A02 PWS DRAFT 20250521.pdf

DRUG ENFORCEMENT ADMINISTRATION 1

U.S. DEPARTMENT OF JUSTICE

DRUG ENFORCEMENT ADMINISTRATION

PERFORMANCE WORK

STATEMENT (PWS)

HRU: Medical Surveillance Exams

RFQ #: 15DDHQ25R00000026

HEALTH SERVICES SECTION

DRUG ENFORCEMENT ADMINISTRATION 2

1 . 0 B AC K G R O U N D

1.0.1 With more than 10,000 employees, The Drug Enforcement Administration (DEA) is charged with enforcing the controlled substances laws and regulations of the United States and bringing to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations, involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States;

and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets.

1.0.2 Within DEA, specialized Federal Law Enforcement Officers and other Core series staff are hired and trained to perform vitally important activities such as investigating criminals and drug gangs that traffic in illegal drugs, regulating the manufacture and distribution of controlled pharmaceuticals (such as scheduled prescription drugs) and listed chemicals through DEA’s Diversion Control Division, providing and coordinating for DEA and other enforcement organizations the collection, analysis and dissemination of world class drug-related intelligence through DEA’s Intelligence Division, and analyzing evidence and providing science-based research that supports drug-related investigations and the U.S. criminal justice system at-large through DEA’s Office of Forensic Sciences.

1.0.3 Since the duties of these positions are exacting and involve the responsibility for the safety of others under potentially dangerous and stressful conditions, all applicants and incumbents shall possess physical, emotional, and mental stability. Therefore, all applicants and incumbents shall meet the medical standards outlined in the DEA medical qualification standards approved by the Office of Personnel Management (OPM).

1.0.4 To this end, DEA’s medical capabilities include not only medical clearance and medical employability, but also Employee Medical Clinics located at DEA Headquarters in Arlington, VA and at the DEA Training Academy in Quantico, VA. DEA health clinics ensure that eligible persons (staff, trainees, applicants) receive the appropriate scope of medical support compatible with the mission of the population and location served. DEA relies on referral to the local health system for complex, urgent, or emergent care.

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2 . 0 O B JE C TI VE S

DEA is seeking medical exams and evaluations of its identified applicants and employees (approximately 2,500 medical exams and 300 ad hoc/psych exams annually) in accordance with the specifications within this PWS.

2.1 OBJECTIVES – MEDICAL SURVEILLANCE EXAMS

2.1.1 The Drug Enforcement Administration (DEA) is seeking a medical contractor to provide medical surveillance services for identified applicant and incumbent employees (“incumbents”) across the United States, Guam, the Virgin Islands, and Puerto Rico. The Contractor shall be required to evaluate applicants to determine if they meet the DEA medical qualification standards. The Contractor shall also conduct mandatory periodic medical examinations of incumbents to determine if they continue to meet the DEA medical qualification standards and can safely carry out law enforcement duties.

2.1.2 The Contractor shall provide the necessary facilities, staff, materials and equipment to administer an all-inclusive medical examination program and comply with current policies and programs. The Contractor shall sub-contract medical specialists as needed. The Contractor shall work with DEA personnel to update forms and reports as needed to reflect changes in DEA medical policies. The Contractor shall provide Quality Assurance reviews of exams prior to transmitting exams to DEA for review and clearance determination. In the instance that the DEA Reviewing Medical Officer finds Missing Exam Information (MEI), the Contractor shall complete the MEI and return the exam to DEA within specified time period at no additional cost.

2.2 OBJECTIVES – PSYCHIATRIC, PSYCHOLOGICAL AND

SUITABILITY ASSESSMENTS

2.2.1 The Drug Enforcement Administration (DEA) is seeking a medical contractor to provide an effective, repeatable process that is in place for both applicants and employees. DEA utilizes a provider of psychiatric and psychological assessments. For applicants, psychiatric and psychological assessments are ordered by Health Services Section clinical personnel when medically indicated to identify candidates with the appropriate mental ability to pass law enforcement training programs, emotional stability to withstand the stress associated with positions in law enforcement and the maturity to work within the DEA. For employees, to ensure that an effective mechanism exists within the agency for utilization by DEA’s managers and supervisors to make a referral of an employee for a psychiatric/psychological assessment when that employee has engaged in behavior that may negatively affect the employee’s suitability to perform his/her duties reliably, safely or effectively.

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2.2.2 The Contractor shall provide mental health assessments in support of the Drug Enforcement Administration (DEA) Pre-Employment Assessments, Fitness for Duty Examination, and to assess fitness for employees that have had their security clearances suspended. These services incorporate both psychological and psychiatric examinations that meet practice and ethical requirements for the assessment of law enforcement personnel. These practices address the essential issues regarding effective and reliable law enforcement performance and are proven to adhere to requirements stipulated by the Adjudicative Guidelines for 32CFR Part 147 (Adjudicative Guidelines for determining eligibility for Access to Classified Information), Americans with Disabilities Act (ADA)/Americans with Disabilities Act Amendments Act of 2008 (ADAAA), Genetic Information Nondiscrimination Act of 2008 (GINA) and Equal Employment Opportunity Commission (EEOC) requirements.

