Statement_of_Work_-_For_RFI_Only.pdf

Statement of Work for U.S. Immigration and Customs Enforcement

Medical, Psychological, Fitness, and Drug Testing Services

Statement of Work Medical, Psychological, Fitness, and Drug Testing Services

I 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.

This Statement of Work (SOW) encompasses certain pre-employment medical, employee medical, and drug/alcohol screening services for ICE personnel located throughout the country. Pre-employment medical services include applicant medical and physical screening, fitness/physical performance assessment, and drug testing in accordance with U.S. Department of Health and Human Services (HHS) regulations. Employee medical services include one or more of the following:

periodic medical examinations, fitness for duty examinations, return to work reviews after an injury or illness, drug testing, and alcohol testing in accordance with HHS regulations and Department of Transportation (DOT) regulations. 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 OHC DallasOffice of Human Capital (OHC) Dallas Hiring Branch 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).. Requests may also originate from either ICE’s authorized delegate or designee. The contractor is required to fully cooperate with any requests for testing set forth in the SOW originating from authorized personnel.

On a daily basis, or when available, the ICE authorized officials will send an electronic file to the contractor to notify them of the applicant’s drug screening tests and/or medical examinations and physical fitness tests. This file will contain all the information about the applicant contact and required tests/exams that are needed to schedule the applicants and/or employees.

II Authority

The following authorities affect the services the contractor shall deliver under this SOW:

Per Section 503 of Public Law 10071, 5 U.S.C. Section 7301, A. An agency may establish medical standards for positions that predominate in that agency. Such standards must be justified on the basis that duties of the position are arduous or hazardous, or require a certain level of health status or fitness because the nature of the positions involves a high degree of responsibility toward the public or sensitive national security concerns.

B. Executive Order 12564, dated September 15, 1985, Drug Free Workplace (DFW), requires agencies to establish drug free federal workplace programs, to include drug testing and substance abuse education for federal employees.

C. Public Law 100-71, dated July 11, 1987, requires HHS to do the following: (1) certify that each agency has developed a plan for achieving a drug free workplace in accordance with Executive Order 12564 and applicable provisions of law, and (2) publish mandatory guidelines that establish scientific and technical standards for Federal drug testing programs and standards for certification of laboratories engaged in urine drug testing for Federal agencies.

D. DOT 49 CFR Part 40, describes required procedures for conducting workplace drug and alcohol testing for the federally regulated transportation industry.

III Pre-Employment Medical Services

A. 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:

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

2. 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.

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 appropriate for either a Pre-Employment or

FFDE.

B. Pre-Employment Physical Fitness Tests (PFT)

1. 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.

2. 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:

a. 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 audiotape will provide verbal cues during this test so that applicant does not have to memorize the sequence.

b. 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.

c. 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 documents:

i. ICE Fitness Testing Fact Sheet

ii. ICE Test Administrator checklist

iii. Script of the ICE Officer Fitness Tape

3. 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 writing, 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 1 working day and forward all materials, documentation, score sheets, etc. to the OHC Dallas within 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 will be paid for the entire test.

C. Pre-employment Medical Examinations

Pre-employment medical services covered in the SOW will include one or all of the following:

applicant medical and physical screening, fitness/physical performance assessment, and drug testing in accordance with HHS procedures.

1. Pre-Employment Examination Process

Medical examinations performed under the auspices of the SOW 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:

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

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

c. The etiology of any disease or condition;

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

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

f. 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:

a. vital signs

b. height/weight

c. vision

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

ii. peripheral vision

iii. visual depth perception

iv. color vision per Ishihara Color Vision Test or in the alternative

Farnsworth D-15

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

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

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

g. medical doctor’s interpretation of twelve lead EKG (upon review of the EKG, the

Primary 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

The contractor shall have three (3) working days from Government notification to contact applicants to schedule medical tests and PFTs and five (5) working days to complete the pre-employment medical screening and PFT process. The Primary Reviewing Physician shall review the completed examination to determine if an applicant is medically suitable for the position. The Primary Reviewing Physician shall render a written medical opinion either to the OHC OHC DallasMedical Branch within seven (7) working days of the pre-employment medical exam date.

