The State Department is seeking information for the availability of a new medical service provider for U.S. Mission Iraq. There is an incumbent contractor, CHS Middle East, LLC of Cape Canaveral, Florida. The total estimated contract value for the incumbent contractor is approximately $234M. According to the fedbiz announcement, the health units and diplomatic support hospitals will need to be mission capable by summer 2016. Below is an excerpt from the announcement:
Government is requesting information regarding the availability and feasibility of attracting new medical service providers to support the requirements of the U.S. Mission Iraq as described in this RFI. This notice is issued solely for information and planning purposes and does not constitute a Request for Proposal (RFP) or a commitment on the part of the Government to conduct a solicitation for the below-listed services in the future.
The DOS has a follow-on requirement for a Contractor to provide medical service support to U.S. Government (USG) personnel, USG third party contractors and authorized foreign nationals in Iraq. These medical services will be provided at USG facilities and include but are not limited to the following: general medical, surgical, orthopedic, gynecologic, dental, behavioral health, public health, urgent and emergency care and mortuary affairs. In order to fulfill these requirements the Contractor is responsible for providing trained and certified health care professionals (e.g., physicians, nurse practitioners, surgeons, emergency medical technicians, etc…) and the administrative services and staff to equip and operate the USG contractor-operated health care facilities in Iraq.
The Contractor is responsible for performing random and non-random drug testing for other third party contractors operating in support of the DOS in Iraq. Additionally, because other third party contractors require Emergency Medical Technicians (EMTs) in country, the Contractor is responsible for the medic validation and verification to ensure the verification of maintenance of credentials for EMTs.
Supported population is between 3500-5800
While the primary place of performance is throughout the country of Iraq, the Contractor may be tasked with providing temporary medical service support to other USG facilities located in the Near East Region (i.e., North Africa and the Middle East).
The BDSC Large Diplomatic Support Hospital not only provides primary care to personnel at BDSC, but also may serve as the secondary and trauma care center for the patient population within U.S. Mission Iraq (4300 – 5800 personnel). These services include evacuation management and mortuary affairs.
The Contractor shall provide on-site primary, urgent and initial emergency care for general medical, surgical, orthopedic, gynecologic, and mental health conditions; triage, stabilize and evacuate patients to the next level of medical care; and keep up to two patients in the Health Unit (HU) for up to 24 hours until stabilized or medically evacuated. Staffing shall be continuous and uninterrupted; coverage for illness and vacations shall be the responsibility of the Contractor.
The Contractor is responsible for providing routine care during regular working hours and on an emergency basis after normal working hours based on Chief of Mission (COM) requirements. Medical Service Support Iraq (MSSI) II; Solicitation SAQMMA-15-SS-MSSI .
I’ve blogged about mental health in the State Department for years now (see links below). I know that a mental health issue affecting one person is not a story of just one person. It affects parents, spouses, children, siblings, friends; it affects the home and the workplace. It is a story of families and communities. While there is extensive support in the military community, that’s not always the case when it comes to members of the Foreign Service.
With very few exceptions, people who write to this blog about mental health and PTSD do so only on background. Here are a few:
A State Department employee with PTSD recently told this blog that “Anyone outside of our little insular community would be appalled at the way we treat our mentally ill.” The individual concludes with clear frustration that it “seems sometimes the only unofficially sanctioned treatment plan encouraged is to keep the commissaries well stocked with the adult beverage of your choice.”
Another one whose PTSD claim from service at a PRT in Iraq languished at OWCP said, “I can assure you that OER and State Med have been nothing but obstructions… as a vet, I have been treated at VA for the past ten months, else I would have killed myself long ago.”
Still another one writes: “VA indicates the average time between trauma and treatment-seeking is eight years. The longer it is undiagnosed and treated, the more difficult to ameliorate. I have a formal diagnosis from VA but could not even get the name of a competent psychiatrist from DoS. The bulk of DoS PTSD claims are still a few years away (2008/2009 PLUS 8), with no competent preparation or process.”
A friend of a State employee wrote that her DOS friend was “deployed/assigned to a war-torn country not too long ago for a year. Came back with PTSD and was forced by superiors to return to very stressful/high pressure work duties while also seeking medical attention for an undiagnosed then, but eventually diagnosed (took about 6 months) disease triggered by environmental conditions where s/he was last posted.”
