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HomeMy WebLinkAboutBack-Up DocumentsCITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO : FROM Emilio T. Gonzalez, Ph.D. City Manager Annie Perez, CPPO Director, Department of Procurement DATE : May 6, 2019 SUEJECT REFERENCES FILE : Recommendation of Award of a Contract for RFP 610384, Psychological Screening Services ENCLOSURES: Request to Negotiate Memo and Compensation Proposal Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby recommends approval for award of a contract pursuant to Request for Proposals ("RFP") No. 610384 Psychological Screening Services to the sole responsive and responsible proposer, Law Enforcement Psychological & Counseling Associates, Inc. ("LEPCA"), for Psychological Screening Services for the City of Miami Police Department ("Police"). Background: On November 7, 2018 Procurement, issued RFP 610384 under full and open competition, on behalf of Police, to solicit proposals from experienced and qualified firms to perform psychological screening services required in order to obtain personnel that meet the psychological requirements of a diverse police force. On December 12, 2018, one (1) proposal was received in response to the RFP. Subsequently, the proposal was reviewed by Procurement for responsiveness. The Evaluation Committee ("Committee") met on February 25, 2019 and has completed the review and evaluation of the proposal, following the guidelines published in the RFP. On March 1, 2019 the Report of the Committee/Request to Negotiate memo was submitted to the City Manager, and subsequently approved on March 5, 2019. The Negotiation Team met April 29, 2019 to negotiate a contract. Fiscal Impact: The term of the contract for Psychological Screening Services is five (5) years, with one (1) additional five (5) year option to renew period. The Fiscal impact for the negotiated initial term of the contract for Psychological Screening Services varies greatly from year to year depending on hiring needs, however it has averaged about $150,000 per year during the last decade, with only a slight increase due to inflation. The negotiation savings achieved by the negotiation team was an 8.43% discount for the first three years of the contact, and 4.34% discount for the fourth through sixth years from the originally proposed prices. PR19144 After successfully completing the negotiations process, and agreement was reached with LEPCA. Procurement hereby recommends award of a contract to LEPCA. Your signature below will indicate approval of this recommendation. APPROVED: DATE: EmilioGo'nzalez, Ph.D. City nager (71 sh, AP:ejf c: Joseph F. Napoli, Deputy City Manager Sandra Bridgeman, CPA, Assistant City Manager/Chief Financial Officer Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement Jorge R. Colina, Chief of Police cf it r of 4iliami ANNIE PEREZ, CPPO Chief Procurement Officer EMILIO T. GONZALEZ, PH.D. City Manager May 15, 2019 All Responding Proposers (See Distribution List) SUBJECT: RFP 610384, Psychological Screening Services Dear Proposers: The Evaluation of the proposals tendered in response to the above cited solicitation has been completed. The City Manager has recommended award as shown within the enclosed document. This notice is provided in accordance with Section 1.20 of the solicitation, and Sections 18-74 of the City of Miami Code. Our provision of this notice also serves to confirm the lifting of the Cone of Silence from this procurement action as dictated by Section 18-74 (d) (2) of the City of Miami Code. We appreciate the participation of all proposers which responded to the subject action. If you have any questions, please contact me at 305-416-1901 or efalcon(cr�miamigov.com. Sincerely, Eduard . Falcon, CPPB Procurement Contracting Manager Distribution List: Law Enforcement Psychological & Counseling Associates, Inc. Enclosure: City Manager's Award Recommendation Memo c: City Clerk Joseph F. Napoli, Deputy City Manager Sandra Bridgeman, CPA, Assistant City Manager/Chief Financial Officer Jorge R. Colina, Chief of Police Annie Perez, CPPO, Director, Procurement Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement From: Falcon, Eduardo To:"d.o.f.consultants(@hotmail.com"; "jr3015Ca1aol.com"; "drgrif(aldrgrif.com" Subject: City of Miami Solicitation Request for Proposals RFP 610384 for Psychological Screening Services Date: Monday, February 25, 2019 5:58:00 PM Good Afternoon; The above referenced Solicitation was advertised on November 7, 2018 and closed on December 12, 2018. Due to lack of participation, the City is reaching out to firms who received notification of the solicitation to determine whether barriers existed in your decision not to compete. For example: 1. My firm was unable to meet the timeline for solicitation due date. 2. My firm did not have enough time to ask the City questions necessary to complete the solicitation. 3. Not enough information in the Scope of Services. 4. Not Interested. 5. Other (please specify) Your response within 72 hours is very much appreciated. Thank you, Eduardo J. Falcon, CPPB Procurement Contracting Manager City of Miami 444 S.W. 2nd Ave 6th Floor Miami, FL 33130-1910 T: 305-416-1901 F: 305-400-5390 Efalcon@miamigov.com "Serving, Enhancing, and Transforming our Community" by Please consider the environment before printing this e-mail. From: To: Subject: Date: Julieta Falcon, Eduardo Re: City of Miami Solicitation Request for Proposals RFP 610384 for Psychological Screening Services Monday, February 25, 2019 8:47:01 PM CAUTION: This is an email from an external source. Do not click links or open attachments unless you recognize the sender and know the content is safe. 3 not enough information Not sure how to proceed to apply Sent from my iPhone On Feb 25, 2019, at 5:58 PM, Falcon, Eduardo <efalcon a•miamigov.com> wrote: Good Afternoon; The above referenced Solicitation was advertised on November 7, 2018 and closed on December 12, 2018. Due to lack of participation, the City is reaching out to firms who received notification of the solicitation to determine whether barriers existed in your decision not to compete. For example: 1. My firm was unable to meet the timeline for solicitation due date. 2. My firm did not have enough time to ask the City questions necessary to complete the solicitation. 3. Not enough information in the Scope of Services. 4. Not Interested. 5. Other (please specify) Your response within 72 hours is very much appreciated. Thank you, Eduardo J. Falcon, CPPB Procurement Contracting Manager City of Miami 444 S.W. 2nd Ave 6th Floor Miami, FL 33130-1910 T: 305-416-1901 F: 305-400-5390 Efalcon@miamigov.com RFP 610384 — Psychological Screening Services The business The 2018. responding Due whether Fo following survey was sent to vendors registered in the Oracle [Supplier system who were notified of the opportunity. above referenced solicitation was advertised on November 7, 2018. The due date was December 12, The solicitation did have minimum requirements; however, these would not preclude firms from that were regularly engaged providing the requested services. to the lack of participation, Procurement reached out to the some of the identified firms to determine barriers existed in their decision not to compete. For example: 1. My firm was unable to meet the timeline for proposal due date. 2. My firm did not have enough time to ask the City questions necessary to complete the RFP. 3. Not enough information in the Scope of Services. 4. Not Interested. lowing are the responses as received from firms: Firm Response 1 6 D.O.F. Consultants LLC No response. 2 Julieta Rodriguez PA Not enough information, not sure how to apply 3 Dr. E.E Griffith No response CITY OF MIAMI, FLORIDA 1NTER.OFFICE MEMORANDUM TO : Fraan,I : Emilio T. Gonzalez, Ph.D. City Manager Annie Perez, CPPO Director, Department of Procurement DATE: SUBJECT : REFERENCES: March 1, 2019 FILE : Recommendation to Negotiate Contract for RFP 610384, Psychological Screening Services ENCLOSURES: Score Sheets Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby requests approval to negotiate a contract pursuant to Request for Proposals ("RFP") No. 610384 Psychological Screening Services to the sole responsive and responsible proposer, Law Enforcement Psychological & Counseling Associates, Inc. ("LEPCA"), pursuant to Section 2.18, Evaluation/Selection Process and Contract Award. Background: On November 7, 2018 Procurement, issued RFP 610384 under full and open competition, on behalf of the City of Miami Police Department ("Police"), to obtain proposals from experienced and qualified firms to perform psychological screening services required in order to obtain personnel that meet the psychological requirements of a diverse police force. On December 12, 2018, one ('1) proposal was received in response to the RFP. Subsequently, the proposal was reviewed by Procurement for responsiveness. The Evaluation Committee ("Committee") met on February 25, 2019 and has completed the review and evaluation of the proposal, following the guidelines published in the RFP. LEPCA received a score of 498, out of a total combined (Technical and Price) score of 500. Proposer Technical Score (max. 450) Price Score (max. 50) Total Combined Score (max. 500) 1 Law Enforcement Psychological & Counseling Associates, Inc. 449 49 498 The Committee decided not to hold oral presentations. Due diligence was conducted to determine proposer's responsibility, including verifying corporate status. There were no performance or compliance issues, and no adverse findings related to LEPCA's responsibility. PR19099 Negotiations: The Committee recommends that the City of Miami ("City") enter into negotiations with LEPCA, the sole responsive and responsible proposer. Should negotiations fail, the City will resolicit for these services. Thefollowing individuals will participate in the negotiations: Eduardo J. Falcon, CPPB, Procurement Contracting Manager Charles Johnson, III, Sr. Procurement Contracting-Officer,--Procurementajor sther Farmer, Personnel Resource Management Section, Police Assistant Chief Dennis Jackson II, Police Consensus Statement: The Committee recommends LEPCA for the following primary reasons: 1) LEPCA has the necessary relevant experience, qualifications, and relevant past performance to provide the services required in the RFP, at the level required by the City; 2) The firm has the ability to provide the Psychological Screening services required by the City and is the incumbent for the City as well as for many other municipalities requiring this specialized service; 3) The firm submitted a comprehensive Proposal, which included years of detailed research in this field and how it has shaped the services they provide; and 4) LEPCA's proposed compensation was reasonable and will be negotiated in the best interest of the City. Copies of the score sheets for each committee member are attached, as well as the composite score sheet. APPROVED: Emilio T G,rizalez, Ph.D. City Maner AP:ejf f C: Joseph F. Napoli, Deputy City Manager Sandra Bridgeman,. CPA, Assistant City Manager/Chief Financial. Officer Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement Jorge R. Colina, Chief of Police DATE: EVALUATION OF PROPOSAL RFP 610384 PSYCHOLOGICAL SCREENING SERVICES Captain Tiffany Wesley Miami Dade Police Department SELECTION PROPOSERS CRITERIA Maximum Points Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) TECHNICAL CRITERIA AND POINTS Proposer's relevant experience, qualifications, and past performance 50 i;_> .3 O Proposer's Ability to Perform Required Services 25 Methodology and Overall Approach to Scope of Services 15 I `, i S PRICE CRITERIA AND POINTS Proposer's financial capabilities, and proposed fees. 10 TOTAL POINTS 100 10 0 OD 2/20/2019 EVALUATION OF PROPOSAL RFP 610384 PSYCHOLOGICAL SCREENING SERVICES Major Esther Farmer, Personnel Resource Management Section, Police SELECTION PROPOSERS CRITERIA Maximum Points Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) TECHNICAL CRITERIA AND POINTS Proposer's relevant experience, qualifications, and past performance 500)' Proposer's Ability to Perform Required Services 25 5 Methodology and Overall Approach to Scope of Services 15% PRICE CRITERIA AND POINTS Proposer'sCr financial capabilities, and proposed fees. 10 TOTAL POINTS e 100 9r 0 1/22/2019 EVALUATION OF PROPOSAL RFP 610384 PSYCHOLOGICAL SCREENING SERVICES Officer Sandy Owen - Village of El Portal SELECTION PROPOSERS CRITERIA Maximum Points Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) TECHNICAL CRITERIA AND POINTS Proposer's relevant experience, qualifications, and past performance 50 �--_ 0 Proposer's Ability to Perform Required Services 25 ,'6 Methodology and Overall Approach to Scope of Services 15 / 3— /5-- PRICE CRITERIA AND POINTS Proposer's financial capabilities, and proposed fees. 10 / 0 /0 TOTAL POINTS 100 / G 0 /OQ 2/20/2019 EVALUATION OF PROPOSAL RFP 610384 PSYCHOLOGICAL SCREENING SERVICES Commandertalibah Simmons - Internal Affairs/Training Miami Gardens Police Department SELECTION PROPOSERS CRITERIA Maximum Points Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) TECHNICAL CRITERIA AND POINTS Proposer's relevant experience, qualifications, and past performance 50 56 =(-s Proposer's Ability to Perform Required Services 25 2 5 Methodology and Overall Approach to Scope of Services 15 !b PRICE CRITERIA AND POINTS Proposer's financial capabilities, and proposed fees. 10 lb TOTAL POINTS 100 l Q D tti S 2/20/2019 EVALUATION OF PROPOSAL RFP 610384 PSYCHOLOGICAL SCREENING SERVICES Lt. Lazaro Alfonso, Recruitment and Selection, Police SELECTION PROPOSERS CRITERIA Maximum Points Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) 1 v' TECHNICAL CRITERIA AND POINTS Proposers relevant experience, qualifications, and past performance 50 5701 30 Proposer's Ability to Perform Required Services 25 5.-- 5 Methodology and Overall Approach to Scope of Services 15 / c / 5 PRICE CRITERIA AND POINTS Proposer's financial capabilities, and proposed fees. 10 i/0 TOTAL POINTS 100 -1 0 0 AO 1/22/2019 COMPOSITE SCORES RFP 610384 PSYCHOLOGICAL SCREENING SERVICES EVALUATION OF PROPOSALS SELECTION CRITERIA PROPOSERS Maximum Points Per Member Maximum Total Points (5 Members) Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) TECHNICAL CRITERIA AND POINTS Proposer's relevant experience, qualifications, and past performance 50 250 250 Proposer's Ability to Perform Required Services 25 125 125 Methodology and Overall Approach to Scope of Services 15 75 74 PRICE CRITERIA AND POINTS Proposer's financial capabilities, and proposed fees. 10 50 49 TOTAL POINTS 100 500 498 SIGNATURE: Chairpers/ Reviewed By PRINT NAME: CITY OF MIAlvil, FLORIDA INTER -OFFICE MEMORANDUM TO Emilio T. Gonzalez, Ph.D. City Manager Annie Perez, CPPOc Director, Department of Procurement DATE : SUBJECT: REFERENCES: ENCLOSURES: February 7, 2019 FILE : Evaluation Committee for RFP 610384, Psychological Screening Services The City of Miami's Department of Procurement ("Procurement"), on behalf of the Miami Police Department ("Police"), issued Request for Proposals ("RFP") No. 610384 on November 7, 2018, to obtain an experienced and qualified firm to perform Psychological Screening Services. It is respectfully requested that you approve the following individuals as members of the Evaluation Committee to evaluate and score the proposals. Each has the requisite knowledge and experience to evaluate the proposals pursuant to the RFP. This request for the establishment of an evaluation committee was originally approved January 14, 2019; however, two (2) of the External Team Members had to be excused due to workload issues, and Procurement had to obtain (2) two replacements. City of Miami Staff (non -voting chairperson) Eduardo J. Falcon, CPPB, Procurement Contracting Manager City of Miami Staff (voting) Lt. Lazaro Alfonso, Recruitment and Selection, Police Major Esther Farmer, Personnel Resource Management Section, Police External Team Members (voting) Ines Collado, Office Associate V, Miami Beach Police Department, Support Services Division Commander Talibah Simmons, Miami Gardens Police Department Jose M. Rodriguez, Recruitment Manager, Dept. of Human Resources, City of Coral Gables Alternates Sgt. Lonise Joseph, Recruitment and Selection, Police Lt. Marc Redondo, Labor Relations, Police Officer Sandy Owen, Village of El Portal Captain Tiffany Wesley, Miami Dade Police Department APPROVED: L Erhili4YT. onzalez, Ph.D. City Mager DATE: AP:ejf C: Joseph F. Napoli, Deputy City Manager Sandra Bridgeman, CPA, Assistant City Manager/Chief Financial Officer Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement PR19084 Detail by Entity Name Page 1 of 2 Florida Department of State , ;ir//9i brg Cir T1f Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Profit Corporation LAW ENFORCEMENT PSYCHOLOGICAL AND COUNSELING ASSOCIATES, INC. Filing Information Document Number 656100 FEI/EIN Number 59-1978758 Date Filed 02/18/1980 State FL Status ACTIVE Last Event CANCEL ADM DISS/REV Event Date Filed 10/04/2007 Event Effective Date NONE Principal Address 9960 NW 116TH WAY, SUITE 12 MIAMI, FL 33178 Changed: 07/16/2012 Mailing Address 9960 NW 116TH WAY, SUITE 12 MIAMI, FL 33178 Changed: 07/16/2012 Registered Agent Name & Address MANGAN, BRIAN DR 9960 NW 116TH WAY, SUITE 12 MIAMI, FL 33178 Name Changed: 08/18/2011 Address Changed: 02/06/2013 Officer/Director Detail Name & Address Title PRES MANGAN, BRIAN 9960 NW 116TH WAY, SUITE 12 MIAMI, FL 33178 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 6/6/2019 Detail by Entity Name Page 2 of 2 Annual Reports Report Year 2017 2018 2019 Document Images Filed Date 01/18/2017 01/19/2018 02/06/2019 0106 2C 19 — ANNUAL REPORT 01/19/2018 — ANNUAL REPORT 01/18/2017 — ANNUAL REPORT 01 /22/2016 — ANNUAL REPORT 01/12/2015 — ANNUAL REPORT 01/29/2014 — ANNUAL REPORT 02/06/2013 — ANNUAL REPORT 03/08/2012 — ANNUAL REPORT 09/0212011 -- Off/Dir Resignation 08/18/2011 — Req. Agent Change 02/16/2011 —ANNUAL REPORT 01/05/2010 — ANNUAL REPORT 05/05/2009 — ANNUAL REPORT 03/13/2008—ANNUAL REPORT 10/04/2007 — REINSTATEMENT 04/06/2006 —ANNUAL REPORT 04/15/2005 — ANNUAL REPORT 03/06/2004 — ANNUAL REPORT 04/11/2003 — ANNUAL REPORT 04/17/2002 —ANNUAL REPORT 04/09/2001 — ANNUAL REPORT 04/11/2000 —ANNUAL REPORT 03/06/1999 — ANNUAL REPORT 04/24/1998 — ANNUAL REPORT 05/09/ 1997 — ANNUAL REPORT 04/08/1996 — ANNUAL REPORT 04/11/1995 — ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF forma( Florida Depar^.nent of Stace, Division of Corporations http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetai l?inquirytype=Entity... 6/6/2019 PROPOSER: Law Enforcement Psychological & Counseling Associates, Inc. CONTACT PERSON: Brian Mangan, Psy.D., ABPP (RFP and Contract) OFFICE LOCATION: Miami -Dade County (Town of Medley) BUSINESS ADDRESS: 9960 NW 116`h Way, Suite 12, Medley, FL 33178 BUSINESS PHONE: 305-442-8800 FACSIMILE: 305-442-4469 EMAIL: bmanQan, flepca.com TITLE OF RFP: Request for Proposals for Psychological Screening Services RFP NUMBER: 610384 FEIN: 59-1978758 rs toN City of Miami: RFP 610384 TABLE OF CONTENTS Page # Certification Document 1 Executive Summary 4 Company Organizational Chart 6 Staff Biographies 7 Staff Licenses and Degrees 14 Current Agency List 24 Client Reference Letters 26 Screening Services Practicalities of Screening Service 30 o Legal Statement 3 I Philosophy of Screening Process 31 Bifurcated Pre -employment Screening Rationale 33 Description of Psychological Screening Process 41 Essential/important Job -Related Traits 43 Evaluation Test Battery and Procedures 44 Determination ofJob-Related Ratings 47 Report Format 47 Adverse Impact Study 49 Sample Reports 50 Pre and Post Personal History Questionnaire (PHQ) 55 Supplementary Background Investigation Interpretation Manual 91 Counseling Services Demonstrated Expertise in Provision of Counseling and Training 108 Current Agency List Counseling/Training 108 Sample of Counseling Training Experiences 109 Organizational/Description Chart of Miami 1 10 Officer Assistance Program Handout 111 Critical Incident Debriefing Program 1 15 Syllabus Stress Management Workshop 1 17 EAP/OAP City of Miami Supervisory Training 118 Client Office Forms 132 Appendix I Business Licenses and Insurance Documents 145 Appendix I1 Attachment C: Compensation Schedule 147 Appendix III Attachment E: HIPAA Business Associate Addendurn 148 City of Miami: RFP 610384 Page 1 City of Miami Request for Proposals (RFP) Procurement Department Miami Riverside Center 444 SW 2^d Avenue, 6th Floor Miami, Florida 33130 Web Site Address: www.miamigov.com/orocurement RFPNumber: Title: Issue Date/Time: RFPClosing Date/Time: Pre-Bid/Pre-Proposal Conference: Pre-Bid/Pre-Proposal Date/Time: Pre-Bid/Pre-Proposal Location: Deadline for Request for Clarification: Contracting Officer: Hard Copy Submittal Location: Contracting Officer E-Mail Address: Contracting Officer Facsimile: 610384 Request for Proposals for Psychological Screening Services 07-NOV-2018 12-DEC-2018 14:00:00 Voluntary Tuesday, November 13, 2018 at 10:00 AM 444 SW 2nd Avenue 6th North Conference Room Monday, November 19, 2018 at 2:00 PM Falcon, Eduardo City of Miami - City Clerk 3500 Pan American Drive Miami FL 33133 US efalcon@miamigov.com 305-400-5390 Page I of 43 City of Miami: RFP 610384 Page 2 Certification Statement Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation. completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION. the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation. firm. or person submitting a submission for the same materials, supplies, equipment, or service. and is in all respects fair and without collusion or fraud. We (1) agree to abide by all terms and conditions of this solicitation and certify that 1 am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME• Law Enforcement Psychological & Counseling Associates, Inc (LEPCA) ADDRESS• 9960 NW 116th Way, Suite 12, Medley, FL 3317E PHONE: 305-442-8800 EMAIL: bmangan@lepca.com SIGNED BY• Brian Man TITLE: President FAX 305-442-4469 CELL(Optional)• FAILURE TO COMPLETE. SIGN. AND RETURN THIS FORM SHALL DISOL'. LIFY THIS RESPONSE. Pa_e2or- City of Miami: RFP 610384 Page 3 Certifications Legal Name of Firm: Law Enforcement Psychological & Counseling Associates, Inc (LEPCA) Entity Type: Partnership, Sole Proprietorship. Corporation. etc. Corporation Year Established: 1977 Office Location: City of Miami. Miami -Dade County, or Other Miami -Dade County (Town of Medley) Business Tax Receipt/Occupational License Number: 305631 Business Tax Receipt/Occupational License Issuing Agency: Miami -Dade County Business Tax Receipt/Occupational License Expiration Date: September 30, 2019 FEIN/EIN Federal Employer Identification Number 59-1978758 Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1. 7/1/17). If no addendum/addenda was/were issued, please insert N/A. N/A If Proposer has a Local Office. as defined under Chapter 18/Articlle III, Section 18-73 of the City Code, has Proposer filled out. notarized. and included with its RFP response the "City of Miami Local Office Certification" form? YES OR NO? (The City of Miami Local Office Certification form is located in the Oracle Sourcing system ("iSupplier"). under the Header/Notes and Attachments Section of this solicitation) N/A Has Proposer reviewed the Attached Sample Professional Services Agreement? Yes / No YES Acknowledge that if awarded. Proposer will be required to execute the Professional Services Agreement in substantially the attached form. In addition Proposer must acknowledge that certain clauses are non-negotiable. Yes 'No • YES Paue 3 or 43 City of Miami: RFP 610384 Page 4 Executive Summary Law Enforcement Psychological and Counseling Associates, Inc. (LEPCA) is a well -established consultation firm that provides comprehensive services exclusively to law enforcement agencies primarily in the South Florida area. The firm was created in 1977 to effectively address the often unique and complex issues facing psychologists who undertake the role of a public safety psychological consultant. Dr. Brian Mangan serves as the President and Senior Psychologist of LEPCA, with Dr. Mark Axelberd, the founder of the firm, still serving as an active consultant and Staff Psychologist. Since the South Florida region is multi -ethnic in composition, the firm further understood the importance of cultural sensitivity and making certain that LEPCA's services would be accepted and utilized by the diverse cultural groups found in public safety work. One way to achieve this goal was to include mental health professionals from varied ethnic backgrounds in all areas of the firm's consultation work and this philosophy remains today. In 2006, the Miami -Dade Police Department with our assistance conducted extensive research for a five and thirteen -year period to determine whether our screening evaluations resulted in any adverse impact by race, sex or ethnic group (study included with this proposal.) The results found that "no adverse impact exists." To our knowledge, this study was one of the most exhaustive of its kind. In 2009, LEPCA also completed a "green initiative" and made extensive investments to achieve a near paperless and seamless psychological screening process both for our internal office and user agencies as well. The project design utilized extensive input from numerous public safety agencies so as to better serve their specific needs. Our new system allows agencies to independently schedule applicants, access and/or download final applicant reports online 24- hours after completion of testing, safely store applicant files electronically, receive or review ancillary screening materials online, produce statistical reports quickly, and provide applicants important information on our website. We believe this achievement is one of the first of its kind in the entire nation and has proved to be well worth the effort extended. Importantly, this service is fully encrypted, protected with secure username and password, and all HIPAA requirements are adhered to regarding electronic storage. In summation, LEPCA has been intricately involved in every facet of law enforcement and public safety consultation. In particular, the firm is very well known for its expertise in pre- employment psychological screening and LEPCA's evaluation process has often served as a model for numerous psychologists entering this specialized field. We have conducted approximately 75.000 evaluations for over 60 public safety agencies over the past nearly forty years and carried out extensive research in this area. Our screening system strictly adheres to laws governed by the EEOC, including the Americans with Disabilities Act (ADA) and Genetic Information Nondiscrimination Act (GINA). Moreover, our system meets and exceeds the guidelines set forth by the IACP. COPPS organization. California Post Commission. and CALEA. No agency using our screening services has ever had difficulties becoming or maintaining CALEA certification. In addition. many public safety agencies around the United States and even internationally both formally and informally have requested our input to implement or improve their selection procedures and design. Li) ems City of Miami: RFP 610384 Page 5 Beyond providing pre -employment screenings and other consultations for almost every public safety agency in Miami -Dade County and many agencies in Broward and Palm Beach Counties, our expertise has been utilized by non -local entities as well. For example, we conduct pre- employment screenings for state agencies, including the Florida Highway Patrol and Florida Fish and Wildlife Commission, and have performed other sensitive evaluations as requested by federal agencies such as the F.B.I., U.S. Secret Service, U.S. Customs, D.E.A., and the Transportation Security Agency. In addition, we have been instrumental in developing public safety fitness standards and guidelines not only for pre -employment screenings but also for Fitness for Duty Evaluations (FFDE). Our firm has been a pioneer in introducing and conducting FFDEs, which typically are very arduous and can frequently result in expensive litigation if not done correctly. Dr. Axelberd and Dr. Mangan have been called upon many times by various national agencies, including public and federal, to conduct extremely important and complicated fitness evaluations. LEPCA has also been a local and national leader in creating innovative and effective specialized counseling, critical incident debriefings and training programs for sworn and non -sworn public safety employees and their family members. Members of the firm have provided thousands of hours of treatment and training to those in the South Florida public safety community for over thirty-five years. Indeed, many of the now commonly accepted psychological service practices for Local and statewide public safety agencies were originally designed and promoted by members of our firm. Most importantly, we have always been known for our constant availability, ease of accessibility, and practical approaches to achieving the highest quality services to our clients. We take great pride in our work and never forget the critical nature of the services we provide. We value the trust placed in us by our law enforcement clients and LEPCA will always strive to be deserving of the respect and opportunity given to us by the law enforcement and public safety community. Brian Magri, Psy.D., President, Law Enforcement Psychological & Counseling Associates, Inc City of Miami: RFP 610384 Page 6 Law Enforcement Psychological & Counseling Associates, Inc (LEPCA) Organizational Structure Officer: Brian Mangan, Psy.D., ABPPPresident Full -Time Staff: Part -Time Staff:. ** Brian Mangan, Psy.D., ABPP Senior Psychologist ** Vanessa Perez, Psy.D. Staff Psychologist ** Maria Galmarini, Psy.D. Staff Psychologist Mayte Aponte Office Manager ** Mark Axelberd, Ph.D., ABPP Senior Psychologist ** Mirelis Peraza, Psy.D. Staff Psychologist * Pablo Martin. LCSW Staff Therapist Va1ery Ochoa Office Assistant ** Involved in both psychological screening and counseling services * Involved only in provision of counseling services City of Miami: RFP 610384 Page 7 n Staff Biographies Brian L. Mangan, Psy.D., ABPP Board Certified in Police & Public Safety Psychology Licensed Psychologist President Dr. Brian Mangan received his Doctor of Psychology in Clinical Psychology from The George Washington University in Washington, D.C. with distinction in 2003, specializing in the areas of adult therapy and assessment. He pursued his pre -doctoral internship at South Florida State Hospital, where he developed skills in dealing with a forensic population. Shortly after, he completed his post -doctoral residency with Citrus Health Network, conducting evaluations for the Juvenile Evaluation and Treatment Services program in the Miami -Dade Juvenile Justice system. After getting licensed near the end of 2005, he became a staff psychologist with Law Enforcement Psychological & Counseling Associates (LEPCA.) Since that time, he received daily mentoring from Dr. Mark Axelberd, and has risen to the levels of Senior Psychologist and Managing Partner. In 2011, Dr. Mangan took over the day to day operations of LEPCA and currently serves as President of the firm. In 2014, Dr. Mangan was awarded Board Certification in Police & Public Safety Psychology from the American Board of Professional Psychology, a unique specialty distinction currently shared by approximately 70 professionals nationwide. Dr. Mangan is an active member of the Intemational Association of the Chiefs of Police- Police Psychological Services Section (IACP-PPSS), currently serving on the Executive Board as General Chair of the Section. In addition, he recently completed a three-year appointment as a member of the Ethics Consultation Committee, and previously served as a member of the Officer Involved Shooting Guidelines Revision Committee (2013) and the Psychological Fitness for Duty Evaluation Guidelines Revision Committee (2013.) Dr. Mangan is an active member of the American Psychological Association, Division 18 Psychologists in Public Service, recently serving as the Secretary/Treasurer of the Police and Public Safety Section. Moreover, he currently serves as the Oral Exam Coordinator for the American Board of Police & Public Safety Psychology, and is a member of the Florida Psychological Association, Society for Police and Criminal Psychology, and the Consortium of Police Psychological Services (COPPS.) He served as the Chair of COPPS in 2008 and 2013, hosting the annual conferences attended by many public safety professionals from the Southeast region of the United States discussing emerging issues related to evaluation, intervention, ethics, and legislation current in police psychology. Currently, Dr. Mangan serves as the President of Law Enforcement Psychological and Counseling Associates (LEPCA) in Medley. Florida. He started with LEPCA in January 2006 and was directed by Dr. Mark Axelberd in advanced training on public safety and law enforcement psychology related issues. His primary duty involves consultation with command staff on law enforcement related issues concerning both community and organizational objectives. On a daily basis, Dr. Mangan conducts numerous pre -employment screening interviews, interprets standardized test profiles, and consults with background investigators and lacy enforcement personnel regarding evaluation results. Moreover. he reviews all pre- employment evaluation files and completes the final report sent to an agency on each applicant. City of Miami: RFP 610384 Page 8 To this date, Dr. Mangan has performed nearly 23,000 screenings and reviewed over 35,000 evaluation files with approval for final report. Additional duties include psychological screening for specialized unit placement (Hostage Negotiator, SWAT, etc.); counseling with public safety personnel from area agencies, as well as the Officer Assistance Program with the City of Miami, Coral Gables, and Hialeah Police Departments; fitness for duty evaluations; critical incident stress debriefings; and conducting trainings with various departments in the south Florida community regarding front line supervision, stress management, and crisis intervention. Since joining LEPCA, Dr. Mangan has also been instrumental in all research activities related to pre -employment psychological screening, including performance of combat veterans and veteran police officers on testing. For example, he conducted an extensive performance review of recruits in the Miami -Dade Police Department (MDPD) public safety academy. The research yielded very positive results and identified specific scores on the pre -employment evaluation that were correlated to successful completion of the academy. Additionally, Dr. Mangan recently completed research on "Successful vs. Unsuccessful" candidates in the Miami -Dade County Corrections training program, utilizing the pre-screening evaluations as a guide indicate potential risk in future screenings. Along with Dr. Mark Axelberd, Dr. Mangan was involved in the development of the Public Safety Suitability Questionnaire (PSSI), which is an objective standardized test used in the pre -employment screening of public safety candidates, and also recently participated in research on the performance of combat veterans on the pre -employment psychological evaluation. Dr. Mangan previously served as Assistant Professor and Forensic Coordinator at Carlos Albizu University. As the coordinator, he monitored a program designed to train students to deliver psychological services, including psycho -diagnostic assessment, case law, legal standards, and expert testimony within the judicial and correctional systems. Additionally, he worked closely with the Miami -Dade Juvenile Courts, providing comprehensive evaluations and treatment recommendations for at -risk youths for a period of one year after completing his post -doctoral commitment. Mark Axelberd, Ph.D., ABPP Board Certified in Police & Public Safety Psychology Licensed Psychologist Dr. Mark Axelberd received his Ph.D. with a specialty in Clinical Psychology from Georgia State University in 1977. He did his doctoral internship at the Counseling and Consultation Center at the Ohio State University. Since that time, he has been a full-time consulting psychologist to law enforcement agencies on a local, state and national level. He was the primary founder of the firm Law Enforcement Psychological and Counseling Associates, Inc. (LEPCA) and served as the President for 34 years. Since 2011. he has served as lead consultant and staff psychologist. In 2010, Dr. Axelberd was awarded Board Certification in Police and Public Safety Psychology from the American Board of Professional Psychology. a unique specialty distinction shared by only 70 professionals nationwide. He is also an active member of the Consortium of Police Psychological Services, the American Psychological Association. and the International Association of the Chiefs of Police. City of Miami: RFP 610384 Page 9 Dr. Axelberd's years of exclusive experience with law enforcement since 1977 has allowed him to develop a most unique and thorough grasp of the complexities of providing psychological services to public safety clients. His reputation and expertise is well known within the law enforcement community and he has often been called upon by law enforcement administrators to advise and consult on the most sensitive and difficult matters. Many of the current psychological services provided to South Florida law enforcement agencies have been a direct result of his efforts. He has provided expert information and testimony numerous times for matters related to psychological fitness standards for law enforcement officers. He has also assisted many agencies in matters such as understanding and complying with the Americans with Disabilities Act (ADA). After 9/11, he was contracted to perform sensitive assessments germane to Homeland Security enhancement and continues to do so. Dr. Axelberd has also been instrumental in including and promoting the utilization of persons of color and women in a wide range of public safety consultations. Encouraged by his colleagues and law enforcement community, Dr. Axelberd designed and developed a new and specialized personality screening instrument for the selection of Public Safety Applicants. The Public Safety Screening Inventory (PSSI) is different from other tests in that a diverse group of actual Public Safety Officers were extensively involved in providing input and creating some of the individual test items. As a result, the item content of the PSSI is very job -related and directly assesses those characteristics and traits deemed essential by those working in the field. The PSSI to date has proved itself to be a very valuable addition to the firm's battery of pre -employment instruments. Dr. Axelberd has received awards and has been frequently recognized for his positive contributions in areas such as Pre -Employment Psychological Screening, Officer Assistance Programs, Personnel Policy Development. Fitness for Duty Evaluations, Critical Incident Debriefings, Officer Training Programs and assisting agencies in the development and implementation of effective selection systems. He has been featured several times in the written and television media for his innovative consultations with law enforcement agencies. For example, he has appeared on the TV news program 20/20, 48 Hours and the USA Today TV News Journal. The International Association of Chiefs of Police honored Dr. Axelberd with a certificate of appreciation for his teaching of seminars involving pre -employment psychological screening. In the early 1980's, Dr. Axelberd also worked closely with the Florida Police Standards and Training Commission to initiate pre -employment psychological testing standards and officer assistance programs throughout the State of Florida. In 1981, Dr. Axelberd wrote the original guidelines on behalf of the commission for the conducting of pre -employment screening in the state. During this same period, he was also one of only a few select public safety psychologists chosen by Harper and Row Media to conduct nationwide workshops with law enforcement executives on the introduction of psychological services to their respective agencies. Dr. Axelberd was selected by the Council of Police Psychologists to initiate national guidelines for psychological screening of law enforcement applicants. He has been called upon by numerous agencies on a local, national and even international level to provide opinions and make recommendations on numerous subjects related to public safety psychological services. For example, he worked closely with the Dallas Police Department. New York City P. D., Rochester Police Department and several others in critically assessing and developing updated selection City of Miami: RFP 610384 Page 10 procedures. On an international level, he has provided extensive input to the Moscow, London, Ottawa and Israeli law enforcement agencies. Dr. Axelberd has gained his reputation and continues to doso through his "hands-on" provision of psychological services. He has been directly involved in the screening of over 70,000 law enforcement applicants and has conducted approximately 300 Fitness for Duty Evaluations. He has also designed innovative and very successful confidential counseling programs, training seminars and Critical Incident Debriefings for law enforcement personnel and their families. Over the years, he has personally provided counseling assistance to an innumerable number of South Florida officers and families. Dr. Axelberd continues to remain directly involved in every facet of the firm's law enforcement consultations. In more recent years, he has provided extensive advanced training to LEPCA staff psychologists in the specialty of public safety psychology. This has provided him the opportunity and time to conduct updated research and to creatively modify and "tweak" existing services. He especially has concentrated on improving effectiveness in the critical area of pre -employment psychological screening. He has conducted validation research, gathered normative data pertaining to minority applicants, provided training to police background investigators and has developed numerous supplemental materials and procedures to assure the highest quality screenings of South Florida applicants. One very important and recent accomplishment was LEPCA's completion of a "green initiative" in 2009. Developed by Dr. Axelberd and Dr. Brian Mangan, with input from the public safety community, this system allows for near paperless and seamless process of screening for both LEPCA and agency users. Lastly, Dr. Axelberd conducted timely research on the performance of combat veterans on pre -employment psychological evaluations. He is honored that his screening and other programs have often served as a model for other psychologists entering the law enforcement consultation field. Vanessa Perez, Psv.D., LMHC Licensed Psychologist Dr. Vanessa Perez was born and raised in Miami. FL. She received her Bachelor's degree in Psychology from Florida International University in 2002 and received her Master's degree in Mental Health Counseling in 2005 from Nova Southeastern University. Dr. Perez completed her mental health internship training at Broward General Hospital and Parkway Regional Medical Center working with individuals diagnosed with severe and persistent mental illness. Dr. Perez further pursued her graduate studies at Carlos Albizu University, receiving an additional Master's in Psychology in 2008 and Doctorate in Clinical Psychology -Forensic Concentration in 2013. While attending graduate school, Dr. Perez worked at Larkin Community Hospital providing outpatient counseling to court mandated dual -diagnosis populations and conducted comprehensive neuropsychological evaluations with the U.S. Department of Veterans Affairs. Dr. Perez completed her APA accredited pre -doctoral internship at South Florida State Hospital. where she developed expertise with forensic assessment. including violence risk assessments and competency evaluations. She specialized in competency restoration. dialectical behavior therapy . c.) City of Miami: RFP 610384 Page 11 behavior modification, and risk management in both individual and group settings. Dr. Perez completed her post -doctoral residency with the G.A.T.E. Diversion Program, specializing in the evaluation and treatment of adolescents charged with sexual offenses. At this time Dr. Perez maintained a supervisory role over program development, clinicians, and community outreach, specializing in trauma informed care, child -on -child sexual abuse, and human trafficking with culturally diverse populations. In 2015, Dr. Perez began working at Law Enforcement Psychological and Counseling Associates, conducting pre -employment psychological screenings, psychological fitness for duty evaluations, and critical incident stress debriefings with various public safety organizations. Additional duties include individual, couples and family counseling with public safety officers and personnel through the Employee/Officer Assistance Program with the City of Miami, City of Coral Gables, and City of Hialeah Police Departments, as well as the City of Hialeah Fire Department. To date, Dr. Perez has completed approximately 3,500 pre -employment psychological screenings. Dr. Perez is a member of the International Association of Chiefs of Police- Police Psychological Services Section (IACP-PPSS), American Psychological Association (APA), Psychologist in Public Service (Division 18), and was a member of the Psi Chi National Honor Society in Psychology. Dr. Perez was an active attendee and participant at the 2017 and 2018 IACP PPSS Annual Conference, participating in the Section's Psychological Fitness for Duty Revision Committee in 2018 and is currently a member of the Section's Annual Conference Education Committee. She also was an active attendee at the 2016 and 2018 Annual Conference for the Consortium of Police Psychological Services (COPPS). Dr. Perez is a highly experienced Licensed Psychologist and Licensed Mental Health Counselor who has over thirteen years success in the field of psychology providing comprehensive psychological evaluations and working with culturally diverse populations. Maria Galmarini, Psy.D. Licensed Psychologist Dr. Maria Galmarini received her Bachelor's degree in Psychology from Boston University in 2008. She completed her Master's degrees in Mental Health Counseling and Clinical Psychology, as well as her Doctorate degree in Clinical Psychology from Nova Southeastern University. Dr. Galmarini has worked with diverse clients in inpatient, outpatient, and correctional settings. Her broad clinical and evaluation experience in the diverse area of South Florida has afforded Dr. Galmarini an opportunity to learn about and integrate cultural awareness in her work. She is bilingual and has experience performing evaluations and providing individual, couples, and family therapy in English and Spanish. Dr. Galmarini completed both her pre -doctoral internship and post -doctoral training at South Florida State Hospital. During her time at South Florida State Hospital, Dr. Galmarini provided individual therapy, group therapy, psychological testing, forensic evaluation, and neuropsychological evaluations. Most of Dr. Galmarini's post -doctoral training specialized in the area of forensics. She performed risk assessments and competency evaluations while also serving as an expert witness in criminal court and re -commitment hearings. Although the focus of her training was on individual patient care. Dr. Galmarini was also a part of a hospital initiative to City of Miami: RFP 610384 Page 12 reduce stress and burnout among staff and support personnel. She assisted in planning and organizing presentations to help staff develop self -care skills, and positive coping strategies to deal with personal and work -related stressors. Dr. Galmarini first gained experience in the field of police psychology in 2013, completing clinical externship at Miami -Dade Police Department's Psychological Services. She provided individual, couples, and family therapy to sworn officers, civilian support personnel, and their families. Dr. Galmarini joined Law Enforcement Psychological and Counseling Associates, Inc (LEPCA) in August of 2015. She currently provides individual, couples, and family therapy to law enforcement and support staff through the employee assistance programs of the City of Miami, City of Coral Gables, and City of Hialeah Police Departments, as well as the City of Hialeah Fire Department. Additionally, Dr. Galmarini conducts pre -employment psychological screenings, fitness for duty evaluations, and critical incident stress debriefings. She has completed nearly three thousand pre -employment psychological evaluations since joining LEPCA. In addition to her work in police and public safety, Dr. Galmarini currently serves as a forensic evaluator for the 11 th Judicial Circuit of Miami -Dade County, conducting competency evaluations and providing expert witness testimony in criminal court. Dr. Galmarini is a member of the American Psychological Association -Psychologist in Public Service Division and the Society for Police and Criminal Psychology. Additionally, she is an Associate Member of the International Association of Chiefs of Police (IACP)- Police Psychological Services Section, where she served on the Officer Involved Shooting Guidelines Revisions Committee in 2018 and currently serves on the Section's Annual Conference Education Committee. Mirelis Peraza, Psy.D. Licensed Psychologist Dr. Mirelis Peraza was born and raised in Cuba, where she completed one year of college before immigrating to the United States. She continued her education at Florida Atlantic University, where she graduated in 2003 with a Bachelor's Degree in Psychology. She pursued her graduate studies at Carlos Albizu University, from where she received her Master's Degree in Psychology (2005) and a Doctorate in Clinical Psychology (2012), both with distinction. Her area of concentration during her doctoral studies was forensic psychology and assessment. Also, while attending Carlos Albizu University she participated in specialty training with Dr. Brian Mangan, who was teaching a specialized course in Police & Public Safety Psychology. During this two - semester training. emphasis was placed on pre -employment psychological screening with public safety applicants. Dr. Peraza completed her pre -doctoral internship and postdoctoral residency at South Florida State Hospital (SFSH), where she remains as a part time psychologist. In her three years working at the state hospital, Dr. Peraza has developed expertise with forensic assessment. including violence risk assessments and competency to proceed evaluations for the court. She has provided competency restoration and risk management on individual and group settings. completed evaluations for the court. and trained graduate students completing their practicum and internship }ears at SFSH. Ld eiN City of Miami: RFP 610384 Page 13 Beginning in 2013, Dr. Peraza became involved with LEPCA on a part-time apprenticeship basis. During this time, she continued her training with integration of standardized objective test profiles, as well as observed clinical interviews and the final report process, while being mentored by Dr. Mangan. She was an active attendee and participant at the 2013 Annual Conference for the Consortium of Police Psychological Services. In early 2014, Dr. Peraza was successfully licensed as a psychologist and subsequently hired as part-time staff with LEPCA. To this date, she has completed approximately 200 pre -employment psychological screenings. Dr. Peraza also has over ten years of experience in clinical therapy, with a diverse. range of populations and disorders. Before providing clinical services to the severe mentally ill population of the state hospital, she had over 7000 hours of experience in clinical therapy with children and families. Additionally, Dr. Peraza serves in private practice, providing individual therapy to adult outpatient population. She has sought extensive training, specializing in the areas of affective disorders, trauma, family dynamics, and immigration and acculturation issues. Pablo Martin, LCSW Licensed Clinical Social Worker (Counseling Services Only) Pablo Martin is a Florida Licensed Clinical Social Worker. He received his Bachelor's degree in Social Work from Florida International University (1998) and his Master's in Social Work from Barry University (2000). Mr. Martin obtained his license to practice Clinical Social Work in 2003 and has experience providing therapy services for children, adolescents, adults, couples and families. He has many years of providing Continuing Education and In -Service trainings in the areas of BioPsychoSocial Assessments & Treatment Planning, Anger Management, Working with Children of Divorce, Laws & Ethical Practice and Clinical Documentation Compliance. Additionally, he is a Qualified Clinical Supervisor for the Social Work Profession as certified by the State of Florida Department of Health. Mr. Martin began working in the field of police and public safety in 2012, regularly providing therapeutic services for individual, couples. and family counseling to law enforcement and public service personnel through the Employee Assistance Program of the City of Miami, City of Coral Gables, and City of Hialeah Police Departments, as well as the City of Hialeah Fire Department. Moreover, he assists with critical incident stress debriefings, staff training, and office consultation regarding referrals for community programs and long-term treatment. In addition to his extensive clinical experience, Mr. Martin also serves as a Peer Reviewer for the Council on Accreditation, an international, independent, nonprofit, human service accrediting organization. City of Miami: RFP 610384 AC# STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE LICENSE NO. CONTROL NO. 05/05/2018 :: PY 7198 46840 The PSYCHOLOGISt. named below has met allire4uirements of the laws and rules ofthestate of Florida. Expiration Date: MAY 31, 2020 BRIM LAWRENCE MAI GAN 9960 NW 116 WAY SUITE 12 MEDLEY, FL 33178 Rick Scott GOVERNOR Celeste MTPhilip, M,D., M.P.H. Surgeon General and Secretary DISPLAY IF REOUtRED'BY.LAW •. J C\! rr) 00 zZ d z z W U Page 14 EXPIRATION DATE: MAY 31, 2020 Your license number Is PY 7198. Pease use it in all correspondence with your boardfcouncil. Each licensee is solely responsible for notifying the Department in writing of the licensee's current mailing address and practice location address. ffyou have not receitied your renewal notice 90 days prior to the expiration date shown on this license, please visit www,FLHeaIthSource,govand click 'Renew ALicense' to renew online. Medical Quality Assurance has a new and Improved Online SeMces Portal. In the new system, you have the ability to renew your license, update your mailing and practice location addresses, request a name change, request a duplicate license and update your profile Information all from the convenience of your online account 1. Go to www.FLHealthSource.gov. 2. Click on 'Provider Services' and select 'Manage Your License.' 3. Select your profession and license type and dick 'Submit." 