2.3 PARTIAL ASSESSMENT (if psyc assessment triggers a different function)

At the request of the Unit Chief/Section Chief (UC/SC) or Chief Medical Officer (CMO), the Contractor shall provide partial psychiatric and psychological assessments as a supplement to an ordered psychiatric and psychological assessment in the instance that new information comes to light following initial tests, examinations, or reports. Partial services shall be requested only in connection with an initial assessment and to allow for a complete review and determination of fitness for duty.

2.4 OBJECTIVES – ADHOC AND FITNESS FOR DUTY

EXAMINATIONS

2.4.1 The Drug Enforcement Administration (DEA) is seeking a medical contractor to provide an effective, repeatable process that is in place for both applicants and employees to conduct ad hoc or Fitness for Duty assessments.

2.4.2 Employees may be directed to undergo a fitness for duty examination when an employee has engaged in violent, threatening, or other inappropriate behavior, whether stemming from subtle or sudden incapacitation, that may negatively affect the employee’s suitability to perform their duties reliably, safely, or effectively. Employees may also be referred for psychiatric and psychological assessment based on behavior that raises concerns regarding judgement, stability, reliability and trustworthiness as it related to protection and proper handling of National Security Information (NSI).

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SECTION I – MEDICAL EXAMS

3 . 0 R E SO U R C E RE Q UI REM E N TS

The Contractor is responsible for all tasks and resource requirements in accordance with this section of the PWS. The Contractor shall ensure all activities outlined above and throughout this PWS are completed and accounted for.

3.1 MEDICAL RESOURCES

3.1.1 The Contractor shall be required to evaluate applicants to determine if they meet the DEA medical qualification standards. The Contractor shall also conduct mandatory periodic medical examinations of incumbents to determine if they continue to meet the DEA medical qualification standards and can safely carry out law enforcement duties.

3.1.2 The Contractor shall provide the necessary facilities, staff, materials and equipment to effectively administer an all-inclusive medical surveillance examination program and comply with current and prospective policies and programs. The Contractor shall work with DEA personnel to revise forms and reports as DEA necessary to align with changes in DEA policies and industry trends. The Contractor shall provide Quality Assurance reviews of exams prior to transmitting exams to DEA for review and clearance determination. In the instance that the DEA Reviewing Medical Officer (RMO) finds Missing Exam Information (MEI), the Contractor shall reconcile the MEI and return the exam to DEA within the period specified in this PWS at no additional cost.

3.1.3 The Contractor shall ensure a fully operational organization comprising credentialed full-time and/or part-time staff, including physicians, nurses, physician assistants, and other relevant qualified personnel, at all examination locations."

3.1.4 The Contractor shall be able to perform all examination components within five (5) workdays spanning a maximum of 72 hours (Purified Protein Derivative (PPD) shall be read within 48 hours), unless otherwise medically required, at a facility located within 50 miles of a domestic DEA office, by zip code (appendix A). If a medical examination is required outside of this distance, the Contractor shall notify DEA HRU of the delay and be able to procure medical examination services for an applicant or incumbent within 50 miles of their home zip code within 21 calendar days of exam request.

3.1.5 Each location shall have the ability to collect laboratory sample in the same location as the medical exam and have access to providers in audiometric testing, spirometry, and vision testing.

3.1.6 The Contractor shall ensure all facilities provide quality care and are knowledgeable and capable of accurately performing the full scope of the DEA medical examination. Facility personnel are expected to be qualified and proficient at performing the services requested in a timely and professional manner, in accordance with all applicable Occupational Safety and Health Administration (OSHA) requirements. The facilities shall be bona-fide medical facilities, to include clinics, and are expected to have a sanitary environment and be located in safe locations.

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3.1.7 The Contractor shall provide the ability for all medical exams to be scheduled via appointment on future dates.

3.1.8 The Contractor shall have sufficient full-time medical staff to supervise and audit the providers and facilities and maintain a system for quality control. This staff shall include, at a minimum, physicians that are Board Certified in Internal medicine, Family Medicine, and/or Occupational Medicine, with the ability to exercise perceptive judgment with respect to agency medical standards.

3.1.9 The Contractor shall establish a viable process to implement standardized training on clinical assessments which correlate to the medical standards of the agency, as well as a method to assess the Contractor’s staff’s proficiency and adequacy of training to perform DEA medical evaluations

3.2 PSYCHIATRIC AND PSYCHOLOGOCIAL RESOURCES

3.2.1 The psychiatric evaluation shall expose any factors that may be of risk to the welfare of the examinee and address his/her ability to perform duties on which the safety of the individual or others would rely. The contractor shall make an earnest attempt to obtain and review pertinent/related historical records (with consent from the examinee), obtain information from the managing mental health provider as needed, and shall conduct a detailed psychiatric interview to determine the nature, extent and cause of any potential emotional or psychopathic symptoms. Psychiatric and psychological assessment and resources services incorporate both psychological and psychiatric examinations that meet practice and ethical requirements for the assessment of law enforcement personnel.

3.2.2 The psychological portion shall assess cognitive functioning and emotional adjustment by a diagnosis-based approach that determines fitness for duty in a law enforcement position and/or fitness to hold a required security clearance. Relevant Agency medical standards and practice guidelines will be provided.

3.2.3 Due to the geographic dispersion of DEA applicants and staff, the Contractor shall have the capability to perform remote psychiatric and psychological assessments. Based on the applicant or employee location, the psychological testing portion of the exam may need to be arranged for and completed at a facility near the employees’ duty location or closest DEA facility. The Contractor is responsible for arranging the psychological testing at another location if required. Any associated cost shall be the responsibility of the contracted providers and should be taken into consideration during their proposal.

