Vision Consultation SOW - 7-13-12.doc

Statement of Work

Pre-Employment and Employee

Vision Consultations

TABLE OF CONTENTS

1TABLE OF CONTENTS

2I.

INTRODUCTION

2II.

REQUIREMENTS

2A. Recommendation Factors

3B. Consultation Documentation

6C. Referrals

6III.

TIMELINE AND TRANSMISSION OF RECOMMENDATIONS

7IV.

QUALIFICATIONS

7V.

QUALITY CONTROL

7VI.

QUALITY ASSURANCE SURVEILLANCE

8VII.

SECURITY PROCEDURES

8A. Document Maintenance

8B. Release of Information

9VIII.

LEGAL TESTIMONY AND TRAVEL

9IX.

MEETINGS

9X.

GOVERNMENT-FURNISHED PROPERTY

9XI.

INVOICING

11XII.

ABBREVIATIONS

Statement of Work Pre-Employment and Employee

Vision Consultations I.

INTRODUCTION

The Minneapolis Hiring Center (MHC) is a nation-wide hiring center for Department of Homeland Security’s (DHS) U.S. Customs and Border Protection (CBP) positions. MHC is required to ensure that all persons being selected for entry on duty for positions within CBP are medically capable of performing the required tasks of the position.

If upon completion of a general medical examination, an applicant’s ophthalmologic health and ability to perform required work duties cannot be substantiated through the information provided in the general medical examination, MHC may require the applicant to obtain follow-up information from a third-party medical professional. Once the follow-up information regarding the applicant’s ophthalmologic health is obtained, MHC forwards requests to the Contractor for vision consultation.

The Contractor shall provide medical consultation services to the CBP Office of Human Resources Management located at the MHC. The Contractor is responsible for providing medical recommendations involving the current ophthalmologic health and visual acuities status of applicants tentatively selected for specific agency positions in which medical standards and/or physical requirements have been established. The Contractor shall have a physician(s) of specialty that is board certified in optometry who shall perform the vision consultations and submit the recommendations.

II.

REQUIREMENTS

The Contractor shall review employment documents and consider medical reports made available to the agency. The agency shall submit the documents to the Contractor via email, facsimile, courier, postal service, or other method as designated by CBP. Based on the Contractor’s review of employment documents and medical reports, the Contractor shall provide a written recommendation that includes the narrative explanation for the conclusion and the medical basis for the recommendation. The recommendation(s) provided by the Contractor’s licensed physician(s) of specialty in optometry shall be in accordance with established diagnostic criteria and consistent with generally accepted professional standards.

A. Recommendation Factors

The recommendation(s) shall be made by the Contractor on a case-by-case basis. However, relevant factors that must be considered include but are not limited to:

1. The applicant’s history of the medical condition(s), including references to findings from previous examinations, treatment, and responses to treatment;

2. Clinical findings from the most recent medical evaluation including findings from physical examination, results from laboratory tests and/or other special evaluations or diagnostic procedures;

3. Diagnosis, including the current clinical status; a “probable” or “likely” diagnosis is not acceptable;

4. Prognosis, including plans for future treatment and an estimate of the expected date of full or partial recovery;

5. An explanation of the impact of the ophthalmologic condition(s) on overall health and activities, including the basis for any conclusion that restrictions or accommodations are or are not warranted and where warranted, an explanation of their therapeutic value to avoid risk;

6. An explanation of the medical basis for any conclusion which indicates the likelihood that the individual is or is not expected to suffer sudden or subtle incapacitation by carrying out the tasks or duties of the specific position, with or without accommodations;

7. Narrative explanation of the medical basis for any conclusion that the condition has or has not become static or well stabilized and the likelihood the medical condition:

(a) Will change as a consequence of the natural progression of the condition (specifically as a result of the normal aging process); or

(b) Will change in response to the work environment or the work itself.