4. The question 'Haw you Registered In Our New Online SeMce System?' will display. a. Click on "No' if you have not registered for an account in the new system and follow the instructions provided for new user registration. b. Click on 'Yes' If you are a returning user. Enter the user ID and password you selected during the registration process, then select *Sign in' to access your MOA Online SeMces Portal account IMPORTANT ANNOUNCEir4BITS Are You Renewal Ready? The Department of Health will now review your continuing education records at the time of license renewal. To learn more, please visit www.FLHeallhScurce.gov1AYRR Grounds for Disdeline You should be familiar with the Grounds for Disdpilne found In Section 456.072(1), Florida Statutes, and in the practice act for the profession In which you are licensed. Florida Statutes can be accessed at www,leg.state.fLus/Statutes ><tti• of IViiatni: RFP 61038=i AC# x r h STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE LICENSE NO CONTROL NO. 05/08/20111'' , PY2025 46949 The PSYCHOLOGIST named below has met all requirements of the laws and rules of the state of Florida. Expiration Date: II A'r31, 2020 MARK M AXgLBERD 9980 NW 11 6TH WAY SUITE 12 MIAMI, FL 33178 Rick Scott Celeste 'Nip, M.D., M.P.H. GOVERNOR • Surgeon General and Secretary DISPLAY IF REQUIRED BY,LAW Page 15 L,' Cr) Cr) CO 0 LICENSE NO. v EXPIRATION DATE: MAY 31, 2020 riN Your license number Is PY2025. Please use It In all correspondence with your board/council. Each licensee is solely responsible for notifying the Department In wrung of the licensee's current mailing address and practice location address. If you have not received your renewal notice 90 days prior bo the expiration date shown on this license, please visit www.FLHeaIthSource.govand click 'Renew A License' b renew online. Medical Quality Assurance has a new and improved Online Services Portal. In the new system, you have the ability to renew your license, update your mailing and practice location addresses, request a name change, request a duplicate license and update your protlle information all from the convenience of your online account 1. Go to www.FLHealthSource.gov. 2. Click on 'Prodder Serrlces' and select' Manage Your License.' 3. Select your profession and license type and didc'Submit' 4. The question 'Haw you Registered in Our New Online Service System?" will display. a. Click on -Nett you have not registered for an account in the new system and follow the instructions provided for new user registration. b. Click on 'Yes' if you are a returning user. Enter the user ID and password you selected during the registration process, then select 'Sign In° to access your MQAOnline SeMces Portal account IMPORTANT ANNOUNCt3W BITS Are You Renewal Ready? The Department of Health will now review your continuing education records at the time of license renewal. To learn more, please visit w' w.FLHealthSource.go'dAYRR Grounds for Discipline You should be familiar with the Grounds for Discipline found in Section 456.072(1), Florida Statutes, and In the practice act for the profession in which you are licensed. Florida Statutes can be accessed at wwwJeg.state.6.us/Statutes City. of Miami: RFP 610384 Page 16 AG# 8 2.15 81 STATE QE E .ORIDA' • DEPARTMEN tOF:HEALTH DIVISION OF MEDICAL CiLIALfre ASSURANCE DATE -LICENSE NO : CONTROL NO. 03/10/2018 PY 9608 `'44701 The PSYCHOLOGIST named below has `mit alr r.e ulrements of the laws and rules of the state of Florida, Expiration Date. :MAY 31, 2020 MARIA EUGE NIA t3'ALMARINI 9960 NW118TH WAY !RATE 12 MIAMI, FL 33178 r 3-11-1111.1, Celeste a ap, M.D., M.P.H. Surgeon General and Secretary DISPLAY IF REQUIRED BY LAW City of Miami: RFP 610384 Page 17 .StEFtCRtDA. DWAIliOr. 7 " .A.TH • • ISJON OF PODibAL QLJAUTY ASSURANCE ,...: • TE I, ..':' - . IltENSE NO.`41/ ' . . , V brrirL NO 02j27- /20iti-' • PY 9518 -.,..„ :- ..:, 4.1i4 • , Y 44iti The p.syptic.)001gT . named Oel 'orWtiesi telt ieOuliements of ilelay.41.end _rules ofthe,t0ate of Florida. ti,;(1. Wel 4041 2020 OtRai ' NW 118TH WAY SUITE12.; MIAMI,"ff. 33.17s ,.Ridc Scott •. • CelestehWp M.D.. M.P.H. GOVERNOR •.: eSurgeon General and Seeretary • • DISPLAY tF RtatilRED.BY LAW ' " ' • .2 AC# fi, "r;; y ; sj, T RF Ft 0 1',0 s DLL xM FiALTH . DIVISION OF MEDIbAL QOALITY ASSURANCE b' , . ^:: v LICENSE Nib , - :✓... '.;` :�C ?t TAO..I NO. .E:. 0$131/201tff' '°'' "l':' PY 9014 j • •-'49021 The PSYCHOLOGIST named bolo* ttas`inttt.el f iuirements of the laws and rules of the.state of Florida. Expiration Date:. •. 4047i.:31, 2020 IV�IRELIS.PERA7�1' '° �.;' esso NW 176 WAY • STE..12 MIAMI, Ft. 33118.: • ,. celeste M. Phide, !LD., M.P.H. ,.Surgeon General and Secretary Discs, AY IF R€QWIREolBY LAW AC#7683.554 STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE ; ;; I.JENSE NO. CONTROL NO. 0410112017 SW 7221 ' 77723 The LICENSED CUNtCAL SOCIAL WORKER named below.has met all'requirements of the lawsand rules of the.s.tate of Florida. Expiration Date: MARCH Si,.2019 PABLO MARTIN LEPCA, INC. 9960 NW 116TH WAY_ STE 1.2 MEDLEY; FL. 33178. • Rick Scott Celeste M PhHIp. M.D., M.P.H. GOVERNOR Surgeon General and Secretary DISPLAY IF;:fl~QU1RED BY LAW PRSRT. FIRST-CLASS U.S. POSTAGE PAID TALLAH SSEE. FL-32301 PERMIT NO. 552 C C C City of Miami: RFP 610384 m\-c n:165544 IC AN ➢nA r iaz In iT n� 4 g• t r Y A l Br it �urtintt tlfaf riatt aturextre ungatt, V.$01-1 IAA* mrt tip c�u�tlifi�inC, rxumiuntiirn, ,itt1 profr$ in uil sf:tnk+-ittg trquirententi. fnreSprriulttl marl QTrrtifir;ttinit Li the Aittrriru r ti1it' & tC IX �Cr ?tit ly .*UrtinIuith Etta is [lrrrh rn tra 4.} a,ul Or.rtiftra itt [nlirr 4tthlir.S.ifrttr ithwd,u[ngn III! tl{t uteri .'ttt nnrlt of rttfp biumil ljsuripalohn intbrr . rat ttil . igiurturir. f rinhrir 24, 2011 iliprituta \ mutt r . 66l -a> �• i:ru, {yWYlra■ limn' f? Wire {.:.I.rLlir 614n10,6+ tlre. Ae1.1.,�arrire, 1111030 rl `Irnft .iur.•1 Q.epr �•..ayl 3 V.r7b• dlfinr, Alan i, .l 11l0.11.0 .[ttr: 11•aiuul tI, .1 11.M City of Miami: RFP 610384 f 311asliiitO1bt, Ptsfrirt f@tihimIiin 'ti 2d1 prrszustuIp rral) firsr Irfikr5, WetAemifrAii./46.11_:-.e? te;,wdevri; efeliwe (AC- allaft;M/4dfr t&?/:911412/ (014J ;7:4 ,e7M. Nrian ifiawrturr Canaan IuLtur of ilsudirulagg disle4Vik ql0f>thlif7A.11.1,1% caht thitnn uIprrnf, 106.4(4;4,6.4,tetze474..,-Any.1106 afid..11.441:#47.4Wft flaeXCJ., /iff.;• •,:(::11:1aeC-6";:t6•MiC um.k, etWa.col aay ?eitetty Zee- •••.% . , ee . I '-"•• .-4114.,..-cal • c 3 City of Miami: RFP 610384 4.4 • .- 01'1, J •.. re,omateattattirit at Aatulto Ltmh roofers upon natal= Ilantrite tip beget" of logy tn Mantra' fauctiotogu complitteb ail requirements for oath bap's. istOttortg thereof tita seal of the )nstitution nub the afitnaharts of its offittrs art hereto affixtb. ' 4rPhsen Aloribs, tIL, sontteridli bay of Nowak aims J 11111 eil,51M1 I 111 r �Itl' tl'ltMl'e ' of the 7llttttler:iltu ou the reclintiuettl,itititt of the farultu confer upon attaria (7,1:iugenia (J? attnarini tlje begree Of !actor f zvrctiotogv t1 linia�l 1;15„,„„,ngn tuitlt all ri9ltts, pritti(e es, aub respousibilities thereto appertainiu&ta. '31n testituoull Whereof (`the lnarb of (`trustees has birectel the :ttuarbit l of thi,, lipIti li;, , certifieb bu the 1lresibeut tinier the corporate weal of thy 3luiuersitit aub (uitli the appropriate slluiuitures�. inrt "liatiberbale-33aliil', ?F Ilil iltl (August 31, 2015 V 11.Jpl, 11 11 41(1 , jl„•u... I .m . . C Customer Agency Contact List Most Recent Contact Phone Street2 City itat. 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Curtis Johnson Chief Luis Cabrera Major Chad Wagner Rita Garcia Lisa McCarty Lisa McCarty Chief Sergio Velazquez Gelien Perez Chief Patrick Flynn Chief Al Rolle Chief Delma Noel -Pratt Det Darwin Villavicencio Chief Nelson Andreu Pamela Asencio Chief Ed Hudak Stacie Ellinson Virginia Booth Jackie Pittman Emily Murphy Mimi Garcia Chief Hufnagel Janetta Melton Allen Lowe Chief Pedro Taylor Captain Ryan Martina Regina Smith Chief Rudy Herbello Freddy Caceres Chief Chris O'Brien Chief Charles Press Chief Constance Stanley Chief Marc Celetti Chief Jeanette Said Sgt. Arley Flahetry Commander John Prats 305-466-8989 305-866-5000 305-866-6242 305-981-4015 954-321-4408 305-593-6699 954-457-1400 954-457-1470 305-953-5343 305-883-6900 305-247-1535 305-622-8022 305-871-3141 305-266-0530 954-973-6700 305-442-1600 954-346-1270 850-245-1318 850-413-4062 850-414-4100 850-413-0060 305-795-7880 850-558-4088 305-348-2997 786-255-1414 850-617-2311 850-617-2374 305-936-2444 305-558-3333 954-967-4357 305-365-5555 954-777-2051 954-730-2950 305-883-2047 305.673.7776 786-263-6209 1 Golden Beach Drive 10301 N.W. 87th Ave. 3250 Hollywood Blvd. 85 W. McIntyre St. 5581 W Oakland Park Blvd 1980 NW 56 Avenue 7331 NW 74TH st. 1100 Washington Ave. 19200 W. Country Club Dr. 655 96th St. 9665 Bay Harbor Terrace 640 N.E. 114th Ave. 2601 W. Broward Blvd. 6100 NW 99th Avenue 400 S. Federal Highway 121 SW 3rd Street 5555 E. 8th Avenue 501 Palm Ave. 83 E 5th Street 790 N. Homestead Blvd. 1515 NW 167 Ave.. Bldg. 5, Ste 6498 N.W. 38th Ter. 901 S.W. 62nd Ave. 4800 Copans Rd. 2801 Salzedo St. 2801 Coral Springs Drive 2005 Apalachee Parkway, Ste. 222 Division of Fraud 325 John Knox Rd., Woodcrest Off. PK. Bldg. K Bureau of Law Enforcement 500 NE 87th Street 75 College Drive, Suite 102 Investigations Unit 404 W. Palm Dr. 200 Aventura Bal Harbour Bay Harbor Island Biscayne Park Ft. Lauderdale Doral Hallandale Beach Hallandale Beach Hialeah Hialeah Hialeah Homestead Miami Gardens Virginia Gardens West Miami Coconut Creek Coral Gables Coral Springs Tallahassee Tallahasse Tallahassee Tallahassee El Portal Havana Miami Florida City 2900 Apalachee Pkwy., BG 1, Room A 302, MS 49 Tallahassee 2900 Apalachee Parkway, MS-45 Tallahassee Golden Beach Hialeah Gardens Hollywood Key Biscayne Lauderhill Lauderhill Medley Miami Beach 2525 NW 62 Ave.,2nd FL,Martin Luther King, Jr. Of Miami FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL 33180 33154 33154 33161 33126 33166 33009 33009 33013 33010 33010 33030 33169 33166 33144 33063 33134 33065 32301 32399 32303 32399 33138 32333 33199 33034 32399 32399 33160 33016 33021 33149 33313 33313 33166 33139 33147 u7 N Miami Police Academy bLMiami Police Department to Miami Shores Police Department Miami Springs Miami -Dade Fire Rescue Miami -Dade Police Department Miami -Dade Public Safety Training Institute Miami -Dade Schools Police Miccosukee Police Department Miramar Police Department Monroe County Sheriffs Office North Miami Beach Police Department North Miami Police Department Office of the Attorney General Office of the Attorney General Cyber Unit Opa-Locka Police Department Palm Beach Sheriffs Office Pembroke Pines Police Department South Miami Police Department Sunny Isles Beach Police Department Surfside Police Department Sweetwater Police Department Town of Davie Town of Davie Fire Town of Palm Beach University of Miami Public Safety Dept. Village of Pinecrest Wilton Manors City of Miami: RFP 610384 C Constant Rosemond Chief Jorge Colina Lt. David McLeod Bill Collins Maria Jose Lazara Broche Sgt Randy Caballero Chief Edwin Lopez Det. Omar Fernandez Captain Rachel Patters Donna Moore Niki Wright Chief Larry Juriga Tiffany Lane Cathy Costley Cpl. Mohan Britton Sgt. John Nolan Chief Dan Guistino Lisa Morton Mike Grandinetti Chief Julio Yero Chief Placido Diaz Chief Keith Dunn Chief Julie Downey Katherine Dyson Albert Alonso Mayra Sauleda Linda Bachewicz 305-603-6624 305-603-6640 305-759-2468 305-805-5100 786-331-4272 305-471-1907 305-715-5000 786-256-9880 305-223-1600 954-602-4000 305-292-7000 305-948-2929 305-891-0294 850-414-3895 305-681-1033 561-688-3061 954-431-2466 305-663-6301 305-947-4440 305-861-4862 305-552-9900 954-693-8200 954-797-1213 561-227-6323 305-284-1541 305-234-2121 954-390-2150 400 N.W. 2nd Ave. 400 N.W. 2nd Ave. 9990 N.E. 2nd Ave. 201 Westward Dr. 9300 NW 41 Street 9105 N.W. 25th St. 9601 NW 58th St. 750 N.W. 20th St., Room E-414 P.O. Box 440021 3064 N. Commerce Pkwy 5525 College Road 16901 N.E. 19th Ave. 700 N.E. 124th St. PL-01, The Capitol Predator Cyber Crime Unit 2495 Alibaba Ave. 3228 Gun Club Road 9500 Pines Blvd 6130 Sunset Dr. 18070 Collins Ave., 2nd Floor 9293 Harding Ave. 500 S.W. 109 Ave. Finance 6901 Orange Drive P.O. Box 2029 5665 Ponce de Leon Blvd. 12645 Pinecrest Parkway 2020 Wlton Drive Miami FL 33128 Miami FL 33128 Miami Shores FL 33138 Miami Springs FL 33166 Miami FL 33178 Miami FL 33172 Doral FL 33178 Miami FL 33127 Miami FL 33144 Miramar FL 33025 Key West FL 33040 North Miami Beach FL 33162 North Miami FL 33161 Tallahassee FL 32399 Jacksonville FL 32207 Opa-Locka FL 33054 West Palm Beach FL 33406 Pembroke Pines FL 33024 South Miami FL 33143 Sunny Isles FL 33160 Surfside FL 33154 Miami FL 33174 Davie FL 33324 Davie FL 33314 Palm Beach FL 33480 Coral Gables FL 33124 Pinecrest FL 33156 Wilton Manors FL 33305 City of Miami: RFP 610384 FLORIDA HIGHWAY SAFETY AND MOTOR VEHICLES Page 26 Terry L. Rhodes Executive Director 2900 Apalachee Parkway Tallahassee, Florida 32399-0500 www.asmv.gov December 5, 2018 RE: Law Enforcement Psychological and Counseling Associates, Inc. (LEPCA) To whom it may concern: Over the past three years. as the Academy Director for the Florida Highway Patrol, I have had the pleasure to work with Law Enforcement Psychological and Counseling Associates (LEPCA) for the agency's hiring psychological requirement. The Florida Highway Patrol has contracted with LEPCA for many years and we have found the staff to be very professional with excellent customer service. Our background investigators have nothing but great things to say about the availability to interact with LEPCA on applicant tiles. They are extremely valuable in assisting us with screening applicants. I have been very pleased with the services they offer and will continue to use LEPCA in the future. It is without hesitation that I would recommend LEPCA for psychological screening of applicants for employment. If you have any questions. please feel free to contact me at 850-558-4250. Sincerely. Major Nancy Rasmussen Academy Director Florida Highway Patrol • Se:v:ce • Iategnty • Courtesy • Frofess:o^a,'ism • 1:.cora_.or: • �z.-el:erce • Ar. Equal Oppo-!u u y Employer City of Miami: RFP 610384 Broward Sheriff's Office 2601 West Broward Boulevard Fort Lauderdale, Florida 33312 954.831.8900 • sheriff.org Sheriff Scott Israel December 3, 2018 To Whom it may concern: RE: Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) The purpose of this letter is to bring to your attention the outstanding service that Law Enforcement Psychological & Counseling Associates, Inc. has provided the Broward Sheriffs Office. The Broward Sheriff's Office has contracted with Law Enforcement Psychological & Counseling Associates, Inc. for the past 9 years, and I'm extremely pleased with the one-on-one counseling services they provide to our agency. Law Enforcement Psychological & Counseling Associates, Inc., are always available when we call upon them, and I find their results to be extremely accurate and beneficial in assisting us to screen and hire the best qualified applicants. Additionally, they are invaluable in helping us understand officer behavior while in training and throughout their careers. It is without reservation that I support Law Enforcement Psychological & Counseling Services; they would be a valuable asset to any Law Enforcement agency. If you have any questions, please feel free to contact me at 954-321-4181. Sincerely, Major C ad agner Director Bureau of Human Resources CEW/cf (0) Page 27 City of Miami: RFP 610384 Page 28 Miami -Dade Police Department Personnel Management Bureau 9105 NW 25th Street • Room 1095 Miami, Florida 33172 305.471.1945 Integrity • Respect Service • Fairness December 4, 2018 Chief Jorge Colina City of Miami Police Department 400 NW 2 Avenue Miami, Florida 33128 www.miamidade.gov RE: Law Enforcement Psychological and Counseling Associates, Inc. Dear Chief Colina: The Miami -Dade Police Department (MDPD) has retained the services of the Law Enforcement Psychological and Counseling Associates (LEPCA) for over 20 years. LEPCA has been a valuable partner with MDPD. MDPD's Recruitment and Selection Section of our Personnel Management Bureau works closely with the LEPCA staff and rely upon them to evaluate our applicants for sworn and non -sworn positons. The volume of applicants we process, has never been an issue for LEPCA and in the event that additional accommodations were needed, they have always assisted without hesitation. The ability to speak with the LEPCA staff directly, as well as obtain reports from their website is a service that goes well beyond our expectations. The personal attention provided by the LEPCA staff should be commended; they have always made themselves available to the staff of MDPD. One of the highlights of our partnership, is a recent request to the LEPCA staff. We wanted members of our recruitment team as well as our basic law enforcement academy training advisors to have a better understanding of the psychological evaluation process for our applicants. We requested the LEPCA staff to prepare a presentation for this purpose, and without delay the staff made themselves available. The LEPCA team's presentation was educational as well as enlightening. The time spent with the LEPCA staff is still one of the highlights for our team; and they have requested that LEPCA return for a presentation to our new members. We not only received valuable information, but we were able to meet the team that we rely heavily upon, in person. I am truly confident to say that 1 have developed great respect for the professional services of the LEPCA staff and their expertise in this field. It is with great pleasure to write this letter to provide insight to their services. I highly recommend LEPCA for your psychological screening of applicants. If you have any further questions, please feel free to contact me at 305-471-2637. rely, Ilia Johnson, Lieutenant ruitment and Selection Section ,4„) L) faN City of Miami: RFP 610384 Page 29 Pre -Employment Screening Services City of Miami: RFP 610384 Page 30 Practicalities of Screening Service Our entire office and screening system have been designed to meet the needs of our Public Safety Agency clients. Any agency that uses our services knows the effort we make to accommodate the sometimes unique needs of our law enforcement clients. For example, we developed a comprehensive website that allows agencies to independently schedule applicants at any time up to the morning of testing and download final applicant reports 24-hours from completion of evaluation. We also have an "applicant's section" on our website, which provides helpful preliminary information to applicants who are about to undergo the evaluation. We welcome any potential user of our services to look over the website located at: www.lepca.com 1. Testing is conducted at our centrally located office at 9960 NW 116th Way, Suite 12, Medley, 33178. In order to provide a more convenient office location for the many applicants who may also live in Broward and Palm Beach Counties, we believe that we found an excellent location close to three major roadways in Miami -Dade County. This office is conveniently located within a mile from the Florida Turnpike, Palmetto Expressway, and Interstate 75. There is ample free parking for applicants. Our office facility is approximately 3,200 sq. ft. and is specifically designed for screening and other public safety services. We have a very large testing room with private individual test booths for each applicant. We do provide off -site screening and travel upon request but ask for adequate advance notice. 2. Testing is conducted Monday -Friday beginning at 9:30 a.m. We can accommodate up to 15 applicants per day or 75 per week. On special request, we can run early and late afternoon testing sessions. 3. For convenience, an agency can schedule their applicants on our website without contacting our office right up to the morning of testing. To date, we are not aware of any agency unable to schedule an applicant on the date desired. 4. The typical applicant takes 4-6 hours to complete the evaluation but there is no formal time limit. 5. All personality instruments are immediately scored in our office as each applicant finishes their individual tests. 6. Concise and job -related final written reports and a related background questionnaire are generated on each applicant and posted for review and/or downloading on our website within 24 to 72 hours of completion of testing. However, verbal feedback or a final report can be provided within a few hours of testing on special request. 7. To assist users of our final report, a Report Interpretation Manual is available. which further elaborates on an applicant's deficits and helps guide the background investigator 1/4.) tool City of Miami: RFP 610384 Page 31 or others in the use of our report. This manual is maintained on our website for easy viewing. 8. Our firm is extremely familiar with and conforms to the Americans with Disabilities Act (ADA), Equal Employment Opportunity Commission (EEOC), and Genetic Information Nondiscrimination Act (GINA.) No legal complaint or litigation alleging discrimination has ever been filed against our firm. 9. Our screening system meets or exceeds all the recommendations and guidelines of the following organizations. International Association of Chiefs of Police, CALEA, Council of Police Psychologists, National Institute of Justice and the California Post Commission. 10. * No legal challenge of a formal or informal nature has ever been sustained against our firm. (Addresses B.6 under SubSection 4 of Section 4) The following is a summation and outline of our screening system and procedures. We have every confidence that our screenings provide relevant applicant information and accurate final ratings, which can make an important contribution to the agency's final selection decisions. Philosophy of Pre -employment Screening Process for Public Safety Personnel Pre -employment psychological screening of Public Safety Position applicants first began to gain popularity and widespread acceptance during the period between 1970 and 1980. Initially, this screening was adopted mostly by urban agencies often in reaction to alleged civil rights violations by their Officers and subsequent protests, legal actions and in some cases civil disturbances. The so called "negligent hiring and retention- legal claims began to proliferate in those years, occasionally resulting in large monetary payouts to Plaintiffs. The psychological screening of applicants became one of the first agency responses to these events, since agencies could implement screening rather quickly at a reasonable cost. Unfortunately, many agencies and contracted screening psychologists knew little about the intricacies of this screening or how to effectively implement or utilize the results. As a consequence, a plethora of screening procedures emerged, many of which were of little use to the agency. Often, the psychologist worked in isolation from the agency and there was scant communication between the two parties. This severely limited the psychologist's effectiveness and the agency frequently had little education on how to interpret or apply what the psychologist's report indicated. As a result, many misconceptions about screening developed and agencies sometimes ran the risk of actually misusing the psychological report. To make matters more complicated. selection procedures generally, and psychological screening specifically. are by their nature vulnerable to criticism and can become "political footballs" between competing factions with different interests. Therefore. although psychological consultants must maintain appropriate flexibility in their work. the consultant has to always demonstrate professional objectivity and honesty even in the face of criticism from others. City of Miami: RFP 610384 Page 32 It was with the above challenges in mind, that nearly forty years ago, our firm set about to address these issues in a professional, logical, and practical approach. Briefly stated, the goal and purpose of pre -employment screening is to screen -out those applicants identified as having high - risk factors for performance of the Public Safety position vs. those applicants who are absent these risk factors and possess traits deemed suitable for the position. To accomplish this goal, our philosophy is quite simple; effective programs + effective people = effective organizations. It is the contracted psychological firms job to create a state of the art screening program and to educate/train relevant agency personnel in the correct application of the system. It is the agency's responsibility to provide motivated selection personnel and policies consistent with the difficult but critical task of identifying the most qualified applicants for final hire. Since no one selection procedure provides all the answers, a systemic and comprehensive approach must be utilized. To achieve maximum effectiveness, agency personnel and members of the psychological firm must be willing to communicate and work as a coordinated team when necessary. We pride ourselves on remaining constantly available to each of our clients and always provide, whatever. extra input is necessary to make our screenings as effective as possible. Improving upon selection procedures is a never-ending endeavor. As a result, the agency and psychological contractor sometimes need to "push the envelope" and challenge each other to enhance their respective expertise. City of Miami: RFP 610384 Page 33 BIFURCATED PRE -EMPLOYMENT SCREENING RATIONALE Approximately two years ago the City of Miami Police Department (MPD) chose to adopt a bifurcated or split pre -employment psychological screening process. Thus far, feedback from those working within the MPD Selection Unit has been very positive about the benefits of utilizing this approach in their screening of public safety applicants. Previously, the agency employed a "one step" or traditional model of screening, which resulted in specific inefficiencies in the selection system. In the one step approach, the entire psychological evaluation is completed in one testing at the end of the selection process. Often, the date of testing would occur close to the start of the training academy and after Background Investigators' had completed their investigation of an applicant. Since it is well known that psychological screenings will typically disqualify perhaps 20%-30% of applicants, this resulted in many potential trainees being eliminated "last second" and after a Conditional Offer of Employment (COE) per ADA. In addition, Background Investigators had to often re -open many files in order to further explore various "red flags" noted on reports of many applicants who actually passed the psychological screening. As a consequence, one step testing after the COE was frequently found to cause a major "bottleneck" for the agency and particularly for those directly involved in filling academy classes. In summation, this approach can be unfair to applicants who are disqualified at the final point of hire, Background Investigators who must do a second investigation and agency administrators charged with the responsibility of meeting manpower needs and hiring goals. Lastly, the screening psychologist is caught in the dilemma of maintaining appropriately high standards on the evaluation, yet trying to assist the agency in meeting their manpower needs. Essentially, the above traditional screening model evolved and became institutionalized by many agencies due to a mistaken belief that the Americans with Disabilities Act (ADA) considered all screening procedures and tests employed by psychologists as medical in nature. Therefore, it followed that the entire psychological screening process must be conducted post COE. Simply stated, this is not the case, and in fact under ADA guidelines most psychological/personality screening procedures and tests are non -medical inquiries. In various ADA publications and communications, ADA officials have clarified and made it known that psychological/personality instruments that are utilized primarily with a non -patient population to measure "normal" personality/behavioral traits and are not diagnostic in nature are non -medical procedures under the ADA. In addition. ADA representatives and recent court rulings, Leonel vs. American Airlines, have also reaffirmed that for a COE to be legally "real," the agency must have substantially completed all non -medical inquiries before issuing a COE. The ADA has opined numerous times that an employer must bifurcate or split their selection system into pre - offer non -medical inquiries from post -offer medical inquiries. The screening of public safety applicants has not been exempted from this requirerr.ent. Therefore, in recent years numerous agencies and their consultant psychologists have bifurcated their psychological screening system into a pre -offer non -medical personalitysui:ability phase and a post -offer medical emotional stability screening phase. This approach appears to City of Miami: RFP 610384 Page 34 more closely comply with ADA intent and eliminated many of the aforementioned problems associated with one step screening at the very end of the selection process. It should be stated one step post -offer psychological screening is still commonly utilized by public safety agencies and no court ruling to date has specifically banned the approach under ADA guidelines. Nevertheless, input from high level attorneys in the ADA's compliance office have supported bifurcated screening as an appropriate method of meeting ADA guidelines and have warned of the potential pitfalls of continuing to administer non -medical parts of the psychological suitability process during the post - offer medical phase. Finally, Dr. Axelberd had a recent phone conversation about these matters with Ms. Sharon Rennert, who is the Senior Attorney in the DOJ regarding employer compliance with the ADA. Ms. Rennert re-emphasized and confirmed her and other ADA officials' prior statements that require public safety employers to bifurcate their psychological screenings into a non -medical pre -offer and medical post -offer phase. For further review and clarification, please read the following correspondences from ADA officials, a brief of the Leonel court case and the International Association of Chiefs of Police (IACP) guidelines for pre -employment psychological screening. City of Miami: RFP 610384 U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION Washington, D.C. 20507 Glen Peterson, PhD. Licensed Psychologist Michigan Law Enforcement Consultants 534 Fountain Street, N.E. Grand Rapids, Micbisan 49503 Dear Dr. Peterson: AUG ' 6 Z001 Page 35 This is in response to your letter ofJune 25, 2001, iaquiringwhsther the involvement of a mental health professional, such as a licensed psychalog;st, in evaluating an applicant's non- medical infor nation constitutes a medical examination tmder the Americans with Disabilities Act (ADA). General Princioles As you are aware, the ADA prohibits medical examinations and disability -related inquiries prior to a conditional job offer. Medial examinations and disabiliry-related ingot -ice can be done during the "post -offer" pwiod, as Ioag as all applicants for a spedEc job category *re subject to them. In order for a fob offe o be. orsi • �. • .•ne :de an ern•to a �• - ev rele� .on-�. edical 'nformation whic orabl ould have obtained and analyzed prior to ma3dng-the offer. The EEOC, in its October 1995 Enforcement Guidance on I'z..cu±ployment Disability- Related Questions and Medical Examinations, offered a list of factors that are helpful in determining whether a procedure or test is medlcal. In some instances one factor nay detcmire whether a test is medical, while in other situations a consideration of several factors will be necessary. One factor is whether a test is administered or the results are interpreted by a health care professional. However, the h volve:rent of a mental health professional, such as a. licensed psychologist, would not ne be etermtnadve of whether a particular test administered or reviewed by this individual is "medical ." Other factors would need to be assessed, including whether tT:e test is desiend to reveal a m:a! imcirment and whether the ernnlo} iris tritnc, to delerrnine vwwhether the applicant has mental impairment. The Preemployment uidrr.ce states thatpsyzhol _al examinations are medal if tire}• provide evidence pat lead to identifying; amenta? disorder or iraoa:uragyxc:h as these listed in the Dia tosticandStatistical Manual cfMental Disorders (DSM W . In contrast, osycho!ovical -ts that are only desired and used to measure such things as honesty, tastes, and tlabita uo ice ❑ot hr "me " The Commission etabtrated on this point in its March 1997 Enforcemert Guidance on the AAA and Psychiatric Disabilities, sta:ing that "'_ raits and beha,riors are rc in themselves mental irr.5airmer.ts zl-.hou h thev rnav .- hnk t ' i pa miner ts." Such personality traits include stress, irritability and anger r+tan_Qct-tclt chronic lateoe_s, pccr jud�'Ti lent, in'.-z-lty, teamwork, andyre'udice. QL'estinrs or tests designed tJ 1-.irs0.7c f Fetraits, b haviorsr?r temperaments wold r : CY:1 I City of Miami: RFP 610384 Page 36 Glen Peterson, Ph.D Page Two must be done duang the pre -offer stage • be considered medic 1 art" .As rioted above, such tests Mould not become "med.1- snatiC s SO emy . us. aps}^ ologist administers Lad ir.terprets them. Application ofT1,ese Principles to Your"Solar-Lsysl" Asassment Your letter states that during th re -offer stage you give and interpret tests that are "completely free orally references to disabilities or emotional disturbances and are roi us - dt ostic p " Tour letter also notes that these pre -offer assessments do not inquire about a coholtsm, a'diction, or treatment for emotional disorders Instmd, you state that you male ssesstnents about "general intellignce,1a cal processing, and abstract reasoning ability." At t1i c.st-cffer stave. after an applicant has received a coroditional offer of employment, you again meet with the selected applicants and ask questions about alcoholism, drug addiction, and any history of trea,tn=tt for mental iUne3s. You also give them a psychological test "designed to assess pathology, such z; depression or anxiety." From the description you provide; it; its;that your "split-level" assessmsnt follows the requirements of the. . as enunciated in the EEOC's l cos. First, your pre -offer inquiries and examloatc .s assess personality' traits, tens?=a nests, and reasoning abilities — to determine what you call "emotional suitability" Second, your post -off= questions and medical examinatons determine the existence of any mental impairment: that mutt preclude an individual from being a police ofacer. From your letter, it appears that the Stale of Miichigan refit es. that anyone who is net determined to be "free of emotional instability" automatically be disqualified for law enforcement positions. Please not; however, that if you determine through a pest -offer medical examination Cant an applicant has a rnental disability, and a law enforcement agency decides to withdraw the job offer, the ADA requires that the agency shove that the reason for the r_ev catior. is job -related and consistent with business necessity. 1r, other words, the agency must show either that the individual cannot perform the essential functions of the position, w th or without reasonable accornmc+datiort, or that the individual poses a direct threat to himself or other that cannot be eliminated with a reasonable accoramodatior_ I hope this information is helpful. This is not an oEacia1 opinion of the Com .nissicr Sincerely, Gt,.t,Z Sharon Rersert • Senior A.r.o. , _y Advisor City of Miami: RFP 610384 U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION Washington, D.C. 20507 MAY 4 - 2001 Shelley Weiss Spilberg, PhD. California Commission en Pease Office~ Standards and Training 1601 Alhambra Boulevard Samm o, California 95316-7083 Dar Ms. SpOterg. This is in response toy our letter o f February 7, 2001, iro.uL-ing whether the ,. olv:;: ent of a mental health professional is evaluating an applicant's na-radical infom:adon eorxit:nes a medical examination under the Amcicaas with Disabilities Act (ADA). In addition, your letter raises issues about what maybe considd medical exazairations- As you are aware, the ADA prohibits medical exaauinations and disability -related mein. es prior to a ceaditicnal job offer. Medical exaai.ations and disabn ity-Anted ingarries can be done during the "post -offer" pciod, *slang as all applicants far a specific job catcgoiy art subject to them. In order for ajob off= to be cc .s d d ber.Ql,de.ATI =ploy_ must rraluarer all relevant non-mydical i.-iforaadon which it reasonably could have obtained and aralyzenor (o,iaking the offer. • The EEOC, in its October 1995 Enforraneat Guidance on PreaaploylnentDisaatlity- Relatcd Questions and Medical Exaratiors, offered a list of factors that are helpful ir. determining whether a pre or test is medical. In some instances cat factor may dete^.t±e whether a test is medical, while in other situations a coasid=ation o f sevcal factors w::1 be necessary. One factor is whether a test is szliiinistesed or the results are interpreted by a health care professional. However the bvolvezn t of a mental health fessionat, by itself, would not mean that any test administered or reviewed by this individu is "medical ." Other factors n - to assess a sea a c.rMi a on, In u^,g whether the test is deli to reveal a manta'. impairm=t and whether the employes is hying to de c w. 1 c the -eppueant has a mental irapairm=it. Tnus, toe involve:;ient of a mmntal heahh professional in a±nicJst:rir.g or intcrpredng a Les; will always n�es.sLate 1oo eg at other ia:;or to determine if the test is ` rt .ical." Yo r leestates t.3t duri.1g the pre -offer stage as. agency ps}cholc st L^te pros tests fift4 Page 37 City of Miami: RFP 610384 i to " tvertories"` thaJt,ssets "normal -range p=onality traits and cbaracterisdes," reviews biographical questionnaires and octs anoc-medical interview for purpose of evaluating a:t licatit's `psychological suitability." he Pr o cat Guidance sign,% that p sychol .e h vide evidence that would lead to identg a m rd� innaitmez 1, such as those Ls:oil:k 1% Diagnostic and St tistical Iisa yf ri Mental DisordcrDSM-I»}. In contrast, psyraologrcai tests that we only deigned ad used to ta=svr: soc1: tugs as honesty, tzstc, and habits would not be' medical." The Cotr r-litsion elaborated on this point in its March 1997 Enforcement Guidance on the ADA and Ps t hiatrie DisabIit±es, stating that It]raits and behaviors ire not, is themselves, mental;mNt**� . although they maybe linked to mental impairments." Such traits include stress, irritability mmd anger management, chronic lateness, poor judgment; integrity, eaaiwo sa pr�tu5ce. Thus, questions or leis designed to ddmnir e R et applicant exhibits am► of ileac tracts or behaviors w d'not be cocsid edieal date dnrhisti th r „Sedge. Such tests would not become `medical" examiaanoas so Y a psi o t �drn�tn sit in3 terpretss ® Dunne -offer stage, allEtholoais: czagtve nun-m�iW1 tests, conduct interviews, or review questio sad ea are for the sole purpose of assessing an 0, cants personality+ cruet, eristics, and behaviors. I hope this information is helpful. This is not an oEacial opinion ate Commission. Sincerely, er! � f ) ', ref 7� Christopher 3. Kuczynski Assistant Legal Counsel Labels such as "psythoiogical tut" and "inventor/ ' would not detemine whether a specific test or inventory is "medical." Rather, the factors discussed above would tx=d to be applied to a spcci3c test or it a tory to determine whether it is "medical." For example, the Minnseta M:tl€phasic personality Inventory (K Z) is a medical exa..iaation because it is desisted and used to deterrnire the presence crmental disorders or lmpai.--re ts. 2 Page 38 i A - City of Miami: RFP'610384 Effecu oa Empleye:s' Pr .Hite Practices Employers use a v-uiety of screening devices is the order they prefer. • Application for Er - ploymeat • Background Checks • Direct Apdrude Tests • Drug and Alcohol Tests • Medical Examinations • Penal & Papa Testy • Personallntarsiew • Psydsoiogicallacuides The EEOC, cow supported by 2 federal appeals court, would requda that employ- ers request and consider information obtained during medical esantinatioos only during the ht-rtep of dte pre - hint process Also, under this haling employers may not obelii such information cr schedule an a mi.namir'�tut- \t1 all oche:Jae-hiring sateens rare completed. I: may be time for you to consider restructuring your comp:tnp s pre -employment. applicetior. process. Fot mere i.•tfotrutior. cr. this matter contact BruceJ. Douglas Piorre: • 932-69G-1369 .E.r.G� bdcuglut`,d'a& .hoE-r-noncom Larkin TT rr raetlraT7 i'rl J ATTC2' Employment Law Alert Americans with Disabilities Act Pre -Employment Medical Inquiries Medical leep.driei Must Be Last is Sequence Recently, the US. Court of Appeals for tote Ninth Circuit, the federal appellate cosier covecing vevtsal western states irultding California, held that an employe: violated the ADA by requiring applicants to eomplere a pre -employment pht-ii al before batkgmurtd checks area oche: nor. -medial incrlries had been completed. The court reasoned that the ADA prohibits medial ir:quides or coruideradon DE medical iafor—..nation tzznl after a `tea?" job of has beta rids Tne court relied upon satcm.ents r de by the U.S. Eelual Employment Opportunity Commission (EEOC) in in ADA Technical Assistance Manua _ • Guidance issued ago. The are is decided co Employer Rescinded Conditional Job Offers In this case, the applianu received cordidonal effen of er.rloymeon the offea required theca to undergo a background check, drug test, and trsed'rcal esuri«adoa The applicants failed to tiisdose tire: HIV-posidv t amtta. During the tr.,•ell^al esamirstior, a blood sample was obtained and in analysis revealed in a number of applicants elevated "mean cotpuscu1 .r vrotur,.rs" (MCVs"). The employes medical expert noted that there is a sigriF.ra:: co:reiidon betareen elevated NICV levtts and radow c^edidons such as alcoholism, Env, sca,.::e disor'hn, ik1le cell tise:ise and Litt disorder, among oche::. Based on the medial report, the employe rescinded in a Elea of employment, citing the applicants' failure to disclose inforrmdon. The employees brought suit contending, eneng other thing', that the medical esaaira :oar west ir: violation of Carrfocaia and federal !awl, specifically that the ADA required that medial exarrs:.atoas and related medical info: icon be obtained and considered only aft all other steps of the pre•li:e process had been completed. A federal disraet court gnaxd su:tar.iay judgment in favor of the employer. The Ninth Ctrs: rev -tried cn the ADA violation issue sr.d remanded the case to the die lot text.: for proceedi gs. "Real" Job Offers According to EEOC guidelines on the subject, r.on•medisal cora:orer.o of the application process c<- shown that eh could riot reasonably hs.- been cort'.et;d before issuing the Tif a'' completed cr it Page 39 >e‘ iRFP 610384 'Schy Structure the Pre - Employment Screening Process? "Congress and the California legislature both have deter- mined that job applicants should not be required to un- derg t medical examinations before they hold real offers of employment . Arreacan —even if well-inteationed— caaaoc avoid the mandate simply because it believes doing so wit be more conve- nient for in applicants." —US. Gant of Appeal! fir lhe Niut6 CCmd: it Lioav!i AseerurarAvSxu, Lee For more information on this ranter contact. Bruce J. Douglas FGor-e • 952-8i6-15G9 Enie: ix.'�u,^'�•�la•=+anhor :...con Larkin TTn„ a ri JJ ATT-;hr Ys Employment Law Alert Continued, Page 2 The EEOCS ADA Technical Assistant Diarstxl on the Employment Provisions of the ADA, Section 6.4, sates: The ADA recoguiza that employ= may cued to conduct medial wrninetiom to dete:taint if an applicant can perform ecttiut jobs effectively a.•td safely: The ADA regti:es only that suth ezarairatiors be conducted as a separate, woad sup of the selection process, after an individual has net all other 'ob ore -requisites. The employer rs ty make a job offer to such aa`rrsdi ual, condiaotueTon the sans factory outcome of a medical eara.•airatioa co instal,, pcovidag that the ezapioyer retitiza such as e.e =M•don oc ir•.qutry for all warning employees in a pi-rctdar job category, not merely mdriduals with known disal>alides, or thou Irhooa the employer believes retry have a dwbility. An enforcement guidance issued by the EEOC in 1995, enrided Pre -employment Disabality-related Questions and Medtcal Esamirt.•ttionl, noted that at the post- offers5ge at employe: ma; ask d:sabala'ty-related questions and perfects medial =minedoas and that the job offer may be conditiorged on the results of past -offer disability -related yes dons or medial er arrirsations. However, the Cotes-arausto a rase; 1e cocrept of : " to her,which it described as follasr an rp • - art as -R=+m. -related questions sad requite t:tecturi .. c�.icao.,txwo after a job offer, it n important that the job or A job offer - reel if the em • • has evaluated all cetera inFous ition mhreh to two= • • co - have o ti_ajen.nng a omen. t course, Caere are tunes reasonaii[y o&era and et aluete all of non -medical inforraaton at the pc: - offer stage. If an employe as shoat that it is the are, the offer would ail be considered a real offer. One example of a sit=tion where an employer cannot reasonably obtain and evaluate all non -medial infocauttion at the pre -offer sage includes eases where • an employee requests that a current employer not be contacted tenth the potential employe: makes a cam:Honal job offer. This escepion, presumably, would be construed netrowiy under the Ninth Grcirit's decision. ForYour Consideration f► v1-1 AA) Page 40 The decision by the Ninth Circuit a uld require employen not only to consider e k the results of a taedical or psychological e_mrri elon as the last step in the pce-hire proeess, it would n • .. - - - - such infnermio49r schedule the exaciu• o t nai at ot4e: ce•i .-ir.z s -e ha been eq_-plet rt- tr vvL I / If this i.te:p::tado:tb.comes accepted by other federal couan,pa-ee1 y courts i~. D1kt^.eso_a adopt this rule, it w11 impact the manner in which yrur company conducts in pre-employme.r: process. Becz.ne the Nir.:11 Circuit's delsica is b�J:d is pa:t or. let.cmei.:; can ._...:d .. EEOC u•1•ich apply is 19 %trot: con1:dei:.g a...'!, to t:._ ey:or.: F(alt4le, y._. cc• ;'s p:.-c- :': .c.1: air'_...__., p:__as aroo:_ nil. City of Miami: RFP 610384 Page 41 Bifurcated Pre -Employment Psychological Suitability Screening Process PHASE ONE: Pre -Conditional Offer Personality Suitability Evaluation Process (non -medial inquiries per ADA) PLEASE NOTE: Per ADA guidelines, this phase of the evaluation consists of what ADA defines as non -medical inquiries, tests, and procedures. Therefore, psychological inquiries, procedures. and tests considered medical under ADA are conducted Post -Condition Offer after a Conditional Offer of Employment (COE) has been provided to selected finalists for the position. The Pre -Offer screening phase covers approximately 75% of the entire psychological evaluation, except for the following: 1. Detailed questions relating to drug and alcohol use (frequency, amount, duration); 2. Detailed question related to medical and mental health history or treatment; and 3. Administration of a psychological diagnostic instrument for which the primary purpose is to assess job -related emotional stability and/or identify recognized psychological and mental health conditions. The Pre -Offer Evaluation consists of the following: 1. Instructions and consent form 2. Pre -Offer comprehensive Personal History Questionnaire (PHQ) 3. Completion of the following standardized objective test instruments: a. California Psychological Inventory (CPI- Police and Public Safety Selection Report) b. Public Safety Selection Inventory (PSSI- Supplementary Research Instrument) 4. Tests are scored utilizing Police and Public Safety norms and actuarial/predictive research data 5. Pre -offer semi -structured job -related suitability interview conducted by a licensed psychologist trained in police and public safety selection. Interview consists of: 1. Review and clarification of Personal History Questionnaire with applicant; 2. Applicants responses to standardized open-ended interview questions; 3. Review and clarification with applicant of theme content derived from critical items endorsed on objective test instruments, revealing specific critical items to applicant is not conducted; 4. Interviewer completes the above steps using a standardized interview form and rates the applicant on the job -related traits deemed essential for the position; and 5. Interviewer then prepares a preliminary report of findings using a standard report format based on the aggregate of material gathered from the Pre -Offer evaluation. 6. Review and approval of preliminary report by a Senior Psychologist with LEPCA. If questions exist, the Senior Psychologist will staff the file with the interviewing psychologist to reconcile remaining questions or issues. 7. The completed Final Report and applicant's Personal History Questionnaire are provided to the agency through the secure agency user access on the website. typically within 24- 48 hours of appointment. 8. Approximate total time of Pre -Offer e' aluation appointment is four to ti\ e hours. City of Miami: RFP 610384 Page 42 Applicants who then go on to successfully complete the various selection steps of the agency and are given a Conditional Offer of Employment per ADA, then return to LEPCA for phase two of the psychological evaluation. PHASE TWO: Post -Conditional Offer Job -related Emotional Stability Evaluation (medical inquiries per ADA.) Phase two conducted only after previously identified processes are completed and approved. PLEASE NOTE: This phase is usually briefer and more narrowly focused relative to the Phase - One Pre -Offer Suitability Evaluation. It consists of inquiries, procedures, and tests considered medical under ADA. Essentially, this Post -Offer phase covers detailed inquiries concerning any drug and alcohol use, mental health and medical history, and a comprehensive standardized psychological instrument used to assess emotional stability and/or the presence of a diagnosable psychological condition. Our experience has been that very few applicants are disqualified by the Phase-2 (bifurcated process) Post -Offer Emotional Stability evaluation. Thus far. the finding of "met standards" on the Phase -Two screening has been approximately 95-98%. The Post -Offer Phase -Two evaluation consists of the following: 1. Instructions, Consent form, and Release of Protected Healthcare Information 2. Post -Offer Personal History Questionnaire (PHQ) 3. Completion of standardized psychological test instrument a. Personality Assessment Inventory (PAI- Police and Public Safety Selection Report) 4. Post -Offer semi -structured job -relevant emotional stability interview conducted. Interview- consists of: l . Review and clarification of Post -Offer Personal History Questionnaire; 2. Brief Mental Status assessment; 3. Review and clarification with applicant of theme content derived from critical items endorsed on objective test instrument, revealing specific critical items to applicant is not conducted; and 4. Review of applicant responses to standard open-ended interview questions. The psychologist completes the above interview utilizing a standard interview form. After integration and consideration of all Post -Offer evaluation material, the interview psychologist then rates the applicant has having 'MET" or "DID NOT MEET" the basic emotional stability standards for the applicable position and comments on any further information that could prove useful to the agency. If the applicant does not meet basic emotional standards, an explanation and the specific reasons for this finding are provided. 5. The complete file with rating is reviewed by a Senior Psychologist. If question arise. the file is staffed with the interviewing psychologist. 6. The Phase -Two Final Report and completed PHQ are provided to the agency through the secure agency user access on the website, typically within 24 hours of appointment. 7. Approximate total time of Phase -Two Post -Offer evaluation is two to three hours. 