Attachment_1_-_Performance_Work_Statement_4.13.17_with_Track_Changes.docx

Attachment 1

Department of Homeland Security (DHS), U.S. Immigration and Customs Enforcement (ICE), Office of Human Capital (OHC)

Medical, Psychological, Fitness, and Drug Testing Services Performance Work Statement (PWS)

March 28, 2017April 13, 2017

Contents

Performance Work Statement (PWS)

Medical, Psychological, Fitness, and Drug Testing Services

Part 1 - Overview and Contract Requirements

1.0 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.

1.1 Scope

This Performance Work Statement (PWS) encompasses Pre-Employment and Post Employment medical, psychological, fitness and drug testing services for ICE personnel. Pre-Employment medical services include applicant medical, fitness and drug testing in accordance with U.S. Department of Health and Human Services (HHS) regulations. Post Employment medical services include the following: support for the Drug Free Federal Workplace Program, Independent Medical Examinations, Paper Only Medical Reviews and Ancillary Testing.

Potential deliveries of services include all 50 US states, plus locations in Puerto Rico, the Virgin Islands, and the Mariana Islands to include Guam.

Requests for the pre-employment testing of individuals from ICE will originate from the ICE Office of Human Capital (OHC) Dallas Pre-Employment Clearance (PEC) Unit and for ICE employee examinations and testing will originate from the ICE Office of Human Capital (OHC) Fitness for Duty Coordinator (FFDC) or Drug Program Coordinator (DPC).

1.2 Applicable Documents

The applicable documents for this PWS are listed below. The contractor is expected to comply with all documents. The contractor must use the latest version of the applicable document. Government documents will be provided to the contractor upon request but no later than before the commencement of services.

A. 41 CFR Chapters 300-304, Federal Travel Regulations http://www.gsa.gov/portal/content/104790

B. HHS Mandatory Guidelines, https://www.samhsa.gov/workplace/drug-testing#HHS Mandatory Guidelines

C. HHS, Urine Specimen Collection Handbook For Federal Agency Workplace Drug Testing Programs

D. Public Law 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA) - The Office for Civil Rights enforces the Health Insurance Portability and Accountability Act (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

E. U.S. Department of Justice, Immigration and Naturalization Service, Medical Standards.

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

G. U.S. Immigration and Customs Enforcement Drug-Free Workplace Plan

H. SAMHSA list of certified laboratories

I. 5 CFR 399 Medical Qualifications

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

J. Medical standards by position description

K. Practical exercise physical requirements (PEPR)

L. Medical history form

M. Fitness Examination DVD

N. Fitness Examination Audio File

1.3. Hours of Operation

The Contractor’s testing facilities and clinics should be open to the maximum extent practicable, so as not to hinder the ability of any applicant or employee to utilize the services provided under this contract.

In the event of a post-accident testing (see Part 5), testing facility and clinic availability should not be allowed to hinder the testing deadlines.

1.4. Geographic Locations

The examining medical/fitness/collection facilities must be located within the potential delivery destinations of all 50 US states, plus locations in Puerto Rico, the Virgin Islands, and the Mariana Islands to include Guam. The examining medical/fitness/collection facility selected should preferably be located within 50 miles of the employee’s home or work. In the event a facility is not located within 50 miles of the employee’s home or work the Government must be notified immediately.

1.5 PERSONNEL REQUIREMENTS

Medical Review Officer (MRO)

The HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines) define an MRO as a licensed physician holding either a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree who has:

• Knowledge regarding the pharmacology and toxicology of illicit drugs;

• Training in the collection procedures used to collect federal agency specimens; the 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; and 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

• 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) must be a licensed physician with documented experience in performing reviews of medical examinations in order to determine whether the applicant meets the Agency’s Medical Standards.

Program Manager (PM) must have at least five (5) years of experience managing programs of the same complexity, and scope of this Performance Work Statement. The Program Manager should be a Subject Matter Expert (SME) in the Medical Services Industry. The contractor shall provide a Program Manager that shall act as the central point of contact with the Government for all program-wide technical issues, and 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 point of contact for the IDIQ Contracting Officer and the IDIQ and Task Order Contracting Officer’s Representative(s).

The Program Manager shall be available to the COR(s) via telephone between the hours of 8:00am-5:00pm (EST), Monday through Friday, and shall respond to a request for discussion or resolution of technical problems within twenty-four (24) hours of notification.

