contacts must include voicemail and text, as applicable, and one attempt via email to notify the examinee for the appointment date, time, address, and contact person. If contact efforts are unsuccessful, HROC PEC unit must be notified within 1 working day once the final effort to contact the selectee has been unsuccessful.

Pre-Employment Physical Fitness Tests

General Information

Before commencing the PFT, selectees shall have completed the pre-employment medical examination (see Section 3.2), including blood pressure readings and a 12-lead EKG with medical doctor’s interpretation, to verify they are medically cleared to take the PFT.

The Contractor must specifically identify whether the selectee is cleared to take a PFT for both deportation officer and criminal investigator positions.

In cases where a PFT and medical exam are ordered at the same time, the Contractor may schedule the selectee for both appointments at the same time. However, the medical exam is completed first, and the selectee only completes the PFT once the examining physician clears the selectee for the PFT. In circumstances where the Government orders only a medical exam, the Contractor will develop and provide a signed PFT Clearance Form to the selectee whereby the examining physician states:

“Based upon my review of the selectee’s medical history, physical examination, and EKG on <DATE>, it is my opinion that the selectee:

· may safely engage in the required fitness test, or.

· is unable to safely engage in the required fitness test.”

Once cleared, the subsequent PFT may be accomplished by the Government or the Contractor at the Government’s option. If no contraindications to participation have been identified, and the selectee provides signed consent to be tested, then the fitness assessments shall be administered. If the selectee experiences chest pains or other problems, or if the test administrator determines that testing should not proceed, then the testing should be immediately stopped. In these cases, the reason for stopping the test is noted on the Physical Fitness Test Score Sheet. In all cases the complete MHPE form and evaluation forms must be completed within 10 working days of the date of completion of all evaluation required of the Contractor.

Description of Contractor-Administered Physical Fitness Test

The PFT consists of three parts and allows for a 3-minute rest period between each part.

The following describes the components:

1. Kneel/Stand Test

The test consists of 10 changes of position, an extended period of upright kneeling (2 minutes), followed by the final position change. The test is administered as one continuing test, with two parts, which are timed separately. The initial 10 changes must be completed within 25 seconds and are immediately followed by 2 minutes of kneeling and then coming to a full standing position. Both parts of the test require the maintenance of upright postures with minimal posture deviations especially during change of positions. The selectee will be required to hold both arms extended in front as if holding a firearm. An audio file will provide audible cues during this test so that the selectee does not have to memorize the sequence.

2. Push-up Test

This is a timed test requiring completion of 15 proper form push-ups in 2 minutes. The depth of the push-up will be measured using a foam block. Rests between push-ups, if needed, must be taken in the “up position.” The test administrator will evaluate the selectee’s form during the test and will provide instructions as to when to start and stop.

3. Step Test

This is a timed test requiring that the selectee step up and down on a 16-inch high step at a rate of 96 steps per minute for a total of 5 minutes duration. An audio file containing constant beat and verbal cues shall be used. The audio file also contains special instructions to switch the lead leg every minute to avoid local muscle fatigue. Providing equipment required to play the audio file such that the selectee can easily hear its content is the responsibility of the Contractor.

These tests are to be administered per the protocol located at https://www.ice.gov/careers/occupations. Go to > Enforcement and Removal Operations > Pre-Employment Fitness (PDF).

Procedures in the Event of Selectee Inability to Successfully Complete the PFT

In the event a selectee fails to successfully complete any one component of the PFT, the test administrator conducting the assessment will stop the test at the point (component) the selectee fails to successfully complete and must fully describe, in writing, the specifics of the event and reason for failure or for stopping the assessment on the back of the Physical Fitness Test Score Sheet. If the test must be stopped because of the selectee’s inability to successfully complete a component, or if the selectee becomes symptomatic and the test administrator stops the test, the Contractor will bill and be paid for the entire test.

Pre-Employment Psychological Evaluations

Assessments of a selectee’s psychological suitability for law enforcement employment will consist of an initial screening assessment using the Inwald Personality Inventory and other screening tools to determine whether specific personality traits/disorders or mental health disorders are present. The mental health disorders include anxiety disorders, depressive disorders, Post-Traumatic Stress Disorder, and any psychosis. These screening tools will be administered at the time and location of the pre-hire medical examination to confirm the identity of the selectee completing the assessment. The initial personality inventory and psychological assessments will be administered electronically. Once the electronic assessment is complete, a preliminary determination of suitability will be made within 5 working days. The preliminary determination will be based upon a T-score threshold approved by the Agency. If there is any determination other than suitable, then the selectee will receive an individualized assessment by a psychiatrist or psychologist certified by the American Board of Professional Psychology in Police and Public Safety Psychology. Other certifications or experience may be acceptable but must be approved by the Agency on an individual basis. For the individualized psychological assessment, when required, a written report will be completed within 10 working days from the date of the computer-based testing and submitted to the Agency with the selectee’s medical examination file. For selectees determined to be suitable following the interview a pre-approved form letter may be used reducing the time and costs incurred in these interviews. For selectees determine to be marginal or unsuitable, a full written report will be required. The Agency is notified when any delay is due to the selectee’s unavailability for an appointment with information on when the selectee will be available for the psychological interview. If the Agency approves a delay the written report is due 5 working days following the date of the psychological interview.