1/4416) City of Miami: RFP 610384 Page 43 rs eiN Essential and Important Job -Related Traits A critical part of effective psychological screening is to identify in common sense language the job -related traits that are most critical to performing the public safety job position. This can be accomplished through observation of those performing the job, conducting job position surveys, reading the formal job description and reviewing any studies and research on the subject by respected public safety organizations such as the Califomia Peace Officer Standards and Training Commission (POST). Over the years, our firm has availed itself of all the aforementioned sources of information and our current system focuses on and rates applicants on the following 13 public safety job dimensions. The report of applicants who do not meet standards on a job -related trait(s) will either state: "Deficit Mildly Indicated," "Deficit Moderately Indicated" or "Deficit Significantly Indicated" for each of the traits listed below. • Integrity / Ethics / Compliance with Rules • Impulse Control / Attention to Safety • Judgment / Decision -Making • Openness / Ability to Admit Shortcomings • Stress Tolerance / Emotional Regulation • Social Competence / Tolerance • Work Habits / Patterns • Avoidance of Substance Abuse and other Maladaptive Behaviors • Learning Ability / Problem Solving • Flexibility / Adaptability • Assertiveness / Initiative / Persuasiveness • Conscientiousness / Dependability • Communication Skills / Verbal Expression For further definition and detail of job dimensions. please refer to our Report Interpretation Manual provided with this proposal. City of Miami: RFP 610384 TEST BATTERY Police Officer and Detention applicants: 2 Page 44 Phase -One: Pre -Offer Personal History Questionnaire (PHQ), CPI, PSSI (Research), Clinical Interview (non -medical inquiries) Phase -Two: Post -Offer Personal History Questionnaire (PHQ), PAI, Clinical Interview (medical inquiries) Dispatch/non-sworn personnel: Phase -One: Pre -Offer Personal History Questionnaire (PHQ), CPI. Clinical Interview (non- medical inquiries) Phase -Two: Post -Offer Personal History Questionnaire (PHQ), PAI, Clinical Interview (medical inquiries) Please remember, Clinical Interview for non -sworn personnel is not as exhaustive as it is for sworn/critical public safety positions. Primary Instruments: California Psychological Inventory (CPI): In our judgment and experience, the CPI is the most often used and validated instrument for the selection of public safety applicants. We have administered approximately 50,000 or more CPI's to applicants and conducted various research projects over the years to improve the accuracy of this instrument for predicting job performance. As with the PAI, we utilize Dr. Robert's specialized CPI public safety report. which provides further important job predictions based on longitudinal studies. As an aside, it should be mentioned that Dr. Roberts is considered an elite public safety psychologist and his specialized reports have been critically reviewed and used by the most knowledgeable and experienced screening psychologists across the country. Contrary to the PAI, the CPI measures dimensions of normal behavior such as Dominance, Social Presence. Empathy, Self -Control. Responsibility, following rules, conformance to team behavior, flexibility, etc. As such, this instrument is critical in assessing the essential traits relevant to almost all public safety positions and therefore the CPI is given great weight in our assessments. The purpose and individual items of the CPI do not identify diagnosable psychological conditions and instead measure primarily interpersonal personality functioning. Therefore, under ADA guidelines this instrument qualifies as a non -medical procedure and ideally should be administered before a conditional offer of employment in a bifurcated system of screening. Personality. Assessment Inventory (PAI): The PAI is a well -researched and accepted comprehensive instrument, which essentially measures and identifies various diagnosable psychological conditions. The emphasis of the PAI is to rule out diagnosable mental health conditions or behavioral patterns commonly associated with psychopathology or emotional disturbance. The purpose and nature of many test items on this instrument makes it a medical eiN City of Miami: RFP 610384 3 Page 45 procedure under ADA guidelines and the PAI can only be administered after a "real'' conditional offer of employment has been provided to the applicant. In terms of use with the screening of public safety applicants, the instrument is utilized by 100's if not 1,000's of psychologists who conduct these screenings. In recent years, it has particularly gained popularity as a more contemporary instrument vs. the MMPI-2, which has been criticized rightly or wrongly for being outdated. Both these tests serve one of the important "screen -out" functions of pre -employment screening, which is to identify and screen -out applicants with propensities towards emotional instability. Of great importance, our firm uses and works closely with Dr. Michael Roberts who has carried out extensive research with the PAI for the screening of public safety applicants. As such, he has produced and we utilize a specialized public safety report that provides specialized and extensive normative data for public safety positions and predictive validity measures of salient traits such as integrity, anger management and other job performance criterion. Clinical Interview: Every applicant undergoes a semi -structured interview with a licensed psychologist specifically trained and supervised by our senior staff. The interview process clarifies and reviews the applicant's personal and work history, explores or compares test profiles with the applicant's history and interview presentation and asks standardized job - relevant questions similar to an oral interview. The structured interview process and areas of questioning must be strictly maintained by each psychologist so as to assure consistency and reliability between our staff. Interviewers are closely supervised and on a daily basis our staff reviews cases and makes certain that everyone understands and applies the same reasoning and standards as others. In addition, interviewers only prepare a preliminary report, which is then carefully reviewed by both Dr. Mangan and Dr. Axelberd. Any possible inconsistent findings or opinions whatsoever are identified and reconciled with the interviewing psychologist before a final report is created. Keep in mind, the interview is only part of a comprehensive evaluation process and in our system, ratings are only determined through a carefully laid out and objective decision process. We rely heavily on well -researched and objective predictions of job performance, which greatly limits the possibility that subjective observations or opinions will "muddy" the water. Unfortunately, due to the limited knowledge about these screenings and stereotypes reinforced by the media, many individuals mistakenly believe that the results of these evaluations are primarily subjective and based on a comment or two an applicant may have made to the interviewer. Nothing could be further from the truth. Personal History Questionnaire: Our firm has developed with input from numerous agencies a relevant and comprehensive self -report questionnaire. We have a pre -offer questionnaire (non- medical) and a post -offer (medical) questionnaire. Essentially, the post -offer questionnaire gathers mental health history, details of drug/alcohol usage and other information considered medical in nature, which cannot be obtained pre -offer. Research Instruments: This instrument is in research phase and applicants are made aware of this during informed consent. As such, the instrument is not considered during the formal rating process, but may be used to augment an interview through clarification or discussion of applicant's particular answers on specific job -related critical items. Overall. the PSSI has shown great promise and on-goingg research has thus far proven its worth and accuracy. City of Miami: RFP 610384 4 Page 46 Public Safety Screening Inventory (PSSI): This instrument was designed and researched specifically for the screening of public safety applicants. Dr. Axelberd, of our firm, is the author of this instrument and he utilized his 31 years of exclusive experience in law enforcement in developing an extremely job -relevant and face valid screening test. He utilized extensive input from those in the public safety community to achieve this goal and all of the PSSI individual items were reviewed by public safety personnel or in some cases the items were written by those working as public safety officers. Essentially, this instrument assesses those on -duty as well as off -duty behaviors, attitudes and traits that land so many officers in trouble. For instance, there are scales designed to measure the likelihood of domestic violence or sexual acting -out, which often are reasons for officer misconduct and embarrassment to the agency. Therefore, the PSSI was an on -going collaboration between Dr. Axelberd, Dr. Mangan and those doing the public safety job the test was designed to measure. The PSSI has been developed and researched over an approximately six -year period and subjected to numerous refinements based on several rounds of research. Dr. Nick Lim, a university professor who teaches statistical analysis and test construction was retained as an independent consultant to supervise the research design and statistical analyses involved in the PSSI's development. So far the test has exceeded our expectations and multiple validation studies yielded very positive results. Conformance to Standards There is no one governing body, organization or authority that officially regulates or defines pre- employment screening of public safety applicants. Nevertheless, there are certain respected organizations, associations and individuals who have developed guidelines for this testing. which act as generally accepted standards within the public safety community. In our professional opinion. the following entities are generally accepted as setting the guidelines and standards in this area: Intemational Association of Chiet s of Police (IACP), California POST Commission. Consortium of Police Psychological Services (COPPS), Michael Roberts. Ph.D., David Corey, Ph.D. and Mark Axelberd, Ph.D. Our firm complies or exceeds all of the above guidelines set forth by the above authorities. Our firm, in particular Dr. Axelberd, assisted the Florida Department of Law Enforcement (FDLE) in the early '80's when they strongly recommended that psychological screening is an important of public safety applicant screening. Dr. Axelberd wrote the initial guidelines for this screening on behalf of FDLE and introduced the screening process throughout the state of Florida. Also, in the early 1990's he assisted with the initial national screening guidelines as part of his association with COPPS. Dr. Brian Mangan is an active member of the IACP Police Psychological Services Section (PPSS). currently serving as the Conference Vice -Chair on the Education Committee, as a member of the Ethics Consultation Committee. and as a member of the revision committees for the Officer Involved Shooting_ Guidelines (2013) and Psychological Fitness for Duty Guidelines (2013). As stated above. the IACP PPSS developed the current guidelines for Pre -Employment Psychological Screening. To this day, our firm continues to often act as the model screening system and advisor to numerous psychologists and public safety agencies on a local. national and even international basis. In conclusion. we never rest on our laurels and those who know us realize how hard we continue to work to provide the highest quality of screenings. City of Miami: RFP 610384 5 Page 47 el) Determination of Job -Related Ratings As with most medically related professional opinions and ratings, the assessment psychologist's decisions are based on procedures and tests considered to be reliable and valid. In the evaluation of public safety applicants, we use multiple and overlapping sources of information in arriving at ratings on each essential job trait as well as an overall job suitability rating. All procedures, forms and the rating system in our evaluation process are carefully standardized so as to assure reliability and fairness for each applicant. Our firm's findings are based on the aggregate of information collected from the four phases of the evaluation. These phases include standardized test profiles derived from the battery of tests, personal history/background information, clinical interview material and performance on a problem -solving and learning ability test. All test profiles and each phase of the evaluation are reviewed closely and then integrated together to achieve the most accurate and complete picture of the applicant's potential job - related strengths or weaknesses. Beyond standard clinical interpretation of test profiles. we also utilize various actuarial predictions of job performance generated by research on each of the instruments. For the great majority of applicants, we find the piecing together of the parts of the evaluation lends itself to clear-cut and logical final ratings. Occasionally, we do find that an applicant's results are ambiguous or "borderline." In those instances, the applicant's file undergoes a thorough staff review and we may compare our findings with those of the Background Investigator. In some cases, it is useful for the Background Investigator to clarify the report with our office and we are always available to do so. To assure the reliability and quality of every report, the findings of each report are carefully reviewed by a senior psychologist before submission to the agency. To further evaluate ourselves, we periodically compare our rating category percentages with a select group of other national experts in this field. Our ratings have always been found to be very similar to this respected group. Lastly, a thorough multi -year study of our evaluation system conducted by the Miami -Dade Police Department found no adverse impact on any protected group. Please be aware, members of our screening team are always interacting and discussing every aspect of the evaluation process on a daily basis. The challenge of rating and predicting human behavior will always remain a daunting task and the assessment psychologist can never let complacency set in. Those who have worked closely with us know how relentless and determined we are in our on -going efforts to be thorough and fully informed with each applicant's evaluation. Report Format Our report format was designed specifically for public safety selection after receiving input from numerous public safety personnel and reviewing ADA guidelines. HIPAA privacy requirements. GNA. and recent court rulings in this area. Our conclusion is that use of "wordy" narrative reports is very questionable for the purpose of employment testing. Ps�cholohlists often "fall in City of Miami: RFP 610384 6 Page 48 love" with lots of psychological jargon and flowery descriptions of applicants but many times these type reports contain superfluous, confusing or irrelevant information and are not practical for the task at hand. As a result, many times a psychologist's screening report can miss the "forest from the trees." Just citing one example, almost all screening psychologists use some type final rating system to categorize applicants. However, some psychologists still do not provide a brief and clear definition differentiating each rating category. Instead, these psychologists assume that the user of the report will automatically define rating categories such as "Suitable," "Suitable with Reservations," "Unsuitable" exactly how the psychologist intended. This is often not the case and can cause major misunderstandings, actual misuse of a report or stigmatize certain applicants. With a few clarifying words or sentences describing a rating category, these problems can be avoided. We find that law enforcement users of screening reports basically want relevant, clear-cut, concise and easy to understand job -related ratings and statements about an applicant. In many cases, the agency also needs reports quickly. These concerns are exactly what our law enforcement screening reports attempt to address. To summarize, we provide all relevant information and final reports typically within 24 to 72 hours of testing in a concise and user- friendly report. We believe our report format is very thorough, but at the same time, easy to use and simplistic in design. Everything contained in our report format has been well thought out and designed for the specific needs of law enforcement agencies. Of course, the applicant's entire file including psychological profiles, raw data and any other supportive information is always available should an administrative or legal challenge ever occur. To further assist the agency, we provide a comprehensive manual that educates the report user on each job -related deficit and assistance in assessing whether the deficit is substantiated by the applicant's personal history and behavior. Without such assistance, we find that users of a psychologist's report will often just look at the overall rating and little else. From reviewing the bid language in this area, we believe our report format provides the requested information in a focused, practical and user-friendly way. L/ • • • 'City of RFP 610384 ••• •Memorandum. DEW • Mach' 22, 2006 • • . • •• • : • • • eRti . • 4.:0' t'• • • To: ' .• Robert Pcler;Directer • •'••• • • MZade Police Deitsilmedi J. • , • • • •••., • From: . idniUndo Valdes, dantmaadir. • • Personnel Menigensent Buresg', • iitibiscit " psychological Test*ts Aep.dversclinpict Stni6.Y. • • ... . , .• . ft. . . • .. • • . . . .. . . • , . • - . ; ..• • As requeeted,:an adverse impact sialysli ;ma Con4ated thr the intry-level iiiYilnola'glail vilnatiOns .....:: . primed' to the guidelinee set firth. in Title 29 of the Cede -of Federal Regulations, Ili the Equal • EillployMECt Opportunity Cormnieden, Subtitle 13-Regolatiom relating to. Lear; part 1607 ..IiilibrIta ' • * . . • . Guidelines on Employee SeleotiOnProoedurei . • . . * .• „ • • • . • • . • According to tie pretedui*, bahg idvene hnpsct• cense:nits ,discrineinatian'tmlers• • • • Instilled.. The use of pmy selection procedure which has adva hipsat cin.the bbing prop:013.mi; :other ecaplaYined opportnnities of snanberi of anitt, racioek.: weenie 'groip will be *considered, to be . discrintinstory and inconilsteatt ...with .the guidelines;.;enalesi the Procedure heel** .validgrad n., , • • scadenaetvith these guidelinti'•Theiet isre set thethf Part 16074 Genet iteidaidslor sha. • The ,battery psYchological:teits need are steamily recogaird and hiveheeni Tadeterrairie. adverie• 14AI:cadet the. l'four-ffrii rule Vifie'need: The revile* Mie „. . • • • rite for 14Y nice, Ole or Ode .0106 ce*Ilt 4i.f the *Ike ,g0 • the 'grew wPktbe bigb04,rete •741.1e*ellii be reSirded ee'evideflee of idYeree fthp Tne..tart gr.0130 Mi...W*14(1.14 sce(etl city gad ei The recOEdedb •the Bureau • SO • adverse with a five - Nall, • att I I, 1 •10 111 Or• fist the 1 IS I, . •• 1)1 •• •••• Ist• • •• • - - ;Tile 11417••••1147-77xv• The results of the ?mach indicaiedthat adV-eitst Attachments (4) •• _ . mi: RFP 610384 Law Enforcement Psychological and Page 50 Counseling Associates, Inc. Pre -Employment Suitability Screening Report NAME: SS#: AGENCY: POSITION: DATE OF TEST: Pre -Conditional Offer 1" Phase APPLICANT xxx-xx-0000 Police Agency Police Officer xx/xx/2018 CONFIDENTIAL IMPORTANT INFORMATION: This assessment and report is intended only for personality suitability screening to identify potential risk factors, traits and attributes associated with satisfactory or below standard performance for the public safety position applied to. Final ratings and information provided in this report are based on this applicant's responses on a battery of standardized tests, a background questionnaire and a semi -structured interview based on job relevant elements. This report should also assist the agency in determining which applicants have the best chance of successfully completing the entire selection process and least likelihood of demonstrating performance problems if employed by the agency. In addition, the report may be of assistance in evaluating potential deficits or problems in the applicant's self -reported background. This suitability assessment should be one part of a comprehensive selection system and the hiring agency must decide upon employment standards and make final hiring decisions. Per the Americans with Disabilities Act (ADA) guidelines. this is Pre -Offer screening and does not take the place of a future full assessment of the applicant's emotional stability that includes complete mental health or substance abuse history, or healthcare issues of any type. • This assessment and report should not be considered valid for use after one year from date of testing. This report is intended for use solely by the referring agency and access to this report should be limited to relevant agency personnel. • The following pages provide a summary of evaluation findings and a signed copy of the applicant's Personal History Questionnaire (PHQ). We recommend that the agency carefully review this questionnaire and rule out any possible discrepancies between information contained in this questionnaire vs. information collected by the agency. • If any discrepancies are discovered through investigation. this office should be contacted immediately with the information as it could potentially affect the overall final rating. • Should there be an further questions or need for clarification about an applicant's report. please feel free to contact our office. 9060 N.W. 116 ` Wa.% Suite 12 \led IPA . FL 33178 305-442-S800 ph. 305-442-4469 fax rot CitOffSlifa%ni: RFP 610384 Page 51 Summary of Evaluation Results This applicant was referred by Police Agency for a pre -conditional offer of employment (Pre-COE) job - related suitability evaluation for the position of Police Officer. The applicant was prompt for this appointment and before initiation of the evaluation, standard instructions were provided and an appropriate Consent Form was obtained (See pgs. 2-4 attached PHQ). The applicant was able to follow test directions and complete the evaluation without undue difficulty. The following standardized battery of tests and procedures were administered: California Psychological Inventory- Police and Public Safety Selection Report (PPSSR), and a Semi -Structured Interview with a licensed psychologist trained in public safety selection. Additionally, a supplementary objective test instrument Public Safety Screening Inventory (PSSI) was administered. A final pre -conditional offer suitability rating was determined after review of the aggregate of information gathered from all phases of the evaluation. A final pre -conditional offer suitability rating was determined after review of the aggregate of information gathered from all phases of the evaluation. The following job -relevant comments and details are provided to the report user to elaborate the reasons, as necessary, for this applicant's final rating and for additional agency investigation of specific events when required. This report was designed with careful consideration of the ADA, GINA. HIPAA and recent legal rulings pertaining to reporting job -related psychological evaluation findings to employers. The applicant's Personal History Questionnaire (PHQ) is attached as an additional reference source for the agency. For further clarification dart applicant's report, please feel free to contact our office. Validity Statement: Standardized objective test results demonstrated normal defensiveness and suggested that the applicant was able to self -disclose appropriately and answer questions without undue guardedness. The applicant responded in a consistent manner and evidenced a deliberate approach to the assessment. There are no clear indications of over- or underreporting of problems. Therefore. the results of this evaluation are likely an accurate representation of this applicant's personality functioning. Job -Related Personality/Interpersonal Deficits: * Note: These "Deficits" will be classified as Mild, Moderate, or Significant. They are determined by the aggregate of information collected from standardized personality profiles, self -reported personal history and a clinical interview.) • Lack of Flexibility: (Possible characteristics noted: Overly Cautious: Rigid: Demanding: Introverted: Socially Avoidant: etc.) Relevant Background History (Pace number of attached PHQ included): 1. License Suspension Page 8 Interview Demeanor: 1. Superficially presents as police. professional. and cooperati\e Citk#CMMhni: RFP 610384 Page 52 Final Rating: SUITABLE A "Suitable" rating is given to applicants with limited, if any, job -related risk factors concerning their ability to handle the applied for position. These applicants demonstrate a likely probability of successfully completing the selection process and performing their public safety job satisfactorily. Despite this rating. there may still be background material and areas of deficit requiring further scrutiny by the agency. Special Comment: Any deficit(s) noted in the "Job -Related Personality/Interpersonal Deficits" section of the report were determined after a review of the aggregate of information collected from the entire assessment. Deficits labeled as "Mild" to "Moderate" should be considered as potentially at risk job -related traits, but were not as strongly pronounced as a "Significant Deficit." Therefore, it is recommended that the agency further investigate/clarify these deficits to determine whether the applicant meets agency standards for final hire. To aid in process, using the Report Interpretation Manual located at www.lepca.com may be helpful. Overall, this applicant presents as polite, cooperative, and professional, reporting an unremarkable background, positive work history as a security officer for the past two years. and successful completion of his Bachelor's degree in Criminal Justice in 2016, graduating with Honors. His current standardized objective test profiles do not indicate any significant suitability concerns, and there are no indications for reckless, dangerous, or rule -breaking behavior. Although there are mild indications that he may be overly -cautious and rigid at times, he presented as much more relaxed and agreeable during the interview. He demonstrated positive self-awareness by commenting that at times he could improve on being more understanding with certain situations, but added that it has never interfered with occupational or interpersonal functioning. Ultimately, he appears eager and willing to learn, and the noted potential deficit will likely improve with continued experience, instruction. and training. It is recommended that the agency further investigate his background and further clarify and/or substantiate the deficit areas noted to determine whether he meets agency standards for final hire. EVALUATOR: Brian Mangan, Psy.D., ABPP Board Certified in Police & Public Safety Psychology. Licensed Psychologist Testing Assistants: Mayte Aponte enti is RFP 610384 Law Enforcement Psychological and Page 53 Counseling Associates, Inc. Pre -Employment Psychological Screening Report Post -Conditional Offer 2nd Phase CONFIDENTIAL NAME: John Doe SS#: xxx-xx-0000 AGENCY: Police Agency POSITION: Police Officer DATE OF TEST: 2015 Important Information: This psychological assessment and report is intended only for psychological suitability screening to identify potential risk factors, traits and attributes associated with satisfactory or below standard performance for the public safety position applied to. This applicant previously underwent the pre -offer psychological suitability evaluation and at least met the minimum standards of that evaluation. This psychological assessment should be one part of a comprehensive selection system and it is assumed that the hiring agency has properly conducted their own investigation and evaluation of the applicant's qualifications and suitability for the applicable law enforcement position. This included scrutiny into background events and areas of mild to moderate deficit that may have been identified in the applicant's pre -offer suitability report. Final ratings and any comments made in this report are based on this applicant's responses on a post -offer psychological test. a post -offer background questionnaire and a semi -structured interview focused on job relevant elements. Psychological ratings should be viewed in the context of probable risk and suitability and the hiring agency must decide upon employment standards and make final hiring decisions. • It is understood that this is post -offer testing and the hiring agency has provided the applicant a Conditional Offer of Employment per the Americans with Disabilities Act (ADA). • This assessment and report should not be considered valid for use after one year from date of testing. This report is intended for use solely by the referring agency and access to this report should be limited to relevant agency personnel and stored in a confidential medical file separate from other personnel information. • The following pages provide a summary of evaluation findings and a signed copy of the applicant's Personal History Questionnaire (PHQ). We recommend that the agency carefully review this questionnaire and rule out any possible discrepancies between information contained in this questionnaire vs. information collected by the agency. • If any discrepancies are discovered through investigation. this office should be contacted immediately with the information as it could potentially affect the overall final rating. • Should there be any further questions or need for clarification about an applicant's report. please feel free to contact our office. 9960 N.V.'. 1 16'17 Wa\ Suite 12 Miami. FL 3,3178 305-442-8800 ph. 305-442-4469 fax \a-\«w.-.lepca.com Cif &f : is RFP 610384 P&ge 54 Summary of Evaluation Results This applicant was referred by the POLICE AGENCY for a post -conditional offer of employment (COE) job -related psychological evaluation for the position of Police Officer. The applicant previously underwent the pre -offer psychological suitability evaluation as part of this selections process and at least met the minimum standards of that evaluation. The applicant was prompt for this appointment and before initiation of the evaluation, standard instructions were provided and an appropriate Consent Form was obtained (See pgs. 2-4 attached PHQ). The applicant was able to follow test directions and complete the evaluation without undue difficulty. The following standardized objective test instrument was administered: Personality Assessment Inventory- Police and Public Safety Selection Report (PPSSR) and a Semi -Structured Clinical Interview with a licensed psychologist trained in public safety selection was conducted. A final rating was determined after review of the aggregate of information gathered from all phases of the evaluation. The following job -relevant comments and details are provided to the report user to elaborate, as necessary, the reasons for this applicant's final rating and for additional agency investigation of specific events when required. This report was designed with careful consideration of HIPAA, ADA, GINA, and recent legal rulings pertaining to reporting job -related psychological evaluation findings to employers. The applicant's Personal History Questionnaire (PHQ) is attached as an additional reference source for the agency. For further clarification of an applicant's report, please feel free to contact our office. Validity Statement: Standardized objective test results demonstrated normal defensiveness and suggested that the applicant was able to self -disclose appropriately and answer questions without undue guardedness. The applicant responded in a consistent manner and evidenced a deliberate approach to the assessment. There are no clear indications of over- or underreporting of problems. Therefore, the results of this evaluation are likely an accurate representation of this applicant's personality functioning. Final Ratine: Based on the aggregate of information obtained from background information, a clinical interview and standardized psychological testing conducted Post -Conditional Offer of Employment, the following professional opinion is offered: This applicant MET the basic emotional stability standards for the position of Police Officer. Overall, this applicant presented as polite. cooperative, and forthcoming. Furthermore. current evaluation results are valid and interpretable, and did not identify a current psychological condition, mental health problem or substance abuse concern that would preclude this applicant from performing the usual and routine duties of the specific public safety position noted in this evaluation report. EVALUATOR: Brian Mangan. Psy.D.. ABPP Board Certified in Police & Public Safety Psyc•hologtr Licensed Ps\cholosist Testin2 Assistant: N.1n�te Aponte 1/4.) City of Miami: RFP 610384 Page 55 Law Enforcement Psychological & Counseling Associates, Inc. 9960 NW 116th Way, Suite 12 Medley, FL 33178 PERSONAL HISTORY QUESTIONNAIRE (PHQ) PUBLIC SAFETY CANDIDATES PRE -CONDITIONAL OFFER OF EMPLOYMENT (Phase 1 of Bifurcated Process) TODAY'S DATE: / / NAME: FIRST MI LAST HOME ADDRESS: TELEPHONE CONTACT #: ,AST 4 DIGITS of SS#: XXX - XX - DATE OF BIRTH: SEX (CIRCLE): M F AGE: MARITAL STATUS (CIRCLE): Single Married Divorced Separated HIGHEST DEGREE (CIRCLE): GED H.S. Associate Degree Bachelor's Degree Master's or Higher Please indicate any previous experience in: MILITARY PUBLIC SAFETY ETHNICITY: Caucasian ( ) African American ( ) Hispanic ( ) Haitian ( ) Amerindian ( ) Asian ( ) Other: specify AGENCY APPLYING TO: POSITION: Cop>right: 3'17 version. LEPCA Last Name. First Initial City of Miami: RFP 610384 Page 56 Please read the following consent form carefully. It contains a description of the evaluation, use of the results and other conditions relevant to this evaluation. PRE -OFFER PERSONALITY TESTING DISCLOSURE & INFORMED CONSENT STATEMENT 1. The public safety position for which you are applying requires that you undergo personality and psychological screening. A portion of this screening involves the assessment of normal traits and abilities and is being administered now. This is NOT an evaluation of your emotional stability, and any consultative rating that you are poorly suited at this time for the position should NOT be taken as an indication of your suitability, for any other position or of your mental health. Later, if you are given a conditional offer of employment, you will be required to undergo the final, qualifying portion of the screening, which will include an assessment of your job relevant mental health. Should you be hired, the findings of this evaluation may also be utilized during the training and probationary period of employment, to further assist the agency in understanding any performance problems you may be experiencing. 2. I understand this evaluation involves the administration of standardized personality instruments, a personal background questionnaire and a semi -structured interview with a licensed psychologist. As with any hiring procedures. I have the right to refuse this evaluation or terminate the evaluation at any time. However, I understand that refusal to complete this evaluation could have negative implications for my final hire as determined by the hiring agency. 3. I understand the usual confidentiality' and Doctor -Patient relationship between a psychologist and a client does not apply to this evaluation. This evaluation is not to provide me any treatment or healthcare. The purpose and use of this evaluation and its results are intended only for the hiring agency. Therefore, I acknowledge and authorize a written and/or oral record of findings of this evaluation be provided to the applicable hiring agency. This report will contain background information, any comments deemed relevant and a final consultative rating as to my suitability/risk for the position I am applying to. 4. 1 acknowledge and understand that the hiring agency makes the final determination as to my employment with that agency and determines the standards and psychological degree of suitability it requires for final hire. It is at the hiring agency's discretion and choice as to how much "weight" or importance it shall place on the psychological suitability report provided by the firm. Therefore, depending on the hiring agency's consideration and use of evaluation findings and consultative ratings. the results of this evaluation may have a significant impact on your ultimate hiring. 5. 1 understand this office will not provide me with a copy of my summary report, nor will my authorization automatically permit the release or disclosure of the results of this evaluation to any third party. Requests for a copy or review of my report should be made to the applicable agency for their consideration and approval. 6. For applicants who have undergone prior evaluations with this office or another mental health professional. prior records may be reviewed. When pertinent or requested by the applicable agency. I understand and authorize information be shared or released from prior my evaluation(s) to the hiring agency initiating this evaluation. 7. I understand that selection research including validity studies and test instrument development may be conducted using the test data from this evaluation. Published written results of such research will not include the identity of any indi%idua! applicants. This is \oluntarn and if l do not \rant to participate I will let the testing coordinating know. City of Miami: RFP 610384 Page 57 8. I require no special accommodation to complete this evaluation. I also confirm that there is no special reason why ellI can not take this evaluation today. If there is a circumstance that prevents me from undergoing this evaluation today, I will let the testing coordinator know immediately. 9. The firm will advise the hiring agency to limit access to my report to only relevant personnel within the selection process. Nevertheless, once my report is submitted to the hiring agency the firm cannot guarantee that the hiring agency will not disclose the report itself or information contained in the report to another party. By signing this authorization, I expressly release the fine and individual members of the firm from any liability for such disclosure. 10. I may revoke/cancel this consent at any time, except when action has been taken in reliance on this authorization. Unless revoked by me through a written request to the fine, this authorization will expire three years from the date of signing. 11. I understand that feedback from this firm regarding my pre -offer evaluation will not be provided to me. However, it is suggested that if I have future questions about this evaluation, re -reading this consent form and/or going to the "Applicant" section of the firm's website, at lepca.com, will address most questions. If I request a copy of this Consent Form, one will be provided. If I have any questions, I will let the testing coordinator or psychologist know now. I have read, understand and agree to all of the above conditions of this evaluation and consent to participate in the evaluation. Print Name Signature Date TESTING INSTRUCTIONS Please read these instructions very carefully. Following these instructions is a critical part of the evaluation process. The department you are applying to makes the final decisions in the selections process and will contact you directly to let you know if you will continue in the hiring process. Do not contact this office regarding the results. 1. The average applicant takes approximately 4-6 hours to complete the evaluation. Therefore, we would recommend completing the tests at a pace that would be natural and comfortable for you. 2. There is to be NO TALKING and NO CELL PHONE USE in the testing area once the testing process has begun (we will be collecting cell phones and tablets). We also require that applicants not discuss the contents of the tests among themselves. You may take rest breaks if desired. You may bring snacks and drinks to help you get through the testing if needed. Restrooms are available outside of the testing room. City of Miami: RFP 610384 Page 58 4. *Forms and test instruments are to be completed in the order they are placed in your folder. *The Personal History Questionnaire must be filled out completely and using a PEN only. if there is a section that doe not apply to you (i.e. military experience/public safety experience), please write N/A for "not applicable" at that section and move on to the next section. *When you complete all sections that apply, be sure'to sign and date the last page. *Please read CAREFULLY and follow the directions for each test instrument. Carefully fill out and bubble in all identifying information on Scantron forms using PENCIL only. Please darken in your answers and DO NOT MAKE ANY MARKS IN THE BOOKLETS. *There are 2 dictionaries located in the testing room in case you need to look up any words that you are not familiar with. We recommend that you use these resources as much as you need to in order to give an accurate representation of yourself. Very Important when filling out Scantron forms for only the tests that you find in your folder: CPI: Leave "Agency" and '`Last 5 Digits" blank STAXI: No Booklet; Leave "Agency' and "Last 5 Digits" blank; * STAXI ITEMS ON BACK OF SCANTRON PSSI: Leave "Grade" blank. Your "I.D. Number" is your Social Security #. *For "Codes" bubble in 01 if applying for Police/Trooper, 02 for Corrections/Detention, 03 for Firefighter. If you have questions regarding what should be bubbled in. please ask the Testing Coordinator, Try to answer all test items, however if you leave an item blank make certain that the number of the next answered question matches the number next to the answer box. 5. Please place your completed fonns. test booklets and answer sheets in the plastic basket on your desk as you finish each one. PLACING COMPLETED ITEMS LN THIS BASKET IS EXTREMELY IMPORTANT. 6. When you finish ALL the testing. any remaining materials in your basket should be placed in your folder and placed in the wire basket located in the back of the room. If you are still waiting to be interviewed by the psychologist. please have a seat in the room labeled "Applicant Waiting Room". REMEMBER: DO NOT leave the office until all remaining materials have been turned in and you have been interviewed by a psychologist. Print Name Signature Date City of Miami: RFP 610384 Page 59 AIV.VPORTANT: Filling out written forms correctly is an important function of being a public safety officer. Therefore, e ask that you follow all instructions and carefully read all questions. All of us have done some things in our past that we regret or perhaps wish we could change. Therefore, we ask that you answer the following questions in an honest and forthright manner. Please answer the items by circling Y (yes) or N (no) and where required filling in the necessary information. Should there be an item that you are uncertain how to respond, answer the best you can and an opportunity will be given in the interview for clarification. Except where specifically instructed otherwise, make sure you answer every question. You may notice that an answer of"Y" or "N" on one question could automatically mean an answer of "Y" or "N' on a subsequent question. In those situations, we still want you to answer the subsequent question "Y" or "N." For example, look now at questions 1-3 below. If you answer "N" to the 1st question on arrest history, you should still circle "N" on questions 2 and 3. Please be aware a copy of this questionnaire will be provided to the applicable public safety agency. so that the comprehensive Background Investigation can further review and verify the accuracy of the information you provide on this questionnaire. If this office becomes aware from any source that you omitted or distorted background information that is considered relevant to this evaluation, you understand that your final rating may be affected. **I have read the above and understand that if I deliberately withhold, falsify or otherwise provide misleading or incorrect information on this background form that my application for employment could be denied or terminated. Please Initial to Acknowledge Instructions: LEGAL HISTORY 1. Have you ever been arrested, or received a Promise to Appear (PTA), even if charges were dismissed or expunged? Y or N 2. Have you been arrested, or received PTA, more than 1 time. even if charges were dismissed Y or N or expunged? If yes, how many times? 3. Have you ever attended a court ordered pre-trial intervention program, pled guilty, no Y or N contest or been convicted of a criminal offense? If yes to any of above 3 questions, please provide following information: Yr: Charge: Outcome: Yr: Charge: Outcome: Yr. Charge: Outcome: 4. Have you ever been a member of a street gang? if yes. provide a brief explanation: Y or N 5. Have you ever been a member of or have associated with persons belonging to groups Y or N such as Ku Klux Klan. neo-Nazi. Skinheads. etc? 11-- yes. name of groups(s) and date(s) associated w ith group City of Miami: RFP 610384 Page 60 6. Have you ever used a fictitious name or someone else's identity for any illegal or Y or N dishonest purpose? If yes. provide a brief explanation: 7. Have you ever been questioned as a suspect in a crime but were never formally charged? Y or N If yes, please provide a brief explanation: 8. Since age 12, have you ever committed petty theft (i.e., taken something from a store Y or N without paying for it)? If yes, please provide a brief explanation: 9. Have you ever taken money that did not belong to you? (Other than small change you Y or N might have taken from a parent as a child) If yes, please provide a brief explanation: 10. Have you ever assisted anyone in stealing money or merchandise? If yes, please provide Y or N a brief explanation: 1 1. Have you ever been accused of stealing money? if yes, please provide a brief Y or N explanation: 12. Have you ever purchased or sold an item which may have been stolen? if yes, please Y or N provide a brief explanation: 13. Did you ever steal a part off a car (radio, tires, hub caps, antenna. etc.)? If yes, please Y or N 1/410,01 provide a brief explanation: 14. Did you ever use a vehicle without permission, to go joy riding? If yes, please provide a brief Y or N brief explanation: 15. Have you ever been a passenger in a vehicle. which you knew or suspected was stolen? If yes, Y or N approx. date(s) of occurrence: 16. Have you ever taken anything from someone else's residence without their permission? Y or N 1f yes, provide a brief explanation: 17. Have you ever filed or been accused of filing a false insurance claim? If yes, provide a brief Y or N exp lanation: 18. Have you ever stolen the services of a utility company (gas, water. power) or a cable Y or N company? If yes, provide a brief explanation: 19. Did you ever deliberately drive off without paying for gas? if yes, number of times Y or N 20. Have you ever obtained or been accused of receiving any government assistance illegally? Y or N If yes, provide a brief explanation: 1. Have you ever set fire to something maliciously? If yes. please provide a brief Y or N explanation: City of Miami: RFP 610384 Page 61 22. Have you ever committed a crime(s) without being caught? If yes, provide a brief explanation: Y or . N 23. Are you presently a plaintiff or defendant in a lawsuit? If yes, provide a brief explanation: Y or N 24. Since age 16. have you been in a fistfight or argument even I time, which involved physical Y or N contact and that was not job -related? 25. Since age 16, have you been in 2 or more fistfights or arguments which involved physical Y or N contact and that was not job -related? [f yes, total number Date of last occurrence 26. Have you been involved in a physical or verbal altercation when any type of weapon was involved? Y or N If yes, provide a brief explanation: 27. Have you ever been involved in a domestic violence incident with your spouse, another family member, roommate, boyfriend/girlfriend or significant other? (includes pushing/shoving) Y or N If yes, how many times? Approx. date(s) Provide a brief explanation including whether police were called: 28. Other than for a domestic violence incident, have you ever been involved in any other kind of domestic incident where the police were called? If yes, approx. date(s) provide a brief explanation: Y or N Has anyone ever requested or received a court ordered injunction against you for any behavior Y or N such as domestic violence or stalking behavior? If yes, provide a brief explanation: 30. Have you or your spouse, or any caretaker of your children ever used physical discipline that produced injuries, welts, or bruises on your children? If yes, please provide a brief explanation: Y or N 31. Have you ever been accused of child abuse, neglect or been referred to HRS (Child Protective Services)? If yes, provide a brief explanation: Y or N 32. Have you ever been accused or charged with cruelty to animals? If yes, please provide a brief Y or N explanation: 33. Have you ever been accused of stalking or making threats of physical harm towards your spouse or romantic partner? if yes. please provide a brief explanation: Y or N City of Miami: RFP 610384 Page 62 DRIVING HISTORY 34. Have you received a moving violation in the last 24 months? 35. Have you received 2 or more moving violations in the last 24 months? 36. Have you received 5 or more moving violations in your lifetime? If yes, number or range Y or N Y or N Y or N 37. Have you received 7 or more total traffic tickets in your lifetime? (do not include parking tickets) Y or N If yes. exact number or range 38. Have you ever been involved, whatsoever, in street drag racing? Y or N 39. Have you received 3 or more parking tickets in the past 12 months? If yes. How many Y or N 40. Have you ever had more than $100.00 in unpaid parking tickets? Y or N 41. Do you currently have unpaid traffic tickets of any kind? Y or N 42. Have you had 2 or more vehicle accidents with over $1,000 dollars of damage? Y or N If yes, total number 43. Do you own or operate any vehicles on which you have no insurance? If yes, please provide a brief explanation: 44. Have you had 2 or more car accidents where you were at fault? If yes, provide a brief explanation: 45. Have you ever been sued as a result of a vehicle accident? If yes, please provide a brief explanation: _ Y or N Y or N L/ Y or N 46. Were you ever the driver in a vehicle accident after consuming any amount of alcohol or an Y or N illicit drug within the previous 3 hours? if yes, provide a brief explanation: 47. Has your driver's license ever been suspended? If yes. number of times _ Approx. date(s) Y or N and reason for suspension(s): 48. Has your driver's license ever been suspended for excessive points? Y or N 49. Have you ever driven a vehicle with a suspended license? Approx. date of last occurrence Y or N 50. Have you ever been refused a driver's license by any state? If yes. please provide a brief explanation: Y or N 1/4.) City of Miami: RFP 610384 Page 63 DRUG HISTORY If you have ever used any illegal substances such as marijuana. cocaine, hashish, ecstasy, steroids, LSD -Acid, etc., please provide the requested information below: SUBSTANCE: YEAR OF LAST USAGE: 51. Other than work related duties, have you knowinvly been around illicit drugs in the past 12 months? Y or N 52. Have you ever experimented with marijuana, whatsoever, even if only 1 time? Y or N 53. Have you ever experimented with cocaine or crack cocaine, whatsoever. even if only 1 time? Y or N 54. Have you experimented with any other illicit drug(s) i.e., steroids, LSD -Acid, ecstasy, Y or N hashish. etc.. whatsoever, even if only 1 time? 55. Have you used marijuana or any other illicit drug. whatsoever, in the last 12 months? Y or N Approximate date of last occurrence 6. Have you ever held illegal drugs for anyone? If yes, please provide a brief explanation: Y or N 57. Have you ever purchased marijuana or any other illicit substance for your personal usage? Y or N If yes, please provide approximate date of last occurrence 58. Have you ever provided or supplied marijuana or any other illicit drugs for other persons, such as friends, even if you received no money? If yes, please provide a brief explanation: Y or N 59. Have you ever used marijuana or any other illicit drug with no one else present? Y or N 60. Have you ever sold or exchanged marijuana or any other illicit drugs for monetary gain or to Y or N acquire something you wanted? If yes, provide approximate date of last occurrence: 61. Has anyone ever given you money, to purchase marijuana or any other illicit drugs for them? Y or N If yes. please provide approximate date of last occurrence: 62. Have you ever driven a vehicle even I time, after having used marijuana or any other illicit Y or N drug in the previous 4 hours? If yes. please provide approximate date of last occurrence: 63. Have you ever reported to work even 1 time after having used marijuana or an other illicit drug Y or N in the previous 8 hours? If yes. what was the drug(s) used and date of last occurrence: City of Miami: RFP 610384 64. Do you smoke cigarettes or use any other tobacco products? If yes, for how long and how many per day? 65. Have you ever used a fake I.D. to obtain alcohol? If yes, please provide approximate date of last occurrence : 66. Have you ever bought alcohol for or sold alcohol to a minor? If yes, please provide approximate date of last occurrence : 67. In your lifetime, have you ever driven a vehicle even 1 time after having consumed 4 or more alcoholic beverages in the previous 3 hours? If yes, approx. date of last occurrence JOB HISTORY 68. Please list the information for all jobs held for the past seven years from most recent job first: Employer: Job Position: Length of Employment: From: To: Reason for Dismissal/Leaving Employer: Job Position: Length of Employment: From: To: Reason for Dismissal/Leaving Employer: Job Position: Length of Employment: From: To: Reason for Dismissal/Leaving Employer: Job Position: Length of Employment: From: To: Reason for Dismissal/Leaving Employer: Job Position: Length of Employment: From: To: Reason for Dismissal/Leaving Page 64 Y or N Y or N Y or N Y or N 69. Have you ever been fired or forced to resign from a job? ** Include any jobs you may have left Y or N while under investigation. If job is not already listed in above history, please provide brief explanation: City of Miami: RFP 610384 Page 65 70. Have you been fired or forced to resign from two or more jobs? Include any jobs you may have Y or N left while under investigation. If yes, how many 71. Have you been fired or forced to resign from a job in the past 24 months? Include any jobs you Y or N may have left while under investigation. 72. Other than when a full-time student or for child rearing, have you ever been unemployed Y or N for a period of 6 months or longer? 73. Has the longest full-time job you have ever held, been less than 2 years? Y or N 74. Other than jobs where you were terminated, are there any other employers that you believe Y or N would not consider you for rehire or provide you a positive reference? If yes, provide name of employer(s) and your job position: 75. Have you ever worked "off the books' for an employer where you did not pay income tax Y or N and/or were paid in cash? If yes, how many times and please provide a brief explanation: 76. Have you ever taken unauthorized merchandise from an employer? (excluding Y or N a petty item such as a pencil or pen) If yes, number of times _approx. date(s) what did you take 77. Have you ever taken unauthorized money of any amount from an employer? If yes, number of Y or N times approx. date(s) of last occurrence amount taken 8. Have you ever been aware of thefts by co-workers and you did not report it? If yes, please Y or N provide a brief explanation: 79. Have you ever deliberately damaged or broken any merchandise or property belonging to an Y or N employer? if yes, provide a brief explanation: 80. Have you had any unscheduled absences at work over the last 12 months due to car Y or N trouble, weather, family problems or emergencies? How many 81. Have you ever applied for unemployment insurance and been turned down? Y or N 82. In the last 12 months did you ever call in sick when you were well enough to work? If yes, Y or N number of times: 83. Have you ever helped anyone steal merchandise or money from an employer? If yes. Y or N please provide a brief explanation: 84. Have you ever used an employer's telephone for personal long distance calls without permission? Y or N If yes. number of times: 85. Have you ever been counseled at work for unauthorized use of a telephone or computer? Y or N (i.e.. sending personal e-mails) If yes. please provide a brief explanation: efts City of Miami: RFP 610384 Page 66 86. Have you been late to work, even if by only a few minutes, 3 or more times in the last twelve Y or N months? If yes, approx. number of times: 87. Have you ever been counseled or reprimanded for being late or missing many days of work? Y or N If yes, provide a brief explanation: 88. Have you ever been counseled or reprimanded by your employer/supervisor for Y or N unsatisfactory performance on a job? If yes, number of times _ approx. date(s) reason(s) 89. Have you ever gotten into arguments with co-workers or supervisors at work, where you raised your voice or used insulting language? If yes, number of times approx. date(s) Briefly describe nature of argument(s) 90. Have you ever had a physical altercation at work (includes pushing. shoving) with a co-worker or supervisor? If yes, number of times _ date(s) briefly describe reason for fight(s) Y or N Y or N 9 I . Have you ever had an argument at work with a co-worker or supervisor that you feared might Y or N become physical? 92. Have you ever been accused or had a complaint filed against you alleging insensitive or inappropriate behavior against women, minorities, or homosexuals? If yes, provide a brief explanation: 93. Have you ever had a serious personality conflict with a co-worker or supervisor at work? 94. Have you changed jobs 2 or more times in the last 3 years? 95. Have you ever been accused of sexual harassment by any co-worker or has anyone ever filed a sexual harassment complaint against you? If yes, provide a brief explanation: 96. Do you sometimes make jokes or negative comments at work about women, minorities, or other protected groups (such as homosexuals, transgender people)? 