1.6. Contractor’s Responsibilities

A. The contractor’s responsibilities shall include, but are not limited to, providing all labor, materials, and equipment necessary for the applicant/employee medical examination services, fitness assessments, and for the collection and transportation of all specimens.

B. The contractor shall pay all fees and postage relating to information submitted to the Government, including forms, reports, shipping to collectors, etc.

C. For Random Drug Testing, the contractor shall identify and establish facilities for examination services and for specimen collection and ensure that they are equipped with appropriate supplies and materials within seven (7) calendar 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 appropriate designated contracting officer’s representative (COR), within 48 hours and shall note any corrective action undertaken.

D. The contractor shall reschedule, within 48 hours, all applicants/employees whose specimens have been rejected or lost and shall not bill the Government for any specimens that are rejected or lost due to collection errors.

E. For Independent Medical Examination, the contractor shall invoice the Government only after all of the agency’s questions have been fully answered.

F. The contractor shall provide all training necessary to navigate and fully utilize their Customer Portal.

1.7. Contractor Quality Control Plan

The contractor is responsible for the quality and timeliness of all services and products under this PWS. The contractor shall monitor pending exams/tests and follow up with facilities to ensure the completion of services are within required timeframes stated in this PWS.

1.8 Electronic Files

The contractor shall send the Government electronic files containing information on their medical, fitness testing, and drug testing scheduling activity that took place within the previous 24 hours on a daily basis. The file shall be sorted by the type of test. The file shall specify applicants who were difficult to reach or failed to keep the appointment. Difficult to reach applicants are those whom the contractor has been unable to reach after three documented attempts. The contractor is expected to attempt to reach the applicant on at least three different occasions and to document the details of each attempt. These calls are expected to be made at different times of day using all phone numbers available.

1.9 Contractor’s Customer Access Portal

The Government requires the contractor to have a web-based protected site that complies with the Privacy Act at 5 U.S.C. 552a and meets the minimum requirements stated below.

Minimum Requirements: Portal enables the Government to determine the current status of a requested examination at any time and shows the scheduling dates for the examination(s) and estimated date for the return of results. The contractor must provide the Government with the ability to produce standard and ad hoc reports from the Portal data system. If the established reports are not responsive to the Government user, the contractor must provide the requested reports within five calendar days of the request.

Preferred Requirements: Portal can store electronic versions of the drug testing chain of custody forms. ICE PEC needs the CFC after the final receipt at the HHS certified laboratory.

1.10 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 general public or visitors.

1.11 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 applicant/employee privacy. Applicants/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 which the information is to be released, along with 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:

7701 N. Stemmons Freeway, 6th Floor Dallas, TX 75247

For requests concerning Fitness for Duty examinations, 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 Washington, D.C. 20020

1.12 Billing

Invoice submission shall be monthly via email to ICE Finance Center (invoice.consolidation@ice.dhs.gov), COR and ACOR (for the respective task order)

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;

· EFT Information (bank name, ABA and account name/number);

· DUNS Number;

· Contractor POC information;

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 of SSN, exam date, appointment date, category, exam type, exam procedure/exam name, price billed, invoice total)

1.13 Travel / Other Direct Cost

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. Local travel 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 CO 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 as long as 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 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 other direct costs are included in the fixed price CLINs of this task order.

1.14 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 course of 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 into the price of the services as outlined in the PWS. The contractor should anticipate that no show or canceled appointments may occur up to 6% of the time. The exception to this is Independent Medical Examinations. Those will be billable to the Government at a fixed price rate.

1.15 Additional Services

In the event the medical requirements change, within either ICE’s Pre-Employment, Post-Employment or Drug Free Work force program, the Government may negotiate additional CLINs added to this IDIQ. These additional services must fall within the scope of Medical, Psychological, Fitness, and Drug Testing Services as stated in Paragraph 1.1.

1.16 Mobile One-Stop Hiring Event(s)

As required during the term of the contract, 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. Travel costs will be reimbursed in accordance with Para 1.13.

The task orders will be awarded at one fixed price per event (plus travel) for a minimum of 30 (maximum of 55) applicants per day, for 3 – 5 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, TB 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 sq ft meeting space:

· Contractor’s medical staff will set up pipe and drape for medical exams

· 3 - tables outside of meeting space for check-in

· 10 - chairs for applicants to fill out paper work near check-in

· 2 - 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

· 1 exclusive restroom for drug testing.