B. Consultation Documentation

After review of the Minneapolis Hiring Center’s pre-employment clearance processes, the Office of Personnel Management requires that all evaluations include specific components in each written recommendation. Each written recommendation shall follow a format that begins with background information regarding the reasoning behind the decision to recommend that an applicant does/does not meet minimum medical qualifications. The initial background information shall be followed by the five (5) requirements listed below. Each of the five (5) requirements listed below shall be labeled with the respective number and addressed in detail within the written recommendation.

1. Diagnosis: Give the diagnosis of a medical condition consistent with generally accepted medical principles. This diagnosis shall avoid language such as “possible” or “likely” and must provide a firm diagnosis;

2. Nexus: An analysis of the medical basis that supports the conclusion that this condition is incompatible with the full range of essential duties and responsibilities of the respective position. In describing the nexus, it is necessary to include specific examples of job essential tasks of the position for which the applicant applied that would be inhibited due to the ophthalmologic health and/or visual acuities state of the applicant (see PEPRs and position descriptions for job essential tasks to be referenced in the recommendation); Written recommendations of “does NOT meet minimum medical qualifications” shall not be accepted without references to specific job essential tasks;

3. Medications: Discussion of medications and whether those medications might give rise to subtle or sudden incapacitation (including the level of sedation or potential cognitive deficits);

4. Breakthrough Symptoms: Discussion of the likelihood of breakthrough symptoms based on the stress or requirements of the job for which the applicant is applying, whether there is a likelihood of acceleration of the ophthalmologic condition, etc.;

5. Final recommendation: State whether or not the examinee does meet or does NOT meet minimum medical qualifications based on the above information regarding the medical qualification/disqualification of the applicant for the position for which the applicant applied. This formatted wording shall be used in the written recommendations: “Based on the information provided with respect to [condition(s)], I find that the applicant [DOES/DOES NOT] meet the minimum medical qualifications.”

The five (5) required items listed above must be included in each written recommendation. If the five requirements listed above are not adequately addressed in each recommendation, CBP will contact the Contractor in writing (usually via email) to request clarification on and/or revision of the document; such discussions for clarification or requests for revisions to recommendations are not billable and shall not be invoiced to the Government.

Please refer to the attached position descriptions and practical exercise performance requirements (PEPR) for any job-related tasks or other job descriptions necessary in the aforementioned evaluation. As positions requiring vision consultations are added throughout the performance of this agreement, CBP shall provide the changes to the Contractor with no cost impact to the agreement. Included are position descriptions and PEPRs for:

· Agricultural Specialist (AGS)

· Air Interdiction Agent (AIA)

· Air Interdiction Officer (AIO)

· Aircraft Mechanic (ACM)

· Automotive Mechanic (AM)

· Aviation Advisor (AA)

· Aviation Enforcement Officer (AEO)

· Aviation Maintenance Inspector (AMI)

· Aviation Operations Analyst (AOA)

· Border Patrol Agent (BPA)

· Customs and Border Protection Officer (CBPO)

· Enforcement Aviation Specialist (EAS)

· Engineering Equipment Operator (EEO)

· Heavy Mobile Equipment Mechanic (HMEM)

· Laborer

· Maintenance Mechanic (MM)

· Marine Interdiction Agent (MIA)

· Materials Handler (MH)

· Motor Vehicle Operator (MVO)

· Range Officer (RO)

· Tools & Parts Attendant (TPA)

· Welder

If not enough information can be gleaned from the follow-up data submitted by the applicant to make a recommendation that the applicant DOES meet minimum medical qualifications, it shall be noted in the written recommendation that further information shall be required for any future evaluations and that the current decision based on the insufficient information given to the Contractor is that the applicant DOES NOT meet minimum medical qualifications.

If candidate truthfulness cannot be substantiated, the lack of honesty may be noted in the written recommendation; however, it shall be noted that candidate truthfulness would not be a basis for ophthalmologic diagnoses.