97. Have you ever filed a lawsuit or other legal action against an employer? if yes, provide a brief explanation: 98. Have you ever applied for or received Workers' Compensation? If yes, please provide a brief explanation: 99. Have you had 2 or more work related accidents? If yes, please provide a brief explanation: 100. Have you ever gotten into any trouble at a job. even if you were not terminated? If )es. provide a brief explanation: 101. If ou have never had supervisory duties on a job. please circle the "Y- to the right. Y or N Y or N Y or N Y or N Y or N Y or N Y or N Y or N Y or N Y L) L) City of Miami: RFP 610384 Page 67 102. Have you ever applied for a public safety position and/or self -sponsored academy and falt not been selected? If yes. please provide ONLY the department(s) and/or academy and year of non -selection: Y or N ITEMS 103 -124 TO BE COMPLETED ONLY BY APPLICANTS WITH PUBLIC SAFETY EXPERIENCE (i.e., Police Officer, Deputy Sheriff, Trooper, Correctional/Detention Officer, Detention Deputy, Detention Technician, Detention Aide, FirefiEhter, etc.) Please complete items 103 —124 as it applies to your Public Safety Position experience: 103. Have you ever received an unsatisfactory performance evaluation while a public safety officer? If yes, please provide a brief explanation: Y or N 104. As a public safety officer. (to your knowledge) have any citizen complaints been filed Y or N against you? if yes, how many? 105. Were any of these complaints sustained? If yes, please provide a brief explanation: Y or N 106. Did any of these complaints involve excessive use of force? If yes, how many? Y or N 107. Were any of these excessive use of force complaints sustained? If yes. how many? Y or N If yes, please provide a brief explanation: 108. Have you ever received any written reprimands? If yes, how many? Y or N If yes, please provide a brief explanation: 109. Have you ever planted evidence on a person or place? If yes, please provide a brief Y or N explanation: 110. Have you ever been accused or investigated for planting evidence? If yes, please provide Y or N a brief explanation: 1 11. Have you ever kept property, illicit drugs or money from any search. crime scene, Y or N accident scene or dead person? If yes. please provide a brief explanation: 112. Have you ever falsified anything on a police report or affidavit? if yes. please provide a brief explanation: Y or N City of Miami: RFP 610384 Page 68 113. Have you ever been accused or investigated for falsifying a police report. Y or N affidavit or giving false statements during an official departmental investigation or court related matter? If yes, please provide a brief explanation: 114. Have you ever resigned from a law enforcement position to avoid termination and/or as part of an agreement/settlement with the department? If yes, provide a brief explanation: 115. Other than for a complaint already noted, have you ever been the subject of an internal affairs investigation for any reason? If yes, please provide a brief explanation: 116. Have you ever been suspended from duty? If yes, please provide a brief explanation Y or N Y or N Y or N 117. Since becoming a public safety officer, have you ever used any illegal drugs, whatsoever? Y or N If yes, provide approximate date of last occurrence: 1 18. As a public safety officer, did you ever drink alcohol while on duty without authorization? Y or N If yes, please provide approximate date of last occurrence: 119. As a public safety officer have you had 3 or more on -duty traffic accidents? (regardless of who was at fault) If yes, approximate number Y or N 120. Have you ever been involved in any duty related shooting? If yes, number Y or N 121. Have you ever been terminated or forced to resign from a public safety position? Y or N (Even if reinstated) If yes, please provide a brief explanation: 122. Are you presently or have you ever been a plaintiff or defendant in any lawsuit related to your work activities? If yes, please provide a brief explanation: Y or N 123. List all the public safety agencies you have worked for, approximate date of employment and reason(s) for leaving. 124. If you are applying for the same public safety position you currently hold, please briefly state why you want to work at a different agency? City of Miami: RFP 610384 Page 69 FINANCIAL HISTORY 125. Have you ever declared bankruptcy, had serious credit problems, or do you currently have any Y or N accounts in collections? If yes, please provide a brief explanation: 126. Have you been turned down for a loan in the past 24 months. due to a low credit score? Y or N 127. Do you currently have an educational loan (school loan) that you are behind on the payments? If yes, please provide a brief explanation: Y or N 128. If married, do you have any asset accounts (including checking accounts, savings accounts, cash funds, real estate property, deeds of trust, certificates of deposit, etc.) that are unknown to your spouse? If yes, please provide a brief explanation: Y or N 129. Do you have any credit cards in your name of which your spouse is unaware? (Purpose of this private account?) If yes, please provide a brief explanation: Y or N 130. Have you ever pawned any merchandise? If yes, how many times Y or N 131. Have you written a check in the past 12 months that bounced? Y or N If yes, how many? Did you cover the check? Circle Y or N 2. Have you ever written checks, used credit cards, gas cards. phone cards without the Y or N owner's permission? Please explain: 133. Have you ever been taken to court due to a debt or a bill? If yes. please provide a Y or N brief explanation: 134. Have you ever failed to file an income tax return for any year, which one was required? If yes. Y or N provide a brief explanation: 135. Do you currently owe the IRS money for past due taxes? If yes, how much do you owe Y or N 136. Have you ever been evicted from your place of residence due to nonpayment of rent? Y or N If yes, date(s): 137. Have you ever had any property items (car, house etc.) repossessed by or turned into a bank Y or N or finance company? If yes, please provide a brief explanation: 138. Do you currently have more than $7.000 dollars of credit card debt? If yes. amount Y or N 139. In the past 12 months, have you had to borrow money from someone to pay your monthly bills? Y or N 140. Do you owe an ex-spouse/romantic partner. any past due mone. for child support? Y or N If ,)es. provide explanation: City of Miami: RFP 610384 Page 70 141. Has an ex-spouse/romantic partner ever initiated a court action against you to collect past due Y or N child support? If yes, what was the outcome: 142. Have you had other people tell you that you have to learn to handle your finances better? Y or N GAMBLING HISTORY 143. Do you gamble on sporting events, horse races, cards, in casinos, etc. 2 or more times a month? Y or N 144. Have you placed a bet on something in the past 6 months? Y or N 145. Have you placed a bet on something in the past 30 days? Y or N If yes, what did you bet on Amount of bet 146. Have you ever been involved in illegal gambling? If yes, please provide a brief Y or N explanation: 147. Have you ever borrowed money to gamble? How much and from whom: 148. Do you typically spend more than $25.00 a week buying Florida lottery tickets? 149. Do you have any gambling debts now? Approximate amount: 150. Have you gambled more than $200 dollars in 1 week during the past 12 months? 151. Have you gambled more than $500 dollars in 1 month during the past 12 months? 152. Have you placed a bet on one event that was $100 dollars or more in the past 12 months? If yes, how much did you bet: what did you bet on: Y or N Y or N Y or N( Y or Nei Y or N Y or N 153. Has anyone ever considered your gambling to be a problem? Y or N 154. Do you think your spouse/significant other would be surprised to find out how Y or N often you gamble and/or the amount of money you gamble? 155. Have you ever argued with your spouse/significant other or anyone else regarding your gambling? Y or N 156. Has there been a period of your life where you gambled more than you do now? If yes, provide a brief explanation: Y or N 157. In your lifetime. have you ever been in anv kind of trouble, whatsoever. due to your gambling? If yes. please provide brief explanation: Y or N L) City of Miami: RFP 610384 Page 71 EDUCATIONAL HISTORY 158. In school, did you ever have to repeat a grade? If yes, please provide a brief explanation: Y or N 159. In High School. did you ever attend summer school because of low grades? Y or N 160. Did you drop out of high school or leave high school early and receive a GED? Y or N 161. Did you attend an alternative High School in order to receive your High School diploma? Y or N 162. Did you ever fail a state required educational test like the FCAT, any part at any time? Y or N 163. Did you ever receive a report card in High School, where you had less than a Y or N C in either English or Math? 164. Have you ever been suspended (indoor or outdoor) from High School due to your behavior? (skipping, fighting. etc.) If yes, please provide a brief explanation: Y or N 165. Have you ever been expelled from a school? If yes. please provide a brief explanation: Y or N 166. Did you graduate High School with less than a C+ (2.3 GPA) average? Y or N eilt7. Do you know or believe that you graduated High School in the bottom half of your class? Y or N . 168. Have you ever attended more than two colleges or universities without receiving a degree? Y or N 169. Have you ever been suspended or dismissed from college because of low grades or poor Y or N academic performance? 170. Please list any public safety academy experience by indicating name of academy attended and graduation date if applicable: 171. Did you ever attend a law enforcement training academy and did not pass a state certification Y or N examination on the first try? Name of academy: 172. Were you ever dismissed or quit attending a law enforcement academy due to a low grade(s) Y or N on a test? If yes, name of academy Date you left 173. Please list college level degree(s) you have received (name of school, type of degree, major, and date of graduation): 174. If no degree completed. how many college credits did you complete and where? eiN City of Miami: RFP 610384 Page 72 SEXUAL HISTORY 175. Have you ever been in trouble for or been accused, whatsoever, of sexual misconduct? (i.e., accused of molestation, date rape, sexual assault, indecent exposure. peeping Tom behavior or any other sex offense) If yes, please provide a brief explanation: Y or N 176. Since you have been 18 years of age have you had any sexual involvement with a person 15 years old or younger? If yes, please provide a brief explanation: Y or N 177. Have you ever committed a sex act in a public place or in open public view? Y or N If yes, please provide a brief explanation: 178. Have you ever solicited or used the services of a prostitute? If yes, please provide a brief Y or N explanation: 179. Have you ever paid for any type of sex act? If yes, please provide a brief explanation: Y or N 180. Have you ever received money or gifts for providing sexual services? If yes, please provide a Y or N brief explanation: 181. Have you ever accessed a pornographic Internet site from a computer at work, even if you use your own personal computer on the job? If yes, provide a brief explanation: 182. Have you ever used the Internet to post or send a picture of yourself to someone other than your spouse/romantic partner that could have been considered sexually provocative in nature? If yes, please provide a brief explanation: Y or I'Lred Y or N 183. Have you ever used the Internet. magazines. movies or other media to view child pornography? If yes. please provide a brief explanation: Y or N 184. Have you ever bought. ordered, obtained, used or sold any sort of child pornography? Y or N If yes, please provide a brief explanation: 185. Have you ever made obscene phone calls of a sexual nature? If yes. please provide a brief Y or N explanation: 186. Have you ever had sex in the workplace or while on duty? If yes. please provide a brief Y or N explanation: 181. Do .ou spend on a+erage 2 or more hours per ++eek +ie+king porno�_raphin ma_azines. or \ ideos. the Internet. etc.'' If +e<. number of hours 1/441101) City of Miami: RFP 610384 Page 73 Has your spouse/romantic partner or anyone else ever complained to you about your viewing of pornography? If yes, please provide brief a explanation: Y or N 189. Other than your spouse/romantic partner, have you ever taken a photo or video of anyone in the Y or N nude? If yes, provide a brief explanation: 190. Have you gone to a strip club 5 or more times in the past 12 months? If yes, approx. number of times Y or N WEAPONS HISTORY ** Complete items 191 - 195 only if you currently own firearms, otherwise skip to item 196: 191. Do you currently own 4 or more firearms? If yes. number of firearms Y or N 192. Do you own any firearms that would be considered an assault weapon? If yes, please Y or N describe the weapon(s): Number you own 193. Do you store your firearm(s) and ammo in some place other than a lockbox or safe? If yes, Y or N please briefly describe how you store your firearm(s) and ammo? 194. Do you keep any firearms in your home loaded with easy access? 1f yes, please describe type of firearm and location you keep it 195. Briefly state why and for what purpose you own a firearm: Y or N **itiric*****ir********9eir**********nr**************e't*dr**ir*ie*******A***********fie*****ieir**** 196. Have you ever had any accidents or accidental discharges using a fireann? If yes, please provide a brief explanation: Y or N 197. Other than for legitimate job related duties (i.e.. public safety. military combat) have you ever pointed a firearm at someone? If yes. provide a brief explanation: Y or N 198. Have you ever lost a firearm? If yes. please provide brief explanation: Y or N 199. Hare you ever had an unauthorized or illegal firearm in our possession? If yes. pro\ ide a Y or brief explanation: City of Miami: RFP 610384 Page 74 200. To your knowledge. have you ever given or sold a firearm to someone which was later used in a Y or N crime? if yes, please provide a brief explanation: 201. Did you ever have a gun permit denied or revoked? If yes, please provide a brief explanation Y or N 202. If you have not undergone some type of formal training or class in gun safety, please circle -Y." Y If yes, why haven't you attended such training MILITARY HISTORY (if applicable) Branch of military service: Dates of military service: Primary' Military Occupation: Final Rank at Discharge or Current Rank: 203. Did you receive any disciplinary' action(s) whatsoever while a member of the armed forces? If yes, please brief explanation: Y or N 204. While in the military, did you ever receive a reduction in rank? Y or N 205. Did you leave the service before you completed your full term of enlistment? (other than Y or N routine early out or troop reduction program) if yes, provide a brief explanation: 206. If in the service did you receive less than a full honorable discharge? If yes. please provide a brief explanation: Y or N 207. Did you serve in an overseas combat operation? If yes, please provide a brief explanation: Y or N City of Miami: RFP 610384 Page 75 SUPPLEMENTAL SECTION eisN Who do you currently live with and what is the relationship: 208. Have you been divorced 2 or more times? Y or N 209. Has any immediate family ever been in trouble with the law (other than traffic violations)? Y or N 210. To your knowledge, do you have any immediate family members, significant others or close Y or N friends currently involved in any criminal activities or an inmate in a correctional facility? 211. While growing up was your family life often unstable with many family conflicts? Y or N 2 12. Did you ever witness physical violence between your parents or primary caretakers? Y or N 213. Do you have 5 or more tattoos? [f yes, exact or approx. number? Y or N 214. Has anyone ever commented to you that any of your tattoos are frightening or might be Y or N insulting to a particular group of people? if yes, please describe the tattoo(s) in question: 215. Do you have any visible Tattoos, if you wear shorts or a short sleeve Shirt? if yes, briefly Y or N describe Tattoo(s): 16. Are you currently experiencing any life event that you believe may potentially distract you from Y or N the responsibilities and obligations of the position you are applying to? (including family conflict. financial or legal concerns. etc..) 217. if you have received professional advice or training about how to take a psychological evaluation, please provide a brief explanation: What motivates you to apply for this position? City of Miami: RFP 610384 Page 76 **I have answered all questions honestly, carefully and to the best of my ability. I consent and understand that the 1/401600 information I provided may be used to assist in determining my application/employment status. I further understand that any intentional misstatements, incomplete information or false information could result in the denial or termination of my application. Print Name Signature Date Do not complete below this line until asked to do so after the interview TO BE COMPLETED AFTER INTERVIEW WITH PSYCHOLOGIST: [ have been given the opportunity to discuss and address all relevant background related information and do not have any additional information that I would like to discuss at this time. I have answered all the interviewer's questions honestly and completely. Moreover, I believe all my questions have been addressed at this time. Signature Date eiN City of Miami: RFP 610384 Page 77 Law Enforcement Psychological & Counseling Associates, Inc. 9960 NW 116`h Way, Suite 12 Medley, FL 33178 PERSONAL HISTORY QUESTIONNAIRE (PHQ) PUBLIC SAFETY CANDIDATES POST -CONDITIONAL OFFER OF EMPLOYMENT (Phase 2 of Bifurcated Process) TODAY'S DATE: NAME: FIRST MI LAST HOME ADDRESS: TELEPHONE CONTACT #: LAST 4 DIGITS of SS#: XXX - XX - DATE OF BIRTH: / / SEX (CIRCLE): M F AGE: MARITAL STATUS (CIRCLE): Single Married Divorced Separated HIGHEST DEGREE (CIRCLE): GED H.S. Associate Degree Bachelor's Degree . Master's or Higher ETHNICITY (Please check all that apply): Caucasian ( ) African American ( ) Hispanic ( ) Haitian ( ) Amerindian ( ) Asian ( ) Other: (specify) AGENCY APPLYING TO: POSITION: Copyright: 3'18 Version. LEPCA Last Name. First Initial City of Miami: RFP 610384 Page 78 Before beginning the evaluation, we ask that you carefully read and sign the following consent form. It provides a description of the evaluation, use of the results and other conditions relevant to this evaluation. STATEMENT OF UNDERSTANDING AND INFORMED CONSENT Between Law Enforcement Psychological and Counseling Associates (LEPCA) and Examinee 1. I understand this pre -employment psychological evaluation is required by and part of the selection process for employment with the agency I am applying to. This evaluation is being conducted on that agency's request and for their sole use. As a result, the agency is the client of record. This evaluation is Post -Conditional Officer of Employment (COE) per the Americans with Disabilities Act (ADA) and you should have already received a COE from the hiring agency. The only purpose of this evaluation is to assess my psychological suitability and potential risk factors for the applicable position. The hiring agency will notify me of my results. Therefore, I will not contact the LEPCA office for my results. 2. I understand this evaluation involves the administration of standardized psychological instruments, a personal background questionnaire and a semi -structured interview with a licensed psychologist trained in public safety assessment and screening. Some of the written and interview questions by necessity relate to private and protected healthcare information and I understand the importance of answering questions honestly. As with any hiring procedure, I have the right to refuse this evaluation or terminate the evaluation at any time. However, 1 understand that refusal to complete this evaluation could have negative implications for my final hire as determined by the hiring agency. 3. The Genetic Information Nondiscrimination Act of 2008 (GINA), is an Act of Congress in the United States designed to prohibit the use of genetic information in health insurance and employment. As such, during this screening process, LEPCA will not request or require any protected genetic information, which directly includes family medical information. such as the manifestation of a disease or disorder in family members. 4. I understand the usual confidentiality and Doctor -Patient relationship between a psychologist and a client does not apply to this evaluation. This evaluation is not to provide me any treatment or healthcare. Therefore, I acknowledge and understand that a written and/or oral record of findings of this evaluation shall be provided to the applicable agency. The report could include job relevant protected healthcare information such as drug usage and alcohol habits. Moreover, this report will contain background information, along with comments deemed relevant and consultative ratings as to my suitability/risk for the position I am applying to. 5. I further understand that a separate form regarding Authorization to Use and Disclose Protected Healthcare Information (PHI) is contained in this packet (Page 4) for my review and signature. Should I choose not to sign the authorization to release protected healthcare information, the evaluation will not be conducted. If the findings of this evaluation are challenged in an adjudicative procedure, the firm may make full disclosure as may be necessary or required by law. 6. I acknowledge and understand that the hiring agency makes the final determination as to my employment with that agency and determines the standards and psychological degree of suitability it requires for final hire. It is at the hiring agency's discretion and choice as to how much "weight" or importance it shall place on the psychological suitability report provided by the firm. Therefore. depending on the hiring agency's consideration and use of LEPCA's findings and consultative ratings the results of this evaluation may ha\e a significant impact on ultimate hiring.. City of Miami: RFP 610384 Page 79 eS. I understand that selection research including validity studies and test instrument development may be conducted using data from this evaluation. Published written results of such research will not include the identity of any individual applicants. This is voluntary and if I do not wish to participate I will let the testing coordinator know. 8. This evaluation is being conducted solely to assist the hiring agency in determining my suitability for hire. Regardless of who makes payment for this evaluation, the hiring agency is the client of record and sole user of the report. As a result, my authorization will not permit LEPCA to release my report to me or any third party. Therefore, I understand that requests for a copy of my report or any other data produced by this evaluation should be made to the hiring agency for their consideration. 9. If I have undergone prior mental health treatment or psychological evaluations with another healthcare provider, I may be requested to sign an additional release of information for LEPCA to obtain and review those records. I understand my refusal to provide this authorization may result in LEPCA being unable to complete my evaluation. If a prior evaluation of me was conducted by LEPCA. I understand and acknowledge that LEPCA may review the record of that evaluation. I understand and agree that any relevant information from past treatment or evaluations may be commented on in my report to the agency. 10. If it is anticipated or known that I will be undergoing a pre -employment psychological evaluation within the next six months. then feedback about my evaluation results, verbal or otherwise, will not be provided by LEPCA to me. 11. The firm will advise the hiring agency to limit access to my report to only relevant personnel within the selection process. Nevertheless, once my report is submitted to the hiring agency the firm cannot guarantee that the hiring agency will not disclose the report itself or information contained in the report to another party. By signing this authorization, 1 expressly release the fine and individual members of the firm from any liability for such disclosure. 12. 1 understand that if hired, during training and probationary phases of employment a member of this firm when requested by the hiring agency may discuss my evaluation results with an agency official. 13. I require no special accommodation to complete this evaluation due to any handicap and/or disability. I also confirm that there is no special reason (illness, etc.) why I can not take this evaluation today. If there is a circumstance that prevents me from undergoing this evaluation today, I will let the testing coordinator know immediately. If I have any questions, I will let the testing coordinator or psychologist know now. I have read, understand and agree to all of the above conditions of this evaluation and consent to participate in the evaluation. Print Name Signature Date n**If you request a copy of this Consent Form, one will be provided to you City of Miami.: RFP 610384 Page 80 Authorization To Use And Disclose Protected Healthcare Information (PHI) I authorize Law Enforcement Psychological & Counseling Associates, Inc. and its agents (referred to as "LEPCA") to use and disclose findings and opinions concerning my past, present or future physical or mental health condition, as well as ratings, recommendations and comments as to my psychological suitability for the position I have applied for, to a designated representative of the referral agency for this evaluation. l further authorize LEPCA to disclose any relevant information from my evaluation to an agency representative during my training phases of employment. should I experience performance problems and remedial measures are being considered. This authorization does not further authorize any of my prior or current health care providers to disclose my healthcare records to LEPCA, without a separate authorization signed by me to release such records. I understand that the information disclosed to the agency may contain information of the type listed below. By placing my initials on the appropriate space below, I understand and agree that such information may be disclosed. If I choose to refuse disclosure of this type information. then the evaluation will not be conducted and the referring agency will be notified accordingly. I further understand that this refusal may have a negative impact on my job application, as determined by the agency. I hereby release LEPCA from any and all liability, or negative consequences resulting from my refusal to disclose this information: (Please initial to consent) Mental Health Information (you must initial this for evaluation to be conducted) Alcohol/Drug diagnosis or treatment (you must initial this for evaluation to be conducted) I understand the following: 1. LEPCA will make a good faith effort to only release that private information. which is relevant and necessary to address the purpose of the evaluation and to support the findings and ratings contained in the report. 2. LEPCA will advise the agency to store my report in a confidential medical file separate from other personnel materials. and to make this information available only to those with a genuine reason to know. However, LEPCA cannot take responsibility or control how an agency will ultimately use the report and/or possibly release this report to another party. I hereby release LEPCA from any and all liability that might arise from an agency's misuse or unauthorized disclosure of information. 3. l understand that I will not receive a copy of my report from LEPCA. and will not have the authority to compel LEPCA to release my report to any other party or third person. 4. I do not have to sign this authorization. However, refusal shall result in the evaluation not being conducted, and at the agency's discretion, may have a negative impact on my employment application. If I do not sign this authorization form, I hereby release LEPCA from any and all liability from negative actions that may result from this decision. 5. You may revoke this authorization at any time by sending written notice to: Law Enforcement Psychological and Counseling Associates, Inc.. 9960, NW 1 I6'h Way. Suite 12, Miami, FL 33178 Any disclosures or use of your report made before this notice cannot be withdrawn or undone. I have carefully read this authorization form and I understand it. Unless revoked, this authorization shall expire three years from the date signed below. Signature of Applicant Signature of Witness (OFFICE) Date Printed Name of Applicant Date Printed Name of Witness City of Miami: RFP 610384 Page 81 TESTING INSTRUCTIONS Please read these instructions very carefully. Following these instructions is a critical part of the evaluation process. **The department you are applying to makes the final decisions in the selections process and will contact you directly to let you know if you will continue in the hiring process. Do not contact this office regarding the results. 1. The average applicant takes approximately 1-2 hours to complete the Phase-2 evaluation. Therefore, we would recommend completing the tests at a pace that would be natural and comfortable for you. 2. There is to be NO TALKING and NO CELL PHONE USE in the testing area once the testing process has begun (we will be collecting cell phones and tablets). We also require that applicants not discuss the contents of the tests among themselves. 3. You may take rest breaks if desired. You may bring snacks and drinks to help you get through the testing if needed. Restrooms are available outside of the testing room. 4. *Forms and test instruments are to be completed in the order they are placed in your folder. *The Personal History Questionnaire must be filled out completely and using a PEN only. If there is a section that does not apply to you (i.e. military experience/public safety experience), please write N/A for -not applicable" at that section and move on to the next section. *When you complete all sections that apply, be sure to sign and date the last page. *Please read CAREFULLY and follow the directions for each test instrument. Carefully fill out and bubble in all identifying information on Scantron forms using PENCIL only. Please darken in your answers and DO NOT MAKE ANY MARKS IN THE BOOKLETS. *There are 2 dictionaries located in the testing room in case you need to look up any words that you are not familiar with. We recommend that you use these resources as much as you need to in order to accurately represent yourself. Very Important when filling out Scantron forms for only the tests that you find in your folder: PAI: Leave "Agency" and "Last 5 Digits" blank If you have questions regarding what should be bubbled in, please ask the Testing Coordinator. Try to answer all test items, however if you leave an item blank make certain that the number of the next answered question matches the number next to the answer box. 5. Please place your completed forms. test booklets and answer sheets in the plastic basket on your desk as you finish each one. PLACING COMPLETED ITEMS IN THIS BASKET IS EXTREMELY IMPORTANT. rs City of Miami: RFP 610384 Page 82 6. When you finish ALL the testing. any remaining materials in your basket should be placed in your folder and placed in the wire basket located in the back of the room. If you are still waiting to be interviewed by the psychologist, please take a seat in the room labeled "Applicant Waiting Room". REMEMBER: DO NOT leave the office until all remaining materials have been turned in and you have been interviewed by a psychologist Print Name Signature Date Filling out written forms correctly is an important function of being a public safety officer. Therefore, we ask that you carefully read all questions and answer each one with honest and complete information. * Please remember, following instructions is a part of this evaluation. Please answer the following items by circling Y (yes) or N (no) and where required filling in the necessary information. Should there be an item where you are uncertain how to respond, answer the best you can and an opportunity will be given in the interview for clarification. A copy of this questionnaire will be provided to the applicable public safety agency, therefore we remind you to be truthful when answering all items. If this office becomes aware from any source that you omitted or distorted background information that is considered relevant to this evaluation, you understand that your final rating may be affected. **1 have read the above and understand that if 1 deliberately withhold, falsify or otherwise provide misleading or incorrect information on this background form that my application for employment could be denied or terminated. Please Initial to Acknowledge Instructions: 1. Has there been any significant changes in your personal life or employment since the Pre - Offer Evaluation you participated in at this office? If yes. please provide a brief explanation: Y or N 2. Other than the above Pre -Offer evaluation that you previously completed for this agency, have Y or N you ever undergone a psychological pre -employment evaluation for any other agencies. academies, or positions? If yes, for what department or academy and year of testing(s): 3. Have you ever previously applied for a public safety position and/or self -sponsored academy and not been selected? If yes. list department(s). dates of application, and a bried explanation for not being selected: Y or N orgi City of Miami: RFP 610384 Page 83 MEDICAL HISTORY 4. Have you ever had any major illnesses, accidents or injuries? Y or N 5. Are you currently under a Dr.'s care for a medical condition? Y or N 6. Are you taking any prescribed medications now? Y or N 7. Do you currently have any physical limitations? Y or N 8. As a child, did you have learning disabilities or attended remedial classes? Y or N 9. As a child, were you diagnosed with Attention Deficit Disorder (ADD), hyperactivity or Y or N prescribed medications such as Ritalin? If yes, please provide a brief explanation: 10. Has there ever been a period where you missed work an unusual amount of time due to Y or N illness? eiN 11. Have you ever applied for or received Workers' Compensation due to a work -related injury? Y or N DRUG HISTORY If you have ever used any illegal substances such as marijuana. cocaine, hashish, ecstasy, steroids, LSD -Acid, etc., please provide the requested information below: SUBSTANCE: EXACT OR APPROXIMATE YEAR OF FIRST YEAR OF LAST NUMBER OF TIMES USED: USAGE: USAGE: 12. Other than work related duties. have you ever knowing:1N been around illicit drugs in your lifetime, even if you did not use them? If yes. approx.. date of last occurrence and circumstances: Y or N City of Miami:: RFP 610384 Page 84 13. Other than work related duties, have you knowingly been around illicit drugs in the past 12 months? Y or N If yes. number of times: 14. Have you ever experimented with marijuana, whatsoever. even if only 1 time? 15. Have you used marijuana 10 or more times in your lifetime? 16. Have you ever experimented with cocaine or crack cocaine, whatsoever, even if only 1 time? 1 7. Have you used cocaine or crack cocaine 2 or more times in your lifetime? 18. Have you experimented with any other illicit drug(s) i.e., steroids. LSD -Acid, ecstasy, hashish, etc., whatsoever, even if only 1 time? 19. Have you experimented with any other illicit drug(s) i.e., steroids, LSD -Acid. ecstasy, hashish, etc., 2 or more times in your lifetime? 20. Have you used marijuana or any other illicit drug, whatsoever, in the last 12 months? If yes. number of times Approximate date of last occurrence 21. Have you ever held illegal drugs for anyone? If yes, please provide a brief explanation: Y or N Y or N Y or N Y or N Y or N Y or N Y or N Y or N 22. Have you ever purchased marijuana or any other illicit substance for your personal usage? Y or N If yes, exact or approx. number of times date of last occurrence 23. Have you ever provided or supplied marijuana or any other illicit drugs for other persons. such as friends, even if you received no money? If yes. please provide a brief explanation: Y or N 24. Have you ever used marijuana or any other illicit drug with no one else present? Y or N 25. Have you ever sold or exchanged marijuana or any other illicit drugs for monetary gain or to Y or N acquire something you wanted? If yes, provide a brief explanation: 26. Has anyone ever given you money, to purchase marijuana or any other illicit drugs for them? Y or N If yes, number of times Date of last occurrence 27. Have you ever driven a vehicle even I time, after having used marijuana or any other illicit Y or N drug in the previous 4 hours? 28. Have you ever driven a vehicle 2 or more times. after having used marijuana or any other Y or N illicit drug in the previous 4 hours? If yes, approx. number of times approx. date of last occurrence 29. Have you ever reported to work even 1 time after having used marijuana or any other illicit drug Y or N in the previous 8 hours? If >es. what was the drug(s) used: 30. Have you e'er reported to work 3 or more times after having used marijuana or an other illicit 1. or in the pre\ iou• 8 hours? ft es. aprro\. number of times appro... date of last occurrence City of Miami: RFP 610384 Page 85 fliN 31. Do you smoke cigarettes or use any other tobacco products? If yes, for how long and how Y or N many per day? 32. Have you ever taken prescription medication prescribed for someone else on 3 or more different occasions? (i.e., Xanax, Valium, sleeping medication, etc.) If yes, please provide a brief explanation: Y or N 33. Have you ever been dependent on, or addicted to any prescription or over the counter medication? if yes, please provide a brief explanation: Y or N 34. Have you ever been confronted by someone who believed or suspected that you were abusing Y or N prescription or over-the-counter medication, even if you disagreed? If yes, provide a brief explanation 35. Are you currently taking any prescribed or over the counter pain or sleep aid medications? Y or N If yes, name of medication(s) 36. Please list any physician prescribed medication(s) you are currently taking: 37. Have you ever been in any kind of trouble whatsoever for your drug usage? Y or N If yes, please provide a brief explanation: 38. Have you ever been refused or not selected for a job due to your drug usage? Y or N If yes, please provide a brief explanation: ALCOHOL HISTORY 39. List the type of alcohol you like to drink in order of preference, i.e., beer, wine, vodka. etc. If you do not consume any alcohol, write "none." 40. Do you typically spend $150 dollars or more on alcohol per month? Y or N 41. Have you consumed any alcohol in the past 30 days? Y or N 42. Have you consumed any alcohol in the past 7 days? If yes, approx. date of last drink Y or N How many drinks did you have: 43. Have you consumed 5•or more alcoholic drinks in a 24 hr. period in the past 12 months? Y or N If yes. approx. date of last occurrence riN 44. Ha\e you consumed 5 or more alcoholic drinks in a 24 hr. period in the past 12 months. 5 V or or more times? Ifes. exact or approx. number of times City of Miami: RFP 61038.1 Page 86 45. Have you consumed 8 or more alcoholic drinks in a 24 hr. period in the past 24 months? Y or N If yes, exact or approx. number of times 46. In your lifetime, have you ever consumed 10 or more alcoholic drinks in a 24 hr. period? Y or N If yes, exact or approx. number of times: 47. Have you consumed any alcohol in the past 24 hours? If yes, how many drinks: Y or N 48. During the past 12 months, on average did you consume 8 or more alcoholic drinks per week? Y or N 49. During the past 12 months, did you typically consume alcohol on 5 or more days of the week? Y or N 50. Does it usually take 4 or more drinks for you to feel the first effects of alcohol (feel "high," Y or N or "buzzed")? 5 1 . Does it typically take 6 or more alcoholic drinks before you consider yourself intoxicated? Y or N [f yes, number of drinks until intoxication 52. In your opinion, have you been intoxicated 4 or more times in the past 12 months? if yes, Y or N number of drinks used for being intoxicated number of times _ last occurrence 53. Have you ever experienced blackouts (loss of recall for events that occurred while Y or N intoxicated) or missed any days of work because of alcohol consumption? If yes, exact or approx. number of times date of last occurrence 1/41601) 54. Have you ever used a fake I.D. to obtain alcohol? If yes, approx. number of times _ Y or N approx. date of last occurrence 55. Have you ever bought alcohol for or sold alcohol to a minor? Y or N If yes, approx. number of times 56. In your lifetime. have you ever driven a vehicle even 1 time after having consumed 4 or more Y or N alcoholic beverages in the previous 3 hours? if yes. approx. date of last occurrence 57. In your lifetime. have you driven a vehicle 3 or more times after having consumed 4 or more Y or N alcoholic beverages in the previous 3 hours? If yes. exact or approx. number of times 58. In the past 12 months. have you ever driven a vehicle after having consumed 4 or more Y or N alcoholic beverages in the previous 3 hours? if yes. number of times 59. Have you ever consumed alcohol, beer or wine while on the job without permission? Y or N If yes, approx. number of times approx. date of last occurrence 60. Have you ever been warned by an employer regarding your alcohol habits? Y or N Please provide a brief explanation: 61. Have you ever gone to v\ork even 1 time \\ ith a hangover or still feeling the effects of alcohol? Y or N 62. Ha\e you e\er gone to \\ork 3 or more times \\ ith a hangover or still feeling the effects of Y or alcohol? It es. appro\. number of times apprr\. date of last c-NcCurreilCe City of Miami: RFP 610384 Page 87 elliN 63. Have you ever gone to work in the past 6 months with a hangover or still feeling the effects Y or N of alcohol? If yes, approx. number of times _ date of last occurrence 64. Has there been a period in your life when you consumed alcohol much more than you do now? Y or N If yes, please provide a brief explanation: 65. Have you ever been involved in a physical altercation (includes pushing, shoving), after you Y or N had a few drinks? If yes, number of times approx. date of last occurrence 66. Have you ever been either voluntarily asked or forced to leave an establishment for rowdy Y or N behavior, after consuming alcohol? If yes, number of times approx. date(s) 67. Have you noticed yourself or has someone told you that you become more emotional, Y or N loud or aggressive after a few drinks? 68. Have you ever been in any kind of trouble, whatsoever, for your alcohol behavior? Y or N If yes, please provide a brief explanation: 69. In your lifetime, has anyone ever complained about or been concerned about your drinking? Y or N If yes, provide brief explanation: Items 70 — 73 are intended for ONLY APPLICANTS WITH PUBLIC SAFETY EXPERIENCE (i.e., Police Officers, Correctional/Detention Officers, Firefighters, etc.) **Please complete items 70 — 73 as it applies to your public safety position experience: 70. Since becoming a public safety officer, have you ever used any illegal drugs? lfyes, Y or N please provide a brief explanation: 71. As a public safety officer, did you ever drink alcohol while on duty? If yes, please Y or N provide a brief explanation: 72. During your employment as a public safety officer, have you ever been mandated for a psychological fitness for duty evaluation or any kind of counseling? If yes, please provide a brief explanation: Y or N 73. Have you ever been granted or applied for disability as a result of your public safety work? Y or N If yes. please provide a brief explanation: City of Miami: RFP 610384 Page 88 PSYCHOLOGICAL TREATMENT Please note: A history of psychological counseling does not automatically result in disqualification of an application for a public safety position, and in most cases. it is not a concern. 74. Have you ever received assistance from a mental health professional e.g. psychologist, psychiatrist, social worker, marriage/family therapist, etc. for an emotional or personal concern? (Includes stress or marital counseling) If yes, please provide a brief explanation including approximate date(s) of counseling: Y or N 75. Have you ever attempted suicide or made a suicidal gesture? If yes, please provide a Y or N brief explanation: 76. Have you ever attempted suicide, made a suicidal gesture, or made a statement that you Y or N thought about committing suicide in the past 3 years? 77. Has any doctor ever prescribed medication to you for anxiety, depression, sleep, anger, attention, concentration. or any other mental health reasons? If yes, please provide a brief explanation and dates: Y or N 78. Have you ever been hospitalized for a mental health concern or emotional condition? Y or N If yes, please provide a brief explanation: 79. Have you ever received in -patient or out -patient treatment for substance abuse? Y or N (i.e. alcohol. drugs) If yes, please provide a brief explanation: 80. Have you ever been ordered to attend some form of mental health/personal counseling, evaluation or related training due to your behavior? (i.e. ordered by a court, employer. military or as part of a civil legal action) If yes, please provide a brief explanation: Y or N 81. Have you ever received mental health counseling and/or pastoral advice related to suicidal Y or N thoughts or concerns? If yes. please provide a brief explanation: 82. Have family members or close friends ever strongly suggested that you seek mental health Y or N counseling.? If yes. please provide a brief explanation: e eriN City of Miami: RFP 610384 Page 89 83. Have you ever filed a lawsuit or been involved in a legal action (including disability or workers compensation) in which your psychological or emotional well-being was an issue? If yes, please provide a brief explanation: 84, Have you at any time in your life participated in or been accused of one or more of the following behaviors: Voyeurism (peeping tom), Sexual phone calls, Flashing (sexual self - exposure to strangers,) Forced sexual contact (Unwanted fondling; date rape; rape), Sexual harassment? If yes, please provide a brief explanation: Y or N Y or N 85. Have you ever applied for any disability due to mental health/medical related conditions? Y or N If yes, Please provide a brief explanation: 86. Have you ever not been selected for hire with a public safety agency within the last 3 years Y or N due to not meeting agency standards on a psychological evaluation? If yes, date and agency MILITARY HISTORY 87. Did you receive a medical discharge and/or were separated from the service due to an injury, Y or N medical problem or adjustment problem? 88. Did you serve in a combat zone? Y or N 89. Did you receive any injuries in combat? Y or N 90. If in the service. was your discharge related in any way to psychological issues? Y or N If yes, please specify: 91. Did you ever apply to the Veteran's Administration (VA) for a service connected disability for Y or N either psychological or medical injuries? If YES, please provide info on if the request was awarded, for what condition, and for what % disability: 92. Have you ever received any disability benefits related to your military service? Y or N 93. Other than required counseling/debriefinss upon return from a combat zone. have you ever Y or N received any additional treatment for emotional/personal concerns after your return? 94. In your judament. are currently experiencing any symptoms that could be related to your Y or N combat experience (sleep disturbance. nightmares. appetite changes. anxietx. sadness. etc.)? City of Miami: RFP 610384 Page 90 SUPPLEMENTAL SECTION 95. Please briefly describe the two most stressful. emotionally upsetting or traumatic events in your life so far. l" Event: 2"d Event: 96. Besides the information you have already provided on this questionnaire, is there any other information regarding your physical, medical or emotional well-being, whatsoever, that you believe may be relevant to this evaluation? If Yes, please provide a brief explanation. Y or N 97. In your opinion, have you ever been physically, sexually, or emotionally abused by Y or N anyone (including family. members)? 98. Are you currently experiencing any life event that you believe may potentially distract you from Y or N the responsibilities and obligations of the position you are applying to? (including family conflict. financial or legal concerns, etc..) 99. Have ever received any professional advice or training about taking a psychological evaluation? Y or 0111641 **I have answered all questions honestly. carefully and to the best of my ability. I consent and understand that the information I provided may be used to assist in determining my application/employment status. 