The Contractor’s duties are as follows:

A. Perform administrative, medical, fitness (if applicable) and drug services in accordance with (IAW) all contract requirement(s) set forth in this Performance Work Statement (PWS).

B. Provide service for a guaranteed minimum of 100 pre-employment medical, fitness (if applicable) and drug testing exams at major metropolitan locations.

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

D. Provide a booth meeting OSHA testing requirements for the hearing tests.

E. Last applicant will be accepted by OHC Staff no later tha2:30PM each day to allow for all tests to be completed by 8:00PM. 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 utilized for examination purposes. OHC staff will email fillable forms to each applicant prior to each one-stop. Provide additional forms onsite in the event an applicant is unable to bring provided forms. Input test results into the Customer Access Portal for each applicant as follows:

1. Blood test will be used for the PPD test.

2. Further Evaluation rating (follow-ups) should be priced separately.

3. Each Event should be set up and ready for applicants by 7:00 am

4. Each Event should continually run throughout the day

5. Drug results within 4 working days of actual test

6. Medical results within 7-14 working days of actual test

7. Fitness results (if applicable) within 7-14working days

F. Medical result pdf file for each applicant sent to OHC, electronically, within 7-14 working days of actual exam.

G. Furnish all personnel and any additional equipment needed for screening during each event to include but not limited to pipes, drapes, clipboards, and anything else needed that the hotel does not provide.

Part 2 - Pre-Employment Medical Services

2.0 Description

Federal agencies are responsible for ensuring that their employees are fully qualified to safely and efficiently perform the essential duties of their respective positions. 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:

A. that applicants undergo a pre-employment medical examination and provide specific documentation related to their medical histories; and

B. that employees demonstrate their continued medical suitability 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 test (for certain designated positions)

If an applicant has a history of a mental health disorder, then copies of treatment records may be requested and reviewed to further assess the status of the mental health disorder.

Psychological screening should be treated as a component of the Pre-Employment medical examination. Any Pre-employment psychological consultation would be a paper records review only. If requested as part of a Fitness for Duty exam (FFDE) it would require a specialty consultation with a psychologist or psychiatrist.

When requested as part of a FFDE the request will describe the services requested. During the Pre-Employment Examination any tool commonly employed in a primary care setting is appropriate. A “virtual face-to-face” is not specific and would not be appropriate for either a Pre-Employment or FFDE.

2.1. Pre-Employment Drug Screening

All Pre-Employment Drug Test Collection will occur at a clinic within the 50 mile limit from the applicant’s recorded address and be performed in accordance with HHS guidelines.

A. Drug Screening Process/ Scheduling

On a daily basis, or as needed, ICE OHC Pre-Employment Clearance (PEC) Unit will send an electronic file to the contractor to notify them of the applicants’ drug screening requests. This notification will be an electronic web-based data file. This file will contain all the contact information about the applicants’ test scheduling.

Within three (3) working days of the initial notification, the contractor shall be responsible for coordinating the scheduling of the services with the applicant. Upon successfully notifying the applicant of the need for a urine specimen, the contractor shall make provisions to assure that the applicant provides such a specimen within 48 hours of the applicant being notified. The Medical Reviewing Officer will notify OHC Dallas PEC Unit within two (2) working days after notification of the results of the test. A chain of custody form should arrive via electronic format to complete the record. It is the responsibility of the Medical Review Officer to report positive and irregular results to OHC Dallas PEC Unit as they are identified.

The contractor shall make three (3) attempts to contact the applicant, via telephone, to notify the examinee for the appointment date, time, address, and contact person.

B. Procedure in the Event of Applicant unavailability, “no shows”, no nearby clinic

In the event the applicant is unable to schedule within 48 hours the contractual medical company must refer the examination request back to the initiating OHC Dallas PEC Unit.

If an applicant does not appear for the scheduled examination, the contractor shall notify OHC Dallas PEC Unit immediately (within 4 hours of the scheduled appointment). “No shows” fees will not be billed to the Government. The Government reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

In certain cases, not more than five times per year, the contractor may be required to travel to the individual’s location if a collection site is not located within 50 miles of the applicant. This will be at no cost to the Government.