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3.3 CENTRAL ADMINISTRATION AND RECORDS

3.3.1 The Contractor shall use technology and processes consistent with DEA’s Rules of Behavior to safeguard, transmit, and store DEA employee information related to this contract and consistent with the Privacy Act of 1974.

3.3.2 The Contractor shall maintain and store electronic copy applicant/incumbent examination/medical records and have appropriate security to safeguard these records for the life of the contract.

3.3.3 Within 60 calendar days of an option renewal and/or contract award, the contractor shall return all employee related files to the DEA to be retired. The contractor shall also provide a listing of employee files contained in each box. The electronic alphabetical listing shall include Name, SSN, and date of birth of each employee.

3.3.4 The Contractor shall have operating procedures that allow for secure and effective communication between the examination locations, the Contractor’s staff, and DEA personnel as designated by DEA’s Chief Medical Officer, Health Services Unit Chiefs or Section Chief.

3.3.5 The Contractor shall provide a secure database to track exam status and medical clearance determinations.

3.3.6 The Contractor shall provide a secure electronic process to request medical exams.

3.3.7 Agency personnel shall have access to the Contractor’s tracking database as delineated by the

DEA Health Services Unit Chiefs or Section Chief.

3.3.8 The Contractor shall not breach the confidential nature of the medical records generated under this contract.

4 . 0 E X AM I N AT I O NS

The Contractor is responsible for all tasks and examination requirements in accordance with this section of the PWS. The Contractor shall ensure all activities outlined above and throughout this PWS are completed and accounted for.

4.1 GENERAL EXAMINATIONS PROCESS

4.1.1 The Contractor shall have the ability to transmit information (examinations, lab results, assessments, etc.) to DEA using secure send and/or utilization of an Electronic Health Record (EHR) as available by DEA. DEA reserves the right to specify the preferred method of receiving secure information if more than one option is available.

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4.1.2 Examiners shall have access to and be familiar with DEA medical qualification standards.

Pertinent positives and negatives in the examinee's medical history and physical examination shall be documented with respect to the current, published medical standards. In the event of periodic updates made to said standards, DEA will electronically provide the contractor with the latest version for prompt dissemination to its medical providers. The Contractor shall detail a plan to verify providers’ receipt and understanding of updated medical standards and/or Agency forms to ensure consistent exam quality.

4.1.3 All exams shall be signed by the examining physician credentialed in Occupational medicine in the state in which they practice.

4.1.4 The Contractor shall schedule and track examinations and appointments via a secure database through which designated DEA personnel may verify examinations and appointments. The database shall have the ability, at a minimum, to track exam status, progression, and medical clearance status.

4.1.5 Any printed communication to incumbents or applicants containing Personally Identifiable

Information (PII) (i.e., social security numbers, date of birth (DOB), etc.) shall be double packaged. Double packaged is defined as information sealed within an envelope and then placed in suitable mail carrier packaging.

4.1.6 Facilities shall perform all examination components within five (5) workdays spanning a maximum of 72 hours (PPD shall be read within 48 hours), unless otherwise medically required.

4.1.7 The Contractor shall have a Quality Assurance (QA) process in place to ensure examination completeness prior to forwarding to DEA for review and clearance determination. Incomplete examinations shall be returned to the clinic for completion and DEA HRU staff shall be notified of delay.

4.1.8 Network providers are actively licensed and duly credentialed in accordance with (IAW) Section

3.1.3, (3.1.3 – 3.1.5) and are sufficient in number, capacity, and specialty to deliver medical exams and evaluations, considering approximately 2,500 exams annually, patient characteristics, medical needs including frequency of access within the prescribed geographic distance, i.e., 50 miles radius of domestic DEA offices.

4.1.9 Standard components of medical examinations which coincide with agency medical standards shall not be substituted for alternative testing (i.e., Cambridge color vision test shall not be substituted for Ishihara, etc.)

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4.2 EXAMINATION REQUIREMENTS

The Contractor shall have the ability to complete applicant and incumbent examinations based on requirements specified by DEA. The examination components are listed below:

LEGEND: Y = YES, N = NO, MI = MEDICALLY INDICATED

4.3 PRE-PLACEMENT MEDICAL CLEARANCE EXAM PROCESS

4.3.1 DEA will provide the Applicant Medical Examination Forms and documentation that provide the specifics of this process.

4.3.2 DEA will provide the Contractor with contact information of applicants that require pre-placement examinations.

DEA EXAM PROTOCOL APPLICANT EXAM PERIODIC EXAMINATION AD HOC EXAM DoS Exam

HEALTH HISTORY QUESTIONNAIRE Y Y Y Y

PHYSICAL EXAM Y Y Y Y

BLOOD PRESSURE Y Y Y Y

HEIGHT & WEIGHT Y Y Y Y

HEARING HISTORY Y Y Y Y

AUDIOGRAM Agents-Y Agents-Y Agents-MI N

DI/FC-N DI/FC-N DI/FC-N

RESTING EKG Y Y MI MI (over 50) EXERCISE EKG (Stress Test) N N MI N

SPIROMETRY MI Agents/DI- N, Lab/IHE - Y MI N

VISION Y Y MI N

DISTANT (Snellen) – uncorrected and corrected Y Y MI N NEAR – uncorrected and Y Y MI N corrected DEPTH PERCEPTION (Titmus) – Y Y MI N seconds of arc COLOR – Ishihara Y N MI N