Another FSO said, “I actually thought State did a decent job with my PTSD. After I was subject to an attack in Kabul, the social worker at post was readily available and helpful. He indicated I could depart post immediately if I needed to (and many did after the attack). When I departed post I was screened for PTSD and referred to MED here in DC. After a few sessions here with MED, I was referred to a private psychologist who fixed things up in a few months.”
One FSO who suffered from PTSD assured us that “State has come a very long way since 2005” and that it has made remarkable progress for an institution. Her concerns is that PTSD is widespread in the Department in the sense that people develop it in a wide range of posts and assignments. She cited consular officers in particular, who evacuate people from natural disasters and civil wars and deal with death cases on a regular basis, and are particularly at risk.
It’s not everyday that we get a chance to ask questions from somebody with post traumatic stress disorder. On Monday, June 29, FSO Rachel Schneller will join the forum and answer readers’ questions based on her personal experience with PTSD. She will be at this blog’s forum from noon to 2 pm EST. She will join the forum in her personal capacity, with her own views and not as a representative of the State Department or the U.S. Government. She’s doing this as a volunteer, and we appreciate her time and effort in obtaining official permission and joining us to help spread PTSD awareness. Please feel free to post your questions here.
Rachel Schneller joined the Foreign Service in 2001. Following a tour in Iraq 2005-6, she was diagnosed with PTSD. Her efforts to highlight the needs of Foreign Service Officers returning from tours in war zones helped prompt a number of changes in the State Department, for which she was awarded the 2008 Rivkin Award for Constructive Dissent.
Prior to joining the U.S. Department of State, Rachel served as a Peace Corps volunteer in Mali from 1996-98. She earned her MA from the Johns Hopkins School of Advanced International Studies (SAIS) in 2001. We have previously featured Rachel in this blog here, and here.
Below are some of our previous blog posts on mental health, PTSD, security clearance and the State Department’s programs:
This is excerpted from the Opinion from the Court of Appeals for the Sixth Circuit, filed on May 27, 2015 concerning a case of a U.S. citizen found guilty of abusing his own children who are also U.S. citizens. News reports are often loud when things go wrong, but never as loud when things go right. We don’t often hear about these cases until they go to court and we almost never hear the role played by our consular officials when assisting the victims. An RSO was also involved in this case, but was unnamed in court documents. We understand that this official will be DCM at one of our embassies in the Middle East this summer.
The vice consul in this case is FSO Mark Goldrup. His name appeared on the Congressional Record in June 2009 for his consular officer appointment. We suspect but could not confirmed that he was on his first overseas assignment at US Embassy Damascus when he assisted these victims find safe shelter in Syria back in 2010. The prosecutor said that Mr. Goldrup “took the extraordinary step of keeping an American citizen away from his two citizen sons because he felt that he posed a danger to them.” The State Department’s recruitment slogan last year was Change the World, Join the Foreign Service. Not sure about the world, but here is proof of one FSO who helped changed three lives, forever.
Malek M. Al Maliki was sentenced to 292 months on each of counts 1 & 2, to be served concurrently last year. He was remanded to the custody of the US Marshal. Supervised Release 10 years. This term consists of 10 years on each of counts 1 & 2, all such terms to run concurrently, with several conditions including Firearms and Dangerous Weapons Prohibition; DNA Collection; Mental Health Treatment; Minor Protection and Restriction Program; Sex Offender Registration and Notification Act. (United States of America v. Al Maliki; 1:13-cr-00121-SL-1). The U.S. Court of Appeals for the Sixth District affirmed the lower courts decision on May 27, 2015 (Case No. 14-3386). Excerpt below:
McKEAGUE, Circuit Judge. A jury of his peers found Malek al-Maliki guilty of a heinous crime: sexually abusing his own two children, ages twelve and three. Al-Maliki challenges several aspects of his conviction and sentence. His constitutional challenge to his conviction is a close call, but it ultimately fails under plain-error review. The rest of his challenges fail as well. We affirm.