If an applicant does not appear for the scheduled examination, the contractor shall notify the OHC Dallas immediately (within 4 hours of the scheduled appointment) and the Government will reimburse the contractor a fee, not more than one-half the billing amount for that CLN that was requested by the government. The Government reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

There are times when a paper-only pre-employment consultation may be required by the contractor before a recommendation can be made, for example an Optometry or Psychological evaluation of past history. These are reviews of paper records and not face-to-face evaluations which must be pre-approved by the Contracting Officer’s Representative (COR). There are two types;

1. Pre-employment non-psychological Medical or ancillary paper-only review consultations

A medical or ancillary paper-only pre-employment consultation may be requested by the government when there is a question that is beyond the scope of experience of the government decision maker. An example of a specialty paper-only review would be an optometry consultation.

Upon request by the COR, the paper-only consultation would consist of the consultant reviewing the entire pre-employment medical history, physical examination and any other documentation provided by the applicant and results in the consultant providing a short, one page report explaining which medical documents were reviewed and a recommendation that the applicant be hired or not be hired.

The COR will specify whether a medical paper-only review (i.e.: all medical items for which a hiring recommendation was deferred) or particular specialty paper-only review (i.e.: a specialty issue for which a hiring recommendation was deferred) is requested on the pre-employment request form.

If psychological condition/item deferral is noted in concert with medical condition/item deferral, the COR will specify if a psychological recommendation is also requested, through a separate psychological paper-only review request. All conditions for which the COR did not request a hiring recommendation by the consultant reviewing medical documents should be noted in the report. If the consultant reviewing the applicant’s medical documentation reports being incapable of performing the entire requested paper-only review based upon any of the documented deferral conditions/items, the COR should be notified immediately, prior to initiating paper review. There would not be any additional recommendations beyond these two possibilities. It is anticipated that each review and report should take approximately 30-45 minutes of the consultant’s time to prepare this report and make the recommendation.

2. Pre-employment Psychological paper-only review consultations

A psychological paper-only pre-employment consultation may be requested by the government when there is a question that is beyond the scope of experience of the government decision maker.

An example would be an interpretation of a Veteran’s Administration Disability Rating Decision of an applicant who had been diagnosed with Post Traumatic Stress Disorder. Upon request by the COR, the paper-only consultation would consist of the consultant reviewing the pre-employment medical history, physical and any other documentation provided by the applicant and results in the consultant providing a short, one page report explaining what medical documentations were reviewed and a recommendation that the applicant be hired or not be hired. There would not be any additional recommendations beyond these two possibilities. It is anticipated that each review and report should take approximately 30-45 minutes of the consultant’s time to prepare this report and make the recommendation.

D. 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 Contractor’s Primary Reviewing Physicians.

The Contractor’s Primary 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 Contractor’s Primary Reviewing Physicians shall determine whether the individual meets the medical requirements of the position. The OHC Dallas staff will receive and review the Primary Reviewing Physician’s recommendation, and forward to management accordingly.

1. Contractor’s Primary Reviewing Physicians shall be responsible for:

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

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

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

d. Indicating to the OHC Dallas staff through 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).

e. 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 written in narrative form and shall indicate exactly what documentation was reviewed prior to reaching the decision. The written medical opinion of the applicant’s suitability for the position shall be submitted within seven (7) 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 Primary Reviewing Physician’s opinion shall specify what additional medical documentation is needed to clarify the status of a particular medical condition(s).

IV Post-Employment and Employee Medical Services

A. Description

Physical examinations performed under the auspices of the SOW must be consistent with the medical guidelines for weapon-carrying positions. Specifically, the medical examination shall include an assessment of the individual’s medical history and his or her current medical and physical status and provide sufficient information to provide a recommendation concerning the individual’s continued suitability for the position.