PERIPHERAL (Visual Field) Agents - Y Agents - Y MI N BLOOD LEAD & ZINC Agents (firearms)-Y Agents (firearms)-Y MI N

PROTOPORPHYRIN (ZPP)

CMP (fasting) Y Y MI Y

LIPID PANEL (fasting) Y Y MI Y

THYROID PANEL MI MI MI N

COMPLETE BLOOD COUNT WITHDIFFERENTIAL (CBC W/D) Y Y MI Y

ROUTINE URINALYSIS Y Y MI Y

PURIFIED PROTEIN DERIVATIVE Y MI MI Y

(PPD) (Tuberculosis Skin Test)

QUANTIFERON GOLD MI MI MI N

HEPATITIS B ANTIBODY (HBsAb) N N MI N

HEPATITIS B SURFACE ANTIGEN N N N Y

HEPATITIS C ANTIBODY N N N Y

RPR/VDRL N N N Y

HIV I/II ANTIBODY N N N Y

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4.3.3 The Contractor shall assign a clinic within 50 miles of the closest domestic DEA office, by zip code (Appendix A), or the applicant’s provided home address within three (3) calendar days of exam request from DEA personnel. The Contractor shall ensure that initial exam appointments are available to the applicant within ten (10) calendar days of the exam request. In the event an applicant is located in a rural/hard to fill location (not to exceed 10% of total number of exam requests), the Contractor shall assign a clinic within 50 miles of the closest domestic DEA office or the applicant’s provided home address. If a medical examination is required outside of this distance, the Contractor shall notify DEA of the delay and be able to procure medical examination services for an applicant within ten (10) calendar days of notification.

4.3.4 The Contractor shall schedule and electronically transmit the pre-placement exam forms, instructions, appointment details and related information directly to the applicant within three (3) calendar days of examination request, and courtesy copy (cc) the DEA Applicant Exam Program Manager (PM).

4.3.5 The Contractor shall facilitate the applicant medical exam process and provide DEA-designated personnel with access to a secure database to track the examination progression. Tracking information shall be updated no less frequently than one (1) business day.

4.3.6 The Contractor shall ensure that the exam undergoes quality assurance (QA) review for completeness. Incomplete exams will be returned to examining clinic for completion at the Contractor’s expense. The Contractor shall reschedule the applicant to complete missing items and return the updated exam within seven (7) calendar days of the original date of examination completion.

4.4 PRE-PLACEMENT/BASELINE EXAM COMPONENTS

4.4.1 The Contractor shall have the ability to complete applicant examinations based on requirements specified by DEA. The examination components include but not limited to:

• Medical history review / interview

• Physical examination

• Blood pressure measurement

• Height / weight

• Vision (corrected and uncorrected, near and far visual acuity; color vision, peripheral vision-agents and chemists; depth perception)

• Audiogram (as directed by DEA)

• Resting electrocardiogram

• Spirometry (as directed by DEA)

• Blood lead and zinc protoporphyrin (ZPP) (Firearms instructors)

• CBC

• Routine urinalysis

• Blood chemistry -CMP

• PPD (QuantiFERON if h/o positive PPD)

• Lipid Profile

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*If a positive tuberculosis (TB) test result is indicated, Contractor shall set applicant as a “further evaluation” required. The Contractor shall send the applicant a letter including the test results, and notify DEA of the delay. A chest x-ray may be necessary for positive PPD or QuantiFERON-TB Gold In- Tube Test (QFT) tests.

*The applicant is responsible for obtaining a chest x-ray, at their own expense, to obtain a medical clearance and provide it to DEA.

4.4.2 Specific exam components are subject to routine and regular update by DEA depending on interpretation of standards and program improvements. While this section is current at the time of offering, the Contractor shall update examination components upon notification by DEA. The Contractor shall submit the effective, itemized work order to DEA for confirmation of accuracy prior to initiation of applicant or incumbent examinations under this contract.

4.5 PERIODIC MEDICAL EXAMINATION (PME) – INCUMBENTS

PROCESS

4.5.1 A PME is mandatory for agency identified incumbents. The Contractor shall assign a clinic within 50 miles of the incumbent’s DEA office, by zip code (Appendix A), within three (3) calendar days of exam request from DEA personnel. The Contractor shall ensure that initial exam appointments are available to the incumbent within ten (10) calendar days of the exam request. If a medical examination is required outside of this distance, the Contractor shall notify DEA of the delay and be able to procure medical examination services for the incumbent within ten (10) calendar days of notification.

4.5.2 The Contractor shall facilitate the incumbent exam process.

4.5.3 At the conclusion of the exam, the Contractor shall review the exam findings with the examinee, and provide the examinee with a copy of their exam to take with them.

4.5.4 The Contractor shall ensure that the exam undergoes quality assurance (QA) review for completeness. Incomplete exams will be returned to examining clinic for completion. The Contractor shall reschedule the applicant to complete missing items and return the updated exam within five (5) business days of the original date of examination completion.