2.2. Pre-Employment Physical Fitness Tests (PFT)

A. General Information

Before commencing the PFT, applicants may have completed the pre-employment medical examination, including blood pressure readings and a twelve-point EKG with Medical Doctor’s Interpretation. At times, applicants may be required to complete a combination of required services: EKG, Fitness/Performance assessment, and Drug Test.

In the event that no contraindications to participation have been identified, and the applicant provides signed consent to be tested, then the fitness assessments may be administered. It should be noted that testing is always stopped at the request of the applicant for chest pain or other problems, or if the test administrator determines that testing should be stopped.

B. Description of Physical Fitness Test

This PFT, for ICE applicants only, consists of three parts and allows for a three-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 ten changes must be completed within 25 seconds and are immediately followed by two 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 applicant will be required to hold both arms extended in front as if holding a firearm. An audio file will provide verbal cues during this test so that applicant does not have to memorize the sequence.

2. Push-up Test

This is a timed test requiring completion of fifteen proper form push-ups in two 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 applicant’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 applicant 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 audiotape, containing constant beat and verbal cues shall be used. The audiotape also contains special instructions to switch the lead leg every minute to avoid local muscle fatigue. The audiotape is responsibility of the contractor.

These tests are to be administered per the protocol outlined in the following link: https://www.ice.gov/careers/occupations Go to - > Occupations - > Enforcement and Removal Operations - > DRO Applicant Pre-Employment Fitness (PDF)

Fitness results should be delivered to OHC Dallas PEC within 7-14 working days.

The ICE Administrator Score Sheet must be utilized for each Fitness Test.

C. Procedures in the Event of Applicant Inability to Successfully Complete the PFT

In the event that an applicant 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 applicants fails to successfully complete and must fully describe, in a type written format, the specifics of the event and reason for failure or for stopping the assessment on the back of the assessment score sheet. The test administrator shall legibly sign and date the document, notify the contractor of the failure within one (1) working day and forward all materials, documentation, score sheets, etc. to OHC Dallas PEC Unit within one (1) working day of the test. In the event that the test must be stopped because of the applicant’s inability to successfully complete a component or if the applicant becomes symptomatic and the test administrator stops the test, the contractor will bill and be paid for the entire test.

2.3. Pre-employment Medical Examinations

When contacting the applicant to schedule a medical exam (and fitness assessment), the contractor shall advise the applicant that medical records related to current or past medical conditions should be copied and brought by the applicant to the medical examination., This includes any Veterans Affairs Disability Rating Decision letters and any form of disability compensation that the applicant may be receiving. The applicant should be made aware that the individual is expected to provide these records to the examining physician.

A. Pre-Employment Medical Examination Process

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

1. The applicant’s current and forecasted future medical suitability for fulfilling the duties of the advertised positions;

2. Whether the individual has a history of a particular medical problem in which recurrence cannot be medically ruled out;

3. The etiology of any disease or condition;

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

5. The level/degree of severity of conditions identified, and

6. The existence and extent of any current concern that is not identified in 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 utilized for examination purposes. These forms also serve as guidelines as to what information is salient to the exam process and include guidelines for the measurement of:

1. vital signs

2. height/weight

3. vision

i. corrected and uncorrected visual acuity (near and distant)

ii. peripheral vision

iii. visual depth perception

iv. Hardy, Rand and Rittler (HRR) pseudo isochromatic plate test for color vision testing

4. pure tone audiometry (500; 1,000; 2,000; 3,000; 4,000; 6,000; 8,000 frequencies)

5. tuberculosis skin test results (to be read 48 to 72 hours past administration)

6. Chest x-ray for all applicants who have a positive tuberculosis skin test

7. medical doctor’s interpretation of twelve lead 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 applicant has a positive tuberculosis skin test

B. Scheduling

The contractor shall have three (3) working days from OHC Dallas PEC Unit notification to contact applicants to schedule medical tests (and PFTs, if applicable). Upon successfully notifying the applicant of the need for medical and/or fitness test, the applicant is given seven (7) working days to complete the pre-employment medical screening and PFT process (if applicable). The Reviewing Physician shall review the completed examination to determine if an applicant is medically suitable for the position. The Reviewing Physician shall render a type written medical opinion to the OHC Dallas PEC Unit within 7-14 working days of the pre-employment medical exam date.