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

The government will have obtained the necessary previous medical documentation and consent forms prior to requesting a FFDE to be scheduled. The contractor shall schedule a FFDE within 5 working days of notification by the government. The examination shall take place within five (5) working days of being scheduled. The examination shall be within 60 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 60 mile radius and 5 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 consents for the examination. The Government will provide the contractor with all necessary consents at the time the FFDE is requested.

The contractor’s Primary Reviewing Physicians shall review all exam and lab results, and provide a final report to the Fitness for Duty Coordinator office within five (5) working days from receipt of results. In the event that the Contractor’s Primary Reviewing Physicians indicate that a more detailed assessment by a physician specialist is required, the Primary Reviewing Physicians shall notify the 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 Fitness For Duty Coordinator immediately (within 4 hours of the scheduled appointment) and the Government will reimburse the contractor a fee, not more than one-half the billing amount for that CLN that was requested by the government. The Government reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

B. Ancillary Medical Tests

A Fitness for Duty Examiner may need an ancillary test to make a recommendation regarding an employee’s ability to perform the duties of their position description as noted in the above paragraphs. These are some of the ancillary tests that may be required to make that determination and if so may be obtained by the consultant but are not billed separately, the ancillary tests are bundled into the CLN costs that the government requested the services for.

• OSHA Audiometry

• Blood glucose

• Blood lead level

• CBC with differential

• Chemistry Profile

• Cardiac risk level (The Cardiac Risk Profile is a very standard phrase referring to a laboratory determination of serum total cholesterol, triglycerides, LDL, HDL, and a ratio estimating a person risk for developing cardiovascular disease.)

• Chest x ray (PA and lateral)

• Color vision assessment (Ishihara 14 plate edition)

• Hemoglobin A1C

• Lab profile (CBC with differential, chemistry profile, urinalysis)

• Maximal stress EKG with MD interpretation

• Peripheral vision and visual depth perception

• Protoporphyrin, zinc (ZPP) blood test

• Resting twelve lead EKG with MD interpretation

• Spirometry (FVC%, FEV1, FEV1/FVC%)

• Thyroid Panel

• TB Skin test (with chest x-ray if indicated)

• Urinalysis

• Visual acuity (corrected and uncorrected, near and distant)

• Psychological/Psychiatric testing

• Resting EKG with physician interpretation

• Chest x-ray with physician interpretation for those with a positive tuberculosis skin test

C. Fitness for Duty Specialty Consultant Medical Examinations

The Government will request a Fitness for Duty 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: 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, ancillary tests listed in above. 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;

• What, if any, additional medical records were reviewed in conjunction with this evaluation?

• 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.

• 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).

• 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.

• 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).

• 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.

• 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 SOW will be specified by the FFDC and will include all of the following: scheduling of the applicant for applicant medical screening, all nursing support, ancillary tests as necessary and a comprehensive report which addresses the 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 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. 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.

D. Independent Medical Evaluation

The Government will request an Independent Medical Evaluation 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. Fitness for Duty Independent Medical Evaluations include: scheduling of the employee for the evaluation and all nursing support. Due to the requirement for a highly skilled, trained, and experienced provider the contractor may, only upon agreement with the Fitness for Duty Coordinator be allowed to schedule appointments outside the 60 mile radius and 5 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. An IME 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;

• What, if any, additional medical records were reviewed in conjunction with this evaluation?

• 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.

• 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).

• 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.

• 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).

• 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.

• 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 IME.

Independent Medical Evaluations covered in this SOW 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.

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.

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.

E. Independent Medical Evaluation for 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 SOW 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 requested and a general medical FFDE will be performed prior to the certified Forensic Psychiatric evaluation. For psychological FFD examinations, the FFDE will always request a general medical examination prior to the psychological examination.

F. Independent Medical non-Psychiatric Evaluation

The Government will request an Independent Medical non-Psychiatric Evaluation whenever there is a question requiring the training and experience of a certified Independent Medical Examiner (CIME). 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. The Government Fitness for Duty Coordinator will specifically request this level of an evaluation when necessary.

Independent Medical non-Psychiatric Evaluations covered in this SOW 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.