4.6 PERIODIC MEDICAL EXAMINATION COMPONENTS

4.6.1 The Contractor shall have the ability to complete periodic medical examinations based on requirements specified by DEA. The examination components include but not limited to:

• Review of medical history

• Performance of physical examination and review of test results

• Vision (corrected and uncorrected, near and far visual acuity; depth perception; visual field-agents and chemists)

• Lipid profile

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• Blood pressure

• Height / weight

• Resting electrocardiogram (EKG)

• Spirometry (IIIicit Hazardous Environment Certified, Chemist)

• Blood lead and ZPP (firearms instructors)

• Complete Blood Count (CBC)

• Routine urinalysis

• Blood chemistry (CMP)

• Audiogram (as directed by DEA)

• PPD (QuantiFERON if h/o positive PPD)

*If a positive TB test result is indicated, Contractor shall set applicant as a “further evaluation” required.

The Contractor shall send the incumbent a letter including the test results, and notify DEA of the delay.

A chest x-ray may be necessary for positive PPD or QFT tests.

4.6.2 Specific exam components are subject to routine and regular update by DEA depending on interpretation of standards and program improvements. While this section is current at the time of offering, the Contractor shall update examination components upon notification by DEA. The Contractor shall submit the effective, itemized work order to DEA for confirmation of accuracy prior to initiation of applicant or incumbent examinations under this contract.

4.7 PSYCHIATRIC, PSYCHOLOGICAL AND SUITABILITY PROCESS

4.7.1 The Contractor shall be familiar with the Diagnostic and Statistical Manual of Mental Disorders

(DSM-V) and psychological testing (such as The Shipley Institute of Living Scale, Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B), Sixteen Personality Factor Questionnaire (16PF), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Million Clinical Multiaxial Inventory-IV (MCMI-IV), and Sentence Completion personality assessment tests etc.).

Review of the objective psychological testing (with provided interpretation of the results), and an interview addressing pertinent history and reasons for referral shall be used to formulate the psychological assessment. The completed examination shall facilitate the agency’s ability to determine fitness for duty in the employee’s current occupational capacity.

4.7.2 Contractor shall endeavor to ensure that the final product/assessment rendered to DEA is based on substantiated information/data. The contractor shall clearly address the question of fitness for duty in law enforcement and/or fitness to hold a high-level security clearance within the specific medical/mental health specialty addressing the current status and/or concern. The final delivered product shall also include the following information: any past or present diagnoses, prognosis, the need for additional or ongoing treatment, any applicable treatment suggestions, and restrictions or limitations to the examinee’s function based on the current status and/or concern.

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4.7.3 The Contractor shall assign a clinic within 50 miles of the examinee’s DEA office, by zip code

(Appendix A), within ten (10) calendar days of exam request from DEA personnel. The Contractor shall ensure that initial exam appointments are available to the examinee within thirty

(30) calendar days of the exam request. If a medical examination is required outside of this examination services for the examinee within fifteen (15) calendar days of notification.

4.8 PSYCHIATRIC, PSYCHOLOGICAL AND SUITABILITY

COMPONENTS

The Contractor shall have the ability to complete psychological and suitability examinations based on requirements specified by DEA. The examination components include but are not limited to:

1. Background:

• Chief complaint/reason for referral according to examinee

• Chief complaint/reason for referral according to DEA

2. Review of relevant history:

• Occupational History

• Educational History

• Social History

• Prior psych pathology

3. Evaluation results:

• Review of findings and interpretation of objective testing

• Review and interpretation of subjective findings identified during psych interview

4. Conclusion: Summary of clinical impression

5. Recommendation:

• Completion of any applicable physician or mental health provider questionnaire as to the ability of the employee to fully perform the duties of position.

• Statement of whether examinee is currently fit for duty based on this evaluation.

4.9 AD HOC MEDICAL EXAM OR FITNESS FOR DUTY PROCESS

4.9.1 The DEA may request a Specialty Consultant examination whenever there is a question regarding the employee’s fitness for duty, which requires the training and experience of a particular type of specialty consultant, such as:

o Internal Medicine o Orthopedics/Sports Medicine o Cardiology o Neurology o Ophthalmology o Nephrology o Pulmonology o Endocrinology o Gastroenterology

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o Otolaryngology (ENT) o Dermatology o Mental Health (i.e. General Psychiatry/Psychology, Forensic Psych, Police Psychology)

4.9.2 The contractor shall have the ability to obtain a specialist to perform both required components and specific assessment as medically indicated. The specialist assessments are likely to vary and will be dependent on the incumbent or applicant’s specific medical concern(s) and/or issue(s). This level of service specialty consultation will be requested by DEA when there are specific questions concerning an employee’s injury or fitness for duty.

4.9.3 The Contractor shall assign a clinic within 50 miles of the examinee’s DEA office, by zip code (Appendix A), within ten (10) calendar days of exam request from DEA personnel. The Contractor shall ensure that initial exam appointments are available to the examinee within thirty

(30) calendar days of the exam request. If a medical examination is required outside of this examination services for the examinee within fifteen (15) calendar days of notification.

4.10 AD HOC MEDICAL EXAM OR FITNESS FOR DUTY

COMPONENTS

1. Background:

• Chief complaint/reason for referral according to examinee

• Chief complaint/reason for referral according to DEA

2. Review of relevant history:

• Occupational History

• Educational History

• Social History

• Prior psych pathology

• Prior physical injury

3. Evaluation results:

• Review of findings and interpretation of objective testing

• Review and interpretation of subjective findings identified during psych interview

4. Conclusion: Summary of clinical impression

5. Recommendation:

• Completion of any applicable physician or mental health provider questionnaire as to the ability of the employee to fully perform the duties of position.