Medical Conclusion/Recommendation Process for Pre-Employment Medical Services

After performing an assessment of the selectee’s medical history and a comprehensive systematic examination, the examining physician shall complete a summary of the findings in order to establish the selectee’s health status and the stability of the condition(s) identified. Medical Examination Review, Medical Document Review, and Waiver Option Notification Templates will be provided by the Government.

The examining physician shall document information regarding the assessment and should specify what, if any, activities may be limited by any reported medical condition, and/or whether the medical condition is variable or recurrent. The physical examination should be focused on items noted in the medical history. For all examinations, a functional test evaluating upper and lower extremities and spine will be performed. Functional tests may include single-leg deep knee bends, squat-walking, resisted upper extremity range of motion, and lifting a 50-pound weight from the floor to chest level. The Agency must approve the proposed functional assessments prior to implementation. If during the physical exam, a discrepancy is noted between the physical exam and the reported history, such as an abdominal scar but no reported history of surgery, this discrepancy should be noted in the comments section. The medical history is not corrected or changed once the selectee certifies the information is complete and correct. Where a discrepancy is discovered, the selectee should be asked why they failed to report that part of their medical history with the selectee’s answer noted in the comment section of the Medical History and Physical Examination (MHPE) form.

The examining physician shall refrain from making any recommendation verbally or in writing to the individual regarding the individual’s medical qualification for the position other than notifying the selectee of any abnormal findings that require follow-up and treatment by their personal physician. Finally, the examining physician shall forward the exam/history data to the reviewing physicians.

The reviewing physicians shall possess an understanding of the stressors and responsibilities of the various positions and shall be thoroughly knowledgeable of the medically established guidelines for each position. Occupations may be added, or guidelines may be revised as needed by the Government, and the Contractor shall adjust work processes and occupational knowledge as needed. Upon review of the information obtained from the selectee’s pre-employment medical examination, the reviewing physicians shall render an opinion/recommendation concerning whether the individual meets the medical requirements of the position. OHC will receive and review the reviewing physician’s recommendation. Reviewing physicians shall be responsible for:

A. Reviewing all MHPE forms and examination records and ensuring their completeness.

B. Ensuring that the information obtained from the medical examination, the medical findings, conclusions, and recommendations are consistent with generally accepted professional guidelines.

C. Ensuring that the examination procedures and methods for reporting the information are uniform.

D. Providing a type-written medical opinion of the selectee’s qualification.

The reviewing physician’s opinion as to the selectee’s medical qualification for the position shall address a description of current health status, stability of condition, and the rationale for the recommendation. This recommendation shall be provided in the Medical Examination Review, Medical Document Review, and Waiver Option Notification Templates. The type-written medical opinion of the selectee’s qualification for the position shall be submitted to OHC within 10 working days from the date of examination completion. If the results of the medical exam do not clearly support the selectee’s qualification for the position, the reviewing physician’s opinion shall specify what additional medical documentation is needed to clarify the status of a particular medical condition(s). Additional medical documentation shall be obtained when currently available medical documents fail to support that a particular condition:

· is stable.

· presents no risk of sudden or subtle partial or total incapacitation for performing the duties of the position.

· does not present a hazard or risk to the selectee’s ability to perform the duties of the position safely and reliably at the current time.

· does not present a risk for recurrence, relapse, or aggravation by performing the expected duties of the job.

Self-reported absence of symptoms or impairment are insufficient for any condition that may have residual impairment despite treatment or may have a remittent course with episodes of mild or partial impairment. Examples include shoulder or knee arthroscopy, and diseases such as inflammatory bowel disease.

The recommendation for additional medical documentation must be in a format that can be directly inserted into a letter to the selectee. The requested type of information should minimize a requirement for a new assessment, instead, it should request recent or past medical treatment records for the specific medical condition of concern.

Pre-Employment Medical - Medical Examination Review

If the review of the medical history and physical examination does not clearly support the selectee’s qualification for the position, the reviewing physician’s opinion shall specify what additional medical documentation is needed. Medical documentation must be reviewed supporting that a past or current, medical condition does not present a current, or risk of future, impairment sufficient to disable the selectee from reliably, and safely, performing the high-risk, high-stress duties of the position. Self-reported absence of symptoms is not acceptable unless a detailed, objective, and functional assessment fails to reveal any abnormalities. Medical conditions diagnosed based primarily on self-reported symptoms, such as mental health conditions, will require either a current assessment based upon objective, functional assessments or assessments using validated tools. Alternatively, resolution/stability of the medical condition may be confirmed based upon review of past treatment records for treatment of the medical condition of concern.