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.

G. Employee Post-employment Examinations

An “exit examination” may on occasion be requested for an employee who is approaching termination. This examination must include the following components:

• Audiometry

• Height and Weight

• Lab profile (CBC with differential, chemistry profile, urinalysis)

• Resting EKG with physician interpretation

• Visual acuity (corrected and uncorrected, near and distant)

• Vital signs

E. Medical Conclusion/Recommendation Process for Post-Employment Medical Services

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

1. Contractor’s Primary Reviewing Physicians Post Employment medical services shall be responsible for:

a. Reviewing all medical examination records and ensuring their completeness.

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

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

d. Indicating to the Government’s FFDC through written report within five (5) working days of receipt of file whether and what additional medical documentation is necessary to clarify the status of a particular medical condition(s).

e. Providing the Government’s FFDC staff with the written report as to the employee’s medical suitability within five (5) working days from receipt of the employee’s exam/history data from the examining physician/specialist.

V Drug Testing Services

A. Background

The primary objective of a urine drug screening program is to establish and maintain a Drug Free Federal Workplace in accordance with Executive Order 12564 and Public Law 100-71. The work shall be performed in accordance with all applicable policies procedures and rules set for the by HHS rules outlined in the “urine specimen collection handbook for Federal Workplace Drug Testing Programs” at http://workplace.samhsa.gov/DrugTesting/SpecimenCollection/UrnSpcmnHndbk10012004.htm. The contractor shall update processes, as necessary, according to the HHS rules outlined in the above referenced handbook, and stay abreast of HHS requirement changes, and modify processes to accommodate HHS requirement modifications.

The contractor shall, upon notification from ICE authorized officials, select from the Designated Drug Testing Position List an adequate number of random donors and coordinate this random selection list with the DPC who will determine which donor will have an on-site (at ICE location) or off-site (at contractor clinic location) collection and coordinate this determination with the contractor who will collect urine specimens from applicants/employees listed for off-site collection. The Government will send electronic files to the contractor to maintain the Designated Testing List. The collections may occur at many duty locations and the contractor shall be willing to make these collections by establishing a clinic if necessary. The contractor shall also make available a Litigation Package consisting of the necessary documentation, outlined in the Definitions Appendix XI from the HHD-certified laboratory and expert witnesses, as necessary, in connection with administrative and judicial proceedings.

All Pre-Employment Drug Test Collection will occur at a clinic within the 60 mile limit from the applicant’s home.

Under the Random Drug Test Program, collections will be made at government facilities where large numbers of employees are assigned. The number of government facility collection sites and collections will be small and arranged with the DPC. Under the Random Drug Test Program the collections may take place on-site at a government facility when the DPC determines that it is in the best interest of the government to do on-site testing, otherwise the collections will take place off-site http://workplace.samhsa.gov/DrugTesting/SpecimenCollection/UrnSpcmnHndbk10012004.htm at a contractor clinic. Most of the Random and urgent collection, e.g. Post Accident, Reasonable Suspicious will be made at a clinic site.

B. Routine Urine Drug Screening

Executive Order 12564 and Public Law 100-71 prohibit any unauthorized use of controlled substances. The drug testing is conducted by analyzing the applicant’s/ employee’s urine specimen.

The analysis shall be is performed at HHS-certified laboratories certified and monitored by HHS. A list of HHS approved laboratories is published monthly in the Federal Register. Specimens are analyzed for the following:

• Marijuana metabolites

• Cocaine metabolites

• Opiate metabolites Codeine/Morphine

• 6-Acetylmorphine

• Amphetamines AMP/MAMP

• MDMA

• Phencyclidine

• Other substances identified by HHS or other legal entities in the future

The analysis on Bottle B will occur only if the donor requests analysis and it must be done by a different HHS-certified laboratory or laboratory branch than the one that originally processed the Bottle A, if a Bottle B analysis is requested by the donor. The contractor will submit a separate invoice for the Bottle B under the specimen using the proper 0004 CLN, i.e. 0004AB for a Random collection, 0004AC for a post-accident, 0004AD for a Reasonable Suspicion collection, etc.