If the Contractor has been given information regarding a change in the use of a medication and due to the short time span in which the change has been made, if a solid DOES/DOES NOT meet minimum medical qualifications recommendation cannot be made until the applicant has continued on this change in medication use long enough for a conclusion to be made, the Contractor shall note it in the report with a recommendation that the applicant DOES NOT meet minimum medical qualifications. The report shall also state what the Contractor considers to be a more substantial length of time (as appropriate case-by-case) in order to demonstrate that an applicant’s ability to complete the tasks necessary in the position for which the applicant applied shall not be inhibited; if the applicant reapplies at a later date, MHC shall know precisely what follow up must be requested of the applicant.

If an applicant’s paperwork is incorrect or does not match up with regard to names and/or positions, the Contractor may indicate as much on the written recommendation to ensure the exam is for the correct position application and to clarify if questioned in the future. As all of MHC’s medical exams include the same components, the same information is included in the examination regardless of which position the applicant originally applied for; what matters most is the position for which MHC is requesting a recommendation. If there is a discrepancy in the paperwork that the Contractor would like to clarify, the Contractor may contact MHC for clarification before submitting the report.

If CBP finds that the requested recommendation is no longer required for the particular applicant, CBP shall notify the Contractor via email that the request for consultation has been withdrawn. The Contractor shall then respond to CBP that the consultation request has been withdrawn, the consultation work has already begun, or the consultation is already complete. If the Contractor has not begun work on the consultation, the Contractor shall shred all paperwork related to the specific consultation request and not invoice CBP. If the Contractor has already begun work on the consultation as requested by CBP prior to CBP’s request for withdrawal, the Contractor shall complete the consultation, forward to MHC, and invoice at the regular contracted rate. If the Contractor has already completed the consultation as initially requested by CBP prior to CBP’s request for withdrawal, the Contractor shall forward the recommendation to MHC and invoice at the regular contracted rate.

Note: Due to the technical nature of medical information, if CBP Nurse Consultant Medical Staff cannot clearly determine by the written report submitted to CBP by the Contractor all necessary information to process the medical examination within CBP, CBP Nurse Consultant Medical Staff may at times contact the Contractor to follow-up. If a revised recommendation is needed, CBP shall not be billed for the contact or the revision.

C. Referrals

The contract vision specialist may also be asked to identify, throughout the United States of America, vision specialist(s) qualified to perform specific job-related vision tests (i.e. L’Anthony D-15, Farnsworth D-15) when needed. It is a conflict of interest for the Contractor to provide the initial follow-up examination that MHC requests from the applicant as it would then be forwarded back to the Contractor by MHC for a vision consultation; as such, the Contractor shall not perform initial follow-up requests that MHC requires of the applicant. In the event that the Contractor is approached by an MHC applicant for a required initial follow-up, the Contractor shall refer the applicant to other colleagues not performing vision consultations under this agreement.

III.

TIMELINE AND TRANSMISSION OF RECOMMENDATIONS

The written recommendation from the physician of specialty shall be provided within fifteen (15) calendar days from the date of CBP’s written request, not including federal holidays.

An electronic, signed version of the written recommendation shall be sent to MHC via email the day it is completed; email addresses for MHC shall be provided to the Contractor upon contract award. The emailed copy shall be password protected to ensure privacy of personally identifiable information. The signed, original written recommendation shall be sent to MHC along with the documentation of the evaluations that MHC provided to the Contractor at the time of the consultation request (see MHC address below). The cost of delivery of the original documents to MHC is the responsibility of the Contractor.

Pre-employment Clearance Services

Minneapolis Hiring Center

DHS, CBP, HRM

5600 American Boulevard, Suite 700

Bloomington, MN 55437-1450

IV.

QUALIFICATIONS

The Contractor shall have a physician(s) of specialty that is board certified in optometry who shall perform the vision consultations and submit the written recommendations. It is a requirement that the optometrist(s) submitting the written recommendations have at least five (5) years of experience demonstrating knowledge of forensic law enforcement hiring/screening experience and knowledge of the Office of Personnel Management’s policies about federal hiring.

All contractor and subcontractor employees working on this contract shall be U.S. citizens or Lawful Permanent Residents.