If an applicant does not appear for the scheduled examination, the contractor shall notify OHC Dallas PEC Unit immediately (within 4 hours of the scheduled appointment). “No shows” fees will not be billed to the Government. OHC Dallas PEC Unit reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

The contractor shall make three (3) attempts to contact the applicant, via telephone, to notify the examinee for the appointment date, time, address, and contact person.

2.4 Medical Conclusion/Recommendation Process for Pre-Employment Medical Services

After performing an assessment of the applicant’s medical history and a comprehensive systematic examination, the examining physician shall complete a summary of the findings in order to establish the applicant’s health status and the stability of the condition(s) identified.

The examining physician shall refrain from making any recommendation verbally or in writing to the individual regarding the individual’s medical suitability for the position. Rather, 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 applicant pre-employment medical examination, the Reviewing Physicians shall determine whether the individual meets the medical requirements of the position. The OHC Dallas PEC Unit staff will receive and review the Reviewing Physician’s recommendation, and forward to management accordingly.

A. Reviewing Physicians shall be responsible for:

1. Reviewing all medical history and examination records and ensuring their completeness.

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

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

4. Indicating to the OHC Dallas PEC Unit staff through a type written report seven (7) working days of receipt of a file whether and what additional medical documentation is necessary to clarify the status of a particular medical condition(s).

5. Providing an opinion as to the applicant’s medical suitability for the position including a description of current health status, stability of condition, and the rationale for the decision. This recommendation shall be type written in narrative form and shall indicate exactly what documentation was reviewed prior to reaching the decision. The type written medical opinion of the applicant’s suitability for the position shall be submitted within 7-14 working days from receipt of medical records. If the results of the medical exam do not clearly support the applicant’s suitability 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).

6. Providing a letter (within 7-14 working days) to send to the applicant that states that they have 30 days to respond.

B. Timeframes:

The Reviewing Physician shall provide a type written medical opinion of the applicant’s suitability for the government position to ICE within 7-14 working days of the completion of the medical examination, a Primary Review. If the review of the medical examination does not clearly support the applicant’s suitability for the position, the Reviewing Physician’s opinion shall specify what additional medical documentation is needed. The Reviewing Physician may be requested to perform a review of the additional medical documentation received and provide an opinion on suitability, a Secondary Review. A type written medical opinion based on the Secondary Review shall be provided to the Government within 7-14 working days beginning from the date upon which the OHC Dallas PEC Unit or OHC Medical Branch or their designee receives the additional medical documentation and determines that a Secondary Review is required.

2.5 Hiring Surges

On occasion there may be an unplanned increase in hiring as a result of many factors to include Executive Orders, Legislation or abnormal attrition. In the event an unplanned increase in hiring is required, it is possible that thousands of applicants will be processed per quarter verses throughout the year as is normally done.

Part 3 – Fitness for Duty / Independent Medical Examinations

3.0. Description

Medical examinations performed under the auspices of the 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 and physical status and provide sufficient information concerning the individual’s medical condition in order for the agency to make a final determination of suitability for the position. Fitness for Duty Independent Medical Evaluations includes 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 the area of 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 safely and effectively performing the duties of the job, a Certified Independent Medical Examination will be required for medical diagnoses with a Forensic Psychiatric Examination required for mental health diagnoses.

Expert opinion would involve case review, a narrative summary and in some case in-person testimony.

3.1 General Medical Examination Process.

The government will have obtained the necessary authorization for release of medical documentation forms prior to requesting a Fitness-for-Duty Examination FFDE. Once the contractor has submitted the authorizations for release of medical documentation and received copies of past medical treatment records for treatment of the medical condition creating a concern about the employee’s ability to safely and effectively do their job, the contractor will notify the agency of that fact and confirm that the agency is ready for the contractor to schedule an appointment for the type of medical examination specified by the government.