1 further understand that intentional misstatements, incomplete information or false information could result in the denial or termination of my application. Signature Date Do not complete below this line until asked to do so after your interview with a psychologist. TO BE COMPLETED AFTER INTERVIEW WITH PSYCHOLOGIST: I have been given the opportunity to discuss and address all relevant background information, and do not have any additional information that [ would like to discuss at this time. Moreover. believe all my questions have been addressed at this time. Signature Date 1/4.) City of Miami: RFP 610384 Page 91 to) osour i'L atli 1,{1 Law Enforcement Psychological and Counseling Associates, Inc. Supplementary Background Investigation Interpretation Manual 1/15 Version * Important document for anyone who reviews the screening report. Please be certain to distribute this manual to all relevant persons in the selection system including background investigators and administrators. © 2009 — Law Enforcement Psychological & Counseling Associates. Inc. Mark Axelberd. Ph.D. ABPP & Brian Mangan. Psy.D.. ABPP 9960 N.W. 116th Way Suite 12 Medley, FL 33178 305-442-8800 ph. 305-442-4469 fax w,vww.lepca.com City of Miami: RFP 610384 Page 92 Introduction to Interpretation Manual The following guidelines should assist you in using this manual effectively and understanding the intent and proper use of the screening report itself. We are always available and welcome questions, should you desire further explanation. Our reports are designed and limited to identifying high-risk/unsuitable applicants, who do not meet minimum standards, and for those who do meet standards, to further comment on any Areas of Deficit or Strength which were observed. • We have identified and assess traits which we consider essential for a Public Safety position. These traits are described and clarified in detail in this manual, By utilizing this information, the user of the report can gain a fuller understanding of the scope and definition of each Deficit. To read about a particular job deficit, simply turn to the index of deficits on pg. 4 and go to the corresponding pg. number for the specific deficit of interest. ♦ ' For the selection process to function effectively, there must be appropriate communication and sharing of information between various persons within the system. Sometimes it is the psychologist who will provide the background investigator with new and important information and vice versa. Therefore, when the background investigator becomes aware of potentially relevant information that the applicant may not have revealed to the psychologist or was discovered after the date of the psychological, then it is critical for the background investigator to contact our office. Occasionally, this new information could result in an actual change of an applicant's rating. • When an applicant has Deficits but is not rated "Unacceptable," it is very important for the background investigator to investigate these deficits to determine whether they are generally substantiated or refuted by additional information obtained during other selection procedures, especially the comprehensive background investigation and polygraph examination. In other words, for those who "pass" the evaluation the report becomes an investigative tool for Background Investigators. • When other phases of the selection process generally support or validate an "Area(s) of Deficit," then the agency should be cautious in considering that applicant for final hire. This recommendation should apply not only to applicants rated "Marginal" or "Suitable with Reservations" but to applicants rated fully "Acceptable" as well. • The final ranking of applicants for hire should be made after integrating and reviewing our screening report in conjunction with all other information contained in an applicants' file. Remember, the "whole file is greater than the individual parts". City of Miami: RFP 610384 Page 93 • An increasing number of Public Safety agencies have initiated policy standards, whereby, applicants rated as "Marginal" or "Suitable with Reservations" will not be considered competitive applicants for final hire. Whether your agency has such a policy, really depends on your agency's hiring needs, philosophy and selection standards. • For those agencies who do consider "Marginal" or "Suitable with Reservations" ratings for final hire, it is extremely important to thoroughly investigate and rule out to the extent feasible the Deficit(s) described in the screening report. We would strongly recommend that a formal written policy be put in place, which assures the asencv that any Areas of Deficit were appropriately addressed. As most agencies know, we are more than willing to assist you in determining whether Deficit(s) are substantiated by other information the investigator has obtained. As a point of reference, it is our experience over the years that the majority of applicants rated "Marginal" or "Suitable with Reservations" are ultimately judged as non- competitive once a thorough background process is completed and/or the entire file is reviewed with this office. Nonetheless, there are a number of competitive applicants within those ratings. • We realize that some of you may view our arriving at risk/suitability ratings as a mysterious or subjective process. Those of you who do interact frequently with our office know that the evaluation process is actually very comprehensive, thorough, objective and usually very accurate. Please keep in mind, when an applicant is rated "Marginal/Suitable with Reservations" or especially "Unacceptable" fit, it is for a good and demonstrable reason. In addition, please beware final ratings are not simply determined lust by the number of Deficits or back round events listed on a report. Sometimes an applicant can have a few deficits but the Deficits appear "mild" or "moderate" and not likely to significantly interfere with the applicant's actual job performance. On the other hand. someone might have only one Deficit or problem background event but the Deficit or event was very significant or severe. A person's behavior is determined often by complex and multiple factors, therefore, we (and you) must weigh the gravity of an applicant's deficits in context with their strengths and overall personality functioning. • Some agencies have different rating and screening systems. so when reviewing reports from other agencies this must be kept in mind. It is up to each azencv as to whether they are willin& to share their reports on specific applicants with other agencies. Nevertheless, the reports are intended solely for the position and department considered at the time of evaluation • Therefore. requests for an applicant's report should be made to the applicable agency and not to our office. More than ever, recently passed laws make it very difficult for us to provide or discuss any applicant's file with anyone other than the original referring agency. • Again. we are readily available to assist you and feel free to contact our office. City of Miami: RFP 610384 Page 94 INDEX The following list of Job Related Traits was derived from the California Commission on Peace Officer Standards and Training (POST) Job Task Analysis Job Related Traits: Page Integrity / Ethics 5 Impulse Control / Attention to Safety 6 Capacity for Responsibility / Judgment 7 Openness / Forthcoming 8 Stress Tolerance / Emotional Regulation 9 Tolerance / Social Competence / Teamwork 10 Avoidance of Substance Abuse / Maladaptive Behaviors 1 1 Learning Ability / Problem -Solving 12 Flexibil ity / Adaptability 13 Assertiveness / Initiative 14 Conscientiousness / Dependability 15 Communication Skills 16 4 City of Miami: RFP 610384 Page 95 Job Trait: INTEGRITY / ETHICS Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Reports a history of lawful attitudes and conduct (+) Values honesty. has integrity, and does not blame others for mistakes (+) Follows rules as expected (+) Appreciates authority and is trustworthy (+) Respects others and is not deceitful or manipulative (+) Conscientious/reliable Negative iob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: (-) Could sometimes be viewed as charismatic. friendly and a good leader, but at the same time, demonstrate arrogance and believe the same rules for others' do not apply to them (-) May be deceitful, clever and manipulative behind a friendly and "smooth" front (-) Blames others for his/her mistakes and only feels guilty after being caught for wrongdoing (-) A tendency towards being rebellious and inconsiderate of others (-) May lack loyalty and use relationships for personal gain (-) May gravitate to a negative crowd and believe bending rules is okay (-) May have underlying resentment of authority and feel discriminated against or victimized (-) Could be a "crash and bum" type of officer. seemingly productive and adventuresome in style but having difficulty slowing down or dealing with detailed regulations (-) Likes power and control over others. and in extreme cases, may be abusive towards others (-) In very extreme cases. may be capable of committing serious crimes (-) Feels the world owes them something (-) Could hold prejudices and hostility towards specific groups of people Specific background information/events to substantiate or support a deficit in the above trait: \7 \' ' V V N' VVVVV Frequent minor violations of the law. such as traffic violations. petty theft. etc. Arrest(s) or frequent brushes with the law or past or present delinquent behavior History of job instability and conflict with supervisors Currently associates or has associated with persons of questionable character History of serious rule violations or significant disciplinary problems in high school Frequent family/relationship problems such as divorce. conflict with friends, sexual promiscuity. and in extreme cases. domestic violence Risk -taking behaviors such as experimenting with illicit drugs or excessive alcohol consumption may be indicated Poor handling of money matters or over spends for unnecessary things Poor driving record (e.g. license suspensions) Trouble passing polygraph examination Caught in lies or half-truths during interview/omissions or inconsistencies on applications In extreme cases. may feel alienated from the main stream society and associate or have sympathy for extremist groups City of Miami: RFP 610384 Page 96 Job Trait: IMPULSE CONTROL / ATTENTION TO SAFETY Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to think through situations in a logical progression before acting or engaging in high - risk behavior (+) Ability to control anger and remain level-headed when provoked (+) Capacity to direct others without becoming overly aggressive (+) Demonstrates adequate maturity (+) Demonstrates adequate decision -making and readiness for a critical job (+) Calm and sensible approach to conflicts (+) Pays attention to detail and is disciplined Negative iob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: (-) (-) Often described as somewhat impulsive. easily excited and a high -risk taker. possibly even clever and deceitful to get their way Likable but may tend to be immature and still "growing up" Shows a need for high level of excitement and inability to deal with boredom or detailed tasks Under stress. may exhibit a low frustration tolerance. poor judgment. and act impulsively May be productive but described by others as an "up" and "down" moody person May be described at times as childish, over -emotional. and may have trouble being patient or dealing with structured rules May demonstrate carelessness and inattention to detail or safety procedures May be vulnerable to associating with a negative crowd or those of poor character May be described by others as outgoing and confident, but very competitive and socially aggressive May seek out dangerous or high risk activities Specific background information/events to substantiate or support a deficit in the above trait: V \% \' V \� Parties/Socializes too much/places themselves in risky situations Described as friendly and fun but can display explosive temper May have a poor driving record and enjoy driving fast Frequent change of jobs due to a need for excitement and to quickly make more money May be status -oriented (nice cars. house, clothes, status symbols. etc.) Over uses credit and spends beyond their means > Evidence of a greater incidence of aggressive or hostile incidents such as verbal arguments, fights or domestic conflicts/domestic violence > Accident prone due to excessive risk -taking Overuse of credit cards: loans May lack loyalty in relationships and "dump" people when relationships become mundane May be sexually promiscuous Propensities towards high risk -taking behaviors such as excessive use of alcohol or other chemical substances 6 rot City of Miami: RFP 610384 Page 97 Job Trait: CAPACITY FOR RESPONSIBILITY / JUDGMENT Positive lob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to process essential information quickly and make sound decisions (+) Ability to be realistic and have a mature approach to problem -solving (+) Is observant, alert, and quick to respond to the subtleties of others' behavior (+) Possesses adequate readiness for a critical job (+) Is a clear -thinker (+) Hard working and self -motivated (+) Pays close attention to details (+) Conscientious attitude towards meeting personal and work responsibilities (+) Goal Oriented Negative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: (-) Unable to utilize resources to make appropriate and sound decisions (-) Unable to work independently in situations that are vague and lacking clear-cut solutions (-) Often described as careless and prone to making mistakes (-) Often described by others as lazy, immature. rebellious or unconcerned about responsibilities (-) Easily distracted and discouraged (-) Lack of productivity/initiative (-) Insensitivity towards others' problems (-) Unsophisticated and not realistic about his/her abilities or shortcomings (-) Could lack life and/or job experience Specific background information/events to substantiate or support a deficit in the above trait: History of poor job performance or not moving ahead in a job (e.g. promotions at work) > History of underachieving both at work and in school > History of poor decision making/poor choices > History of rule violations and disciplinary actions > Lack of accomplishments or achievements > Careless and repeats same mistake > Disorganized and "sloppy" in carrying out responsibilities/loses or > Job application incomplete/contains mistakes Missing or late to appointments • Late to work or excessive absenteeism • Unwilling to go the "extra mile" or go out of their way to meet job Not able to recognize expectations others' have of them. > Forgets to do things not receiving timely misplaces things responsibilities 7 City of Miami: RFP 610384 Page 98 Job Trait: OPENNESS / FORTHCOMING Positive lob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to be honest and realistic about one's limitations and shortcomings (+) Can admit mistakes and receive corrective feedback (+) Demonstrates adequate psychological sophistication and does not think in an overly rigid or stereotypic manner (+) Able to self -disclose and answer written questions on the psychological evaluation without undue defensiveness jYet:ative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: Strong intentional attempts to make a good impression and to deny faults most people admit to May try to outsmart tests by presenting an extremely positive front Lack of psychological sophistication often associated with limited life experiences or low learning ability Views the world and themselves in an overly simplistic "good" versus "bad" manner Has a rigid way of thinking and may hold many stereotypes May harbor underlying suspicious ideas and general distrust of others In extreme cases. may be described as a "liar" or as being untrustworthy or dishonest Difficulty understanding and accepting criticism Specific background information/events to substantiate or support a deficit in the above trait: Check polygraph results carefully for evidence of deception i Check carefully for discrepancies in information provided by the applicant during the selection process i History of difficulty with past polygraph evaluations Only reveals very limited or "safe" information during interviews - Overly polite and "eager" to say the "right" thing but hard to get to know the person's true opinions and beliefs 8 City of Miami: RFP 610384 Page 99 Job Trait: STRESS TOLERANCE / EMOTIONAL REGULATION Positive job behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to keep emotions and worries from affecting job performance (+) Does not reveal strong proneness towards stress -related ailments and can face traumas of the job (+) Possesses adequate confidence and self-esteem to solve problems without becoming overly demanding or dependent on others (+) Anxiety level is not unduly high Negative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: Lack of self confidence Complaints of physical problems which are associated with stress such as headaches, stomachaches. etc. During periods of high stress, increased frequency of disturbed sleep, loss of appetite. irritability, and perhaps withdrawal from friends A tendency to deny problems and use physical symptoms as an excuse for difficulties Over -sensitivity to personal faults May demonstrate immaturity and emotional outbursts especially when under stress May try to manipulate and control others by gaining their sympathy or producing guilt May become very nervous and worry excessively over problems May be prone to burnout (heart disease, ulcers. etc.) because of inability to relax Seems overly idealistic and unrealistic about many things Specific background information/events to substantiate or support a deficit in the above trait: > History of counseling for personal concerns and in extreme cases, suicidal gestures or attempts > Excessive absenteeism or injuries on the job due to stress related symptoms > May have specific phobias, such as fear of heights. close spaces, and so on > Past traumatic events such as physical, sexual or emotional abuse > Serious past or present family conflicts > Trouble with polygraph because of nervousness > Seems too sensitive. nervous or "nice" to be a law enforcement officer • May have fear of guns and seem overly hesitant to use lethal force, when necessary > Could be going through a situational crisis i.e. divorce. death in family, money problems etc. A City of Miami: RFP 610384 Page 100 Job Trait: TOLERANCE / SOCIAL COMPETENCE / TEAMWORK Positive job behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to demonstrate understanding and tolerance towards others (+) Works well in group settings (+) Open-minded and feels comfortable with a wide range of people (+) Does not view others in an overly suspicious or cynical manner (+) Demonstrates adequate communication skills and interest in people (+) Puts organizational goals ahead of self/individual goals Negative iob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: (-) Described as shy, serious, reserved, and uncomfortable around people (-) Could be intolerant, critical, unsympathetic or suspicious of others (-) Could display cynical or skeptical attitudes from job burn -out (-) May quickly become verbally aggressive when authority is challenged (-) Difficulty participating as a team member and inability to form adequate social networks during times of stress (-) May have difficulty developing close relationships and communicating understanding of others (-) Has narrow interests or described as stubborn and resistant to new ideas (-) May harbor stereotypes or prejudice toward others from different cultural or social backgrounds (-) In extreme cases, can become over -reactive to negative comments by others Specific background information/events to substantiate or support a deficit in the above trait: • Maintains few friendships and interacts mostly with only "people like themselves." • Has history of participating in few group or community activities (school teams. clubs, etc.) 'r Few experiences and contacts with people of varied cultural backgrounds - Seems somewhat suspicious. guarded and cautious with others Frequently complains or generally critical about others • May present in an authoritative, combative, defensive. or evasive style Presents poorly or hard to really get to know the person during oral interview In more extreme cases, person could be rude, harsh. abrasive. and/or dismissive of others 10 City of Miami: RFP 610384 Page 101 Job Trait: AVOIDANCE OF SUBSTANCE ABUSE / MALADAPTIVE BEHAVIORS Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Demonstrates a personality type and behavioral style which is not prone to inappropriate or excessive use of alcohol and other chemical substances (+) Has the necessary personal resources to not engage in self-destructive habits (gambling, etc.) or dysfunctional relationships which may interfere with job performance Neeative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: Descriptions of the applicant as being overly reckless, impulsive, and excessive risk- taking in style May be seen by others as "moody" and solves problems though seeking escape or excitement through questionable activities May enter quickly into self-destructive and volatile relationships with others Misses work duties due to alcohol use/or other similar behavior Susceptibility to addictive behaviors Periodically behaves in a way that results in embarrassment or damaging to personal or agency reputation Specific background information/events to substantiate or support a deficit in the above trait: i Excessive under age alcohol consumption or started using alcohol at a very young age i= 'Enjoys gambling and has money problems Y Unstable/volatile family relationships Periodic problems with the law i Disciplinary problems at work Family history of alcohol/substance abuse Excessive use of over the counter or prescription drugs Actual current or recent abuse of alcohol/illicit drugs In extreme cases, history of episodic violent outbursts especially during period of alcohol/drug ingestion (i.e. domestic violence, bar fights, etc.) > History including Driving Under the Influence or Driving While intoxicated (e City of Miami: RFP 610384 Page 102 Job Trait: LEARNING ABILITY / PROBLEM SOLVING Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Capacity to easily learn new things and acquire basic knowledge during training (+) Ability to follow directions and deal with complex situations (+) Demonstrates proficiency in academic subjects such as reading, spelling. and math Negative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: Problems passing entry level public safety examinations Description of the applicant as being dull. not too bright. or as experiencing difficulties in intellectually demanding situations or in understanding complex situations Little interest in cultural or academic matters and little interest in reading Poor academic performance in the academy Difficulty following detailed directions or instructions Difficulty learning to use equipment such as mastering the radio Difficulty passing the state required exam for law enforcement officer Specific background information/events to substantiate or support a deficit in the above trait: • Demonstrated difficulty passing the academy, entry level exams. and state required exams Poor writing skills/preparation of reports Poor schoolwork with school grades typically "C" or lower School records indicating poor scholastic achievement. learning difficulties. or flunking of grades >- Written productions characterized by poor grammar. frequent misspellings. and poor organization of the content :- Poor communication skills and/or difficulty with verbal expression 1- Problems with geography i.e. finding locations quickly/mastering use of equipment Requires close supervision and often has to be provided remedial training Y Problems with multi -tasking or complicated directions vvvvvvV City of Miami: RFP 610384 Page 103 Job Trait: FLEXIBILITY / ADAPTABILITY Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Capacity to respond and adapt to changeable situations and circumstances at work (+) Ability to be resourceful when facing new or unstructured situations (+) Not unduly rigid or stubborn (+) Willing to carry out a wide range or work assignments (+) Open to new ideas and innovation Negative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: (-) Tendency to be inflexible and sometimes stubborn in style (-) May lack creativity or spontaneity (-) During circumstances that are not routine or ordinary. independent decision making and efficiency diminishes (-) May demonstrate rigid and conservative attitudes (-) May become impatient towards others for minor indiscretions and mistakes (-) Over dependent on quasi -military structure and efficiency declines rapidly when directions are not clearly defined (-) Can be intolerant of others' minor faults (-) Trouble adapting to or accepting new or innovative ways to do things Specific background information/events to substantiate or support a deficit in the above trait: • Described by others as liking or needing excessive structure :- May tend to have difficulties readily self -disclosing and may keep emotions hidden Past difficulty adapting to new jobs. environments. or situations Past difficulty with getting along with others (co-workers, colleagues. friends, etc.) due to stubbornness Does well with repetitive and structured guidelines but has difficulty working independently. Must do one thing at a time and has trouble multitasking Gets upset with others who interrupt them May become hesitant about willingness to take on new or additional job responsibilities Set in ways and slow to accept innovations on the job Unwilling to consider opinions different from their own Occasionally, in unstructured or threatening situations, could become overly self- protective and aggressive • Needs uniform and authority for self —esteem/feel in control torl I3 City of Miami: RFP 610384 Page 104 Job Trait: CONFIDENCE / INITIATIVE Positive lob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to show assertiveness and act decisively when necessary (+) Belief in one's abilities and does not shy away from new or challenging work assignments (+) Demonstrates a high level of productivity and can work independently (+) Possesses good social poise Negative lob behaviors expected when an applicant DOES demonstrate a deficit in the above trait: May lack ambition. or present as awkward and somewhat apathetic May lack aggressiveness and function poorly in unstructured situations May demonstrate poor social poise and communication skills Difficulty in completing tasks, especially where achievement through independence is stressed May demonstrate low level of productivity May not show a strong interest in learning or improving skills May be a limited independent thinker and be dependent on being told exactly what to do Could create problems or a crisis through inaction or responding too slowly Specific background information/events to substantiate or support a deficit in the above trait: > Described by others as being self -doubting, lacking in initiative and having narrow interests Described by others as being more of a follower than a leader > Low productivity on the job • Described as others as being overly dependent on guidance and direction from others • Lack of progress on the job due to limited assertiveness > History shows no indication of ever being in a leadership position > Described by others as a person who needs to be told what to do Does not always complete their goals or gives up on things L) City of Miami: RFP 610384 Page 105 Job Trait: CONSCIENTIOUSNESS / DEPENDABILITY Positive lob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Exhibits diligent. reliable, conscientious work patterns (+) Pays close attention to details, agency rules, regulations, and policies (+) Performs assigned tasks in a successful and timely manner (+) Takes pride and accountability for one's work and analyzing mistakes to learn from them (+) Stays organized and focused on the task at hand (+) Maintains a punctual and reliable attendance record (+) Persevering and willing to go the extra mile to accomplish work goals, with minimal supervision Negative behaviors expected when an applicant DOES demonstrate a deficit in the above trait (-) Lax about responsibilities and obligations (-) Unreliable team member (-) Difficulty meeting deadlines (-) Frequently late to appointments or other events (-) Unwilling to go the "extra mile" when needed (-) Avoids or resents demands of others (-) Inattention to details (-) Seems to be disorganized or misplaces things (-) Easily distracted or frustrated (-) Does just what is necessary to get by (-) Mistake prone or careless (-) Relies on others to be reminded of responsibilities (-) May be viewed as lazy or unproductive Specific backround information/events to substantiate or support a deficit in the above trait: • Job application contains mistakes or evidence of carelessness r Late to required appointments without a good reason • Slow to provide documents or other information • Below or very average grades in school Ignores or does not pay close attention to directions • Poor credit rating or pays routine bills late Counseled at ajob for being late or absent too much Counseled at a job for careless mistakes - History of not finishing what they start (school. job training. sports. etc.) ▪ Inattention to obvious spelling or grammatical errors Seems to lack motivation to excel at things History lacks many achievements. difficult accomplishments or special honors Described by others or co-workers as very average or needing prodding to get things done • Might ignore or not pay close attention to instructions or directions 15 City of Miami: RFP 610384 Page 106 Job Trait: COMMUNICATION SKILLS Positive iob behaviors expected when an applicant DOES NOT demonstrate a deficit in the above trait: (+) Ability to express self effectively with verbal and written communication (+) Communication, both verbal and written, is well thought out and organized (+) Communication is complete and accurate Nesative behaviors expected when an applicant DOES demonstrate a deficit in the above trait (-) Uncommunicative or extremely reserved demeanor (-) Avoids group interactions where speaking is required (-) Has difficulty expressing ideas and thoughts (-) Verbal fluency is poor (-) Disorganized and inaccurate written communication (reports) Specific background information/events to substantiate or support a deficit in the above trait ➢ History suggests preference for jobs and activities where interaction with others is limited Y Multiple corrective counseling statements or "re -phasing" due to poor writing skills, inaccurate reports, inattention to details in a report (facts, grammar, etc.) Could be excessively shy or quiet during interview process • Gives very brief answers to questions and trouble elaborating on responses Speech pattern may be halting. uneven or stutter is noticeable • Limited social relationships and hard to get to know person ▪ Unusually nervous or uncomfortable when interacting with others History suggests limited ability to reach out to a support group during times of stress Difficult to understand person's verbalizations English language deficiency or heavy accent 16 City of Miami: RFP 610384 Page 107 Employee Assistance Program Counseling Services City of Miami: RFP 610384 Page 108 Justification for Aeency EAP/OAP Services The City of Miami Employee Assistance Program (EAP) or Officer Assistance Program (OAP) was established and has served the employees of MPD since 1978, and quickly became a state and national model for implementing such programs successfully with law enforcement agencies. The program also has been featured numerous times over the years in news periodicals, television, and law enforcement related materials for its innovative and effective approach in providing these services. In terms of the current need and relevance for the continuance of these services, consider the following summary and comments: 1. It is well known and accepted that police work is extremely challenging and stressful both from a physical and especially psychological standpoint. It is well established that various mental health problems such as severe stress, depression, marital/family problems. abuse of alcohol, etc, account for the vast majority of police officer problems and can in some instances become the direct cause of poor performance, lack of productivity, low morale and even misconduct. Beyond the individual human toll, the dollar cost of these maladies over many years to a municipality is virtually incalculable but obviously very substantial. As a result, every professional law enforcement association strongly recommends the maintenance of a specialized OAP for police employees (sworn and non -sworn.) These agencies include the Commission on Accreditation for Law Enforcement (CALEA), U.S. Justice Department, International Chiefs of Police (IACP) and FDLE. In fact, the Miami OAP has been cited favorably by all these organizations and held up as a model program. 3. Therefore, the local and national practice has been for all law enforcement agencies to establish the above program and services. In fact, I am not aware of any medium to large urban agency that has not heeded the recommendations for such programs. For example, locally the Miami -Dade, Hialeah, Miami Beach. and Coral Gables Police Departments, just to name a few. have on -going OAP programs. 4. Over the years, the existence and effectiveness of the Miami OAP program in several instances has assisted in mitigating the City's liability in various legal actions. Indeed, there have been rulings in various court cases where the municipality was held liable for not having these services available to their law enforcement employees. These programs are also considered an integral part of an agency's Early Warning System (EWS). which certainly has been the case with MPD. Current Agency List for CounselineTraining LEPCA is designated EAP/OAP provider for City of Miami Police Department. City of Hialeah Police Department. City of Hialeah Fire Department. and City of Coral Gables Police Department. In addition. LEPCA pro ides counseiint2 services to agenc\ personnel «ith roam other local a_encies on an as needed basis 1/4.) City of Miami: RFP 610384 Page 109 Sample of Firm's Counseling and Training Experience with Public Safety Law Enforcement Psychological & Counseling Associates, Inc (LEPCA) has been exclusive full- time law enforcement and public safety consultants for the past forty years. Our services to law enforcement agencies have been most extensive on a local, statewide, national, and international level. Many of our programs and services have been utilized as model law enforcement programs throughout the country. In 1983, LEPCA was featured on the 20/20 news program for their innovative work with South Florida law enforcement agencies. Below is just a sample of various experiences our firm has to date: • LEPCA has developed, set standards, and pioneered Officer Assistance Programs for law enforcement agencies and our successful model is recognized throughout the country. • LEPCA continues to provide comprehensive psychological services to numerous departments and has had face-to-face therapy contact with thousands of law enforcement clients, significant others, and families over the years. On average, LEPCA provides approximately 1,750 to 2,000 hours of therapy or intervention services per year. • LEPCA developed the Florida state certified training program for stress management seminars for Florida law enforcement agencies. LEPCA's Crisis Intervention training was also adopted as the state certified program years ago and received acclaim during the early stages of LEPCA's presence in the South Florida public safety community. • LEPCA provides Critical Incident Stress Debriefing (CISD) for numerous local and statewide public safety agencies. Members of the firm have conducted multiple training workshops in the area of CISD and Post -Incident Officer Involved Shooting interventions. • LEPCA has been called upon to act as expert witness and provide testimony involving law enforcement consultation on numerous occasions. • In 1981, LEPCA developed guidelines for the Florida Department of Law Enforcement for statewide implementation of standards for psychological screening of police applicants. • LEPCA worked as a consultant to the Florida Police Standards and Training Commission providing workshops and consultation for law enforcement personnel and psychologists interested in initiating Officer Assistance Programs. • LEPCA has conducted numerous psychological evaluations for entrance to specialty units such as SWAT and Hostage Negotiation. • LEPCA has developed a stable and experience multi -ethnic professional staff with extensive experience working with public safety officers, significant others, and families. • LEPCA is utilized on an as needed basis for expert consultations services by nearly all local law enforcement agencies in the Nliami-Dade. Monroe. Broward. and Palm Beach area. Criy of Miami: RFP 610384 rsavENr/w. Training sod• =Kb dodal, do ms& Tido= DIOdkotke Woo adomelood mated* ss Poll Rookie comas aead acdri dea Eisrasanse dim aural to imiqu s Co tact and niaaak from FOP Contact and Mask from Ries* Service Lick Caestac t eta Wank from Claseiskes ORGANIZATIONAL CHART QTY OF MIAMIFOLKS DEPAIMIONT OPF t ASB TANCB PRO( LAM CXNlIDD/11AL TRIATMENV =MING SWIMS Comprehensive emmidlog mod • twatmsai modslldas for kadividtals and family sos®bses poditldual. alooboi. msdosl.:rtated= taking. reheat b P17 . ic.) • . C dtkol inddarst del drdoss foe say Mole Inaba 1 io a shoado* or asrsaattc wad Cowman fa Lay W edemas Melaka competing molds ddae sod desk family mambas deans tbst few d employment Inionisot awed sad coc aiinst= when raga-sd (s.f. alcohol, arms Page 110 ADIMIMIAT1VE admiolstoolve codas bpsycbolesecall onion n Ooloins :dawdles milk Wind Wm 10 ha paorms. ba Commodac d dm Pommel Unit Pakitlicbrithogcd Chief dd Police as status ci rdemmt� ado t aids sou policypolicy(m Ls, .f, • of wiaruj: RFP 610184 CITY OF MIAMI Police Department EMPLOYEE ASSISTANCE PROGRAM 9960 NW 116th Way, Suite 12 Medley, FL 33178 To make an appointment, contact: 305-442-8800 ext. 101 _Pagg11 NO FEE FOR SERVICE **6 sessions per calendar year COMPLETE CONFIDENTIALITY CONTACT US DIRECTLY- NO NEED TO GO THOUGH AGENCY City of Miami: RFP 610384 Page 112 OFFICER/ EMPLOYEE ASSISTANCE PROGRAM (OAP/EAP) City of Miami Police Department Welcome to the Officer/Employee Assistance Program As an employee of the Miami Police Department serving and protecting the City of Miami community, you and your family members may face many challenges and stressful situations. These challenges, at times, may result in personal difficulties, conflict in relationships and quite possibly job dissatisfaction and performance issues. As a benefit of your employment, the Miami Police Department offers a confidential Officer/Employee Assistance Program (OAP/EAP) specifically designed to meet and address the needs of sworn and non -sworn employees, their spouse/significant others, and dependents. Law Enforcement Psychological and Counseling Associates (LEPCA) provides a comprehensive range of mental health services available as part of the OAP/EAP. This firm has particular expertise with law enforcement and has successfully provided services to law enforcement clients for a number of years. LEPCA's diverse staff is specially trained to address mental health and wellness issues in a private and confidential setting. We hope that you will take advantage of these services in an effort to promote and achieve a more fulfilling personal, family and career life. Appointments Sworn and non -sworn department employees, their spouse, or significant other and dependents will be eligible for a total of (6) free visits annually per family, individual or combination of both. Under special circumstances and need, additional free sessions may be offered. Appointments with an OAP/EAP professional may be scheduled by contacting LEPCA at (305) 442-8800 ext #1 between 9:OOam and 5:OOpm. If more convenient, you may also email the EAP Coordinator Mayte Aponte @ MAponte•u-lepca.com to request information or appointment availability. This contact may be made directly by the employee or family members and notification to or permission from a supervisor is not necessary or recommended. If an emergency situation exists, please contact 9-1-1 as necessary or go to the nearest emergency room or hospital. During OAP/EAP non -business hours, if you have concerns or would like to consult with an on -call psychologist you may call the regular OAP/EAP phone number and a recording will prompt you with directions. foN Cit 1.4 iiP.m 8 t1'O984 Services Pale 113 The OAP/EAP offers a full range of short-term counseling services available in a conveniently located Miami -Dade County location. This office is private and not part of any City of Miami facility. Law Enforcement Psychological & Counseling Associates, Inc. (LEPCA) 9960 NW 116th Way, Suite 12 Medley, FL 33178 General Individual Counseling Services This service provides crisis intervention, short-term counseling, and treatment for those who may be experiencing mental health concerns from a wide range of sources including: depression, anxiety, job dissatisfaction, or other such problems associated with stressful Iife events. Stress Management Services This specialized service offers assessment and treatment of stress related disorders, including panic attacks, generalized anxiety disorder, and additional physiological concerns. Treatment techniques include progressive muscle relaxation, cognitive therapy, assertiveness and interpersonal skills training, and lifestyle modification. In addition, services may include referral to outside professionals within the OAP/EAP network for medication management as requested. Marriage/Family Counseling Services This family -oriented service provides consultation, counseling and intervention to those members experiencing marital/couple disharmony, parent -child relationship problems, divorce issues, sexual difficulties and/or family violence. Child/Adolescent Counseling Services Providing comprehensive evaluation and treatment for youths ages 5 to 18 years, this service offers individual, family and group interventions, parent counseling, school consultation. psychoeducational testing, psychological testing and medication evaluation. Addictions Referral Service This service provides consultation and treatment referral for individuals with alcohol or other substance use problems. If referral to a specialized facility for such services is necessary. then OAP/EAP will coordinate such services and the employee will be given an opportunity to complete such treatment per departmental policy. Cit �`l M�tit�RIDFCM0884 Pie 114 Psychiatric Referral Service This service assists with referrals for psychiatric evaluation and pharmacologic (medication) intervention as necessary in conjunction with other OAP/EAP services. Confidentiality The OAP/EAP will guarantee strict standards of privacy, privilege, and confidentiality according to State and Federal guidelines. Neither the City of Miami nor the Miami Police Department will have access to OAP/EAP files or records. The only involuntary waiver of confidentiality will occur in the extreme instance where a client has shown evidence of clear and imminent danger to self or others. Under Florida law, child and/or elder abuse, as well as, incidents of domestic violence where a child was a witness to the event, must also be reported to State Human Resources Department. No Fee for Service As indicated, all sworn and non -sworn employees of the department, their immediate family or significant other will be eligible for a total of six (6), combined. free visits annually. These visits will bebilled in a confidential manner to the Miami Police Department. At no time will an employee's (or family member's) name appear on invoices sent to the Miami Police Department. LEPCA OAP/EAP Staff: Mayte Aponte: Office Manager, OAP/EAP Coordinator @ Ext. 1 Brian Mangan, Psy.D., ABPP : Senior Psychologist Vanessa Perez, Psy.D.: Psychologist Maria Galmarini, Psy.D.: Psychologist Mirelis Peraza, Psy.D. : Psychologist Pablo Martin, LCSW : Therapist Elena De Cardenas, LMHC : Therapist Melissa Noya, Psy.D.: Test Assessment Questions? In the event of any questions regarding specific services offered. please feel free to contact the OAP/EAP office coordinator at (305) 442-8800 ext #1 or email the Office Manager & EAP Coordinator Mayte Aponte .c . !Aponte ci lepca.com Remember. no personal problem or question should be considered unimportant. City of Miami: RFP 610384 Page 115 o Law Enforcement Psychological and Counseling Associates, Inc. CRITICAL INCIDENT STRESS DEBRIEFING (CISD) A Critical Incident Stress Debriefing (CISD) is a specialized counseling/educational session utilized with Public Safety Officers who have experienced an unusual, abnormal or potentially traumatic job -related event. Typically. officers are most often referred for this service after discharging their firearm in the performance of their duties. However, any event viewed as possibly traumatic by a supervisor or the affected officer may warrant referral. For example, an officer responding to the scene of a murdered child can have serious emotional repercussions for particular officers. In many medium to large sized agencies, the CISD program is often a part of a comprehensive EAP services. The majority of officers responding to abnormal or traumatic events only require 1-2 sessions to resolve or deal with their emotional reactions. For these officers, the C1SD is more of an, educational and preventative session vs. an in-depth therapeutic intervention. Nevertheless. for a minority of officers the referral event can trigger more severe and long lasting emotional reactions and can even develop into Post -Traumatic Stress Disorder (PTSD). Lastly but of importance. unless an officer displays what would be considered very unusual or disturbing behavior before. during or after a critical event then an officer is typically presumed to be fit for duty. In other words, responding to potentially critical incidents is part of an officer's routine job description and should not ordinarily trigger serious concerns about an officer's emotional fitness. Per the international Association of Chiefs of Police (IACP) guidelines. the following are the recommended practical considerations in an agency's creation of an effective policy for a CISD; I. A CISD is conducted for the benefit of the Officer and is NEVER to be confused with a formal Fitness for Duty Evaluation (FFDE); or to be used as part of any administrative or criminal investigation into the critical event itself. The client of record for the CISD is the individual officer. In contrast, in a FFDE referral the agency is the client of record and a formal evaluation is conducted that includes extensive standardized testing. review of ancillary background materials and a comprehensive written report of findings is provided to the agency. 2. To avoid the fear of stigmatizing any individual officer. all officers exposed to a critical incident should be mandated to attend an initial CISD session. It should be the shift Commander's or the officer's immediate supervisor's responsibility to verify that a referral has been made. 3. Except as an emergency might dictate. CISD sessions are to take place at the psychological consultant's private office. This provides a private setting for more open dialogue by clearly separating the CISD from other administrative or investigative 9960 N.W. 1 16th Way Suite 12 Ntiarni. Fl. 33178 305-442-8800 ph. 305-442-4469 fax w w lepca.c'oni City of Miami: RFP 610384 Page 116 2 processes. Whenever possible, the CISD should occur within 24-72 hours after the event. Many agencies will remove the officer(s) from their usual duties, at least until the CISD is concluded. 4. A C[SD should be considered a confidential professional service and other than verifying an officer's attendance when requested, the consultant will not provide further information to anyone except as specified below. 5. If during a CISD it becomes apparent to the psychologist that the officer is experiencing acute or incapacitating symptoms, then the psychologist will explain to the officer the need for temporary removal from their usual job duties and the necessity for further treatment. The psychologist typically with the officer present will then immediately contact by phone a designated agency Commander to inform them of the situation. The psychologist will discuss and coordinate with the Corrunander the specific actions that are being recommended before release of the officer back to full duty. As previously stated, for the great majority of officers, the CISD is more of a required educational and psychological debriefing session and removal of officers from their routine job duties is very much the exception vs. the rule. 6. As previously stated, a C[SD is a very different service from a Fitness for Duty Evaluation (FFDE). A CISD is confidential and conducted for the benefit of the officer. A FFDE is not confidential and is performed on behalf of the agency to address specific documented issues of officer fitness. Occasionally, an agency may require an officer to undergo a FFDE in addition to the required CISD. For example, assume an officer has experienced one or more recent critical incidents in addition to the current one and is also known to be going through a difficult and upsetting divorce. As a result, the agency may determine a formal FFDE is justified and necessary in that circumstance in addition to the CISD. In this situation, the FFDE should be performed by a different psychologist than the one who conducted the CISD. Completed by LEPCA staff: Brian Mangan, Psy.D., ABPP Board Certified in Police & Public Safety Psychology Licensed Psychologist Mark Axelberd. Ph.D.. ABPP Board Certified in Police & Public Safety Psychology Licensed Psychologist Copyright 0 2009 by Law Enforcement Psychological and Counseling. Associates. Inc. City of Miami: RFP 610384 JEANS 1O[]CKDEPAi?LAIN! sums riminainor Moodhey 9d10-*AS mutomucnott 9A5 -15 D6Ai}IVII$ COMPULSIVZ BEFIA'V11011$ 11.7f5 - L00 Lunen LIMP - EV/lU A11 llearday 9:00- t200 PO LICS/PAMILY MSS& 1200-LI0 LUNCH 1:00 - 430 MAIIACIISSI f! • samAzanatir 12:00 - I500 LUNCH • 1.110 - 4:30 PHYSICAL Thararlsy 9m-I1:00 NUTSMOtt WO- MI ISSUISAMCSINI S MMS mmumamoner AND-COMOSC1tAs: 1:00 - 2:00 LUNCH 2:00"- *30 AM WINDOW fit' W >iE MD -Kr The iiiAMOUCIIIIniThiainnAiNINC112= >ocskd �t 400 N.W. 2 Avenue (dial -flood. Mimi, FL 95oo-moo EMIR * 1L00- I� nNAL S:YAM & 611AlIttiMIW City of Miami: RFP 610384 � J 3 Employee/Officer Assistance Program City of Miami Police Department Brian Mangan, Psy.D., ABPP Board Certified in Police & Public Sufety Psychology Licensed Psychologist Law Enforcement Psychological & Counseling Associates, Inc 9960 NW 116 Way, Suite 12, Medley, FL 33178 RFP 610384 8 EAP/OAP Program ■ CALEA Law Enforcement Agency Standards (2006): From Standard 22.2.6 • The agency makes available to employees an Employee Assistance Program (EAP) designed to assist in the identification and resolution of concerns or problems (personal or job related), which may adversely affect an employee's personal or professional well-being or job performance. These personal concerns may include, but are not limited to, health, marital status, family, financial, substance abuse, emotional/stress, and other personal matters. � C C City of Miami: RFP 610384 J EAP/OAP Program • Standard 22.2.6 continued • The EAP shall include, at a minimum: • A written directive describing program services; • Procedures for obtaining program services; • Confidential, appropriate, and timely problem assessment services; • Referrals to services, either workplace or community resources for appropriate diagnosis, treatment, and follow-up; • Written procedures and guidelines for referral to and/or mandatory participation; and, • Training of designated supervisory personnel in the program services, supervisor's role and responsibility, and identification of employee behaviors which would indicate the existence of employee concerns, problems and/or issues that could impact employee job performance!. Voluntary Participation ■ This service is provided to sworn and non -sworn personnel in the department, specifically designed to meet the needs of this population including significant others and immediate family members ■ Employees may be made aware of the EAP services through: ■ Posted brochures and pamphlets throughout various areas in the department offices; ■ Weekly roll call announcements; ■ Departmental newsletters; ■ New hire orientation; and ■ Annual trainings/procedure updates City of Miami: RFP 610384 Voluntary Participation • Employees are allowed and often encouraged to contact the LEPCA office independently and without permission from their supervisors • People are less likely to seek treatment if they feel as though they have to let other people know about their personal situation • Our office assures the employee that their personal information is kept confidential from all people, as long as it is consistent with state and national regulations • Billing for the department is done in a confidential manner • Confidentiality is paramount. Traditional EAPs that involve the employer's insurance provider and claims often lead to issues regarding necessary authorizations and diagnosis, which may perpetuate the concerns with confidentiality, stigma, and rumors 3 City of Miami: RFP 610384 Voluntary Participation • Supervisors should remain vigilant of the traits, patterns, and characteristics of those they supervise. Ideally, all employees should remain vigilant of fellow employees • Every individual goes through brief periods of "ups and downs," and every individual experiences a period of adjustment to changes in life • A typical adjustment period will last approximately six months • During this period, simple "peer support" should be provided. With time and support from friends, family, and fellow employees, proper adjustmentt is likely to be achieved • If any symptoms persist beyond that period, of if any symptoms substantially impact an individual's personal or occupational functioning, then participation in the EAP program should be encouraged C G C 3 J 3 Voluntary Participation ■ If a voluntary referral is recommended to the employee, then the agency will not be provided confirmation of attendance unless the employee makes the request and signs the appropriate release • So how will you know if they attend? • Continue to observe the employee. If the concerning traits, behaviors, or patterns improve, then it is likely that the employee participated in at least one session with a professional or the individual improved simply by being made aware that others were noticing problematic symptoms • What happens if the symptoms continue to get worse? • Whether or not the appointment was made, if the symptoms get worse and interfere with personal and occupational functioning for more than a brief period of time, or substantially interfere at any point, then consideration for a more stringent intervention is suggested in order for the agency to receive confirmation of intervention (Mandatory Referral) Mandatory Referral • With the guidance of the Departmental Order regarding Mandatory Referrals, proper procedures should be taken to generate the order • Contact may be made to LEPCA at any time to discuss the concerns and consider appropriate measures • Once the mandatory appointment is set, our office will provide the employee with clear and concise information regarding the limits of confidentiality, purpose of mandatory referrals, and the minimum required communication that will take place in the form of an attendance confirmation letter to the agency • The employee may refuse at any time, but in such a case, the agency will receive appropriate notification of the refusal City of Miami: RFP 610384 Mandatory Referral • If an employee's functioning continues to worsen despite voluntary and/or mandatory referral, then additional steps may be considered: • Disciplinary actions, administrative leave, FMLA, etc. are all reasonable approaches depending on the particulars of the situation • Depending on the severity, and if the threshold is met as per the guidelines established by the IACP Police Psychological Services Section, then a Fitness for Duty Evaluation may be considered • IMPORTANT: A Fitness for Duty Evaluation (FFDE) is a stringent intervention and is in no way to be used as a disciplinary measure or a means of termination. Unless the case is severe, many FFDEs result in a rehabilitative approach to returning the employee to "baseline" functioning and back to work v et CA City of Miami: RFP 610384 Symptoms From the National Institute of Mental Health • Symptoms related to traumatic or problematic events can be divided into four separate categories: • Behavioral: Binge drinking, fighting with others, outbursts, etc. • Cognitive: Forgetfulness, distracted, confused, "in a daze", etc. • Physical: Severe headaches, stomach aches, ulcers, body pains, etc. • Emotional: Tearfulness, withdrawn, depressed mood, etc. • The following slides identify more symptoms (non -exhaustive) for adults, teens, and younger children • It is important to remember that the EAP program is available to all employees, significant others, and children • A healthy home is important in the maintenance of a healthy employee City of Nliami: RFP 610384 Symptoms From the National Institute of Mental Health ® Adults: • Confused thinking • Long-lasting sadness or irritability • Extremely high and low moods • Excessive fear, worry, or anxiety • Social withdrawal • Dramatic changes in eating or sleeping habits • Strong feelings of anger • Delusions or hallucinations (seeing/hearing things that arc not really there) • Increasing inability to cope with daily problems and activities • Thoughts of suicide • Denial of obvious problems • Many unexplained physical problems • Abuse of drugs and/or alcohol RFP 610384 s 0 Symptoms From the National Institute of Mental Health • Older children and pre -teens: • Abuse of drugs and/or alcohol • Changes in school performance, falling grades • Inability to cope with daily problems and activities • Changes in sleeping and/or eating habits • Excessive complaints of physical problems • Defying authority, skipping school, stealing, or damaging property • Intense fear of gaining weight • Long-lasting negative mood, often along with poor appetite and thoughts of death • Frequent outbursts of anger City of Miami: RFP 610384 3 � Symptoms From the National Institute of Mental Health e Younger children: ■ Changes in school performance ■ Poor grades despite strong efforts ■ Excessive worry or anxiety ■ Hyperactivity ■ Persistent nightmares ■ Persistent disobedience and/or aggressive behavior ■ Frequent temper tantrums ■ Withdrawal from others Considerations for Supervisors • If you notice symptoms that persist and/or limit a major life activity or impair a work function: • Contact our office to discuss any observations, questions, or concerns; • Discuss observations with the employee (this is why supervisor rapport with employee is very important to develop); • Directly educate the employee about the services available to them and provide a brochure for referral purposes s CONTACT: Brian Mangan, Psy.D., ABPP Board Certified in Police & Public Safety Psychology Licensed Psychologist Law Enforcement Psychological and Counseling Associates, Inc (LEPCA) 305-442-8800 C C C city oamirnEttfutorntont Psychological & Counseling Associates, Inc. Page 132 GENERAL CLIENT INFORMATION Date: Client Name: D.O.B. / / Last 4 of SS#: Address: Apt. City: Zip Code: Phone(s): Primary Secondary Email: MAY WE CALL YOU IF NEEDED AT PHONE NUMBERS AND/OR EMAIL LISTED ABOVE?: Primary #: Yes No. Secondary #: Yes No Email Yes No Employer: Address: Relationship to Patient (if applicable- Parent/Guardian): Emergency Contact: Phone: Relationship: HAVE YOU EVER BEEN TO A THERAPIST BEFORE? Yes No If Yes (Focus of Therapy): Present Medication(s): Serious Illness/Disabilities/Hospitalizations: Reason for Making Appointment Today: Family Doctor: Phone: SOURCE OF REFERRAL TO US: *************************************************************************************** Office I"se Only: Assigned to 4Q6u \.1\ I I"" 11;r.. S :ite I' • \IIA\II. FLORID \ _. }-g • T EL• -05-442-8S'.n • f .\\:05-44'-446o toN City ofklidwiEWrgfgfent Psychological & Counseling Associates, Inc. Page 133 CLIENT INFORMATION This document serves to provide important information about work environment safety and psychological treatment at Law Enforcement Psychological & Counseling Associates (LEPCA). Please read and sign at the bottom to indicate that you have reviewed this information. WORKPLACE SAFETY: In order to maintain a safe working environment for both clients and staff, LEPCA maintains a strict NO WEAPON policy within the confines of the office and treatment facility. As we mainly provide services to law enforcement officers, we acknowledge and respect the practice of carrying a firearm/weapon. Nevertheless, based on the sensitive nature of the work we conduct within the office, we require all individuals to refrain from carrying any firearms/weapons into the office. We encourage you to securely lock your weapons in your vehicle or we will provide you with a locked cabinet to secure your firearm/weapon in the office. If you choose not to comply with this policy, the assigned therapist or office staff may request that you leave the office until you speak with the program coordinator to discuss your concerns. LENGTH OF TREATMENT: Counseling typically involves weekly sessions, usually 50 minutes in length. Duration of treatment varies depending on the nature of the problem and your individual needs. However, the goal of the program is short-term counseling which usually involves six (6) sessions or less. CONFIDENTIALITY: Information shared with a therapist is kept strictly confidential and is not disclosed without your written permission. However, confidentiality is not guaranteed in cases of (a) danger to yourself or others (e.g., homicide or suicide), or (b) situations in which children or the elderly are endangered (e.g., sexual or physical abuse or neglect). Consultation with the head psychologists, Dr. Brian Mangan and Dr. Mark Axelberd, or another staff psychologist may be done on an as needed basis in order to facilitate case management and treatment planning. FEE: All services through the Officer/Employee Assistance Program are free of charge for participating agencies or otherwise arranged through a referring agency. No names of clients/service users are provided to the City or agency during billing. If your agency does not cover the cost of treatment through an existing program. you do have the option to pay out-of-pocket for services rendered. The program coordinator will arrange a reduced fee relative to typical private practice fees. 1)061) \ \\ !It 1\,,.. Suit., 12 • \II.