• Statement of whether examinee is currently fit for duty based on this evaluation.

4.11 HEARING CONSERVATION PROGRAM

Incumbents which meet the standard for inclusion in the Hearing Conservation Program (HCP) shall receive an annual audiogram, as requested by DEA HR Division personnel. These incumbents will require specialized testing for functional hearing. All tests shall be performed utilizing accurate, properly calibrated and maintained testing equipment by properly trained and credentialed personnel familiar with the required occupational health standards for testing and services. The tests and exams shall be reviewed for the quality and accuracy of examination and testing, and shall include accurate, legible, and complete documentation. The contractor is

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responsible for ensuring that necessary training and instructions are given to all staff providing testing and services. Tests may be requested individually or included as part of customized physical exam requests. Facility personnel are expected to be qualified and proficient at performing the services requested in a timely and professional manner, in accordance with all applicable Occupational Safety and Health Administration (OSHA) requirements.

4.12 OVERSEAS TRAVEL EXAMINATIONS AND IMMUNIZATIONS

4.12.1 The Contractor shall have the ability to complete overseas travel examinations based on requirements specified by DEA. The examination components include but not limited to:

• Review of medical history

• Performance of physical examination and review of test results

• CMP (fasting)

• Hemoglobin A1C (MI)

• Blood pressure

• Height / weight

• Hearing History

• Resting EKG (over 50)

• Blood lead and ZPP (firearms instructors)

• CBC

• Routine urinalysis

• Hepatitis B Surface Antigen

• Hepatitis C Antibody

• Rapid Plasma Reagin (RPR)/ Venereal Disease Research Laboratory (VDRL)

• Human Immunodeficiency Virus (HIV) I/II Antibody

• PPD

• Lipid Panel

4.12.2 Vaccinations may include but are not limited to:

• Yellow Fever

• Oral Polio Vaccine [OPV]

• Inactivated Polio Vaccine [IPV]

• Immune Globulin [IG]

• Typhoid

• Rabies

• Influenza Vaccine

• Meningitis Vaccine

• Japanese Encephalitis

• Tickborne Encephalitis

*If a positive TB test result is indicated, Contractor shall set incumbent as a “further evaluation” required. The Contractor shall send the incumbent a letter including the test results, and notify DEA of the delay. A chest x-ray may be necessary for positive PPD tests.

*The incumbent is responsible for obtaining a chest x-ray, at their own expense, to obtain a medical clearance and provide it to DEA.

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4.12.3 Incumbents assigned to work in foreign locations are required to have a current medical clearance and also required to obtain proper medical clearance from the Department of State (DoS) prior to leaving the United States. If necessary, the contractor shall schedule required medical examinations/ immunizations upon notice from the DEA Foreign Medical Program Manager (FMPM) or other Health Unit designee.

4.12.4 Employee medical examinations for an overseas assignment are conducted using the Medical

History and Examination for Foreign Service form, DS-1843, and are in addition to the PME (if required). The Department of State Medical Examination consists of Medical History, Clinical Evaluation, and Laboratory testing (Hematology, Chemistry, Serology, Tuberculin Skin Test).

Additional testing may include Lipid Profile and electrocardiogram (ECG) if over 50 years of age, and a chest x-ray if clinically indicated.

4.12.5 The Contractor shall work with the incumbent to schedule required examinations/immunizations for the travel location within five (5) calendar days of request, schedule the appointment(s) at a clinic close to the incumbent’s preferred address, and explain the exam process. Once the incumbent exam is QA’d to be complete, the Contractor shall forward the information to the

FMPM.

4.12.6 Department of State dictates examination requirements, however exams are facilitated through

DEA. As such, the contractor shall have the ability to modify the DoS exam process as directed by the DoS or DEA.

4.13 HEPATITIS B IMMUNIZATIONS

4.13.1 Upon graduation from the DEA Training Academy and arrival to the duty station, the Contractor shall offer Hepatitis B immunizations to incumbents if the pre-employment exam shows no immunity.

4.13.2 If the Hepatitis B immunization is administered, the Contractor shall schedule a titer blood test to determine immunity and schedule additional Hepatitis B immunizations if needed in accordance with OSHA standards.

4.13.3 As requested by the DEA, the Contractor shall schedule an antibody blood test to determine immunity and coordinate additional Hepatitis B immunizations, if needed.

4.14 BREATH ALCOHOL TESTING

4.14.1 Special Agents in Charge (SAC) and equivalent Headquarters personnel are authorized to order an incumbent to undergo alcohol testing when they have reasonable cause to believe that an incumbent is intoxicated or under the influence of alcohol while on official duty.

4.14.2 Breath alcohol tests are conducted to detect alcohol use (i.e., the consumption of any beverage, mixture, or preparation, including any medication, containing alcohol). The Contractor shall be available 24/7, 365 days a year, to set up testing using evidential breath alcohol (EBT) testing by an appropriate Breath Alcohol Technician as close to the incumbent’s location as possible.

DRUG ENFORCEMENT ADMINISTRATION 17

4.14.3 The Drug Test Coordinator will contact the Contractor directly to request the test and provide the following information:

• SAC’s name

• SAC’s telephone number

• Name of the incumbent suspected to be under the influence

• Incumbent’s social security number

• Incumbent’s address at the time the call is placed

4.14.4 Upon receiving a request for a breath alcohol test, the Contractor shall identify a provider, or send a certified collector on site, to provide breath alcohol testing within 2 hours of the request.