A. General Medical Independent Medical Examination

For medical examinations where the specific diagnosis or therapy are unknown, or in an effort to determine if there is any medical or physical condition that would explain the employee’s performance or conduct problems, a general medical independent medical examination is conducted. This type of examination may also be used to determine fitness for special assignments to high-risk tactical units. Once the contractor has received the request for the examination and the signed authorization for release of medical documents, the contractor will request and obtain copies of the documents specified in the authorization forms. Once received, the contractor shall coordinate with the agency point-of-contact prior to scheduling an appointment. The contractor will schedule an appointment for an FFDE within 5 working days of confirmation that the agency is ready to proceed. The examination shall take place within thirty (30) working days of being scheduled. The examination shall be within 50 miles of the employee’s home or workplace. For FFD exams where an employee requires a unique specialty provider or where the employee is in a remote location, the contractor may be allowed to schedule appointments outside the 50 mile radius and 30 day completion time. The contractor will notify the requesting FFD Coordinator office of the unique circumstances so a mutually agreeable appointment date, time, and location can be established. The contractor shall provide the Government with the specifics of the appointment within 48 hours of being scheduled, to allow the Government sufficient time to notify the employee. It should be noted that in all FFDEs it is the Government, and not the contractor, who is responsible for informing the employee of the appointment and for having the employee sign all necessary forms for the examination. The Government will provide the contractor with all necessary signed forms at the time the FFDE is requested. In general, the contractor is not to engage in communications directly with the employee.

The contractor’s Reviewing Physicians shall review the final IME report, including all exam and lab results, perform a quality assurance review to determine whether the IME properly answered the agency’s questions and whether the recommendations and opinions are sufficiently supported, and provide a final report to the ICE Fitness for Duty Coordinator’s office within five (5) working days from receipt of a complete IME report. In the event that the Contractor’s Reviewing Physicians finds that a more detailed assessment by a different type of physician specialist is required, the Reviewing Physicians shall notify the ICE Fitness for Duty Coordinator staff within five (5) working days from receipt of results and upon the coordinator’s approval will then schedule the appropriate specialist examination.

If an employee does not appear for the scheduled examination, the contractor shall notify the ICE Fitness For Duty Coordinator (FFDC) immediately (within 4 hours of the scheduled appointment). The Government reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

B. Specialty Consultant Independent Medical Examinations

The Government will request a Specialty Consultant Independent Medical 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: Orthopedics, Internal Medicine, Cardiology, Neurology, Ophthalmology, general Psychiatry (Psychological), Functional Capacity Evaluation by a Physical Therapist, etc. Fitness for Duty Medical Examinations includes scheduling fees . This level of service Specialty Consultation will be requested by the Government when there are general questions concerning an employee’s injury or fitness for duty as noted on the ICE Fitness for Duty Request. The final report should answer:

1. What, if any, additional medical records, provided by the employee at the time of the examination, were reviewed in conjunction with this evaluation?

2. In your opinion, what is the employee’s diagnosis, the severity of the condition at present, and the prognosis for the condition? Please provide a detailed explanation for every opinion you provide.

3. In your opinion, can the employee safely and efficiently perform all of the essential duties of the position? As to any essential duty the employee is unable to safely and efficiently perform, please provide a detailed explanation of the bases for your opinion(s).

4. What, if any, restrictions or limitations does the employee currently have with respect to performing the essential duties of the position? As to each restriction or limitation, please provide a detailed explanation about the severity and the nature of the restriction or limitation.

5. If the employee is presently able to perform the essential functions of the position, can a recurrence of any past medical condition be ruled out? If a recurrence cannot be ruled out, please state with a reasonable degree of medical certainty whether a recurrence would pose a reasonable probability of substantial harm to the employee or others given the nature of the duties to be performed. Please provide a detailed explanation to support the bases of your opinion(s).

6. What, if any, medications does the employee currently take or has taken within the last six months that may affect the employee’s ability to perform the essential duties of the position? If any medication would have this affect, please provide a detailed explanation to support your opinion.

7. If the employee requests a copy of your report, may the report be issued to the employee directly or do you recommend that your report be issued to a physician/treatment professional of the employee’s choice?

Fitness for Duty Specialty Consultant Medical Examinations covered in this PWS will be specified by the ICE FFDC and will include all of the following: scheduling of the applicant for applicant medical screening, all nursing support, and a comprehensive report which addresses the questions posed, along with the provision of a fitness for duty recommendation.

If a general Psychiatry (Psychological) Specialty Consultant examination for a FFDE is necessary it will be specifically requested by the FFDC and a general medical FFDE will be performed prior to the psychological specialty consultant evaluation to determine if there is a non-psychiatric explanation for the employee’s performance or conduct problems. For psychological FFD examinations, the FFDE will always request a general medical examination prior to the psychological examination. Appropriate psychiatric/psychological testing should accompany all general Psychiatry (Psychological) Specialty Consultant examinations, inclusive of Minnesota Multiphasic Personality Inventory (MMPI-2) testing and evaluation.