V.

QUALITY CONTROL

The Contractor shall create and maintain a thorough Quality Control Plan that shall be submitted at the time of proposal. In the Quality Control Plan the Contractor shall address issues that may arise and how each issue will be addressed, monitored, corrected, and prevented going forward. The Quality Control Plan shall include but not be limited to discussion on ways to ensure that all written consultations are consistent, lack errors, and are delivered timely.

VI.

QUALITY ASSURANCE SURVEILLANCE

The Government retains the right to monitor, assess, record and report on all aspects of the Contractor's technical performance.

The Government has the right to review statistical data from the Contractor’s invoices and reports, and/or from CBP’s internal reporting regarding the Contractor’s performance at any time. For example, the Government has the right to assess performance based on timeliness of reviewing and returning consultations to the Government, etc.

The Government has the right to perform audits which may include requests for credentials of the physician(s) of specialty, etc.

The Contractor shall submit a thorough Quality Control Plan in their proposal for this solicitation. The Government has the right to request the Contractor’s most current Quality Control Plan at any time for review; the Government may offer suggestions to the Contractor regarding items that may require more extensive quality control measures.

The Government has the right to conduct site visits at the Contractor’s place of business. The Government has the right to discuss information related to the site visits with the Contractor regarding quality control and potential areas for improvement.

The Government has the right to 100% services/goods inspection.

VII.

SECURITY PROCEDURES

A. Document Maintenance

The Contractor is responsible for ensuring that all information and medical records obtained are maintained in a strictly confidential manner, adhering to the National Institute of Standards and Technology guidance and requirements (http://www.nist.gov/index.html). The records must be stored either in locked, fireproof metal filing cabinets or in a secured room that is not accessible to the general public or visitors. At all times the Contractor shall take necessary precautions to ensure that the medical information, written recommendations, and all electronic files are properly secured to prevent unauthorized access to the documents. The Contractor shall maintain electronic copies of the written recommendations for the duration of this agreement and an additional five (5) years after the end of this performance period.

B. Release of Information

All records are subject to the Privacy Act, 5 USC, 552a. The information and records shall be maintained and used with the highest regard for employee privacy. Applicants may review the information obtained from the physical/medical exam; however, the applicant must submit his/her request to review records to MHC. Any requests received by the Contractor must be referred to CBP for response. If an applicant should inquire to the Contractor regarding the status of a consultation, the Contractor shall refer the applicant to MHC. At no point shall the Contractor provide information regarding CBP’s medical consultations directly to applicants.

Applicants may obtain a copy of their medical examination results by sending an original notarized letter authorizing release of the information; the applicant should forward the formal request to the following address:

Pre-employment Clearance Services

Minneapolis Hiring Center

DHS, CBP, HRM

5600 American Boulevard, Suite 700 Bloomington, MN 55437-1450

VIII.

LEGAL TESTIMONY AND TRAVEL

The physician(s) of specialty in optometry may be required to provide legal testimony or testify in court proceedings for CBP. Required travel shall be in accordance with Government regulations (Federal Acquisition Regulations 31.205-46). The Contractor shall handle its own travel arrangements (i.e. flight, hotel, etc.) and shall submit a travel estimate to the COR prior to completing the travel. Without prior approval of a travel estimate, the Government reserves the right to reject travel charges that are not reasonable or in accordance with Government regulations.

IX.

MEETINGS

The Contractor shall not be required to travel to MHC for meetings; MHC is able to convene for the post-award orientation and to address most of the agreement issues via teleconference. Time spent in meetings with MHC is not billable as it is considered a part of administration of this agreement.

X.

GOVERNMENT-FURNISHED PROPERTY

The Government shall not provide the Contractor with any government-furnished property under this contract.

XI.

INVOICING

The Contractor shall submit invoice statements for work accomplished on a monthly basis by the 15th calendar day of the month. Meetings to discuss the agreement and changes needed, etc. shall not be invoiced to the Government. Meetings are a part of the administration of this agreement and are not billable.