The Contractor shall notify the DEA Unit Chief and Drug Test Coordinator of the testing location.

4.14.5 The DEA is responsible for transporting the incumbent to the testing facility.

4.14.6 The Contractor shall confirm the incumbent’s identity with acceptable photo ID.

4.14.7 If the initial test shows an alcohol concentration of less than 0.02, no further testing is done. If the initial test is equal to 0.02 or greater, a confirmation test shall be conducted. The confirmation test is performed after a 15-minute mandatory waiting period which begins with completion of the initial test. The incumbent will be given instructions to prevent any accumulation of alcohol in the mouth which could lead to an artificially high reading. The confirmation test is done even if the incumbent fails to follow test instructions.

4.14.8 If the initial or confirmation cannot be completed, or if an event occurs that would invalidate the test, the test shall, if practicable, begin again.

4.14.9 If the testing equipment becomes unavailable, the test shall be declared invalid and the testing process shall stop.

4.14.10 If the incumbent refuses to provide adequate breath for testing, fails to cooperate with the testing process, or engages in conduct that clearly obstructs the testing process, the Technician shall terminate the testing and notify the SAC and accompanying manager.

4.14.11 If the incumbent is unable to provide a sufficient amount of breath for a valid test due to a medical condition, the incumbent will be instructed to make a second attempt. If the incumbent is still unable to provide adequate breath, the testing process shall stop, and the Technician shall note the circumstances.

4.14.12 If an event occurs during the testing process which invalidates the test, the Technician shall note the problem. The incumbent and the Technician shall initial/sign the remark.

4.14.13 If the initial and confirmation test results differ, the confirmation results shall be considered the final result.

4.14.14 If the confirmation test result is less than 0.02, the result shall be recorded as acceptable.

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4.14.15 If the confirmation test result is 0.02 or greater, the final numerical reading is noted.

4.14.16 The Technician shall share the results with the incumbent and the accompanying manager.

4.15 LITIGATION SUPPORT

The Contractor’s reviewing physicians, specialists, or other staff may be required to provide legal testimony or testify in court proceedings for the DEA. These services may include:

• Providing copies of medical files and related documentation

• Ad hoc consulting

• Participate in investigatory interviews in person or by electronic means

• Prepare affidavits

• Participate in depositions in person or by electronic means

• Provide testimony in person or by electronic means

• Related travel as needed

4.16 REPORTING

Contractor shall provide routine and regular reporting on status, quantity, quality, and timeliness of examination requests. Such reporting will be at the request of DEA and contractor shall endeavor to develop robust tracking and reporting mechanisms as may be requested.

5 . 0 R E PO R T S AN D O N LI N E C LEAR AN C E / EX AM T R AC K I N G

S YS T EM

Monthly invoice shall provide an itemized break-down of services provided via spreadsheet that can be sorted by Contract Line Item Number (CLIN) and/or by examinee. Additional information on invoicing can be found in Section 3: General Terms. In the event an EHR or agency sponsored tracking system is deployed, the contractor shall use the tracking system specified by DEA. The contractor shall demonstrate ability to obtain a secure file sharing platform to receive exams and PII. Status of examinations or assessments shall be made available real time and capture the following information:

• Examinee’s last name, first name, middle initial

• Type of examination (new or further evaluation)

• Date of exam

• Date examination results received by contractor

• Was follow-up information requested

• Date follow-up information was received by contractor

• Remarks

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6 . 0 P L AC E O F PER F O RM AN C E - EX AM S

The Contractor shall be able to perform all components of the medical examination, exclusive of PPD read, within one (1) day at a facility located within fifty (50) miles of a domestic DEA office, by zip code (Appendix A). If a medical examination is required outside of this distance, the Contractor shall notify the COR and identified DEA personnel of the delay and shall be able to procure medical examination services for an applicant or incumbent within fifty (50) miles of their home zip code.

7 . 0 S C H E D U LE O F D EL I V ER AB L E S - E X AM S

The Contractor shall prepare and deliver items as shown in the following table defined thereafter.

Reports shall be submitted in electronic format to the Contract Officer Representative (COR) by the dates indicated below:

Task Reference Deliverable Timeframe Medical Exam 3.1 Examination Results Within 3 days of exam completion

Missing Exam Item (MEI) 3.1 Completion of Exam/Assessment Within 5 days of exam/assessment

Psychological Exam 3.2; 4.7; 4.8 Written Reports Within 3 days of evaluation

Specialty Medical Exam 4.9 Examination Results Within 3 days of exam

Ad hoc/Fitness for Duty 4.9 Results of Test Within 5 days of exam/assessment

Breath Alcohol Test 4.11 Results of Test Within 2 hours of DEA request

Hearing Conservation 4.11 Results of Test Within 3 days of testing

Program Status Report 10.1 Program Status Report Quarterly beginning post award

Security Clearance Status Report

10.1 Security Clearance Status Report 30, 60, 90, 120 days post award

Monthly Report 11.0 Monthly Status Report 10th of each month following reporting period

Quality Control Plan 11.0 Quality Control Plan Quarterly beginning post award

Insurance 20.0 Proof of Insurance Upon request

Phase-In/Ramp up 21.1 Phase-In Plan 30 days post award

Phase-Out 21.2 Phase-Out Plan 30 days upon notification

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SECTION II – GENERAL TERMS

8 . 0 P O LI C I E S AN D PR O CE D U RE S

The contractor, in consultation with DEA Health Services Section leadership, DEA Chief Medical Officer, contractor Medical Leadership, and other professional personnel, as appropriate, shall develop and implement written policies and procedures related to the provision of medical examinations for DEA personnel to include policies and procedures regarding examination services, patient consents, and medical record privacy and security. DEA will notify the contractor of any requirements with regard to DEA/Health Services Section policies and procedures, and the contractor shall conform policies and procedures to such requirements. Where current DEA policy and forms exist, the contractor shall utilize DEA authorized documents to the maximum extent possible.