\\II. FLORIDA :: 1-S • TEL::U5-442-SSO!) • F.\\ O --1L=- 400 City ofbbnnEttitite~t Psychological & Counseling Associates, Inc. Page 134 EMERGENCIES: We maintain 24-hour availability should an emergency occur. In such a case, please call the normal office number 305-442-8800 and instructions will be provided on how to reach the on -call therapist. • PHYSICIAN CONTACT: Physical and psychological symptoms often interact, and we encourage you to seek medical consultation if warranted. In addition, medication may sometimes be helpful for psychological problems. When appropriate, referral for psychiatric consultation can be arranged. EXPERT WITNESS SERVICES: This counseling program is a special benefit by the City for police department employees and their family members. Program staff will not provide expert witness testimony for program participants. If you are involved in current or anticipated litigation and may require expert psychological testimony, such services must be received from an independent psychologist not connected to this City sponsored program. If you have any questions about this policy, please let your counselor know immediately. FREEDOM TO WITHDRAW: You have the right to end therapy at any time. If you wish, your counselor will provide you with the names of other qualified therapists. INFORMED CONSENT: I have read and understood the preceding statements, and agree to begin treatment through the Officer Assistance Program. Should you have further questions about treatment, please be sure to ask your treating counselor. Print Name: Signature: Date: (Guardian or Parent signs for minor under 18-years of age) LEPCABM 9-14 qt)(. \ \\ . I I' \\. . Suite 12 • \11.\\11. FLORID \ !- • [Et • 3n5-142-SS '' • r.\\ City of RinrOgarttfiffent Psychological & Counseling Associates, Inc. Page 135 PRIVACY POLICY It is the policy of our practice that all staff preserve the integrity and confidentiality of protected health information (PHI) pertaining to our clients. The purpose of this policy is to ensure that our practice and its staff have the necessary medical and/or PHI to provide the highest quality mental health care possible while protecting the confidentiality of the PHI of our clients to the highest degree possible. Clients should not fear about providing information to our practice and its staff for purposes of treatment. To that end, our practice and its staff will: • Adhere to the standards set forth in the Notice of Privacy Practices • Collect, use and disclose PHI only in conformance with state and federal laws and current covenants and/or authorizations, as appropriate. Our practice and its staff will not use or disclose PHI for uses outside of treatment purposes. • Recognize that PHI collected about clients must be accurate, timely, complete, and available when needed. Our practice and staff will: o Implement reasonable measures to protect the integrity of all PHI maintained about clients. • Recognize that clients have a right to privacy. Our practice and staff will respect the client's individual dignity at all times. Our practice and its staff will respect the client's privacy to the extent consistent with providing the highest quality care possible and with the efficient administration of the mental health office. • Act as responsible information stewards and treat all PHI as sensitive and confidential. Consequently. our practice and staff will: o Treat all PHI data as confidential in accordance with professional ethics, accreditation. standards. and legal requirements. o Not disclose PHI data unless the client (or his/her authorized representative) has properly consented to or authorized the release, or law otherwise authorizes the release. • Recognize that, although our practice "owns" the psychological record, the client has a right to inspect and obtain a copy of his/her PHI. In addition clients have a right to request an amendment to his/her psychological record if he/she believes his/her information is inaccurate or incomplete. Our practice and staff wil I: o Permit clients access to their mental health records when their written requests and approved by our practice. If we deny such requests, we will inform the clients that they may request a review of our denial. In such cases, we will have an on -site health care professional review the client's appeals. o Provide clients an opportunity to request the correction of inaccurate or incomplete PHI in their records in accordance with the law and professional standards. • All staffof our practice will adhere to any restrictions concerning the use or disclosure of PHI that clients have requested and have been approved by our practice. • All staff of our practice must adhere to this policy. Our practice will not tolerate violations of this policy. Violation of this policy is grounds for disciplinary action, up to and including termination of employment and criminal or professional sanctions in accordance with our practice's personnel rules and regulations. Our practice may change this privacy policy in the future. Any changes will be effective upon the release of a revised privacy policy and will be made available to clients upon request. If you would like a copy of this policy. request one and a copy will be given to you. I have read the above: Print Name Signature Date 4��hii \.\\ I I( \\ u\. Suite 12 • \11.-\\II. FLtaRlf) \ 33I'1 LA =(15--142-8`�W)n • F.\\ 305-442446u City of taliciiEROVIEMtlt Psychological and Counseling Associates, Inc. Page 136 MANDATORY COUNSELING GENERAL CLIENT INFORMATION Date: Client Name: D.O.B. / / Last 4 of SS#: Address: Apt. City: Zip Code: Phone(s): Primary Secondary Email: MAY WE CALL YOU IF NEEDED AT PHONE NUMBERS AND/OR EMAIL LISTED ABOVE?: Primary #: Yes No Secondary #: Yes No Email Yes No Employer: Address: Relationship to Patient (if applicable- Parent/Guardian): Emergency Contact: Phone: Relationship: HAVE YOU EVER BEEN TO A THERAPIST BEFORE? Yes No If Yes (Focus of Therapy): Present Medication(s): Serious Illness/Disabilities/Hospitalizations: Reason for Making Appointment Today: Family Doctor: Phone: SOURCE OF REFERRAL TO US: ***************************************************************************************** Office Use Only: Assigned to oo i \\\ 1 Ibth \\��. `L ITE 12 • \II \\ll. FL I %8• [EL • =' .-LJ`-8Stm • FAN City of Axing: r B x W nt Psychological and Counseling Associates, Inc. Page 137 CLIENT INFORMATION This document serves to provide important information about work environment safety and psychological treatment at Law Enforcement Psychological & Counseling Associates (LEPCA). Please read and sign at the bottom to indicate that you have reviewed this information. WORK PLACE SAFETY: In order to maintain a safe working environment for both clients and staff, LEPCA maintains a strict NO WEAPON policy within the confines of the office and treatment facility. As we mainly provide services to law enforcement officers, we acknowledge and respect the practice of carrying a firearm/weapon. Nevertheless, based on the sensitive nature of the work we conduct within the office, we require all individuals to refrain from carrying any firearms/weapons into the office. We encourage you to securely lock your weapons in your vehicle or we will provide you with a locked cabinet to secure your firearm/weapon in the office. If you choose not to comply with this policy, the assigned therapist or office staff may request that you leave the office until you speak with the program coordinator to discuss your concerns. LENGTH OF TREATMENT: Counseling typically involves weekly sessions, usually 50 minutes in length. Duration of treatment varies depending on the nature of the problem and your individual needs. However, the goal of the program is short-term counseling which usually involves six (6) sessions or less. LIMITS OF CONFIDENTIALITY: Any individual sent for mandatory counseling is being required by the referring department/agency to attend and cooperate as a work -related requirement. As a result, written record will be provided to the relevant staff within the department/agency confirming your attendance and cooperation, or the lack thereof. Aside from this communication with the department/agency, personal information shared with a therapist during the session(s) is kept strictly confidential and is not disclosed without your written permission. However. confidentiality is not guaranteed in cases of (a) danger to yourself or others (e.g., homicide or suicide), or (b) situations in which children or the elderly are endangered (e.g.. sexual or physical abuse or neglect). Consultation with the head psychologists, Dr. Brian Mangan and Dr. Mark Axelberd, or another staff psychologist may be done on an as needed basis in order to facilitate case management and treatment planning. FEE: All services through the Officer/Employee Assistance Program are free of charge for participating agencies or otherwise arranged through a referring agency. No names of clients/service users are provided to the Citv or agency during billing. If your agency does not cover the cost of treatment through an QQt,ii \11 I loth 1,1a . SLITS 12 • \IIA\11. FI. 1'S• TEL• 3115_442_S8.H • L.1t; City of Atinti:E0/6161314nt Psychological and Counseling Associates, Inc. Page 138 existing program, you do have the option to pay out-of-pocket for services rendered. The program coordinator will arrange a reduced fee relative to typical private practice fees. EMERGENCIES: We maintain 24-hour availability should an emergency occur. In such a case, please call the normal office number 305-442-8800 and instructions will be provided on how to reach the on -call therapist. PHYSICIAN CONTACT: Physical and psychological symptoms often interact, and we encourage you to seek medical consultation if warranted. In addition, medication may sometimes be helpful for psychological problems. When appropriate, referral for psychiatric consultation can be arranged. EXPERT WITNESS SERVICES: This counseling program is a special benefit by the City for police department employees and their family members. Program staff will not provide expert witness testimony for program participants. If you are involved in current or anticipated litigation and may require expert psychological testimony, such services must be received from an independent psychologist not connected to this City sponsored program. If you have any questions about this policy, please let your counselor know immediately. FREEDOM TO WITHDRAW: You have the right to end therapy at any time. Nevertheless, refusal to comply with a Mandatory Counseling session(s) will be reported to the referring department/agency. If you wish. your counselor will provide you with the names of other qualified therapists within the fine. INFORMED CONSENT: I have read and understood the preceding statements, and agree to begin Mandatory Counsleing treatment through the Officer Assistance Program. Should you have further questions about treatment, please be sure to ask your treating counselor. Print Name: Signature: Date: (Guardian or Parent signs for minor under 18-years of age) LEPCA'BM 9-14 LAN, \\\ 1 Int \\:1 .'l•11 F. 12 • \II.\\II. I -I. .FF.I :ii:,_1-12.33I • FAX :'i:.;42._l4 Q> eIN city of gutifiERfirratramit Psychological and Counseling Associates, Inc. Page 139 PRIVACY POLICY It is the policy of our practice that all staff preserve the integrity and confidentiality of protected health information (PHI) pertaining to our clients. The purpose of this policy is to ensure that our practice and its staff have the necessary medical and/or PHI to provide the highest quality mental health care possible while protecting the confidentiality of the PHI of our clients to the highest degree possible. Clients should not fear about providing information to our practice and its staff for purposes of treatment. To that end, our practice and its staff will: • Adhere to the standards set forth in the Notice of Privacy Practices • Collect, use and disclose PHI only in conformance with state and federal laws and current covenants and/or authorizations, as appropriate. Our practice and its staff will not use or disclose PHI for uses outside of treatment purposes. • Recognize that PHI collected about clients must be accurate, timely, complete, and available when needed. Our practice and staff will: o Implement reasonable measures to protect the integrity of all PHI maintained about clients. • Recognize that clients have a right to privacy. Our practice and staff will respect the client's individual dignity at all times. Our practice and its staff will respect the client's privacy to the extent consistent with providing the highest quality care possible and with the efficient administration of the mental health office. • Act as responsible information stewards and treat all PHI as sensitive and confidential. Consequently, our practice and staff will: o Treat all PHI data as confidential in accordance with professional ethics, accreditation, standards, and legal requirements. o Not disclose PHI data unless the client (or his/her authorized representative) has properly consented to or authorized the release, or law otherwise authorizes the release. • Recognize that, although our practice "owns" the psychological record, the client has a right to inspect and obtain a copy of his/her PHI. In addition clients have a right to request an amendment to his/her psychological record if he/she believes his/her information is inaccurate or incomplete. Our practice and staff will: o Permit clients access to their mental health records when their written requests are approved by our practice. If we deny such requests, we will inform the clients that they may request a review of our denial. In such cases, we will have an on -site health care professional review the client's appeals. o Provide clients an opportunity to request the correction of inaccurate or incomplete PHI in their records in accordance with the law and professional standards. • All staff of our practice will adhere to any restrictions concerning the use or disclosure of PHI that clients have requested and have been approved by our practice. • All staff of our practice must adhere to this policy. Our practice will not tolerate violations of this policy. Violation of this policy is grounds for disciplinary action. up to and including termination of employment and criminal or professional sanctions in accordance with our practice's personnel rules and regulations. Our practice may change this privacy policy in the future. Any changes will be effective upon the release of a revised privacy policy and will be made available to clients upon request. If you would like a copy of this policy. request one and a copy will be given to you. l have read the above: Print Name Signature Date 99,ii \\\ 116r11 \\;r.. St IF 12 • \I!•\\II. FI. ;1-8• IFf • ;'15_142_Suui • I- :ii:;•-!'-4-1nu city of MimiDifrPretWit4it Psychological and Counseling Associates, Inc. Page 140 CRITICAL INCIDENT STRESS DEBRIEFING GENERAL CLIENT LNFORMATION Date: Client Name: D.O.B. / / Last 4 of SS;-`,': Address: Apt. City: Zip Code: Phone(s): Primary Secondary Email: MAY WE CALL YOU IF NEEDED AT PHONE NUMBERS AND/OR EMAIL LISTED ABOVE?: Primary #: Yes No Secondary #: Yes No Email: Yes No Employer: Address: Emergency Contact: Phone: Relationship: HAVE YOU EVER BEEN TO A THERAPIST BEFORE? Yes No If Yes (Focus of Therapy): Present Medication(s): Serious Illness/Disabilities/Hospitalizations: Reason for Making Appointment Today: CRITICAL INCIDENT STRESS DEBRIEFING Family' Doctor: Phone: SOURCE OF REFERRAL TO US (AGENCY): LEPCA'BI 10-14 996!J \\\ 1 ibt! \\ J:. SUITE 12• \II \\1I. FL : 2; 1 -S• TLL: 3H-4-I_'-SSM U • F.\\ :!i_---_-44b9 city- of lAtwiERtRiftt Psychological and Counseling Associates, Inc. Page 141 CLIENT INFORMATION This document serves to provide important information about work environment safety and psychological treatment at Law Enforcement Psychological & Counseling Associates (LEPCA). Please read and sign at the bottom to indicate that you have reviewed this information. WORK PLACE SAFETY: In order to maintain a safe working environment for both clients and staff. LEPCA maintains a strict NO WEAPON policy within the confines of the office and treatment facility. As we mainly provide services to law enforcement officers, we acknowledge and respect the practice of carrying a firearm/weapon. Nevertheless, based on the sensitive nature of the work we conduct within the office, we require all individuals to refrain from carrying any firearms/weapons into the office. We encourage you to securely lock your weapons in your vehicle or we will provide you with a locked cabinet to secure your firearm/weapon in the office. If you choose not to comply with this policy. the assigned therapist or office staff may request that you leave the office until you speak with the program coordinator to discuss your concerns. NATURE OF SESSION: A Critical Incident Stress Debriefing (CISD) is not disciplinary in nature, nor is a CISD an evaluation to determine an individual's "fitness for duty." A CISD is a confidential communication, primarily educative in nature regarding critical incidents, stress, common changes to perception, attention, and memory, etc. In addition, the CISD is intended to provide education regarding the management of any problematic post - incident reactions. COURSE OF INTERVENTION: Any participation beyond attendance of the first CISD session is voluntary on the part of the officer. Our office contact information will be provided to you in the case that additional assistance is needed. LIMITS OF CONFIDENTIALITY: Any individual sent for a Critical Incident Stress Debriefing is being mandated by the referring department/agency to attend as a work -related requirement. As a result, written record will be provided to the relevant staff within the department/agency confirming your attendance and participation. Aside from this communication with the department/agency. personal information shared with a psychologist during the session(s) is kept strictly confidential and is not disclosed without your written permission. However. confidentiality is not guaranteed in cases of (a) danger to yourself or others (e.g.. homicide or suicide). or (b) situations in which children or the elderly are endangered (e.g.. sexual or physical abuse or neglect). 99611 \1,1 1 Ibth 1\ SUITE 12 • \11.1\11. FL 331786 TEL: 3u5-442-S$60 • F.\\ - )5-4i_-44bQ City of if:ERfd�kct Psychological and Counseling Associates, Inc. Page 142 Consultation with the head psychologists, Dr. Brian Mangan and Dr. Mark Axelberd, or another staff psychologist may be done on an as needed basis in order to facilitate case management and treatment planning. FEE: Agency covers cost. EMERGENCIES: We maintain 24-hour availability should an emergency occur. In such a case, please call the normal office number 305-442-8800 and instructions will be provided on how to reach the on -call therapist. PHYSICIAN CONTACT: Physical and psychological symptoms often interact, and we encourage you to seek medical consultation if warranted. In addition, medication may sometimes be helpful for psychological problems. When appropriate, referral for psychiatric consultation can be arranged. EXPERT WITNESS SERVICES: This counseling program is a special benefit by the City for police department employees and their family members. Program staff will not provide expert witness testimony for program participants. If you are involved in current or anticipated litigation and may require expert psychological testimony, such services must be received from an independent psychologist not connected to this City sponsored program. If you have any questions about this policy, please Iet your counselor know immediately. FREEDOM TO WITHDRAW: You have the right to end the CISD at any time. Nevertheless, refusal to attend the initial CISD will be reported to the referring department/agency, as they do require a confirmation letter for participation. If you wish at any time, you may request the names of other qualified therapists within the tirm trained in conducting CISDs. INFORMED CONSENT: I have read and understood the preceding statements, and agree to begin the Critical Incident Stress Debriefing through the Officer Assistance Program. Should you have further questions about the session. please be sure to ask the psychologist. Print Name: Signature: Date: 'N(n \\\ I I0h \\:1%. • \II \\II. FI.. I. I El 3115-41_'-8Gui • F.\Th5-41"--11no City of lis:latfrtt Psychological and Counseling Associates, Inc. Page 143 PRIVACY POLICY It is the policy of our practice that all staffpreserve the integrity and confidentiality of protected health information (PHI) pertaining to our clients. The purpose of this policy is to ensure that our practice and its staff have the necessary medical and/or PHI to provide the highest quality mental health care possible while protecting the confidentiality of the PHI of our clients to the highest degree possible. Clients should not fear about providing information to our practice and its staff for purposes of treatment. To that end, our practice and its staff will: • Adhere to the standards set forth in the Notice of Privacy Practices • Collect, use and disclose PHI only in conformance with state and federal laws and current covenants and/or authorizations, as appropriate. Our practice and its staff will not use or disclose PHI for uses outside of treatment purposes. • Recognize that PHI collected about clients must be accurate, timely, complete, and available when needed. Our practice and staff will: o Implement reasonable measures to protect the integrity of all PHI maintained about clients. • Recognize that clients have a right to privacy. Our practice and staff will respect the client's individual dignity at all times. Our practice and its staff will respect the client's privacy to the extent consistent with providing the highest quality care possible and with the efficient administration of the mental health office. • Act as responsible information stewards and treat all PHI as sensitive and confidential. Consequently, our practice and staffwill: o Treat all PHI data as confidential in accordance with professional ethics, accreditation, standards, and legal requirements. o Not disclose PHI data unless the client (or his/her authorized representative) has properly consented to or authorized the release, or law otherwise authorizes the release. • Recognize that, although our practice "owns" the psychological record, the client has a right to inspect and obtain a copy of his/her PHI. In addition clients have a right to request an amendment to his/her psychological record if he/she believes his/her information is inaccurate or incomplete. Our practice and staff will: o Permit clients access to their mental health records when their written requests are approved by our practice. if we deny such requests. we will inform the clients that they may request a review of our denial. In such cases, we will have an on -site health care professional review the client's appeals. o Provide clients an opportunity to request the correction of inaccurate or incomplete PHI in their records in accordance with the law and professional standards. • All staff of our practice will adhere to any restrictions concerning the use or disclosure of PHI that clients have requested and have been approved by our practice. • All staff of our practice must adhere to this policy. Our practice will not tolerate violations of this policy. Violation of this policy is grounds for disciplinary action. up to and including termination of employment and criminal or professional sanctions in accordance with our practice's personnel rules and regulations. Our practice may change this privacy policy in the future. Any changes will be effective upon the release of a revised privacy policy and will be made available to clients upon request. if you would like a copy of this policy. request one and a copy will be given to you. 1 have read the above: rint Name Signature Date 9061i \\\ I Inth FE 12 • \IL\III. FL.. 1'S• TEL: :»'5 �-2-SS'.lU • F.\\ :1)5-442•-140 City of Miami: RFP 610384 Appendix I - III Page 144 Lid on, City of :Miami: RFP 610384 004585 • Local Business Tax Receipt Miami -Dade County, State of 'Florida -THIS IS NOT A BILL -,.DO NOT PAY 305631 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES _ LAW ENFORCEMENT PSYCHOLOGICAL AND COUN015315E1110CIATESepTEmBER 30, 2019 9960 NW 116TH WAY 12 308831 Must be displayed at place of business MEDLEY FL 33178 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER INC 002145 SEC. TYPE OF BUSINESS 212 CONSULTANT PAYMENT RECEIVED ■Y TAX COLLECTOR $60.00 07/02/2018 CREDITCARD-1 8-046470 This Local Business Tax Rscalpt only ooafirma payment of the Laval Business Tax. The Receipt is note items, permit, or a csrtfflaatian of the hold -sea q�uualifications, to do business. Holder swat comply whh any povsrnnsatal of deolorernmentsl mguktory IawsaaiYgafrestenb which apply to the !wafnaa. The RECEIPT NO. above mast be displayed on ell commerelat vehicles- Mleatf-Oade Cade Sec Sa--276. For more Information, visit yyww,miemideds.novRaxcollector Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -CO NOT PAY 890047 BUSINESS NAME/LOCATION MANGAN BRIAN PSY D 9960 NW 116TH WAY 12 MEDLEY FL 33178 OWNER MANGAN BRIAN PSY D RECEIPT NO. RENEWAL 890047 SEC. TYPE OF BUSINESS 212 PROFESSIONAL 2025 LBT EXPIRES SEPTEMBER 30, 2019 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $60.00 07/02/2018 CREDITCARD-1 8-04 6470 This Local Business Tax Receipt only confirms payaram of tha Local Business Tax. The Receipt Is not a license, permit, or a certification at the holder'sqquualificatieas, to do business. Holder must comply with any governmental or aongarrsmmentaitegaistory laws ardregniremanta whicli apply to the business. The RECEIPT NO. above mum be displayed anal! commercial vehicles - Miami-Oads Code Sec 8a-276. For more Information, visit yvww,miamidads.00vAaxcollector Page 145 Acc.efIroNalRE 47920 Date: 10/01/18 Initials: CERTIFICATE OF INSURANCE ALLIED WORLD INSURANCE COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 800-421-6694 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. LPDPage 1 d6 Name and Address of Named Insured: LAW ENFORCEMENT PSYCHOLOGICAL AND COUNSELING ASSOCIATES, INC 9960 NW 116TH WAY SUITE 12 MIAMI FL 33178 Type of Work Covered: PROFESSIONAL PSYCHOLOGIST Location of Operations: N/A (If different than address listed above) Claim History: Retroactive date is 11/01/1992 Additional Named Insureds: BRIAN MANGAN, PSY.D. MARK AXELBERD, PH.D. Coverages Policy Number Effective Date Expiration Date Limits of Liability PROFESSIONAL/ LIABILITY 5012-4507 • 11/01/18 11/01/19 2,000,000 4,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: Defense CITY OF MIAMI POLICE DEPARTMENT 400 NW 2ND AVE MIAMI FL 33128 This Certificate Issued to: Name: LAW ENFORCEMENT PSYCHOLOGICAL AND COUNSELING ASSOCIATE Address: 9960 NW 116TH WAY SUITE 12 MIAMI FL 33178 APA 00138 00 (06/2014) Reimbursement Proceedings Limit i MIAMI-DADE COUNTY METRO POLICE DEPARTMENT 111 NW 1ST ST, STE 2340 MIAMI FL 33128 s $25,000. 3/9 ADDL.INS.BELOW: STATE OF FLORIDA FLORIDA HIGHWAY PATROL 2900 APALACHEE PKWY TAIL SEE FL 32399 Autjorized Representative is) C400103(4 AkRoki1g9cV4 Screening Services Attachment C Compensation Proposal INSTRUCTIONS: The Proposers price shall be submitted on this Form, 'Compensation Proposal", and in the manner stated herein. Proposer is requested to fill in the applicable blanks on this form and to make no other marks The rates outlined below are for the term of the contract and include all out -of -pocked expenses, including materials, employee travel, per diem and miscellaneous costs and fees. Page 147 Item Number Description Unit of Measure Estimated Yearly Quantity , Proposed Price 1 Psychological Screening Services for the Miami Police Department. Phase 1: Pre -Employment Psychological Services for Personnel, Pre- Offer Evaluation Phase - Cost Per Applicant. Each 344 $ 250.00 2 Psychological Screening Services for the Miami Police Department. Phase 2: Post -Offer Psychological Services for Personnel Evaluation Phase - Cost Per Applicant. Each 108 $ 50.00 3 Psychological Screening Services for the Miami Police Department. Legal Defense Fee (Cost to defend and/or represent the City in any lega proceeding) Hour 2 175.00 4 Psychological Services for Personnel. Counseling and Training Services. Hour 1028 $ 115.00 City of Miami: RFP 610384 Attachment E APPENDIX A HIPAA BUSINESS ASSOCIATE ADDENDUM Page 148 This HIPAA Business Associate Addendum ("Addendum") supplements and is made a part of the Agreement by and between City of Miami ("City"), a municipal corporation of the State of Florida, and Law Enforcement Psychological & , Business Associate ("Associate"). Counseling Associates . Inc (LEPCA) RECITALS A. As part of the Agreement, it is necessary for the City to disclose certain information ("Information") to Associate pursuant to the terms of the Agreement, some of which may constitute Protected Health Information ("PHI"). B. Cityand Associate intend to protect the privacy and provide for the security of PHI, including but not limited to, PHI, disclosed to Associate pursuant to the Agreement in compliance with the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 ("HIPAA") and regulations promulgated thereunder by the U.S. Department of Health and Human Services (the "HIPAA Regulations") and other applicable laws. C. The purpose of this Addendum is to satisfy certain standards and requirements of HIPAA and the HIPAA Regulations, including, but not limited to, Title 45, Sections 164.308(b), 164.314(a), 164.502(e) and 164.504(e) of the Code of Federal Regulations ("CFR"'), as the same may be amended from time to time. In consideration of the mutual promises below and the exchange of information pursuant to the Agreement, the parties agree as follows: 1. Definitions. Terms used, but not otherwise defined, shall have the same meaning as those terms in 45 CFR Sections 160.103, 164.304 and 164.501. a. "Business Associate" shall have the meaning given to such term under the HIPAA Regulations, including, but not limited to, 45 CFR Section 160.103. b. "Covered Entity" shall have the meaning given to such term under HIPAA and the HIPAA Regulations, including, but not limited to, 45 CFR Section 160.103. 1/4.) L) City of Miami: RFP 610384 Attachment E Page 149 c. "Protected Health Information" or "PHI" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual, the provision of health care to an individual, or the past, present or future payment for the provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under HIPAA and the HIPAA Regulations, including, but not limited to 45 CFR Section 1103. [45 CFR Parts 160, 162 and 164] d. "Electronic Protected Health Information" or "ePHI" means any information that is transmitted or maintained in electronic media: (i) that relates to the past, present or future physical or mental condition of an individual, the provision of health care to an individual, or the past, present or future payment for the provision of health care to an individual. and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under HIPAA and the HIPAA Regulations, including, but not limited to 45 CFR Section 160.103. [45 CFR Parts 160, 162 and 164] e. "Electronic Media" shall have the meaning given to such term under HIPAA and the HIPAA Regulations, including but not limited to, 45 CFR Section 160.103. f. "Security incident" shall have the meaning given to such term under HIPAA and the HIPAA Regulations,•including but not limited to, 45 CFR Section 164.304. 2. Obligations of Associate. a. Permitted Uses and Disclosures. Associate may use and/or disclose PHI received by Associate pursuant to the Agreement ("City's PHI") solely in accordance with the specifications set forth in the Scope of Services, Appendix A. In the event of any conflict between this Addendum and Appendix A, this Addendum shall control. [45 CFR § 164.504(e)(2)(i)] b. Nondisclosure. Associate shall not use or further disclose City's PHI other than as permitted or required by law. [45 CFR § 164.504(e)(2)(ii)(A)] c. Safeguards. Associate shall use appropriate safeguards to prevent use or disclosure of City's PHI in a manner other than as provided in this Addendum. [45 CFR § 164.504(e)(2)(ii)(B)] Associate shall maintain a comprehensive written information security program that includes administrative, technical and physical safeguards appropriate to the size and complexity of the Associate's operations and the nature and scope of its activities. Appropriate safeguards used by Associate shall protect the confidentiality, integrity, and availability of the PHI and ePHI that is created, received, maintained, or transmitted on behalf of the County. [45 CFR § 164.314(a)(2)(i)(A)] City has at its sole discretion, the option to audit and inspect, the Associate's safeguards at any time during the life of the Agreement, upon reasonable notice being given to Associate for production of documents and coordination of inspection(s). City of Miami: RFP 610384 Attachment E d. Reporting of Disclosures. Associate shall report to the City's Project Manager, any use or disclosure of the City's PHI in a manner other than as provided in this Addendum. [45 CFR § 164.504(e)(2)(ii)(c)] Associate shall report to the City through the City's Project Manager, any security incident of which it becomes aware within forty-eight (48) hours of discovery of the incident. [45 CFR § 164.314(a)(2)(i)(C)] Page 150 e. Associate's Agents. Associate agrees and shall ensure that any agents, including subcontractors, to whom it provides PHI received from (or created or received by Associate on behalf of) the City, agrees in writing to the same restrictions and conditions that apply to Associate with respect to such PHI and that such agents conduct their operations within the United States. Associate agrees and shall ensure that any agents, including subcontractors, to whom it provides ePHI received, created, maintained, or transmitted on behalf of the City, agrees in writing to implement reasonable and appropriate safeguards to protect the confidentiality, integrity, and availability of that ePHI. [45 CFR § 164.314(a)(2)(i)(B)] In no case may Associate's Agents reside and operate outside of the United States. f. Documentation of Disclosures. Associate agrees to document disclosures of the City's PH and information related to such disclosures as would be required for the City to respond to a request by an individual for an accounting of disclosures of PHI. Associate agrees to provide the City or an individual, in a time and manner designated by the City, information collected in accordance with the Agreement, to permit the City to respond to such a request for an accounting. [45 CFR § 164.528] g. Availability of Information to County. Associate shall make available to the City such information as the City may require to fulfill the City's obligations to provide access to, provide a copy of, and account for, disclosures of PHI pursuant to HIPAA and the HIPAA . Regulations, including, but not limited to, 45 CFR Sections 164.524 and 164.528. (45 CFR § 164.504(e)(2)(ii)(E) and (G)] h. Amendment of PHI. Associate shall make the City's PHI available to the City as may be required to fulfill the City's obligations to amend PHI pursuant to HIPAA and the HIPAA Regulations, including, but not limited to, 45 CFR Section 164.526 and Associate shall, as directed by the City, incorporate any amendments to the City's PHI into copies of such PHI maintained by Associate, and in the time and manner designated by the County. [45 CFR § 164.504(e)(2)(ii)(F)] Internal Practices. Associate shall make its internal practices, books and records relating to the use and disclosure of the City's PHI (or PHI created or received by Associate on behalf of the County) available to the City and to the Secretary of the U.S. Department of Health and Human Services in a time and manner designated by the City or the Secretary for purposes of determining Associate's compliance with HIPAA and the HIPAA Regulations. [45 CFR § 164.504(e)(2)(ii)(H) and 45 CFR Part 64, Subpart C.] City of Miami: RFP 610384 Page 151 efiN Attachment E j. Mitigation. Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Associate of a use or disclosure of the City's PHI by Associate in violation of the requirements of this Addendum. k. Associate's Insurance. Associate agrees to maintain the insurance coverage provided in the Agreement. I. Notification of Breach. Associate shall notify the City within twenty-four (24) hours, and shall provide written notice no later than forty-eight (48) hours of any suspected or actual breach of security, intrusion or unauthorized disclosure of PHI and/or any actual or suspected disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall take (i) prompt corrective action to cure any such deficiencies, and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. m. Expenses. Any and all expenses incurred by Associate in compliance with the terms of this Addendum or in compliance with the HIPAA Regulations shall be bome by Associate. n. No Third Party Beneficiary. The provisions and covenants set forth in this Agreement are expressly entered into only by and between Associate and the City and are intended only for their benefit. Neither Associate nor the City intends to create or establish any third -party beneficiary status or right (or the equivalent thereof) in any other third party nor shall any other third party have any right to enforce or enjoy any benefit created or established by the provisions and covenants in this Agreement. 3. Audits, Inspection and Enforcement. From time to time, after reasonable notice, upon any breach of this Addendum by Associate, the City may inspect the facilities, systems, books and records of Associate to monitor compliance with this Addendum. Associate shall promptly remedy any violation of this Addendum and shall certify the same to the City in writing. The fact that the City inspects, or fails to utilize its right to inspect, Associate's facilities, systems, books, records, and procedures does not relieve Associate of its responsibility to comply with this Addendum, nor does the City's (i) failure to detect or (ii) detection, but failure to notify Associate or require Associate to remedy such breach, constitute acceptance of such practice or a waiver of the City's enforcement rights under this Addendum. 4. Termination. a. Material Breach. A breach by Associate of any provision of this Addendum, shall constitute a material breach of the Agreement and shall provide grounds for immediate termination of the Agreement by the County. [45 CFR § 164,504(e)(3) and 45 CFR § 164.314(a)(2)(i)(D)) b. Termination for Cause - Reasonable Steps to Cure Breach. If the City recognizes a pattern of activity or practice of Associate that constitutes a material breach or violation of the Associate's obligations under the provisions of this Addendum and does not terminate the Agreement pursuant to Section 4a, above, the City may provide an opportunity for Associate to end the violation or cure the breach within five (5) days, or other cure period as may be specified in the Agreement. If Associate does not cure the breach or end the violation within the time period provided, the City may immediately terminate the Agreement. City of Miami: RFP 610384 Attachment E Page 152 c. Judicial or Administrative Proceedings. The City may terminate the Agreement, effective immediately, if (i) Associate is named as a defendant in a criminal or administrative proceeding for a violation of HIPAA, or (ii) a finding or stipulation that Associate has violated any standard or requirement of the HIPAA Regulations (or other security or privacy law) is made in any administrative or civil proceeding. d. Effect of Termination. Upon termination of the Agreement for any reason, Associate shall return or destroy as directed by the City, all PHI, including but not limited to ePHI, received from the City (or created or received by Associate on behalf of the County) that Associate still maintains in any form. This provision shall also apply to the City PHI that is in the possession of subcontractors or agents of Associate. Associate shall retain no copies of such PHI or, if return or destruction is not feasible, Associate shall provide to the City notification of the conditions that make return or destruction infeasible, and shall continue to extend the protections of this Addendum to such information, and limit further use or disclosure of such PHI to those purposes that make the return or destruction of such PHI infeasible. [45 CFR § 164.504(e)(2)(ii)(l)} 5. Indemnification. Associate shall indemnify and hold harmless the City, and its officers, employees, trustees, agents, and instrumentalities (the indemnified parties) from any and all liability, losses or damages, including attorneys' fees and costs of defense, which the City, or its officers, trustees, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to, or resulting from the performance of this Addendum by Associate or its employees, agents, servants, partners, principals, or subcontractors. Associate shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits, or actions of any kind or nature in the name of any of the indemnified parties, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attomey's fees which may issue thereon. Associate expressly understands and agrees that any insurance protection required by this Addendum, or otherwise provided by Associate, shall in no way limit the responsibility to indemnify, keep and save harmless and defend the indemnified parties as herein provided. This paragraph shall survive the termination of the Agreement. 6. Limitation of Liability. Nothing in this Addendum shall be construed to affect or limit the City's sovereign immunity as set forth in Florida Statutes, Section 768.28. 7. Amendment. a. Amendment to Comply with Law. The parties acknowledge that state and federal laws relating to the security and privacy of PHI, including electronic data, are rapidly evolving and that amendment of this Addendum may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of HIPAA, the HIPAA Regulations and other applicable laws relating to the security or confidentiality of PHI. The parties understand and agree that the City must receive satisfactory written assurance from Associate that Associate will adequately safeguard all PHI that it receives or creates pursuant to this Agreement. Upon the City's request, Associate agrees to promptly enter into an amendment to the Agreement embodying written assurances consistent with the standards and requirements of HIPAA, the HIPAA Regulations or other applicable laws. The City, in addition to any other remedies including specific performance. may terminate the Agreement upon five (5) days' written notice in the event City of Miami: RFP 610384 Attachment E Page 153 Associate does not enter into said amendment to the Agreement providing assurances regarding the safeguarding of PHI that the City, in its sole discretion, deems sufficient to satisfy the standards and requirements of HIPAA and the HIPAA Regulations. Notwithstanding Associate's failure to enter into an amendment, Associate shall comply with all provisions of the HIPAA laws, b. Amendment of Appendix A. In addition to amendments described in 7a above, Appendix A may otherwise be modified or amended by written mutual agreement of the parties without amendment of the remainder of this Agreement." 8. Assistance in Litigation or Administrative Proceedings. Associate shall make itself, and any subcontractors, employees or agents assisting Associate in the performance of its obligations under this Agreement, available to the City at the City's convenience upon reasonable notice, at no cost to the City, to testify as witnesses, for document production, or otherwise, in the event of litigation or administrative proceedings being commenced against the City, its trustees, officers, agents or employees based upon claimed violation of HIPAA, the HIPAA Regulations or other laws relating to security and privacy, except where Associate or its subcontractor, employee or agent is a named adverse party. 9. Effect on Agreement. Except as specifically required to implement the purposes of this Addendum, or to the extent inconsistent with this Addendum, all other terms of the Agreement shall remain in force and effect. In the event of any conflict between this Addendum and Agreement, this Addendum shall control. 10. Interpretation. This Addendum and the Agreement shall be interpreted as broadly as necessary to implement and comply with HIPAA, the HIPAA Regulations and applicable Florida laws. The parties agree that any ambiguity in this Addendum shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the HIPAA Regulations. 11, Jurisdiction. Any litigation between the parties regarding the terms of this Addendum shall take place in Miami -Dade City, Florida. City of Miami Request for Proposals (RFP) Procurement Department Miami Riverside Center 444 SW 20d Avenue, 6'h Floor Miami, Florida 33130 Web Site Address: www.miamigov.com/procurement RFPNumber: Title: Issue Date/Time: RFPClosing Date/Time: Pre-Bid/Pre-Proposal Conference: Pre-Bid/Pre-Proposal Date/Time: Pre-Bid/Pre-Proposal Location: Deadline for Request for Clarification: Contracting Officer: Hard Copy Submittal Location: Contracting Officer E-Mail Address: Contracting Officer Facsimile: 610384 Request for Proposals for Psychological Screening Services 07-NOV-2018 12/12/2018 @ 14:00:00 Voluntary Tuesday, November 13, 2018 at 10:00 AM 444 SW 2nd Avenue 6th North Conference Room Monday, November 19, 2018 at 2:00 PM Falcon, Eduardo City of Miami - City Clerk 3500 Pan American Drive Miami FL 33133 US efalcon@miamigov.com 305-400-5390 Page 1 of 43 Certification Statement Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME. ADDRESS• PHONE: FAX: EMAIL: CELL(Optional) SIGNED BY - TITLE: DATE. FAILURE TO COMPLETE. SIGN, AND RETURN THIS FORM SHALL DISOUALIFY THIS RESPONSE. Page 2 of 43 Certifications Legal Name of Finn: Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Year Established: Office Location: City of Miami, Miami -Dade County, or Other Business Tax Receipt/Occupational License Number: Business Tax Receipt/Occupational License Issuing Agency: Business Tax Receipt/Occupational License Expiration Date: FEIN/EIN Federal Employer Identification Number Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 7/1/17). If no addendum/addenda was/were issued, please insert N/A. If Proposer has a Local Office, as defined under Chapter 18/Articlle III, Section 18-73 of the City Code, has Proposer filled out, notarized, and included with its RFP response the "City of Miami Local Office Certification" form? YES OR NO? (The City of Miami Local Office Certification form is located in the Oracle Sourcing system ("iSupplier"), under the Header/Notes and Attachments Section of this solicitation) Has Proposer reviewed the Attached Sample Professional Services Agreement? Yes / No Acknowledge that if awarded, Proposer will be required to execute the Professional Services Agreement in substantially the attached form. In addition Proposer must acknowledge that certain clauses are non-negotiable. Yes / No Page 3 of 43 Page 4 of 43 Line: 1 Description: Proposers are not required to enter a unit price on this line. Please refer to Section 2.16, Compensation Proposal. Proposers shall submit their proposed prices on Attachment C, Compensation Proposal, (located under the Header/Notes and Attachments section of this solicitation). Category: 94876-00 Unit of Measure: Dollar Unit Price: $ Number of Units: 1 Total: $ Page 5 of 43 Request for Proposals (RFP) 610384 Table of Contents Terms and Conditions 7 1. General Conditions 7 1.1. GENERAL TERMS AND CONDITIONS 7 2. Special Conditions 27 2.1. PURPOSE 27 2.2. PRE -PROPOSAL CONFERENCE 27 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION/CLARIFICATION 27 2.4. TERM OF CONTRACT 27 2.5. CONDITIONS FOR RENEWAL 27 2.6. MINIMUM QUALIFICATION REQUIREMENTS 28 2.7. LIVING WAGE ORDINANCE 28 2.8. EXECUTION OF AN AGREEMENT 28 2.9. FACILITY LOCATION, HOURS OF SERVICE, AND AVAILABILITY 29 2.10. FAILURE TO PERFORM 29 2.11. INSURANCE REQUIREMENTS 30 2.12. PROJECT MANAGER 32 2.13. PRIMARY CLIENT (FIRST PRIORITY) 32 2.14. UNAUTHORIZED WORK 32 2.15. CHANGES/ALTERATIONS 32 2.16. COMPENSATION PROPOSAL 33 2.17. METHOD OF PAYMENT 33 2.18. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD 33 2.19. RECORDS 34 2.20. TRUTH IN NEGOTIATION CERTIFICATE 34 2.21. NON -APPROPRIATION OF FUNDS 34 2.22. TERMINATION 34 3. Specifications 36 3.1. SPECIFICATIONS/SCOPE OF WORK 36 4. Submission Requirements 40 4.1. SUBMISSION REQUIREMENTS 40 5. Evaluation Criteria 43 5.1. EVALUATION CRITERIA 43 Page 6 of 43 Request for Proposals (RFP) 610384 Terms and Conditions 1. General Conditions 1.1. GENERAL TERMS AND CONDITIONS Intent: The General Terms and Conditions described herein apply to the acquisition of goods/equipment/services with an estimated aggregate cost of S25,000.00 or more. Definition: A formal solicitation is defined as issuance of an Invitation for Bids, Request for Proposals ("RFP"), Request for Qualifications ("RFQ"), or Request for Letters of Interest ("RFLI") pursuant to the City of Miami Procurement Code and/or Florida Law, as amended. Formal Solicitation and Solicitation shall be defined in the same manner herein. 1.1. ACCEPTANCE OF GOODS OR EQUIPMENT - Any good(s) or equipment delivered under this formal solicitation, if applicable, shall remain the property of the seller until a physical inspection and actual usage of the good is made, and thereafter is accepted as satisfactory to the City. It must comply with the terms herein and be fully in accordance with specifications and of the highest quality. In the event the goods/equipment supplied to the City are found to be defective or does not conform to specifications, the City reserves the right to cancel the order upon written notice to the Contractor and return the product to the Contractor at the Contractor's expense. 1.2. ACCEPTANCE OF OFFER - The signed or electronic submission of your solicitation response shall be considered an offer on the part of the bidder/proposer; such offer shall be deemed accepted upon issuance by the City of a purchase order. 1.3. ACCEPTANCE/REJECTION — The City reserves the right to accept or reject any or all responses or parts of after opening/closing date and request re -issuance on the goods/services described in the formal solicitation. In the event of such rejection, the Director of Purchasing shall notify all affected bidders/proposers and make available a written explanation for the rejection. The City also reserves the right to reject the response of any bidder/proposer who has previously failed to properly perform under the terms and conditions of a contract, to deliver on time contracts of a similar nature, and who is not in a position to perform the requirements defined in this formal solicitation. The City further reserves the right to waive any irregularities or minor informalities or technicalities in any or all responses and may, at its discretion, re -issue this formal solicitation. 1.4. ADDENDA — It is the bidder's/proposer's responsibility to ensure receipt of all Addenda. Addenda are available at the City's website at: http://www.ci.miami.fl.us/procurement 1.5. ALTERNATE RESPONSES WILL NOT BE CONSIDERED. 1.6. ASSIGNMENT - The Contractor's services are specialized and unique in nature. Contractor agrees not to subcontract, assign, transfer, convey, sublet, or otherwise dispose of the resulting Contract, or any or all of its right, title or interest herein, in whole or in part, without City of Miami's prior written consent. 1.7. ATTORNEY'S FEES - In connection with any litigation, mediation and arbitration proceedings arising out of this Contract, each party shall bear their own attorney's fees through and including administrative trial, appellate litigation and any post judgment proceedings. 1.8. AUDIT RIGHTS AND RECORDS RETENTION - The Successful Bidder/Proposer agrees to provide access at all reasonable times to the City, or to any of its duly authorized representatives, to any books, documents, papers, Page 7 of 43 Request for Proposals (RFP) 610384 and records of Contractor which are directly pertinent to this formal solicitation, for the purpose of audit, examination, excerpts, and transcriptions. The Successful Bidder/Proposer shall maintain and retain any and all of the books, documents, papers and records pertinent to the Contract for three (3) years after the City makes final payment and all other pending matters are closed. Contractor's failure to or refusal to comply with this condition shall result in the immediate cancellation of this contract by the City. The Audit and Inspection provisions set forth in Sections 18-100 to 18-102 of the City Code are deemed as being incorporated by reference herein as supplemental terms. 1.9. AVAILABILITY OF CONTRACT STATE-WIDE - Any Governmental, not -for -profit or quasi -governmental entity in the State of Florida, may avail itself of this contract and purchase any and all goods/services, specified herein from the successful bidder(s)/proposer(s) at the contract price(s) established herein, when permissible by federal, state, and local laws, rules, and regulations. Each Governmental, not -for -profit or quasi -governmental entity which uses this formal solicitation and resulting bid contract or agreement will establish its own contract/agreement, place its own orders, issue its own purchase orders, be invoiced there from and make its own payments, determine shipping terms and issue its own exemption certificates as required by the successful bidder(s)/proposer(s). 1.10. AWARD OF CONTRACT: A. The Formal Solicitation, Bidder's/Proposer's response, any addenda issued, and the purchase order shall constitute the entire contract, unless modified in accordance with any ensuing contract/agreement, amendment or addenda. B. The award of a contract where there are Tie Bids will be decided by the Director of Purchasing or designee in the instance that Tie Bids can't be determined by applying Florida Statute 287.087, Preference to Businesses with Drug -Free Workplace Programs. C. The award of this contract may be preconditioned on the subsequent submission of other documents as specified in the Special Conditions or Technical Specifications. Bidder/Proposer shall be in default of its contractual obligation if such documents are not submitted in a timely manner and in the form required by the City. Where Bidder/Proposer is in default of these contractual requirements, the City, through action taken by the Purchasing Department, will void its acceptance of the Bidder's/Proposer's Response and may accept the Response from the next lowest responsive, responsible Bidder or Proposal most advantageous to the City or re -solicit the City's requirements. The City, at its sole discretion, may seek monetary restitution from Bidder/Proposer and its bid/proposal bond or guaranty, if applicable, as a result of damages or increased costs sustained as a result of the Bidder's/Proposer's default. D. The term of the contract shall be specified in one of three documents which shall be issued to the successful Bidder/Proposer. These documents may either be a purchase order, notice of award and/or contract award sheet. E. The City reserves the right to automatically extend this contract for up to one hundred twenty (120) calendar days beyond the stated contract term in order to provide City departments with continual service and supplies while a new contract is being solicited, evaluated, and/or awarded. If the right is exercised, the City shall notify the Bidder/Proposer, in writing, of its intent to extend the contract at the same price, terms and conditions for a specific number of days. Additional extensions over the first one hundred twenty (120) day extension may occur, if, the City and the Successful Bidder/Proposer are in mutual agreement of such extensions. F. Where the contract involves a single shipment of goods to the City, the contract term shall conclude upon completion of the expressed or implied warranty periods. G. The City reserves the right to award the contract on a split -order, lump sum or individual -item basis, or such Page 8 of 43 Request for Proposals (RFP) 610384 combination as shall best serve the interests of the City unless otherwise specified. H. A Contract/Agreement may be awarded to the Bidder/Proposer by the City Commission based upon the minimum qualification requirements reflected herein. As a result of a RFP, RFQ, or RFLI, the City reserves the right to execute or not execute, as applicable, an Agreement with the Proposer, whichever is determined to be in the City's best interests. Such agreement will be furnished by the City, will contain certain terms as are in the City's best interests, and will be subject to approval as to legal form by the City Attorney. 