Therefore, upon the donor’s request there would ultimately be two invoices, one for Bottle A analysis and one for Bottle B analysis.

C. Categories of Drug Screening

For all services below, the Medical Review Officer (MRO) shall notify the Government’s DPC within 24 hours after verification of a confirmed positive result, and within 1 (one) working day after notification of a negative test result. The contractor shall notify the ICE requesting office within 4 hours of the scheduled appointment for those applicants/employees who do not report for their scheduled test or the next business day if the appointment was on a “walk-in” basis.

1. Applicants

Pre-employment applicants: These services support pre-employment drug screening. Within three (3) working days of the initial notification, the contractor shall be responsible for coordinating the scheduling of the services within the next 48 hours with the individual and the collection facility. Most collections shall occur at clinics. The Medical Reviewing Officer will notify the OHC Dallas Medical Branch within two (2) working days after notification of the results of the test.

If an applicant does not appear for the scheduled examination, the contractor shall notify the OHC Dallas immediately (within 4 hours of the scheduled appointment) and the Government will reimburse the contractor a fee, not more than one-half the billing amount for that CLN that was requested by the government. The Government reserves the right to cancel or reschedule prior to 24 hours of the scheduled appointment without any fee.

2. Employees

Post Accident: These services are conducted after accidents involving drivers or other employees whose performance may have contributed to the accident and on all drivers involved in fatal or serious accidents even if the driver is not cited for a moving violation. The contractor shall schedule this type of testing immediately after notification by ICE authorized officials and testing shall be completed at an off-site collection site within 8 hours of such notifications, providing injuries do not prevent testing from taking place.

Reasonable suspicion: This test is conducted when the appropriate ICE officials authorize testing when management has reason to believe an employee is using illegal drugs, the employee will be given written notification and will be asked to provide a urine sample. The contractor shall schedule this type of testing immediately after notification by ICE authorized officials and testing shall be completed within 8 hours of such notification at an off-site collection site.

Random: Random testing shall be performed at Government on-site work places and at contractor off-sites at scheduled times. The random selection will be made by the contractor upon request of the DPC. The DPC will receive the list of selected donors and determine which will be collected at an on-site collection and those who will be sent to a contractor off-site collection site. The ICE DPC will notify the supervisors of those selected for a random test.

Follow-up: These tests are conducted on an individual who has violated the prohibited drug standards, and returns to duty with a drug monitoring plan. Employees who are undergoing a rehabilitation program or who have a confirmed history of drug use will be required to provide samples on a random, unannounced basis to assure the agency that the employee is remaining drug free. Follow-up tests are unannounced and are scheduled by the government DPC as part of the random testing collections.

Voluntary Testing: Those employees who wish to demonstrate their support of the program may request to be tested voluntarily, whether or not they are in a testing designated position.

Individuals who are not on the Designated Drug Testing List may volunteer to have their names added to the Testing List and will be part of the pool from which the contractor selects random names for testing.

D. Scheduling

1. Applicants

On a daily basis, or when available, the ICE OHC Dallas Entry Hiring Unit will send an electronic file to the contractor to notify them of the applicant’s drug screening tests. This notification will be an electronic web-based data file. This file will contain all the information about the applicant contact and required tests/exams that are needed to schedule the applicants.

It is the responsibility of the MRO to report positive results to the DPC.

The contractor shall be responsible for scheduling and notifying the applicant for drug testing.

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 contractor shall contact the applicant by telephone to notify the examinee for the appointment date, time, address, and contact person. If an applicant does not appear for the scheduled examination, the contractor shall notify the OHC Dallas immediately (within 4 hours of the scheduled appointment) and the Government will reimburse the contractor a fee, not more than one-half the billing amount for that CLN that was requested by 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, the contractor may be required to travel to the individual’s location if the collection site is not located within 60 miles of the applicant.