9 . 0 P AT I E N T RE CO R D S

9.0.1 All documentation related to medical records are the property of the DEA and the Contractor shall maintain appropriate and legally required clinical records for each patient examined or treated.

The contractor shall ensure that clinical records are safeguarded against loss or unauthorized use and shall comply with all applicable laws and regulations governing the privacy and security of such records, including applicable provisions of Health Insurance Portability and Accountability Act of 1996 (HIPAA). As required by applicable laws and regulations, the contractor shall not remove, copy, or take possession of any DEA medical records or medical documentation.

9.0.2 To the maximum extent possible, all medical documentation shall be maintained electronically, vice hard copy.

1 0 . 0 P R OG R AM M AN AG EM EN T ( K EY PE R SO N N E L)

10.0.1 The contractor shall provide offsite program support specialists to assist with critical administrative and human resource related tasks such as, but not limited to, tracking and reporting examination status, invoice related tasks, issue investigation and resolution, and assisting contractors with travel. The contractor shall efficiently and effectively manage the performance under this contract to ensure all the necessary technical, business, and administrative planning; organizing; managing; coordinating; and tracking (e.g., cost, schedule, deliverables), performance management, risk management, component procurement management, system engineering management, resource management, data management, and subcontract management required to perform all the activities successfully as required in the

PWS.

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10.0.2 Minimum Qualifications: Program Manager: The Program Manager, who has overall management, operating, and contracting authority for the Contractor, shall have a minimum of five years of management and supervisory experience in similar positions wherein responsibilities entailed managerial/supervisory oversight of the type of work scope described in Section 10.0. In addition, the Program Manager shall possess either a Master of Business Administration (MBA), Master of Science in Business (MS-Business), Master in Public Health (MPH), or Master in Health Administration (MHA) degree from an accredited college or university. Graduate level coursework in the health administration field is required. Program Management Professional (PMP) certification from the Program Management Institute (PMI) is preferred.

10.1 REPORTING

10.1.1 DEA requires the contractor to conduct and provide regular reporting of examination progress and data analytics related to timeliness and quality. Contractor shall provide routine and regular reporting on status, quantity, quality, and timeliness of examination requests. Such reporting will be at the request of DEA and contractor shall endeavor to develop robust tracking and reporting mechanisms that may be requested.

10.1.2 Security Clearance Status Report delivery 30, 60, 90, and 120 Days after Award outlining dates required documentation was submitted as well as dates when any remediated/correction-based submissions were submitted to the COR and DEA Office of Security Programs.

10.1.3 Approved candidates cannot begin performance under the contract until all required background checks have been completed and appropriate security clearances have been granted. Failure by the Prime Contractor to fill a Key Personnel vacancy (whether via its own employee or that of a subcontractor) may be considered to be a material performance issue that will reflect on the Prime Contractor in any performance evaluation.

10.1.4 The Government reserves the right to re-characterize a position by removing the “Key

Personnel” designation and all work performed thereafter is no longer subject to the terms of the clause, DEA-2852.242-76, Key Personnel (JAN 2014). Similarly, any personnel designated by mutual agreement of the Government as Key Personnel are subject to this clause. To this end, additional Key Personnel positions, if required after award, will be added by bilateral modification.

10.1.5 Program Status Report: The Contractor shall schedule and coordinate a quarterly meeting at a location (or virtually) approved by the Government. The meeting shall, at a minimum, provide updates to program status and changes in management, staffing, training, and applicant/incumbent medical evaluations and surveillance examinations processing plans. The meeting shall provide the opportunity to discuss technical, management, and logistic issues with program execution. At a minimum, the attendees shall include Key Contractor Personnel, DEA Human Resources (HR) Directorate, DEA Information Security government representatives, other key Government representatives, and the COR.

DRUG ENFORCEMENT ADMINISTRATION 22

10.2 COMMAND, CONTROL, COMMUNICATIONS, AND

COORDINATION

10.2.1 The contractor shall be responsive to guidance and requests for information from appropriate

DEA authorities, including from DEA Chief Medical Officer, COR, Health Services Section Chief, and Health Services Unit Chiefs.

10.2.2 Routine, reoccurring meetings shall be scheduled at a cadence determined by DEA, and shall be attended by contractor staff to include Program Manager and Clinical Manager assigned to DEA. At DEA request, contractor Administrative and Medical Leadership shall be available to DEA in order to resolve issues that impact DEA’s mission accomplishment.

10.2.3 The contractor shall be responsive to and cooperate with management inspections and other audits or investigations as appropriate and directed by DEA. Any requests for audit information or participation in investigations by the contractor shall be routed through the COR.

10.2.4 Operational oversight of contractor activities shall be provided by: Health Services…