The contractor shall invoice the government in 15-minute increments.

Pre-employment Medical - Medical Document Review

A medical document review is normally performed by an OHC nurse; however, there may be occasions when the OHC nurse is not available to complete a medical document review and Contractor support is required. The medical document review consists of a review of the initial pre-employment medical examination and any documents submitted by the selectee in response to a notification of the need for such documentation identified by the Contractor during the Medical Examination Review. Upon request by the COR, a medical document review consultation would consist of the Contractor’s reviewing physician reviewing the entire pre-employment medical history, physical examination, and any other documentation provided by the selectee. The reviewing physician will deliver a medical opinion using the Medical Document Review Template within 10 working days of receipt of the additional medical documents, with the final product being a medical opinion explaining which medical documents were reviewed, and whether the selectee meets the medical standards or not. If the follow up information provided by the selectee still leaves some questions in mind, for which if there is a reasonable expectation that the answer to the question may lead the Contractor reviewing physician to clear the selectee, then the Contractor may specify what additional information, if found medically disqualified, would be required from the selectee to support a claims that a condition is resolved or stable enough to meet the medical standard. If the selectee meets the medical standard after review of the requested follow up information, the contracting physician will write a concise response on how the diagnosis (may be multiple diagnoses) in question are stable and qualify the selectee as meeting the medical standard. If after the review the selectee still does not meet the medical standard, the file will then be considered a tertiary review consultation for which the instructions are provided below.

When possible, the Contractor’s reviewing physician performing the medical examination review should be the physician completing any medical document review. For medical document reviews, the Government estimates that the review can take from 15 minutes to 45 minutes of physician time. On occasion, there are voluminous documents that require additional hours to review. If the number of hours required by the Contractor exceed 85 percent of the amount obligated for this CLIN, the Government shall be notified prior to billable work being performed.

The Contractor shall invoice the government in 15-minute increments.

Pre-employment Medical - Tertiary review

There may be occasions when the Agency Medical Officer is not available to complete a tertiary review and Contractor support is required. The tertiary review is required when upon review of the requested additional medical information, the medical document review does not support that the selectee is qualified under the Agency’s Medical Standards. These medical document review and waiver option notification letter consist of a review of the initial pre-employment medical examination and any documents submitted by the selectee in response to a notification of the need for additional documentation defined by the medical examination reviewer. Upon request by the COR, the waiver option notification letter consultation consists of the physician reviewing the entire pre-employment medical history, physical examination, and any other documentation provided by the selectee. The medical reviewing physician will deliver a medical opinion explaining which medical documents were reviewed, whether the selectee meets the medical standards, and any additional supporting documentation that may support the Agency granting a waiver of the disqualifying medical condition. The waiver option notification letter will note the specific disqualifying medical conditions, and any additional medical documentation reviewed, as well as make a recommendation for evidence (e.g., letters from supervisors, performance appraisals, etc.) regarding past demonstrated performance of the same or similar duties, providing specific, detailed examples.

When possible, the Contractor’s reviewing physician for the initial medical examination review should be the physician completing the waiver option notification letter following the medical document review.

For tertiary reviews, the Government estimates that the review can take from 30 minutes to over 2 hours of physician time. On occasion, there are voluminous documents that require additional hours to review. If the number of hours required by the Contractor exceed 85 percent of the amount obligated for this CLIN, the Government shall be notified prior to billable work being performed. No more than 10 tertiary reviews will be submitted weekly and shall be completed and returned to the Government within 10 working days from the date of receipt. Completed reviews should be submitted to the Government upon completion and not held until the final due date.

The Contractor shall invoice the government in 15-minute increments.

Part 4 – Fitness for Duty / Independent Medical Examinations

Medical examinations performed under the requirements of this PWS must be consistent with the medical guidelines for weapon-carrying positions. Specifically, the medical examination shall include an assessment of the employee’s medical history, past medical treatment records, the employee’s current medical, psychological, and physical status and provide sufficient information concerning the individual’s medical condition for the Agency to make a final determination of medical qualification for the position.

Fitness for Duty Independent Medical Evaluations (IME) include scheduling of the employee for the evaluation and all nursing support. There are different scopes of the medical examinations. First is a General Medical Examination when there is a question as to the cause of the employee’s impairment or there are multiple ill-defined medical concerns. The next level is Specialty Consultant Medical Examination where a physician specializing in medicine concurrent with the employee’s medical condition will perform the medical examination. In complex cases or where there is dispute regarding the employee’s medical condition and its impact on the employee’s ability to perform the duties of the job safely and effectively, a Certified Independent Medical Examination will be required for medical diagnoses with a Forensic Psychiatric Examination required for mental health diagnoses.

IME’s will be fixed price per examination (up to 3 hours total time) to include a thorough review and summary of the medical records, scheduling fees, all nursing support, examination, and a comprehensive report.