The invoice shall include a cover sheet and an itemized statement of the services performed. The position of each applicant shall be noted on the invoice backup data (i.e. BPA, CBPO, etc.) as well as the applicant’s name and identification number as submitted by MHC in the request for consultation.

Acceptance shall occur when the invoice is certified by the COR.

Invoices shall be submitted via facsimile or via email (email addresses for MHC to be provided upon contract award), at no cost to the Government.

All invoice statement cover sheets shall include but not be limited to:

· Invoice number

· Bureau (CBP) to which the individual is applying for a position

· Types of exam (vision consultation)

· Quantity of consultations

· Individual and aggregate price of services performed

· Date of the invoice (MUST be dated as close as possible to the date the invoice was submitted to MHC. This date shall be required to be amended should a correction to the invoice be requested from MHC – the new invoice date MUST be dated as close as possible to the date the corrected invoice was submitted to MHC)

· Agreement/Contract number and Task Order/Purchase Order number

· Name of the Contractor

· Address to where the invoice is to be paid

· Address to where the invoice was sent to CBP

Invoice backup documentation detailing each consultation shall be submitted with each invoice cover sheet to include but not be limited to:

· Date of the invoice

· Date of service

· Invoice number

· Identification number of the applicant

· Applicant name

· CLIN #/letter of the service being billed

· Dollar amount for each service

As budget needs and funds tracking change within DHS, CBP shall be required to separate funding for various positions. As such, the Contractor shall separate invoices into the categories designated by CBP. Each separate invoice shall include one type of position: BPA, CBPO, Air & Marine, or CBP Other. For example, Customs and Border Protection Officer consultations shall be separated from all consultations of Border Patrol Agent or any other position or bureau of exam types. If the Contractor has questions regarding which positions should be included in a billing category, the COR shall have the information available. Billing detail shall include a separate invoice for each of the following bureau or position distinctions:

· CBPO: Customs and Border Protection Officer

· BPA: Border Patrol Agent

· CBP Air & Marine: includes Air Interdiction Agent, Air Interdiction Officer, Aircraft Mechanic, Aviation Advisor, Aviation Enforcement Officer, Aviation Maintenance Inspector, Aviation Operations Analyst, Enforcement Aviation Specialist, Marine Interdiction Agent

· CBP Other: includes all other CBP positions such as Agricultural Specialist, Auto Mechanic, Engine Equipment Operator, Heavy Mobile Equipment Mechanic, Laborer, Maintenance Mechanic, Materials Handler, Motor Vehicle Operator, Range Officer, Tools & Parts Attendant, Welder, etc.

Upon request of MHC, the Contractor shall provide the electronic copies of the invoices so that MHC is able to upload the data into MHC’s automated systems. Currently MHC uses files in Microsoft Excel. The format will be designated by CBP but at minimum shall include:

· Date of the invoice

· Date of service

· Invoice number

· Identification number of the applicant

· Applicant name

· CLIN #/letter of the service being billed

· Dollar amount for each service

XII.

ABBREVIATIONS

AA – Aviation Advisor

ACM – Aircraft Mechanic

AEO – Aviation Enforcement Officer

AGS – Agricultural Specialist AIA – Air Interdiction Agent

AIO – Air Interdiction Officer

AM – Automotive Mechanic

AOA – Aviation Operations Analyst

BPA – Border Patrol Agent

CBP – Customs and Border Protection (Agency)

CBPO – Customs and Border Protection Officer (position)

COR – Contracting Officer’s Representative

DHS – Department of Homeland Security EAS – Enforcement Aviation Specialist

EEO – Engineering Equipment Operator

HMEM – Heavy Mobile Equipment Mechanic

HRM – Human Resources Management MH – Materials Handler

MHC – Minneapolis Hiring Center

MIA – Marine Interdiction Agent

MM – Maintenance Mechanic

MVO – Motor Vehicle Operator

TPA – Tools & Parts Attendant

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