C. Certified Independent Medical Evaluation

The Government will request a Certified Independent Medical Evaluation (CIME) whenever there is a question requiring the training and experience of a certified Independent Medical Examiner (CIME) or certified Forensic Psychiatrist with specific credentials and experience. The Government will request this level of highly skilled evaluation when there is conflicting or contradictory medical documentation which the ICE FFDC notes cannot be resolved through the use of a lower level of service Specialty Consultant. Due to the requirement for a highly skilled, trained, and experienced provider the contractor may, only upon agreement with the ICE Fitness for Duty Coordinator be allowed to schedule appointments outside the 50 mile radius and 30 day completion time. The contractor will notify the requesting FFDC Office prior to scheduling the appointment of the unique circumstance in order to schedule a mutually agreeable appointment date, time, and location. A Specialty CIME Consultation will be requested by the Government when there are more specific questions, in addition to those posed for a Specialty Consultant concerning an employee’s injury or fitness for duty as noted on the ICE Fitness for Duty Request which may include;

1. What, if any, additional medical records provided by the employee at the time of the exam were reviewed in conjunction with this evaluation?

2. In your opinion, what is the employee’s diagnosis, the severity of the condition at present, and the prognosis for the condition? Please provide a detailed explanation for every opinion you provide.

3. In your opinion, can the employee safely and efficiently perform all of the essential duties of the position? As to any essential duty the employee is unable to safely and efficiently perform, please provide a detailed explanation of the bases for your opinion(s).

4. What, if any, restrictions or limitations does the employee currently have with respect to performing the essential duties of the position? As to each restriction or limitation, please provide a detailed explanation about the severity and the nature of the restriction or limitation.

5. If the employee is presently able to perform the essential functions of the position, can a recurrence of any past medical condition be ruled out? If a recurrence cannot be ruled out, please state with a reasonable degree of medical certainty whether a recurrence would pose a reasonable probability of substantial harm to the employee or others given the nature of the duties to be performed. Please provide a detailed explanation to support the bases of your opinion(s).

6. What, if any, medications does the employee currently take or has taken within the last six months that may affect the employee’s ability to perform the essential duties of the position? If any medication would have this affect, please provide a detailed explanation to support your opinion.

7. If the employee requests a copy of your report, may the report be issued to the employee directly or do you recommend that your report be issued to a physician/treatment professional of the employee’s choice?

but will also include the specific additional questions annotated by the FFDC on the ICE Fitness for Duty Request and, if necessary included on a supplemental letter to the CIME.

Independent Medical Evaluations covered in this PWS will be specifically requested by the FFDC and will include all of the following: scheduling of the employee for evaluation, all nursing support and a comprehensive report which addresses all questions posed, along with the provision of a fitness for duty recommendation.

There may be a situation in which a follow-up evaluation is necessary by an IME to clarify an issue or to evaluate ongoing treatment. As this follow-up evaluation does not require the extensive review of the past records and the purpose is to clarify an issue or review an ongoing treatment, the follow-up examination billing would revert to a Specialty Consultation versus a new IME Consultation for billing purposes.

D. Forensic Psychiatric Evaluation

The Government will request an Independent Medical Evaluation whenever there is a question requiring the training and experience of a certified Forensic Psychiatrist. A psychologist is not acceptable for this level of service request. The Government will request this level of highly skilled evaluation when there is conflicting or contradictory medical documentation which cannot be resolved through the use of a Specialty Consultant general Psychiatrist. The Government Fitness for Duty Coordinator will specifically request this level of an evaluation when necessary.

Independent Medical Evaluations requiring a certified Forensic Psychiatrist covered in this PWS will be specifically requested by the FFDC and will include all of the following: scheduling of the employee for examination, all nursing support and a comprehensive report which addresses all questions posed, along with the provision of a fitness for duty recommendation.

Any Fitness for Duty recommendation must reflect the employee’s fitness status as of the date of the evaluation without future recommendations, based upon comparison with the employee’s position description.

If an Independent Medical Evaluation for psychological evaluation requiring a certified Forensic Psychiatrist for a FFDE is necessary, it will be specifically…