2. Employees

Upon request generated by the DPC, the contractor shall be responsible for providing to the government a random selection list based upon the Designated Testing List provided to the contractor by the DPC. The notifications will be made by the government DPS to the employee’s supervisor with directions where to report for the collection. The contractor will also be required to perform random drug testing at various locations.

For emergency requests (reasonable suspicion; post-accident) the collection shall be completed within 8 hours of notification. Such requests may occur at any time during the day or week, at off-site locations, and generally will be made via telephone to a 24/7 Drug and Alcohol service, followed by written confirmation from the DPC. Within a reasonable time after award, the contractor shall supply the contact information for such collections.

E. The Collector

The collector will be a certified individual who instructs and assists a donor at a collection site, receives and makes an initial inspection of the urine specimen provided by the donor, and initiates and completes the custody and control form (CCF) in accordance with the HHS DFWP Mandatory Guidelines. The collector is vital to the success of a drug-testing program and is the one individual with whom all donors will have direct face to face contact. If the collector does not ensure the integrity of the specimen and adhere to the collection process, the specimen may not be considered a valid piece of evidence. For the on-site collections, after discussion with the DPC, the contractor shall be expected to provide a collection team consisting of one male and one female collector. The majority of collections will be obtained between the hours of 6:00AM and 7:00PM local time.

Agency site coordinator(s) may travel on site to oversee collection and collectors. On occasion the Government may request that an agency site coordinator serve as a collector. On occasion, a collector may be required to testify.

The contractor must contact the Government to resolve problems concerning:

1. applicants who are unable to provide a specimen while at the collection facility

2. permission to conduct direct observation collections for applicants or employees suspected of adulterating specimens

F. Collection Site

The collection site is the location for specified applicants/employees to present themselves for the purpose of providing their urine specimens under controlled conditions. Generally, Pre-employment;

Reasonable Suspicion; Follow-up; and Voluntary Testing will be conducted at the contractor sites.

Random Testing will be collected at both on-site government sites and off-site contractor sites determined by the DPC. Billing for both on-site and off-site collections will be under the same CLN. The Contractor will supply the appropriate forms with the billing information for the laboratory when collections take place at Government facilities. The contractor shall assume responsibility for ensuring that specific collection site requirements are adhered in the contractor clinic collection sites.

The majority of applicants/employees requiring testing will report to a location designated by the contractor. When the collection site is not at the workplace, then it shall be within 60 miles of the employee’s home or in the case of employees, the workplace. Applicant drug testing may be scheduled either in conjunction with another pre-employment process or is scheduled within 60 miles of applicant’s home. In certain cases, the contractor may be required to travel to the individual’s location if the collection site is not located within 60 miles of the employee.

If the contractor is unable to make a prompt Pre-employment specimen collection appointment because a collection site is not available within a 60 mile commuting radius, the contractor must notify the DPC within 24 hours of the initial request for services. The Government may provide the contactor an additional 24 hours to locate an acceptable collection site and in some isolated instances, after agreement with the DPC may extend the 60 mile radius. However, if unable to locate an acceptable collection site, the contractor shall make arrangements to travel to a site mutually agreed upon by both parties. This travel will be at no additional cost to the Government.

The contractor shall, at a minimum:

1. Provide a facilities plan 45 calendar days after the award that details how the contractor proposes to meet the collection site requirements of the HHS Substance Abuse and Mental Health Services Administration (SAMHSA) Mandatory Guidelines available at http://www.workplace.samhsa.gov/DrugTesting/Level_1_Pages/mandatory_guidelines5 _1_10.html

2. Ensure the collection site provided has restroom facilities that are clean, well lit, and sufficiently secure to prevent compromise during the collection of specimens. The Government will be responsible for securing any collection at Government locations until a contract collector is able to accept responsibility for the specimens.”

http://www.workplace.samhsa.gov/DrugTesting/Level_1_Pages/mandatory_guidelines5_1_10.html http://www.workplace.samhsa.gov/DrugTesting/Level_1_Pages/mandatory_guidelines5_1_10.html

3. Ensure any collection site for urine collections shall be secure at all times.