1.11. BID BOND/ BID SECURITY - A cashier's or certified check, or a Bid Bond signed by a recognized surety company that is licensed to do business in the State of Florida, payable to the City of Miami, for the amount bid is required from all bidders/proposers, if so indicated under the Special Conditions. This check or bond guarantees that a bidder/proposer will accept the order or contract/agreement, as bid/proposed, if it is awarded to bidder/proposer. Bidder/Proposer shall forfeit bid deposit to the City should City award contract/agreement to Bidder/Proposer and Bidder/Proposer fails to accept the award. The City reserves the right to reject any and all surety tendered to the City. Bid deposits are returned to unsuccessful bidders/proposers within ten (10) days after the award and successful bidder's/proposer's acceptance of award. If sixty (60) days have passed after the date of the formal solicitation closing date, and no contract has been awarded, all bid deposits will be returned on demand. 1.12. RESPONSE FORM (HARDCOPY FORMAT) - All forms should be completed, signed and submitted accordingly. 1.13. BID SECURITY FORFEITED LIQUIDATED DAMAGES - Failure to execute an Agreement and/or file an acceptable Performance Bond, when required, as provided herein, shall be just cause for the annulment of the award and the forfeiture of the Bid Security to the City, which forfeiture shall be considered, not as a penalty, but in mitigation of damages sustained. Award may then be made to the next lowest responsive, responsible Bidder or Proposal most advantageous to the City or all responses may be rejected. 1.14. BRAND NAMES - If and wherever in the specifications brand names, makes, models, names of any manufacturers, trade names, or bidder/proposer catalog numbers are specified, it is for the purpose of establishing the type, function, minimum standard of design, efficiency, grade or quality of goods only. When the City does not wish to rule out other competitors' brands or makes, the phrase "OR EQUAL" is added. When bidding/proposing an approved equal, Bidders/Proposers will submit, with their response, complete sets of necessary data (factory information sheets, specifications, brochures, etc.) in order for the City to evaluate and determine the equality of the item(s) bid/proposed. The City shall be the sole judge of equality and its decision shall be final. Unless otherwise specified, evidence in the form of samples may be requested if the proposed brand is other than specified by the City. Such samples are to be furnished after formal solicitation opening/closing only upon request of the City. If samples should be requested, such samples must be received by the City no later than seven (7) calendar days after a formal request is made. 1.15. CANCELLATION - The City reserves the right to cancel all formal solicitations before its opening/closing. In the event of bid/proposal cancellation, the Director of Purchasing shall notify all prospective bidders/proposers and make available a written explanation for the cancellation. 1.16. CAPITAL EXPENDITURES - Contractor understands that any capital expenditures that the firm makes, or prepares to make, in order to deliver/perform the goods/services required by the City, is a business risk which the contractor must assume. The City will not be obligated to reimburse amortized or unamortized capital expenditures, or to maintain the approved status of any contractor. If contractor has been unable to recoup its capital expenditures during the time it is rendering such goods/services, it shall not have any claim upon the City. 1.17. CITY NOT LIABLE FOR DELAYS - It is further expressly agreed that in no event shall the City be liable for, or responsible to, the Bidder/Proposer/Consultant, any sub-contractor/sub-consultant, or to any other person for, Page 9 of 43 Request for Proposals (RFP) 610384 or on account of, any stoppages or delay in the work herein provided for by injunction or other legal or equitable proceedings or on account of any delay for any cause over which the City has no control. 1.18. COLLUSION —Bidder/Proposer, by submitting a response, certifies that its response is made without previous understanding, agreement or connection either with any person, firm or corporation submitting a response for the same items/services or with the City of Miami's Purchasing Department or initiating department. The Bidder/Proposer certifies that its response is fair, without control, collusion, fraud or other illegal action. Bidder/Proposer certifies that it is in compliance with the Conflict of Interest and Code of Ethics Laws. The City will investigate all potential situations where collusion may have occurred and the City reserves the right to reject any and all bids/responses where collusion may have occurred. 1.19. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS - Contractor understands that contracts between private entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, records keeping, etc. City and Contractor agree to comply with and observe all applicable laws, codes and ordinances as that may in any way affect the goods or equipment offered, including but not limited to: A. Executive Order 11246, which prohibits discrimination against any employee, applicant, or client because of race, creed, color, national origin, sex, or age with regard to, but not limited to, the following: employment practices, rate of pay or other compensation methods, and training selection. B. Occupational, Safety and Health Act (OSHA), as applicable to this Formal Solicitation. C. The State of Florida Statutes, Section 287.133(3)(A) on Public Entity Crimes. D. Environment Protection Agency (EPA), as applicable to this Formal Solicitation. E. Uniform Commercial Code (Florida Statutes, Chapter 672). F. Americans with Disabilities Act of 1990, as amended. G. National Institute of Occupational Safety Hazards (NIOSH), as applicable to this Formal Solicitation. H. National Forest Products Association (NFPA), as applicable to this Formal Solicitation. I. City Procurement Ordinance City Code Chapter 18, Article III. J. Conflict of Interest, City Code Section 2-611;61. K. Cone of Silence, City Code Section 18-74. L. The Florida Statutes Sections 218.73 and 218.74 on Prompt Payment. M. City of Miami Financial Policies and Anti -Deficiency Act , City Code , Chapter 18, Article IX. N. State and local laws and regulations regarding the licensing of psychologists and social service counselors, as applicable. Lack of knowledge by the bidder/proposer will in no way be a cause for relief from responsibility. Non-compliance with all local, state, and federal directives, orders, and laws may be considered grounds for termination of contract(s). Copies of the City Ordinances may be obtained from the City Clerk's Office. 1.20. CONE OF SILENCE - Pursuant to Section 18-74 of the City of Miami Code, a "Cone of Silence" is imposed upon each RFP, RFQ, RFLI, or IFB after advertisement and terminates at the time the City Manager issues a written recommendation to the Miami City Commission. The Cone of Silence shall be applicable only to Contracts for the Page 10 of 43 Request for Proposals (RFP) 610384 provision of goods and services and public works or improvements for amounts greater than S200,000. The Cone of Silence prohibits any communication regarding RFPs, RFQs, RFLI or IFBs (bids) between, among others: Potential vendors, service providers, bidders, lobbyists or consultants and the City's professional staff including, but not limited to, the City Manager and the City Manager's staff; the Mayor, City Commissioners, or their respective staffs and any member of the respective selection/evaluation committee. The provision does not apply to, among other communications: Oral communications with the City purchasing staff, provided the communication is limited strictly to matters of process or procedure already contained in the formal solicitation document; the provisions of the Cone of Silence do not apply to oral communications at duly noticed site visits/inspections, pre -proposal or pre -bid conferences, oral presentations before selection/evaluation committees, contract negotiations during any duly noticed public meeting, or public presentations made to the Miami City Commission during a duly noticed public meeting; or communications in writing or by email at any time with any City employee, official or member of the City Commission unless specifically prohibited by the applicable RFP, RFQ, RFLI or IFB (bid) documents (See Section 2.2. of the Special Conditions); or communications in connection with the collection of industry comments or the performance of market research regarding a particular RFP, RFQ, RFLI OR IFB by City Purchasing staff. Proposers or bidders must file a copy of any written communications with the Office of the City Clerk, which shall be made available to any person upon request. The City shall respond in writing and file a copy with the Office of the City Clerk (clerks@miamigov.com), which shall be made available to any person upon request. Written communications may be in the form of e-mail, with a copy to the Office of the City Clerk. In addition to any other penalties provided by law, violation of the Cone of Silence by any proposer or bidder shall render any award voidable. A violation by a particular Bidder, Proposer, Offeror, Respondent, lobbyist or consultant shall subject same to potential penalties pursuant to the City Code. Any person having personal knowledge of a violation of these provisions shall report such violation to the State Attorney and/or may file a complaint with the Ethics Commission. Proposers or bidders should reference Section 18-74 of the City of Miami Code for further clarification. This language is only a summary of the key provisions of the Cone of Silence. Please review City of Miami Code Section 18-74 for a complete and thorough description of the Cone of Silence. You may contact the City Clerk at 305-250-5360, to obtain a copy of same. 1.21. CONFIDENTIALITY - As a political subdivision, the City of Miami is subject to the Florida Sunshine Act and Public Records Law. If this Contract/Agreement contains a confidentiality provision, it shall have no application when disclosure is required by Florida law or upon court order. 1.22. CONFLICT OF INTEREST — Bidders/Proposers, by responding to this Formal Solicitation, certify that to the best of their knowledge or belief, no elected/appointed official or employee of the City of Miami is financially interested, directly or indirectly, in the purchase of goods/services specified in this Formal Solicitation. Any such interests on the part of the Bidder/Proposer or its employees must be disclosed in writing to the City. Further, you must disclose the name of any City employee who owns, directly or indirectly, an interest of five percent (5%) or more of the total assets of capital stock in your firm. A. Bidder/Proposer further agrees not to use or attempt to use any knowledge, property or resource which may be within his/her/its trust, or perform his/her/it's duties, to secure a special privilege, benefit, or exemption for himself/herself/itself, or others. Bidder/Proposer may not disclose or use information not available to members of the general public and gained by reason of his/her/its position, except for information relating exclusively to govemmental practices, for his/her/its personal gain or benefit or for the personal gain or benefit of any other person or business entity. Page 11 of 43 Request for Proposals (RFP) 610384 B. Bidder/Proposer hereby acknowledges that he/she/it has not contracted or transacted any business with the City or any person or agency acting for the City, and has not appeared in representation of any third party before any board, commission or agency of the City within the past two years. Bidder/Proposer further warrants that he/she/it is not related, specifically the spouse, son, daughter, parent, brother or sister, to: (i) any member of the commission; (ii) the mayor; (iii) any city employee; or (iv) any member of any board or agency of the City. C. A violation of this section may subject the Bidder/Proposer to immediate termination of any professional services agreement with the City, imposition of the maximum fine and/or any penalties allowed by law. Additionally, violations may be considered by and subject to action by the Miami -Dade County Commission on Ethics. 1.23. COPYRIGHT OR PATENT RIGHTS — Bidders/Proposers warrant that there has been no violation of copyright or patent rights in manufacturing, producing, or selling the goods shipped or ordered and/or services provided as a result of this formal solicitation, and bidders/proposers agree to hold the City harmless from any and all liability, loss, or expense occasioned by any such violation. 1.24. COST INCURRED BY BIDDER/PROPOSER - All expenses involved with the preparation and submission of Responses to the City, or any work performed in connection therewith shall be borne by the Bidder(s)/Proposer(s). 1.25. DEBARMENT AND SUSPENSIONS (Sec 18-107) (a) Authority and requirement to debar and suspend. After reasonable notice to an actual or prospective Contractual Party, and after reasonable opportunity for such party to be heard, the City Manager, after consultation with the Chief Procurement Officer and the city attorney, shall have the authority to debar a Contractual Party, for the causes listed below, from consideration for award of city Contracts. The debarment shall be for a period of not fewer than three years. The City Manager shall also have the authority to suspend a Contractual Party from consideration for award of city Contracts if there is probable cause for debarment, pending the debarment determination. The authority to debar and suspend contractors shall be exercised in accordance with regulations which shall be issued by the Chief Procurement Officer after approval by the City Manager, the city attorney, and the City Commission. (b) Causes for debarment or suspension. Causes for debarment or suspension include the following: (1) Conviction for commission of a criminal offense incident to obtaining or attempting to obtain a public or private Contract or subcontract, or incident to the performance of such Contract or subcontract. (2) Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property, or any other offense indicating a lack of business integrity or business honesty. (3) Conviction under state or federal antitrust statutes arising out of the submission of Bids or Proposals. (4) Violation of Contract provisions, which is regarded by the Chief Procurement Officer to be indicative of nonresponsibility. Such violation may include failure without good cause to perform in accordance with the terms and conditions of a Contract or to perform within the time limits provided in a Contract, provided that failure to perform caused by acts beyond the control of a party shall not be considered a basis for debarment or suspension. (5) Debarment or suspension of the Contractual Party by any federal, state or other governmental entity. (6) False certification pursuant to paragraph (c) below. Page 12 of 43 Request for Proposals (RFP) 610384 (7) Found in violation of a zoning ordinance or any other city ordinance or regulation and for which the violation remains noncompliant. (8) Found in violation of a zoning ordinance or any other city ordinance or regulation and for which a civil penalty or fine is due and owing to the city. (9) Any other cause judged by the City Manager to be so serious and compelling as to affect the responsibility of the Contractual Party performing city Contracts. (c) Certification. All Contracts for goods and services, sales, and leases by the city shall contain a certification that neither the Contractual Party nor any of its principal owners or personnel have been convicted of any of the violations set forth above or debarred or suspended as set forth in paragraph (b)(5). (d) Debarment and suspension decisions. Subject to the provisions of paragraph (a), the City Manager shall render a written decision stating the reasons for the debarment or suspension. A copy of the decision shall be provided promptly to the Contractual Party, along with a notice of said parry's right to seek judicial relief. 1.26. DEBARRED/SUSPENDED VENDORS —An entity or affiliate who has been placed on the State of Florida debarred or suspended vendor list may not submit a response on a contract to provide goods or services to a public entity, may not submit a response on a contract with a public entity for the construction or repair of a public building or public work, may not submit response on leases of real property to a public entity, may not award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity. 1.27. DEFAULT/FAILURE TO PERFORM - The City shall be the sole judge of nonperformance, which shall include any failure on the part of the successful Bidder/Proposer to accept the award, to furnish required documents, and/or to fulfill any portion of this contract within the time stipulated. Upon default by the successful Bidder/Proposer to meet any terms of this agreement, the City will notify the Bidder/Proposer of the default and will provide the contractor three (3) days (weekends and holidays excluded) to remedy the default. Failure on the contractor's part to correct the default within the required three (3) days shall result in the Contract being terminated and upon the City notifying in writing the contractor of its intentions and the effective date of the termination. The following shall constitute default: A. Failure to perform the work or deliver the goods/services required under the Contract and/or within the time required or failing to use the subcontractors, entities and personnel as identified and set forth, and to the degree specified in the Contract. B. Failure to begin the work under this Contract within the time specified. C. Failure to perform the work with sufficient workers and equipment or with sufficient materials to ensure timely completion. D. Neglecting or refusing to remove materials or perform new work where prior work has been rejected as nonconforming with the terms of the Contract. E. Becoming insolvent, being declared bankrupt, or committing any act of bankruptcy or insolvency, or making an assignment for the benefit of creditors, if the insolvency, bankruptcy, or assignment renders the successful Bidder/Proposer incapable of performing the work in accordance with and as required by the Contract. F. Failure to comply with any of the terms of the Contract in any material respect. All costs and charges incurred by the City as a result of a default or a default incurred beyond the time limits stated, Page 13 of 43 Request for Proposals (RFP) 610384 together with the cost of completing the work, shall be deducted from any monies due or which may become due on this Contract. 1.28. DETERMINATION OF RESPONSIVENESS - Each Response will be reviewed to determine if it is responsive to the submission requirements outlined in the Formal Solicitation. A "responsive" response is one which follows the requirements of the formal solicitation, includes all documentation, is submitted in the format outlined in the formal solicitation, is of timely submission, and has appropriate signatures as required on each document. Failure to comply with these requirements may deem a Response non -responsive. A. Responsible Bidder shall mean a bidder/proposer who has submitted a bid/proposal and who has the capability, as determined under the City Procurement Ordinance, in all respects to fully perform the contract requirements, and the integrity and reliability of which give reasonable assurance of good faith and performance. 1.29. DISCOUNTS OFFERED DURING TERM OF CONTRACT - Discount Prices offered in the response shall be fixed after the award by the Commission, unless otherwise specified in the Special Terms and Conditions. Price discounts off the original prices quoted in the response will be accepted from successful Bidder(s)/Proposer(s) during the term of the contract. Such discounts shall remain in effect for a minimum of 120 days from approval by the City Commission Any discounts offered by a manufacturer to Bidder/Proposer will be passed on to the City. 1.30. DISCREPANCIES, ERRORS, AND ONIISSIONS - Any discrepancies, errors, or ambiguities in the Formal Solicitation or addenda (if any) should be reported in writing to the City's Purchasing Department. Should it be found necessary, a written addendum will be incorporated in the Formal Solicitation and will become part of the purchase agreement (contract documents). The City will not be responsible for any oral instructions, clarifications, or other communications. A. Order of Precedence — Any inconsistency in this formal solicitation shall be resolved by giving precedence to the following documents, the first of such list being the governing documents. 1) Addenda (as applicable) 2) Specifications 3) Special Conditions 4) General Terms and Conditions 1.31. EMERGENCY / DISASTER PERFORMANCE - In the event of a hurricane or other emergency or disaster situation, the successful vendor shall provide the City with the commodities/services defined within the scope of this formal solicitation at the price contained within vendor's response. Further, successful vendor shall deliver/perform for the city on a priority basis during such times of emergency. 1.32. ENTIRE BID CONTRACT OR AGREEMENT - The Bid Contract or Agreement consists of this City of Miami Formal Solicitation and specifically this General Conditions Section, Contractor's Response and any written agreement entered into by the City of Miami and Contractor in cases involving RFPs, RFQs, and RFLIs, and represents the entire understanding and agreement between the parties with respect to the subject matter hereof and supersedes all other negotiations, understanding and representations, if any, made by and between the parties. To the extent that the agreement conflicts with, modifies, alters or changes any of the terms and conditions contained in the Formal Solicitation and/or Response, the Formal Solicitation and then the Response shall control. This Contract may be modified only by a written agreement signed by the City of Miami and Contractor. 1.33. ESTIMATED QUANTITIES —Estimated quantities or estimated dollars are provided for your guidance only. No guarantee is expressed or implied as to quantities that will be purchased during the contract period. The City is not obligated to place an order for any given amount subsequent to the award of this contract. Said estimates may be used by the City for purposes of determining the low bidder or most advantageous proposer meeting Page 14 of 43 Request for Proposals (RFP) 610384 specifications. The City reserves the right to acquire additional quantities at the prices bid/proposed or at lower prices in this Formal Solicitation. 1.34. EVALUATION OF RESPONSES A.Rejection of Responses The City may reject a Response for any of the following reasons: 1) Bidder/Proposer fails to acknowledge receipt of addenda; 2) Bidder/Proposer misstates or conceals any material fact or material omission in the Response; 3) Response does not conform to the requirements of the Formal Solicitation; 4) Response requires a conditional award that conflicts with the method of award; 5) Response does not include required samples, certificates, licenses as required; and, 6) Response was not executed by the Bidder's/Proposer(s) authorized agent. The foregoing is not an all-inclusive list of reasons for which a Response may be rejected. The City may reject and re -advertise for all or any part of the Formal Solicitation whenever it is deemed in the best interest of the City. B. Elimination From Consideration 1) A contract shall not be awarded to any person or firm which is in arrears to the City upon any debt or contract, or which is a defaulter as surety or otherwise upon any obligation to the City. 2) A contract may not be awarded to any person or firm which has failed to perform under the terms and conditions of any previous contract with the City or deliver on time contracts of a similar nature. 3) A contract may not be awarded to any person or firm which has been debarred by the City in accordance with the City's Debarment and Suspension Ordinance. C. Determination of Responsibility 1) Responses will only be considered from entities who are regularly engaged in the business of providing the goods/equipment/services required by the Formal Solicitation. Bidder/Proposer must be able to demonstrate a satisfactory record of performance and integrity; and, have sufficient financial, material, equipment, facility, personnel resources, and expertise to meet all contractual requirements. The terms "equipment and organization" as used herein shall be construed to mean a fully equipped and well established entity in line with the best industry practices in the industry as determined by the City. 2) The City may consider any evidence available regarding the financial, technical and other qualifications and abilities of a Bidder/Proposer, including past performance (experience) with the City or any other governmental entity in making the award. 3) The City may require the Bidder(s)/Proposer(s) to show proof that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.35. EXCEPTIONS TO GENERAL AND/OR SPECIAL CONDITIONS OR SPECIFICATIONS - Exceptions to the specifications shall be listed on the Response and shall reference the section. Any exceptions to the General or Special Conditions shall be cause for the bid (IFB) to be considered non -responsive. It also may be cause for a RFP, RFQ, or RFLI to be considered non -responsive; and, if exceptions are taken to the terms and conditions of the resulting agreement it may lead to terminating negotiations. Page 15 of 43 Request for Proposals (RFP) 610384 1.36. F.O.B. DESTINATION - Unless otherwise specified in the Formal Solicitation, all prices quoted/proposed by the bidder/proposer must be F.O.B. DESTINATION, inside delivery, with all delivery costs and charges included in the bid/proposal price, unless otherwise specified in this Formal Solicitation. Failure to do so may be cause for rejection of bid/proposal. 1.37. FIRM PRICES - The bidder/proposer warrants that prices, terms, and conditions quoted in its response will be firm throughout the duration of the contract unless otherwise specified in the Formal Solicitation. Such prices will remain firm for the period of performance or resulting purchase orders or contracts, which are to be performed or supplied over a period of time. 1.38. FLORIDA MINIMUM WAGE - The Constitution of the State of Florida, Article X, Section 24, states that employers shall pay employee wages no less than the minimum wage for all hours worked in Florida. Accordingly, it is the contractor's and its' subcontractor(s) responsibility to understand and comply with this Florida constitutional minimum wage requirement and pay its employees the current established hourly minimum wage rate, which is subject to change or adjusted by the rate of inflation using the consumer price index for urban wage earners and clerical workers, CPI-W, or a successor index as calculated by the United States Department of Labor. Each adjusted minimum wage rate calculated shall be determined and published by the Agency Workforce Innovation on September 30th of each year and take effect on the following January 1st. At the time of responding, it is bidder/proposer and his/her subcontractor(s), if applicable, full responsibility to determine whether any of its employees may be impacted by this Florida Law at any given point in time during the term of the contract. If impacted, bidder/proposer must furnish employee name(s), job title(s), job description(s), and current pay rate(s). Failure to submit this information at the time of submitting a response constitute successful bidder's/proposer's acknowledgement and understanding that the Florida Minimum Wage Law will not impact its prices throughout the term of contract and waiver of any contractual price increase request(s). The City reserves the right to request and successful bidder/proposer must provide for any and all information to make a wage and contractual price increase(s) determination. 1.39. GOVERNING LAW AND VENUE - The validity and effect of this Contract shall be governed by the laws of the State of Florida. The parties agree that any action, mediation or arbitration arising out of this Contract shall take place in Miami -Dade County, Florida. In any action or proceeding each party shall bear their own respective attorney's fees. 1.40. HEADINGS AND TERMS - The headings to the various paragraphs of this Contract have been inserted for convenient reference only and shall not in any manner be construed as modifying, amending or affecting in any way the expressed terms and provisions hereof. 1.41. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) - Any person or entity that performs or assists the City of Miami with a function or activity involving the use or disclosure of "individually identifiable health information (IIHI) and/or Protected Health Information (PHI) shall comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the City of Miami Privacy Standards. HIPAA mandates for privacy, security and electronic transfer standards, which include but are not limited to: A. Use of information only for performing services required by the contract or as required by law; B. Use of appropriate safeguards to prevent non -permitted disclosures; C. Reporting to the City of Miami of any non -permitted use or disclosure; D. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Bidder/Proposer and reasonable assurances that IIHI/PHI will be held confidential; E. Making Protected Health Information (PHI) available to the customer; Page 16 of 43 Request for Proposals (RFP) 610384 F. Making PHI available to the customer for review and amendment; and incorporating any amendments requested by the customer; G. Making PHI available to the City of Miami for an accounting of disclosures; and H. Making internal practices, books and records related to PHI available to the City of Miami for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records, and/or electronic transfer of data). The Bidder/ Proposer must give its customers written notice of its privacy information practices including specifically, a description of the types of uses and disclosures that would be made with protected health information. 1.42 INDEMNIFICATION - Contractor shall indemnify, hold/save harmless and defend at its own costs and expense the City, its officials, officers, agents, directors, and employees, from liabilities, damages, losses, and costs, including, but not limited to reasonable attorney's fees, to the extent caused by the negligence, recklessness or intentional wrongful misconduct of Contractor and persons employed or utilized by Contractor in the performance of this Contract and will indemnify, hold harmless and defend the City, its officials, officers, agents, directors and employees against, any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted work, even if it is alleged that the City, its officials and/or employees were negligent. These indemnifications shall survive the term of this Contract. In the event that any action or proceeding is brought against City by reason of any such claim or demand, Contractor shall, upon written notice from City, resist and defend such action or proceeding by counsel satisfactory to City. The Contractor expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by Contractor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate Contractor to defend at its own expense to and through appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against City whether performed by Contractor, or persons employed or utilized by Contractor. This indemnity will survive the cancellation or expiration of the Contract. Contractor shall require all Sub -Contractor agreements to include a provision that they will indemnify the City. The Contractor agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Contractor in which the City participated either through review or concurrence of the Contractor's actions. In reviewing, approving or rejecting any submissions by the Contractor or other acts of the Contractor, the City in no way assumes or shares any responsibility or liability of the Contractor or Sub -Contractor, under this Agreement. 1.43. FORMATION AND DESCRIPTIVE LITERATURE —Bidders/Proposer must furnish all information requested in the spaces provided in the Formal Solicitation. Further, as may be specified elsewhere, each Bidder/Proposer must submit for evaluation, cuts, sketches, descriptive literature, technical specifications, and Material Safety Data Sheets (MSDS)as required, covering the products offered. Reference to literature submitted with a previous response or on file with the Buyer will not satisfy this provision. 1.44. INSPECTIONS - The City may, at reasonable times during the term hereof, inspect Contractor's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods and/or services required to be provided by the Contractor under this Contract conform to the terms and conditions of the Formal Solicitation. Contractor shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests and inspections shall be subject to, and made in accordance with, the provisions of the City of Miami Ordinance No. 12271 (Section 18-79), as same may be Page 17 of 43 Request for Proposals (RFP) 610384 amended or supplemented from time to time. 1.45. INSPECTION OF RESPONSE - Responses received by the City pursuant to a Formal Solicitation will not be made available until such time as the City provides notice of a decision or intended decision or within 30 days after bid closing, whichever is earlier. Bid/Proposal results will be tabulated and may be furnished upon request via fax or e-mail to the Sr. Procurement Specialist issuing the Solicitation. Tabulations also are available on the City's Web Site following recommendation for award. 1.46. INSURANCE - Within ten (10) days after receipt of Notice of Award, the successful Contractor, shall furnish Evidence of Insurance to the Purchasing Department, if applicable. Submitted evidence of coverage shall demonstrate strict compliance to all requirements listed on the Special Conditions entitled "Insurance Requirements". The City shall be listed as an "Additional Insured." Issuance of a Purchase Order is contingent upon the receipt of proper insurance documents. If the insurance certificate is received within the specified time frame but not in the manner prescribed in this Solicitation the Contractor shall be verbally notified of such deficiency and shall have an additional five (5) calendar days to submit a corrected certificate to the City. If the Contractor fails to submit the required insurance documents in the manner prescribed in this Solicitation within fifteen (15) calendar days after receipt Notice of Award, the contractor shall be in default of the contractual terms and conditions and shall not be awarded the contract. Under such circumstances, the Bidder/Proposer may be prohibited from submitting future responses to the City. Information regarding any insurance requirements shall be directed to the Risk Administrator, Department of Risk Management, at 444 SW 2nd Avenue, 9th Floor, Miami, Florida 33130, 305-416-1604. The Bidder/Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in effect for the duration of the contractual period; including any and all option terms that may be granted to the Bidder/Proposer. 1.47. INVOICES - Invoices shall contain purchase order number and details of goods and/or services delivered (i.e. quantity, unit price, extended price, etc.); and in compliance with Chapter 218 of the Florida Statutes (Prompt Payment Act). 1.48. LOCAL PREFERENCE A. City Code Section 18-85, states, "when a responsive, responsible non -local bidder submits the lowest bid price, and the bid submitted by one or more responsive, responsible local bidders who maintain a local office, as defined in Section 18-73, is within fifteen percent (15%) of the price submitted by the non -local bidder, then that non -local bidder and each of the aforementioned responsive, responsible local bidders shall have the opportunity to submit a best and final bid equal to or lower than the amount of the low bid previously submitted by the non -local bidder. Contract award shall be made to the lowest responsive, responsible bidder submitting the lowest best and final bid. In the case of a tie in the best and final bid between a local bidder and a non -local bidder, contract award shall be made to the local bidder." B. City Code Section 18-86, states, "the RFP, RFLI or RFQ, as applicable, may, in the exercise of the reasonable professional discretion of the City Manager, director of the using agency, and the Chief Procurement Officer, include a five (5%) percent evaluation criterion in favor of proposers who maintain a local office, as defined in Section 18-73. In such cases, this five (5%) percent evaluation criterion in favor of proposers who maintain a local office will be specifically defined in the RFP, RFLI or RFQ, as applicable; otherwise, it will not apply. 1.49. MANUFACTURER'S CERTIFICATION - The City reserves the right to request from bidders/proposers a separate Manufacturer's Certification of all statements made in the bid/proposal. Failure to provide such certification may result in the rejection of bid/proposal or termination of contract/agreement, for which the bidder/proposer must bear full liability. Page 18 of 43 Request for Proposals (RFP) 610384 1.50. MODIFICATIONS OR CHANGES IN PURCHASE ORDERS AND CONTRACTS - No contract or understanding to modify this Formal Solicitation and resultant purchase orders or contracts, if applicable, shall be binding upon the City unless made in writing by the Director of Purchasing of the City of Miami, Florida through the issuance of a change order, addendum, amendment, or supplement to the contract, purchase order or award sheet as appropriate. 1.51. NO PARTNERSHIP OR JOINT VENTURE - Nothing contained in this Contract will be deemed or construed to create a partnership or joint venture between the City of Miami and Contractor, or to create any other similar relationship between the parties. 1.52. NONCONFOILMANCE TO CONTRACT CONDITIONS - Items may be tested for compliance with specifications under the direction of the Florida Department of Agriculture and Consumer Services or by other appropriate testing Laboratories as determined by the City. The data derived from any test for compliance with specifications is public record and open to examination thereto in accordance with Chapter 119, Florida Statutes. Items delivered not conforming to specifications may be rejected and retumed at Bidder's/Proposer's expense. These non -conforming items not delivered as per delivery date in the response and/or Purchase Order may result in bidder/proposer being found in default in which event any and all re -procurement costs may be charged against the defaulted contractor. Any violation of these stipulations may also result in the supplier's name being removed from the City of Miami's Supplier's list. 1.53. NONDISCRIMINATION —Bidder/Proposer agrees that it shall not discriminate as to race, sex, color, age, religion, national origin, marital status, or disability in connection with its performance under this formal solicitation. Furthermore, Bidder/Proposer agrees that no otherwise qualified individual shall solely by reason of his/her race, sex, color, age, religion, national origin, marital status or disability be excluded from the participation in, be denied benefits of, or be subjected to, discrimination under any program or activity. In connection with the conduct of its business, including performance of services and employment of personnel, Bidder/Proposer shall not discriminate against any person on the basis of race, color, religion, disability, age, sex, marital status or national origin. All persons having appropriate qualifications shall be afforded equal opportunity for employment. 1.54. NON-EXCLUSIVE CONTRACT/ PIGGYBACK PROVISION - At such times as may serve its best interest, the City of Miami reserves the right to advertise for, receive, and award additional contracts for these herein goods and/or services, and to make use of other competitively bid (governmental) contracts, agreements, or other similar sources for the purchase of these goods and/or services as may be available. It is hereby agreed and understood that this formal solicitation does not constitute the exclusive rights of the successful bidder(s)/proposer(s) to receive all orders that may be generated by the City in conjunction with this Formal Solicitation. In addition, any and all commodities, equipment, and services required by the City in conjunction with construction projects are solicited under a distinctly different solicitation process and shall not be purchased under the terms, conditions and awards rendered under this solicitation, unless such purchases are determined to be in the best interest of the City. 1.55.00CUPATIONAL LICENSE - Any person, firm, corporation or joint venture, with a business location in the City of Miami and is submitting a Response under this Formal Solicitation shall meet the City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City of Miami Charter. Others with a location outside the City of Miami shall meet their local Occupational License Tax requirements. A copy of the Page 19 of 43 Request for Proposals (RFP) 610384 license must be submitted with the response; however, the City may at its sole option and in its best interest allow the Bidder/Proposer to supply the license to the City during the evaluation period, but prior to award. 1.56. ONE PROPOSAL - Only one (1) Response from an individual, firm, partnership, corporation or joint venture will be considered in response to this Formal Solicitation. 1.57. OWNERSHIP OF DOCUMENTS - It is understood by and between the parties that any documents, records, files, or any other matter whatsoever which is given by the City to the successful Bidder/Proposer pursuant to this formal solicitation shall at all times remain the property of the City and shall not be used by the Bidder/Proposer for any other purposes whatsoever without the written consent of the City. 1.58. PARTIAL INVALIDITY - If any provision of this Contract or the application thereof to any person or circumstance shall to any extent be held invalid, then the remainder of this Contract or the application of such provision to persons or circumstances other than those as to which it is held invalid shall not be affected thereby, and each provision of this Contract shall be valid and enforced to the fullest extent permitted by law. 1.59. PERFORIVIANCE/PAYMENT BOND —A Contractor may be required to furnish a Performance/Payment Bond as part of the requirements of this Contract, in an amount equal to one hundred percent (100%) of the contract price. 1.60. PREPARATION OF RESPONSES (HARDCOPY FORMAT) —Bidders/Proposers are expected to examine the specifications, required delivery, drawings, and all special and general conditions. All bid/proposed amounts, if required, shall be either typewritten or entered into the space provided with ink. Failure to do so will be at the Bidder's/Proposer's risk. A. Each Bidder/Proposer shall furnish the information required in the Formal Solicitation. The Bidder/Proposer shall sign the Response and print in ink or type the name of the Bidder/Proposer, address, and telephone number on the face page and on each continuation sheet thereof on which he/she makes an entry, where required. B. If so required, the unit price for each unit offered shall be shown, and such price shall include packaging, handling and shipping, and F.O.B. Miami delivery inside City premises unless otherwise specified. Bidder/Proposer shall include in the response all taxes, insurance, social security, workmen's compensation, and any other benefits normally paid by the Bidder/Proposer to its employees. If applicable, a unit price shall be entered in the "Unit Price" column for each item. Based upon estimated quantity, an extended price shall be entered in the "Extended Price" column for each item offered. In case of a discrepancy between the unit price and extended price, the unit price will be presumed correct. C. The Bidder/Proposer must state a definite time, if required, in calendar days for delivery of goods and/or services. D. The Bidder/Proposer should retain a copy of all response documents for future reference. E. All responses, as described, must be fully completed and typed or printed in ink and must be signed in ink with the firm's name and by an officer or employee having authority to bind the company or firm by his/her signature. Bids/Proposals having any erasures or corrections must be initialed in ink by person signing the response or the response may be rejected. F. Responses are to remain valid for at least 180 days. Upon award of a contract, the content of the Successful Bidder's/Proposer's response may be included as part of the contract, at the City's discretion. G. The City of Miami's Response Forms shall be used when Bidder/Proposer is submitting its response in hardcopy format. Use of any other forms will result in the rejection of the response. IF SUBMITTING Page 20 of 43 Request for Proposals (RFP) 610384 HARDCOPY FORMAT, THE ORIGINAL AND THREE (3) COPIES OF THESE SETS OF FORMS, UNLESS OTHERWISE SPECIFIED, AND ANY REQUIRED ATTACHMENTS MUST BE RETURNED TO THE CITY OR YOUR RESPONSE MAY BE DEEMED NON -RESPONSIVE. 1.61. PRICE ADJUSTMENTS — Any price decrease effectuated during the contract period either by reason of market change or on the part of the contractor to other customers shall be passed on to the City of Miami. 1.62. PRODUCT SUBSTITUTES - In the event a particular awarded and approved manufacturer's product becomes unavailable during the term of the Contract, the Contractor awarded that item may arrange with the City's authorized representative(s) to supply a substitute product at the awarded price or lower, provided that a sample is approved in advance of delivery and that the new product meets or exceeds all quality requirements. 1.63. CONFLICT OF INTEREST, AND UNETHICAL BUSINESS PRACTICE PROHIBITIONS - Contractor represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Contract and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Contract. 1.64. PROMPT PAYMENT —Bidders/Proposers may offer a cash discount for prompt payment; however, discounts shall not be considered in determining the lowest net cost for response evaluation purposes. Bidders/Proposers are required to provide their prompt payment terms in the space provided on the Formal Solicitation. If no prompt payment discount is being offered, the Bidder/Proposer must enter zero (0) for the percentage discount to indicate no discount. If the Bidder/Proposer fails to enter a percentage, it is understood and agreed that the terms shall be 2% 20 days, effective after receipt of invoice or final acceptance by the City, whichever is later. When the City is entitled to a cash discount, the period of computation will commence on the date of delivery, or receipt of a correctly completed invoice, whichever is later. If an adjustment in payment is necessary due to damage, the cash discount period shall commence on the date final approval for payment is authorized. If a discount is part of the contract, but the invoice does not reflect the existence of a cash discount, the City is entitled to a cash discount with the period commencing on the date it is determined by the City that a cash discount applies. Price discounts off the original prices quoted on the Price Sheet will be accepted from successful bidders/proposers during the term of the contract. 1.65. PROPERTY - Property owned by the City of Miami is the responsibility of the City of Miami. Such property furnished to a Contractor for repair, modification, study, etc., shall remain the property of the City of Miami. Damages to such property occurring while in the possession of the Contractor shall be the responsibility of the Contractor. Damages occurring to such property while in route to the City of Miami shall be the responsibility of the Contractor. In the event that such property is destroyed or declared a total loss, the Contractor shall be responsible for replacement value of the property at the current market value, less depreciation of the property, if any. 1.66. PROVISIONS BINDING - Except as otherwise expressly provided in the resulting Contract, all covenants, conditions and provisions of the resulting Contract shall be binding upon and shall inure to the benefit of the parties hereto and their respective heirs, legal representatives, successors and assigns. 1.67. PUBLIC ENTITY CRIMES - A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a response on a contract to provide any goods or services to a public entity, may not submit a response on a contract with a public entity for the construction or repair of a public building or public work, may not submit responses on leases of real property to a public entity, may not Page 21 of 43 Request for Proposals (RFP) 610384 be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 1.68. PUBLIC RECORDS - Contractor understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and City of Miami Code, Section 18, Article III, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable law. Contractor shall additionally comply with the provisions of Section 119.0701, Florida Statutes, entitled "Contracts; public records". Contractor's failure or refusal to comply with the provision of this section shall result in the immediate cancellation of this Contract by the City. 1.69. QUALITY OF GOODS, MATERIALS, SUPPLIES, PRODUCTS, AND EQUIPMENT - All materials used in the manufacturing or construction of supplies, materials, or equipment covered by this solicitation shall be new. The items bid/proposed must be of the latest make or model, of the best quality, and of the highest grade of workmanship, unless as otherwise specified in this Solicitation. 1.70. QUALITY OF WORK/SERVICES - The work/services performed must be of the highest quality and workmanship. Materials furnished to complete the service shall be new and of the highest quality except as otherwise specified in this Solicitation. 1.71. REMEDIES PRIOR TO AWARD (Sec. 18-106) - If prior to Contract award it is determined that a formal solicitation or proposed award is in violation of law, then the solicitation or proposed award shall be cancelled by the City Commission, the City Manager or the Chief Procurement Officer, as may be applicable, or revised to comply with the law. 1.72. RESOLUTION OF CONTRACT DISPUTES (Sec. 18-105) (a) Authority to resolve Contract disputes. The City Manager, after obtaining the approval of the city attorney, shall have the authority to resolve controversies between the Contractual Party and the city which arise under, or by virtue of, a Contract between them; provided that, in cases involving an amount greater than $25,000, the City Commission must approve the City Manager's decision. Such authority extends, without limitation, to controversies based upon breach of Contract, mistake, misrepresentation or lack of complete performance, and shall be invoked by a Contractual Party by submission of a protest to the City Manager. (b) Contract dispute decisions. If a dispute is not resolved by mutual consent, the City Manager shall promptly render a written report stating the reasons for the action taken by the City Commission or the City Manager which shall be final and conclusive. A copy of the decision shall be immediately provided to the protesting party, along with a notice of such party's right to seek judicial relief, provided that the protesting party shall not be entitled to such judicial relief without first having followed the procedure set forth in this section. 1.73. RESOLUTION OF PROTESTED SOLICITATIONS AND AWARDS (Sec. 18-104) (a) Right to protest. The following procedures shall be used for resolution of protested solicitations and awards except for purchases of goods, supplies, equipment, and services, the estimated cost of which does not exceed $25,000. Protests thereon shall be governed by the Administrative Policies and Procedures of Purchasing. 1.Protest of Solicitation. i. Any prospective proposer who perceives itself aggrieved in connection with the solicitation of a Contract may Page 22 of 43 Request for Proposals (RFP) 610384 protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within three days after the Request for Proposals, Request for Qualifications or Request for Letters of Interest is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer; or ii. Any prospective bidder who intends to contest the Solicitation Specifications or a solicitation may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within three days after the solicitation is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer. 2. Protest of Award. i. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within two days after receipt by the proposer of the notice of the City Manager's recommendation for award of Contract, which will be posted on the City of Miami Purchasing Department website, in the Supplier Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Recommendation of Award To fields. If "various" is indicated in the Recommendation of Award To field, the Bidder/Proposer must contact the buyer for that solicitation to obtain the suppliers name. It shall be the responsibility of the Bidder/Proposer to check this section of the website daily after responses are submitted to receive the notice; or ii. Any actual Responsive and Responsible Bidder whose Bid is lower than that of the recommended bidder may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within two days after receipt by the bidder of the notice of the city's determination of non -responsiveness or non -responsibility. The receipt by bidder of such notice shall be confirmed by the city by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer. iii. A written protest based on any of the foregoing must be submitted to the Chief Procurement Officer within five (5) days after the date the notice of protest was filed. A written protest is considered filed when received by the Chief Procurement Officer. The written protest may not challenge the relative weight of the evaluation criteria or the formula for assigning points in making an award determination. The written protest shall state with particularity the specific facts and law upon which the protest of the solicitation or the award is based, and shall include all pertinent documents and evidence and shall be accompanied by the required Filing Fee as provided in subsection (f). This shall form the basis for review of the written protest and no facts, grounds, documentation or evidence not contained in the protester's submission to the Chief Procurement Officer at the time of filing the protest shall be permitted in the consideration of the written protest. No time will be added to the above limits for service by mail. In computing any period of time prescribed or allowed by this section, the day of the act, event or default from which the designated period of time begins to run shall not be included. The last day of the period so computed shall be included unless it is a Saturday, Sunday or legal holiday in which event the period shall run until the end of the next day which is neither a Saturday, Sunday or legal holiday. Intermediate Saturdays, Sundays and legal holidays shall be excluded in the computation of the time for filing. (b) Authority to resolve protests. The Chief Procurement Officer shall have the authority, subject to the approval of the City Manager and the city attorney, to settle and resolve any written protest. The Chief Procurement Officer shall obtain the requisite approvals and communicate said decision to the protesting party and shall submit said decision to the City Commission within 30 days after he/she receives the protest. In cases involving more than Page 23 of 43 Request for Proposals (RFP) 610384 $25,000, the decision of the Chief Procurement Officer shall be submitted for approval or disapproval thereof to the City Commission after a favorable recommendation by the city attorney and the City Manager. (c) Compliance with filing requirements. Failure of a party to timely file either the notice of intent to file a protest or the written protest, together with the required Filing Fee as provided in subsection (f), with the Chief Procurement Officer within the time provided in subsection (a), above, shall constitute a forfeiture of such party's right to file a protest pursuant to this section. The protesting party shall not be entitled to seek judicial relief without first having followed the procedure set forth in this section (d) Stay of Procurements during protests. Upon receipt of a written protest filed pursuant to the requirements of this section, the city shall not proceed further with the solicitation or with the award of the Contract until the protest is resolved by the Chief Procurement Officer or the City Commission as provided in subsection (b) above, unless the City Manager makes a written determination that the solicitation process or the Contract award must be continued without delay in order to avoid an immediate and serious danger to the public health, safety or welfare. (e) Costs. All costs accruing from a protest shall be assumed by the protestor. (1) Filing Fee. The written protest must be accompanied by a filing fee in the form of a money order or cashier's check payable to the city in an amount equal to one percent of the amount of the Bid or proposed Contract, or $5000.00, whichever is less, which filing fee shall guarantee the payment of all costs which may be adjudged against the protestor in any administrative or court proceeding. If a protest is upheld by the Chief Procurement Officer and/or the City Commission, as applicable, the filing fee shall be refunded to the protestor Less any costs assessed under subsection (e) above. If the protest is denied, the filing fee shall be forfeited to the city in lieu of payment of costs for the administrative proceedings as prescribed by subsection (e) above. 1.74. SAMPLES - Samples of items, when required, must be submitted within the time specified at no expense to the City. If not destroyed by testing, bidder(s)/proposer(s) will be notified to remove samples, at their expense, within 30 days after notification. Failure to remove the samples will result in the samples becoming the property of the City. 1.75. SELLING, TRANSFERRING OR ASSIGNING RESPONSIBILITIES - Contractor shall not sell, assign, transfer or subcontract at any time during the term of the Contract, or any part of its operations, or assign any portion of the performance required by this contract, except under and by virtue of written permission granted by the City through the proper officials, which may be withheld or conditioned, in the City's sole discretion. 1.76. SERVICE AND WARRANTY —When specified, the bidder/proposer shall define all warranty, service and replacements that will be provided. Bidders/Proposer must explain on the Response to what extent warranty and service facilities are available. A copy of the manufacturer's warranty, if applicable, should be submitted with your response. 1.77. SILENCE OF SPECIFICATIONS - The apparent silence of these specifications and any supplemental specification as to any detail or the omission from it of detailed description conceming any point shall be regarded as meaning that only the best commercial practices are to prevail and that only materials of first quality and correct type, size and design are to be used. All workmanship and services is to be first quality. All interpretations of these specifications shall be made upon the basis of this statement. If your firm has a current contract with the State of Florida, Department of General Services, to supply the items on this solicitation, the bidder/proposer shall quote not more than the contract price; failure to comply with this request will result in disqualification of bid/proposal. Page 24 of 43 Request for Proposals (RFP) 610384 1.78. SUBMISSION AND RECEIPT OF RESPONSES - Responses shall be submitted electronically via the Oracle System or responses may be submitted in hardcopy format to the City Clerk, City Hall, 3500 Pan American Drive, Miami, Florida 33133-5504, at or before, the specified closing date and time as designated in the IFB, RFP, RFQ, or RFLI. NO EXCEPTIONS. Bidders/Proposers are welcome to attend the solicitation closing; however, no award will be made at that time. A. Hardcopy responses shall be enclosed in a sealed envelope, box package. The face of the envelope, box or package must show the hour and date specified for receipt of responses, the solicitation number and title, and the name and return address of the Bidder/Proposer. Hardcopy responses not submitted on the requisite Response Forms may be rejected. Hardcopy responses received at any other location than the specified shall be deemed non -responsive. Directions to City Hall: FROM THE NORTH: I-95 SOUTH UNTIL IT TURNS INTO US I. US 1 SOUTH TO 27 TH AVE., TURN LEFT, PROCEED SOUTH TO SO. BAYSHORE DR. (3RD TRAFFIC LIGHT), TURN LEFT, 1 BLOCK TURN RIGHT ON PAN AMERICAN DR. CITY HALL IS AT THE END OF PAN AMERICAN DR. PARKING IS ON RIGHT. FROM THE SOUTH: US 1 NORTH TO 27 TH AVENUE, TURN RIGHT, PROCEED SOUTH TO SO. BAYSHORE DR. (3RD TRAFFIC LIGHT), TURN LEFT, 1 BLOCK TURN RIGHT ON PAN AMERICAN DR. CITY HALL IS AT THE END OF PAN AMERICAN DR. PARKING IS ON RIGHT. B. Facsimile responses will not be considered. C. Failure to follow these procedures is cause for rejection of bid/proposal. D. The responsibility for obtaining and submitting a response on or before the close date is solely and strictly the responsibility of Bidder/Proposer. The City of Miami is not responsible for delays caused by the United States mail delivery or caused by any other occurrence. Responses received after the solicitation closing date and time will be returned unopened, and will not be considered for award. E. Late responses will be rejected. F. All responses are subject to the conditions specified herein. Those which do not comply with these conditions are subject to rejection. G. Modification of responses already submitted will be considered only if received at the City before the time and date set for closing of solicitation responses. All modifications must be submitted via the Oracle System or in writing. Once a solicitation closes (closed date and/or time expires), the City will not consider any subsequent submission which alters the responses. H. If hardcopy responses are submitted at the same time for different solicitations, each response must be placed in a separate envelope, box, or package and each envelope, box or package must contain the information previously stated in 1.82.A. 1.79. TAXES - The City of Miami is exempt from any taxes imposed by the State and/or Federal Government. Exemption certificates will be provided upon request. Notwithstanding, Bidders/Proposers should be aware of the fact that all materials and supplies which are purchased by the Bidder/Proposer for the completion of the contract is subject to the Florida State Sales Tax in accordance with Section 212.08, Florida Statutes, as amended and all amendments thereto and shall be paid solely by the Bidder/Proposer. 1.80. TERMINATION —The City Manager on behalf of the City of Miami reserves the right to terminate this contract by written notice to the contractor effective the date specified in the notice should any of the following Page 25 of 43 Request for Proposals (RFP) 610384 apply: A. The contractor is determined by the City to be in breach of any of the terms and conditions of the contract. B. The City has determined that such termination will be in the best interest of the City to terminate the contract for its own convenience; C. Funds are not available to cover the cost of the goods and/or services. The City's obligation is contingent upon the availability of appropriate funds. 1.81. TERMS OF PAYMENT - Payment will be made by the City after the goods and/or services awarded to a Bidder/Proposer have been received, inspected, and found to comply with award specifications, free of damage or defect, and properly invoiced. No advance payments of any kind will be made by the City of Miami. Payment shall be made after delivery, within 45 daysof receipt of an invoice and authorized inspection and acceptance of the goods/services and pursuant to Section 218.74, Florida Statutes and other applicable law. 1.82. TIMELY DELIVERY - Time will be of the essence for any orders placed as a result of this solicitation. The City reserves the right to cancel such orders, or any part thereof, without obligation, if delivery is not made within the time(s) specified on their Response. Deliveries are to be made during regular City business hours unless otherwise specified in the Special Conditions. 1.83. TITLE - Title to the goods or equipment shall not pass to the City until after the City has accepted the goods/equipment or used the goods, whichever comes first. 1.84.TRADE SECRETS EXECUTION TO PUBLIC RECORDS DISCLOSURE- All Responses submitted to the City are subject to public disclosure pursuant to Chapter 119, Florida Statutes. An exception may be made for "trade secrets." If the Response contains information that constitutes a "trade secret", all material that qualifies for exemption from Chapter 119 must be submitted in a separate envelope, clearly identified as "TRADE SECRETS EXCEPTION," with your firm's name and the Solicitation number and title marked on the outside. Please be aware that the designation of an item as a trade secret by you may be challenged in court by any person. By your designation of material in your Response as a "trade secret" you agree to indemnify and hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and attorney's fees incurred by the City by reason of any legal action challenging your claim. 1.85. UNAUTHORIZED WORK OR DELIVERY OF GOODS- Neither the qualified Bidder(s)/Proposer(s) nor any of his/her employees shall perform any work or deliver any goods unless a change order or purchase order is issued and received by the Contractor. The qualified Bidder(s)/Proposer(s) shall not be paid for any work performed or goods delivered outside the scope of the contract or any work performed by an employee not otherwise previously authorized. 1.86. USE OF NAME - The City is not engaged in research for advertising, sales promotion, or other publicity purposes. No advertising, sales promotion or other publicity materials containing information obtained from this Solicitation are to be mentioned, or imply the name of the City, without prior express written permission of the City Manager or the City Commission. 1.87. VARIATIONS OF SPECIFICATIONS - For purposes of solicitation evaluation, bidders/proposers must indicate any variances from the solicitation specifications and/or conditions, no matter how slight. If variations are not stated on their Response, it will be assumed that the product fully complies with the City's specifications. Page 26 of 43 Request for Proposals (RFP) 610384 2. Special Conditions 2.1. PURPOSE The purpose of this Solicitation is to establish a contract, for Psychological Screening Services, as specified herein, from a source(s), fully compliant with the terms, conditions and stipulations of the solicitation. 2.2. PRE -PROPOSAL CONFERENCE Prospective Proposers are encouraged to attend the Voluntary Pre -Proposal Conference, which will occur on Tuesday, November 13, 2018 at 10:00 AM, at 444 SW 2nd Avenue 6th North Conference Room. A discussion of the requirements of the solicitation will occur at that time. Each potential Proposer is required, prior to submitting a Proposal, to acquaint itself thoroughly with any and all conditions and/or requirements that may in any manner affect the work to be performed. No allowances will be made because of lack of knowledge of these conditions. The purpose of the pre -proposal conference is to allow potential Proposers an opportunity to present questions to staff and obtain clarification of the requirements of the solicitation documents. Because the City considers the conference to be critical to understanding the solicitation requirements, attendance is Voluntary. 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION/CLARIFICATION Any questions or clarifications concerning this solicitation shall be submitted by email or facsimile to the Procurement Department, Attn: Eduardo Falcon; fax: (305) 400-5390 or email: efalcon@miamigov.com, and a copy filed with the Office of the City Clerk, pursuant to Section 1.20. Cone of Silence. The solicitation title and number shall be referenced on all correspondence. All questions must be received no later than Monday, November 19, 2018 at 2:00 PM. All responses to questions will be sent to all prospective bidders/proposers in the form of an addendum. NO QUESTIONS WILL BE RECEIVED VERBALLY OR AFTER SAID DEADLINE. 2.4. TERM OF CONTRACT The Proposer qualified to provide the service(s) requested herein (the "Successful Proposer") shall be required to execute a Professional Services Agreement ("Agreement") with the City, which shall include, but not be limited to, the following terms: (1) The term of the Contract(s) shall be for five (5) years with an option to renew for one (1) additional five (5) year period. (2) The City shall have the option to extend or terminate the Contract. Continuation of the contract beyond the initial period is a City prerogative; not a right of the Proposer. This prerogative will be exercised only when such continuation is clearly in the best interest of the City. 2.5. CONDITIONS FOR RENEWAL Each renewal of this contract is subject to the following: (1) Continued satisfactory performance compliance with the specifications, terms and conditions established herein. Page 27 of 43 Request for Proposals (RFP) 610384 (2) Availability of funds 2.6. MINIMUM QUALIFICATION REQUIREMENTS The minimum qualification requirements for this solicitation are that the Successful Proposer: A. Shall have clinical psychologist(s) that possess a doctoral level degree in psychology and are licensed with the Florida Board of Psychology to administer psychological testing and evaluations, conduct interviews, and interpret test data. B. Shall be in the business of providing the services as described in this RFP for a minimum of five (5) years; with the same Business Tax Identification Number. Proposer shall have sufficient financial support, equipment, and organization to ensure that they can satisfactorily execute the services if awarded a Contract under the terms and conditions herein stated. C. Shall have no record of judgments, pending lawsuits against the City or criminal activities involving moral turpitude and not have any conflicts of interest that have not been waived by the City Commission. D. Successful Proposer nor any principal, officer, or stockholder of Proposer shall be in arrears or in default of any debt or contract involving the City, (as a party to a contract, or otherwise); nor have failed to perform faithfully on any previous contract with the City. Note: Copies of degrees and licenses for each psychologist proposed to work on this contract shall be included with the proposers proposal submittal. 2.7. LIVING WAGE ORDINANCE The City of Miami adopted a Living Wage Ordinance for City Service Contracts with a total contract value exceeding $100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in F.S. § 287.055, and Section 18-87 of the City Code, and/or the other exclusions provided by Section 18-557 of the City Code. Section 18-557 is attached as Attachment A. (Refer to Attachment A in the Header / Notes and Attachments Section of this RFP.) If a solicitation requires services, effective on January 1, 2017, contractors must pay to all its employees, who provide services, a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City of Miami Living Wage Ordinance. Please review Attachment A, attached hereto, for a complete and thorough description of the City of Miami Living Wage Ordinance. 2.8. EXECUTION OF AN AGREEMENT Page 28 of 43 Request for Proposals (RFP) 610384 The Successful Proposer evaluated and ranked in accordance with the requirements of this Solicitation, shall be awarded an opportunity to negotiate a Professional Services Agreement ("Agreement") (Refer to Attachment D in the Header / Notes and Attachments Section of this RFP). The City reserves the right to execute or not execute, as applicable, an Agreement with the Successful Proposer in substantially the same form as the draft Agreement included as part of this Solicitation. Such Agreement will be furnished by the City, will contain certain terms as are in the City's best interest, and will be subject to approval as to legal form by the City Attorney. 2.9. FACILITY LOCATION, HOURS OF SERVICE, AND AVAILABILITY A. Location The Successful Proposer shall have an office or a facility located in Miami -Dade County for applicant testing and evaluation. The office or facility shall be of sufficient size to accommodate and process approximately 30 to 50 applicants per week; however, the number of applicants may fluctuate, depending on the City's needs. In the event that a higher volume of applicants are being simultaneously processed for pre -employment by the City, to meet academy deadlines or hiring mandates, the City will notify the Successful Proposer at least seventy two (72) hours in advance in order for the Successful Proposer to accommodate this request. B. Hours of Service and Availability The Successful Proposer shall perform testing and evaluation services from 8 a.m. to 5 p.m., Monday through Friday. Depending on the volume of applicants that the City needs to have processed, the Successful Proposer shall have the ability to perform testing on Saturdays and City Observed Holidays. Successful Proposer shall be available 24 hours a day, and upon the Project Manager or designees request, respond to a scene to provide counseling for post -shootings or other traumatic incidents. In addition, Successful Proposer shall also be available for telephone consultations to address administrative issues as requested by the Project Manager or designee. C. Applicant or Employee Referrals Applicants will be referred for Phase 1 and Phase 2 evaluations and any follow up appointments by the authorized City Project Manager or designee. The Successful Proposer will work with the City on an as needed basis to schedule applicants for psychological testing. Personnel seeking Psychological Services/Counseling can contact the Successful Proposer directly for voluntarily services covered under this contract. D. Scheduling Applicants The Successful Proposer shall have the ability to schedule applicants for pre -employment testing utilizing an electronic online scheduler that is accessible 24 hours per day, seven (7) days per week. The Successful Proposer may issue specific usemame and passwords to all authorized users. In the event the online scheduler is temporarily unavailable, the City shall provide the names of the applicants via electronic mail, telephone, or facsimile. 2.10. FAILURE TO PERFORM Page 29 of 43 Request for Proposals (RFP) 610384 Should it not be possible to reach the Successful Proposer or Successful Proposer's Supervisor and/or should remedial action not be taken within 48 hours of any failure to perform according to specifications, the City reserves the right to declare Successful Proposer in default of the contract or make appropriate reductions in the contract payment. 2.11. INSURANCE REQUIREMENTS Successful Proposer shall indemnify, hold and save harmless, and defend (at its own cost and expense), the City, its officers, agents, directors, and/or employees, from all liabilities, damages, losses, judgements, and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, negligent act or omission, or intentional wrongful misconduct of Successful Proposer and persons employed or utilized by Successful Proposer in the performance of this Contract. Successful Proposer shall further, hold the City, its officials and employees, indemnify, save and hold harmless for, and defend (at its own cost), the City its officials and/or employees against any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted Work, even if it is alleged that the City, its officials, and/or employees were negligent. In the event that any action or proceeding is brought against the City by reason of any such claim or demand, the Successful Proposer shall, upon written notice from the City, resist and defend such action or proceeding by counsel satisfactory to the City. The Successful Proposer expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by the Successful Proposer shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate the Successful Proposer to defend, at its own expense, to and through trial, administrative, appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at the City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against the City, whether performed by the Successful Proposer, or persons employed or utilized by Successful Proposer. These duties will survive the cancellation or expiration of the Contract. This Section will be interpreted under the laws of the State of Florida, including without limitation and interpretation, which conforms to the limitations of Sections 725.06 and/or 725.08, Florida Statutes, as applicable and as amended. Successful Proposer shall require all sub -Successful Proposer agreements to include a provision that each sub -Successful Proposer will indemnify the City in substantially the same language as this Section. The Successful Proposer agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Successful Proposer in which the City participated either through review or concurrence of the Successful Proposer's actions. In reviewing, approving or rejecting any submissions by the Successful Proposer or other acts of the Successful Proposer, the City, in no way, assumes or shares any responsibility or liability of the Successful Proposer or sub -Successful Proposer under this Contract. Ten dollars ($10) of the payments made by the City constitute separate, distinct, and independent consideration for the granting of this Indemnification, the receipt and sufficiency of which is voluntarily and knowingly acknowledged by the Successful Proposer. Page 30 of 43 Request for Proposals (RFP) 610384 The Successful Proposer shall furnish to the City of Miami, c/o Procurement Department, 444 SW 2nd Avenue, 6th Floor, Miami, Florida 33130; Certificate(s) of Insurance which indicates that insurance coverage has been obtained which meets the requirements outlined below: Please see Attachment B Insurance Addendum for insurance definitions, requirements, and conditions, in the Header/Attachments Section of this solicitation. (1) Worker's Compensation A. Limits of Liability - Statutory - State of Florida - Waiver of Subrogation (2) Commercial General Liability (Primary & Non -Contributory): A. Limits of Liability Bodily Injury and Property Damage Liability - Each Occurrence: $1,000,000 General Aggregate Limit: $2,000,000 Personal and Adv. Injury: $ 1,000,000 Products and Completed Operations: $1,000,000. B. Endorsements Required: City of Miami included as an Additional insured. Employees included as insured. Contractual Liability. (3) BusinessAutomobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit. Owned/Scheduled Autos including Hired, Borrowed or or Non -Owned Autos used in connection with the work - Any One Accident: S 1,000,000 B. Endorsements Required: City of Miami included as an Additional Insured (4) Employer's Liability A. Limits of Liability S 100,000 for bodily injury caused by an accident, each accident S 100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit (5) Professional Liability/Errors and Omissions Coverage Combined Single Limit, Each Claim: $1,000,000 General Aggregate Limit: S1,000,000 Deductible: Not to Exceed 10% BINDERS ARE UNACCEPTABLE. The insurance coverage required shall include those classifications, as listed in standard liability insurance manuals, which most nearly reflect the operations of the Proposer. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The Company must be rated no less than "A" as to management, and no less than "Class V" as to financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its Page 31 of 43 Request for Proposals (RFP) 610384 equivalent. All policies and/or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. NOTE: CITY BID NUMBER AND/OR TITLE OF BID MUST APPEAR ON EACH CERTIFICATE. Compliance with the foregoing requirements shall not relieve the Proposer of his liability and obligation under this section or under any other section of this Agreement. --If insurance certificates are scheduled to expire during the contractual period, the Proposer shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. --In the event that expired certificates are not replaced with new or renewed certificates which cover the contractual period, the City shall: (4) Suspend the contract until such time as the new or renewed certificates are received by the City in the manner prescribed in the Invitation To Bid. (5) The City may, at its sole discretion, terminate this contract for cause and seek re -procurement damages from the Proposer in conjunction with the General and Special Terms and Conditions of the Bid. The Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period; including any and all option terms that may be granted to the Proposer. 2.12. PROJECT MANAGER Upon award, Successful Proposer shall report and work directly with Major Esther Farmer or designee, who shall be designated as the Project Manager for the City. 2.13. PRIMARY CLIENT (FIRST PRIORITY) The Successful Proposer agrees upon award of this contract that the City of Miami shall be its primary client and shall be serviced first during a schedule conflict arising between this contract and any other contract Successful Proposer may have with any other cities and/or counties to perform similar services as a result of any catastrophic events such as tornadoes, hurricanes, severe storms or any other public emergency impacting various areas during or approximately the same time. 2.14. UNAUTHORIZED WORK The Successful Proposer shall not begin work until a Purchase Order or written Notice to Proceed are received. 2.15. CHANGES/ALTERATIONS Proposer may change or withdraw a Proposal at any time prior to Proposal submission deadline; however, no oral modifications will be allowed. Written modifications shall not be allowed following the proposal deadline. Page 32 of 43 Request for Proposals (RFP) 610384 2.16. COMPENSATION PROPOSAL Proposer shall provide a detailed list of all costs to provide all services as detailed in Section 3, Scope of Services, as proposed. The City reserves the right to add or delete any service, at any time. Should the City determine the need to add an additional service for which pricing was not previously secured, the City will ask the Successful Proposer to provide reasonable cost(s) for same. Should the City determine the pricing unreasonable, the City reserves the right to negotiate cost(s) or seek another Proposer for the provision of said service(s). Failure to submit cofnpensation proposal Attachment C (Refer to Attachment C in the Header / Notes and Attachments Section of this RFP) as required may disqualify Proposer from consideration. 2.17. METHOD OF PAYMENT Full payment will be made upon receipt and acceptance of completed services. Invoices shall contain Purchase Order number and details of services provided. 2.18. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD The procedure for response evaluation, selection and award is as follows: (1) Solicitation issued; (2) Receipt of responses; (3) Opening and listing of all responses received; (4) Procurement staff will review each submission for compliance with the submission requirements of the solicitation, including verifying that each submission includes all documents required; (5) An Evaluation Committee ("Committee"), appointed by the City Manager, comprised of appropriate City Staff and members of the community, as deemed necessary, with the appropriate technical expertise and/or knowledge, shall meet to evaluate each response in accordance with the requirements of this solicitation and based upon the evaluation criteria as specified herein; (6) The Committee reserves the right, in its sole discretion, to request Proposers to make oral presentations before the Committee as part of the evaluation process. The presentation may be scheduled at the convenience of the Committee and shall be recorded; (7) The Committee reserves the right to rank the proposals and shall make its recommendation to the City Manager requesting the authorization to negotiate. No Proposer(s) shall have any rights against the City arising from such negotiations thereof; (8) The City Manager reserves the right to reject the Committee's recommendation to negotiate, and instruct the Committee to re-evaluate and make another recommendation, or reject all proposals. No Proposer(s) shall have any rights against the City arising from such termination thereof; (9) If the City Manager accepts the Committee's recommendation to negotiate, Procurement will negotiate a final contract with the Successful Proposer, and submit a recommendation to award a contract (s) to the City Manager; (10) The City Manager shall then submit his or her award recommendation and negotiated contract (s) to the City Commission for approval. Written notice shall be provided to all proposers. (11) If the City Manager accepts the award recommendation, the City Manager's recommendation for award of contract will be posted on the City of Miami Procurement Department website, in the Supplier Corner, Current Page 33 of 43 Request for Proposals (RFP) 610384 Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Recommendation of "Award To" fields. If "various" is indicated in the Recommendation of "Award To" field, the Proposer must contact the Contracting Officer for that solicitation to obtain the suppliers names. (12) After reviewing the City Manager's recommendation, the City Commission may: 1. Approve the City Manager's award recommendation and negotiated contract(s); 2. Reject all proposals; 3. Reject all proposals and instruct the City Manager to reissue a solicitation; or 4. Reject all proposals and instruct the City Manager to enter into competitive negotiations with at least three individuals or firms possessing the ability to perform such services and obtain information from said individuals or firms relating to experience, qualifications and the proposed cost or fee for said services, and make a recommendation to the City Commission. The decision of the City Commission shall be final. Written notice of the award shall be given to the Successful Proposer. 2.19. RECORDS During the contract period, and for a least five (5) subsequent years thereafter, Successful Proposer shall provide City access to all files and records maintained on the City's behalf. 2.20. TRUTH IN NEGOTIATION CERTIFICATE Execution of the resulting agreement by the Successful Proposer shall act as the execution of truth -in -negotiation certificate stating that wage rates and other factual unit costs supporting the compensation of the resulting Agreement are accurate, complete, and current at the time of contracting. The original contract price and any additions thereto shall be adjusted to exclude any significant sums by which City determines the contract price was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year following the end of the Agreement. 2.21. NON -APPROPRIATION OF FUNDS In the event no funds or insufficient funds are appropriated and budgeted or are otherwise unavailable in any fiscal period for payments due under this contract, then the City, upon written notice to the Successful Bidder(s)/Proposer(s) or his assignee of such occurrence, shall have the unqualified right to terminate the contract without any penalty or expense to the City. No guarantee, warranty or representation is made that any project(s) will be awarded to any firm(s). 2.22. TERMINATION A. FOR DEFAULT If Successful Proposer defaults in its performance under this Contract and does not cure the default within 30 days after written notice of default, the City Manager may terminate this Contract, in whole or in part, upon written notice without penalty to the City of Miami. In such event the Successful Proposer shall be liable for damages including Page 34 of 43 Request for Proposals (RFP) 610384 the excess cost of procuring similar supplies or services: provided that if,,(1) it is determined for any reason that the Successful Proposer was not in default or (2) the Successful Proposer's failure to perform is without his or his subcontractor's control, fault or negligence, the termination will be deemed to be a termination for the convenience of the City of Miami. B. FOR CONVENIENCE The City Manager may terminate this Contract, in whole or in part, upon 30 days prior written notice when it is in the best interest of the City of Miami. If this Contract is for supplies, products, equipment, or software, and so terminated for the convenience by the City of Miami the Successful Proposer will be compensated in accordance with an agreed upon adjustment of cost. To the extent that this Contract is for services and so terminated, the City of Miami shall be liable only for payment in accordance with the payment provisions of the Contract for those services rendered prior to termination. Page 35 of 43 Request for Proposals (RFP) 610384 3. Specifications 3.1. SPECIFICATIONS/SCOPE OF WORK The City of Miami, hereinafter referred to as the City, as represented by the Miami Police Department ("MPD"), is soliciting proposals to obtain professional services from an experienced and qualified Proposer to conduct valid, reliable, and cross-cultural psychological testing for those applying for City employment in the following classifications: sworn personnel and non -sworn personnel ("personnel"). Services are to be provided at the Successful Proposer's facility located in Miami -Dade County. The testing is required by the City as part of a comprehensive background investigation of applicants. The purpose of this service is to evaluate whether said applicants are suitable candidates for public safety positions. 3.2 Background The City is a vibrant, multicultural community comprised of approximately a half a million residents and over one million visitors daily. The City provides law enforcement and public safety services consistent with the needs of the community. These services are directed toward creating and maintaining an environment that is safe, free of crime and disorder within the legal, ethical and resource constraints permitted. MPD is tasked with promoting a safe, secure, and crime free environment, in addition to maintaining order. The MPD utilizes the services of 1369 swom personnel and 400 non -sworn personnel. Assessing the psychological suitability of candidates is one of the essential functions in the hiring process as these personnel must be able to endure the stresses of working in a fast -paced environment, follow rules, use resources responsibly, behave in a trustworthy manner, use good judgment, and refrain from off -duty behavior that would reflect poorly on the City. Evaluations provide assurance that candidates are free of job -relevant emotional and mental impairments, possess adequate stress resilience and emotional stability, and are able to meet the behavioral, social, and cognitive demands of a public safety position. The Successful Proposer shall analyze data, conduct clinical interviews and present a recommendation to the appropriate hiring body that will identify: 1) Positive psychological, characteristics associated with successful job performance; 2) Traits that may interfere with effective job performance; 3) Emotionally unsuitable candidates; 4) Potential for violence, suicide, aggression and substance abuse; 5) Personality problems and emotional disorders; and 6) Stress management characteristics, etc. This analysis will assist in the determination of whether or not a candidate is mentally and emotionally capable as well as mature enough to work in the law enforcement/public safety field. 3.3 Testing and Evaluation The Successful Proposer shall conduct City requested pre -employment psychological evaluations that include a Page 36 of 43 Request for Proposals (RFP) 610384 series of standardized tests as outlined below. Individual face-to-face interviews with applicants should be conducted before a final determination of the applicant's psychological suitability is made. Any testing administered must be objective, job related, non-discriminatory, and validated for use with public safety candidates. Pre -Employment Testing for Personnel Phase 1: Administration and interpretation of one or more tests which identify and assess personality suitability characteristics to include but not limited to: maturity, responsibility, socialization adequacy, flexibility, general academic potential, interpersonal conflict measures (assertiveness, moodiness, social alienation, family discord), social ability, initiative/goal orientation, strong racial or ethnic prejudice, job performance predictions of absence, lateness, and disciplinary actions. Phase 2: Administration and interpretation of one or more tests which identify and assess emotional suitability characteristics to include but not limited to: psychosis, character disorders (especially anti -social personality disorders), significant neurotic Symptomatology (phobic personality, undue suspiciousness), mood disorders (anxiety, depression), poor impulse control (anger/hostility patterns), need for high levels of excitement, tendency to be very passive or aggressive in the face of conflict, strong racial or ethnic prejudice, poor self-concept, job performance predictions of absence, lateness, and disciplinary, substance abuse tendencies. Psychological Services for Personnel The Successful Proposer shall provide psychological services for personnel which include counseling and employee assessments. The counseling services include individual counseling, marriage/family counseling, alcohol abuse counseling, life-style counseling, post traumatic (incident) counseling and crisis intervention including, but not limited to post -shooting or other traumatic counseling/mandated counseling sessions. The Successful Proposer shall make appropriate referrals to the Project Manager or designee for medical, psychiatric evaluation when medical, psychiatric or medication concerns may impact fitness for duty for Personnel. Services to be Provided The successful Proposer shall: A. Follow all guidelines and comply with any current International Association of Chiefs of Police ("IACP") standards for pre -employment evaluation; B. Conduct the pre -employment psychological evaluation service and ensure provisions are established for the security and confidentiality of all testing materials, psychological result reports, statistical and any other raw data in accordance with the Americans with Disabilities Act ("ADA"), the Health Insurance Portability and Accountability Act ("HIPAA") and any federal or state laws applicable in the Successful Proposer's jurisdiction; C. Use written tests that are appropriate evaluations on the occupational exposure of the job classification for public safety; Page 37 of 43 Request for Proposals (RFP) 610384 D. Only test those applicants who are referred to them exclusively by the City's Project Manager or designee; E. Provide the City with a complete glossary of all scales and terms relevant to the screening process and evaluation report; F. Provide documentation that outlines the results of research and investigation to ensure that all tests and procedures used in the screening process are valid, reliable, cross cultural, and relevant to future job performance for the job classifications for which applicants are being evaluated; G. Provide evaluations, test booklets, answer sheets, examiner instructions, taped and written instructions, case notes and other materials at the request of the City's Project Manager or designee; H. Re -test and re-evaluate applicants as requested by the City's Project Manager or designee; I. Appear and testify in a court of law and at administrative hearings regarding work performed herein. This requirement shall survive the termination or expiration of any resultant Contract; J. At the request of the City's Project Manager or designee: a) be available for telephone consultation and occasional meetings to discuss and clarify evaluation results; and b) participate in quarterly meetings (or as required) with the City to review specific test results or developments and milestone events in the psychological testing services program; K. Have access to sufficient computers and ancillary equipment necessary, to score test results, develop performance profiles, prepare various statistical and summary reports, and store all test and evaluation data; and L. Conduct feedback sessions with applicants to discuss the results of the evaluation, at the request of the City. 3.4 Reporting The Successful Proposer shall submit reports as specified below in writing to the City's Project Manager or designee. These reports shall include, but are not limited to the following: A. Test Results and Clinical Interview Results Successful Proposer shall: 1. Provide the City with an electronic written evaluation report to be within 48 hours via electronic mail from the date of testing. The reports shall include: 1) A standardized rating scale indicating a specific rating regarding the Page 38 of 43 Request for Proposals (RFP) 610384 applicant/employee based on the essential functions for the sworn or non -sworn position; 2) An evaluation of the employees' suitability for the position upon analysis of all psychological materials to include test data and interview results; and 3) A recommendation based on the analysis, along with a justification and any reservations that the psychologist may have regarding the validity or reliability of the results. 2. Maintain all psychological test files electronically in a secure manner in accordance with ADA, HIPAA and any federal or state laws for the life of the resultant Contract at no additional cost to the City. Upon termination or expiration of the resultant Contract, the Successful Proposer will transfer all psychological evaluation test files to the City in an acceptable digital format to the City at no additional cost. 3. Deliver expedited tests and clinical interview results via electronic mail or by courier service if unable to do so electronically as requested by the City's Project Manager or designee. In no case shall the expedited request be delivered later than I0:00a.m. on the first business day following the day on which the expedited request was made. In the event that the Successful Proposer experiences computer failure and is unable to electronically submit reports, Successful Proposer shall provide courier services at no cost to the City, during normal working hours, (Monday through Friday 8:00am to 5:00pm) for delivery of reports to the offices of MPD, or as specified by the City's Project Manager or designee. B. Statistical Reports When requested by the City's Project Manager or designee, Successful Proposer shall provide semi-annual and annual statistical reports electronically in a format to include date fields as requested. Report data requested may include, but is not limited to, the following: a) Number of applicants tested; b) Number of applicants tested by race, ethnicity, and gender; c) Number of applicants in each rating category, by race, ethnicity, and gender; and d) Number of applicants in each rating category, by race, ethnicity, and gender, for a specific timeframe, etc. 3.5 Optional Services The City may request the Successful Proposer to provide, Pre and Post -Stress Management Workshops for selected employees to attend in order to reduce or eliminate stress -related behavior or related problems. Additional related seminars and/or workshops not specifically identified in this solicitation requested by the City will be negotiated with the Successful Proposer. Services may be added to any resultant contract upon successful negotiation and mutual consent of the contracting parties via a Contract Amendment. Page 39 of 43 Request for Proposals (RFP) 610384 4. Submission Requirements 4.1. SUBMISSION REQUIREMENTS Proposers shall carefully follow the format and instruction outlined below, observing format requirements where indicated. Proposals should contain the information itemized below and in the order indicated. This information should be provided for the Proposer and any sub -consultants to be utilized for the work contemplated by this Solicitation. Proposals submitted which do not include the following items may be deemed non -responsive and may not be considered for contract award. The Proposal shall be written in sufficient detail to permit the City to conduct a meaningful evaluation of the proposed services. However, overly elaborate responses are not requested or desired. Sealed written Proposals must be received by the Office of the City Clerk no later than the date, time and at the location indicated in the RFP cover page, in order to be considered. Faxed documents are not acceptable. One (1) unbound original and six (6) copies in digital format (on CD-ROM or USB in .pdf file format) of the Proposer's Proposal must be timely received by the Office of the City Clerk, or the Proposal will be disqualified. Proposals can be hand delivered to the Office of the City Clerk, no later than the date, time, and at the location in RFP Cover page. Untimely or misdelivered submittals will not be considered. The responses to this solicitation shall be presented in the following format. Failure to do so may deem your Proposal non -responsive. A. Include the signed RFP Certification Statement. B. Include in detail, documentation that clearly demonstrates Proposer meets the minimum qualification requirements, pursuant to Section 2.6., Minimum Qualification Requirements 1. Cover Page The Cover Page should include the Proposer's name; Contact Person for the RFP; Firm's Liaison for the Contract; Primary Office Location; Local Business Address, if applicable; Business Phone and Fax Numbers, Email addresses; Title of RFP; RFP Number; Federal Employer Identification Number or Social Security Number. 2. Table of Contents The table of contents should outline, in sequential order, the major sections of the proposal as listed below, including all other relevant documents requested for submission. All pages of the proposal, including the enclosures, should be clearly and consecutively numbered and correspond to the table of contents. 3. Executive Summary: A signed and dated summary of no more than two (2) pages containing the Qualifications, and Experience, Ability to Perform Required Services, Methodology and Overall Approach to the Scope of Services as contained in the submittal. Include the name of the organization, business phone and contact person. Page 40 of 43 Request for Proposals (RFP) 610384 4. Proposer Information A. Minimum Qualification Requirements 1) Provide documentation that demonstrates Proposer's ability to satisfy all of the minimum qualification requirements in Section 2.6 of this Solicitation. Proposers who fail to provide supporting documentation may be deemed non -responsive. B. Proposer's Experience and Qualifications 1) Describe the Proposer's organizational history and structure; years Proposer has been in business providing similar service(s). 2) Provide a list of all principals, owners or directors. 3) Provide the names of all of the licensed psychologists. Include their resume, and copy of current license. 4) Provide a complete list of clients for which Proposer has provided similar service(s) as required in this RFP. This list should include those governmental entities of a similar size and diverse population to the City for whom services have been performed during the past five (5) years. Include the overall value of the contract, and include the address, phone number(s), email, and contact persons within each organization. The City reserves the right to contact any reference as part of the evaluation process. 5) Provide three (3) client references on client letterhead from governmental entities of a similar size and diverse population to the City for whom similar services have been performed. These can include the clients listed in item 4 above. 6) Provide a list of clients who Proposer has represented during the past five (5) years, in court as a part of legal challenges in the provision of services similar to those proposed to the City. Explain the nature of those challenges, court outcome(s), and client contact with telephone numbers, and emails. S. Kev Personnel Performing Services 1) Describe the size of Proposer's organization and indicate the number of personnel and its ability to provide required services to the City. 2) Describe where the primary work will be performed. 3) Provide a complete list of the personnel that will be assigned to handle the work to be performed for the City. Include a resume of each describing their experience, training, certifications, and other relevant details. Provide detailed background on the main point of contact to be assigned to the City's account throughout the duration of the Contract. 4) Provide a plan for retention, describing how the Proposer shall ensure the same level of qualification, and experience, of all proposed key personnel who will be assigned to this Contract. 6. Methodology and Overall Approach to Scope of Services I) Describe Proposer's Overall Methodology and Approach to providing the services to be performed. 2) Describe the testing mechanism to be utilized, and provide a sample of the same. 3) Describe the Methodology for validating / upgrading the testing system. 4) Describe how Proposer would approach any legal challenges to its recommendations/findings. 5) Provide a sample of a final report to be submitted for the testing and interview process. Page 41 of 43 Request for Proposals (RFP) 610384 5. Evaluation Criteria 5.1. EVALUATION CRITERIA Each proposal will be reviewed to determine if the proposal is responsive to the submission requirements outlined in this solicitation. A responsive proposal is one which follows the requirements of this solicitation, includes all documentation, is submitted in the format outlined in this solicitation, is of timely submission, and has the appropriate signatures as required. Failure to comply with these requirements may result in the proposal being deemed non -responsive. Proposals will be evaluated by an Evaluation/Selection Committee (Committee) which will evaluate and rank proposals based on the criteria listed below. The Committee will be comprised of appropriate City personnel and members of the community, as deemed necessary, with the appropriate experience and/or knowledge. The criteria are itemized with their respective weights for a maximum of one hundred (100) points per Committee member. Technical Criteria Points Proposer's relevant experience, qualifications, and past performance 50 Proposer's Ability to Perform Required Services 25 Methodology and Overall Approach to Scope of Services 15 Compensation Proposal Proposer's financial capabilities, and proposed fees Total 10 100 Page 43 of 43 Request for Proposals (RFP) 610384 5. Evaluation Criteria 5.1. EVALUATION CRITERIA Each proposal will be reviewed to determine if the proposal is responsive to the submission requirements outlined in this solicitation. A responsive proposal is one which follows the requirements of this solicitation, includes all documentation, is submitted in the format outlined in this solicitation, is of timely submission, and has the appropriate signatures as required. Failure to comply with these requirements may result in the proposal being deemed non -responsive. Proposals will be evaluated by an Evaluation/Selection Committee (Committee) which will evaluate and rank proposals based on the criteria listed below. The Committee will be comprised of appropriate City personnel and members of the community, as deemed necessary, with the appropriate experience and/or knowledge. The criteria are itemized with their respective weights for a maximum of one hundred (100) points per Committee member. Technical Criteria Points Proposer's relevant experience, qualifications, and past performance 50 Proposer's Ability to Perform Required Services 25 Methodology and Overall Approach to Scope of Services 15 Compensation Proposal Proposer's financial capabilities, and proposed fees Total 10 100 Page 43 of 43 Request for Proposals (RFP) 610384 6) Describe how Proposer will conduct counseling and employee assessments, and how it evaluates individuals for each type of counseling provided. 7) Describe the Stress Management Seminars and Workshops to be provided on Pre and Post -Stress Management. Indicate the number of proposed workshops on an annual basis, number of personnel for each seminar/workshop, frequency, location, and trainer(s) (include resume). 8) Provide time required to evaluate and report results. Indicate if / how results will be reported. 9) Describe how Proposer plans to handle daily testing schedules during high demand periods and emergency availability. 10) Identify if Proposer has taken any exception to the terms of this Solicitation. If so, indicate what alternative is being offered and the cost implication of the exception(s). 7. Compensation Proposal Provide, in detail, proposed fee(s) for services provided. Refer to detailed fee requirements cited in Section 2.16 Compensation Proposal. Page 42 of 43