Iraq native Malek al-Maliki had his first child, John Doe #1, with Hinda al-Rhannai in 1998. Two years later, the couple had a civil marriage and al-Maliki (but not his wife) became a United States citizen. Their physical union did not last long. Although they remained legally married, the couple has been separated since 2000 or 2002. Despite the separation, they had one more child, John Doe #2, in 2007. Since around 2000, al-Maliki has lived alone on the west side of Cleveland, Ohio, and al-Rhannai has lived in Morocco and then Syria with the two sons.
Al-Maliki visited his family on a few occasions over the years. The United States claims that during one trip from August to November 2010, he sexually abused his two children (then ages twelve and three), violating 18 U.S.C. §§ 2423(c) and (e). A grand jury indicted him under that statute, which at the time punished any United States citizen “ who travels in foreign commerce, and  engages in any illicit sexual conduct,” which includes noncommercial sexual acts with a minor, or any attempts to do the same.
Al-Maliki denied all of the charges, and a trial began. The jury heard from Mark Goldrup, a vice consul at the U.S. Embassy in Damascus, Syria. He testified that he put al- Rhannai and her children in a safe shelter after al-Rhannai came to the embassy seeking assistance for injuries consistent with domestic abuse. The jury also heard from Department of Homeland Security Special Agent Gabriel Hagan. She testified that she observed the sons’ open affection toward their mother, but that al-Maliki insisted his wife abused the sons. She also testified about a live interview she saw of John Doe #1, where the boy cried and hid his face while struggling to recount the sexual abuse (the “sin,” he called it) that he suffered.
Al-Maliki next challenges the admissibility of Goldrup’s testimony on two grounds: that his testimony included an improper hearsay statement, and that it included prejudicial statements about domestic violence. Nothing improper occurred.
Hearsay. Goldrup’s challenged testimony included this out-of-court statement: “[Al- Rhannai] stated that she had been abused by [al-]Maliki.” R. 97 at 15. But that statement was not offered to prove the truth of the matter asserted (that al-Maliki had in fact abused his wife); it was offered “for the limited purpose of explaining why [Goldrup’s] government[al] investigation” began. United States v. Martin, 897 F.2d 1368, 1371 (6th Cir. 1990) (collecting cases). Two conclusions follow: It is not hearsay, Fed. R. Evid. 801(c), and the government did not violate the Confrontation Clause, Crawford v. Washington, 541 U.S. 36, 59–60 n.9 (2004).
Middle Eastern stereotype. Goldrup’s testimony also included this statement: “You wouldn’t expect a law enforcement response” for spousal abuse in Syria because “it’s culturally understood [there] that a man has a right to beat his wife.” R. 97 at 53. That statement, taken in context, was both relevant and not unduly prejudicial. It was relevant because it rebutted al- Maliki’s attack on Goldrup’s credibility for not reporting the spousal abuse to Syrian authorities. United States v. Chance, 306 F.3d 356, 385 (6th Cir. 2002); see United States v. Segines, 17 F.3d 847, 856 (6th Cir. 1994).
Read in full here(pdf). Warning: Some graphic entries.
On February 6, 2012, the U.S. Embassy Damascus suspended operations and is not open for normal consular services.
“If a T-wall tips over in Baghdad but there’s no media around to hear it, will it make a sound? What if it crushes a local national contractor working on a USG facility— will anyone mention the man’s death, or can we expect radio silence as usual? It’s becoming clear that no one back home really cares about what’s going on over here….it’s like 2004 all over again.”
U.S. Soldiers of Headquarters and Headquarters Company, Brigade Special Troops Battalion, 3rd Brigade Combat Team, 82nd Airborne Division, guide a concrete barrier into a new position at Joint Security Station Loyalty, eastern Baghdad, Iraq, on May 17, 2009. Photo by Staff Sgt. James Selesnick
Note: “T-Walls” or Texas barriers can reached upwards of 12 to 18 feet in height. Some of the tallest reach 24 feet. According to army.mil, t-walls of the larger variety became symbols of life in Iraq although several variations of shapes and sizes also abound around Iraq. Read more here.
A 2011 ranking of private USAID partners by devex.com lists LBG as the third largest USAID private-sector partner that has contracted some of the government’s largest post-conflict redevelopment projects in Iraq and Afghanistan. According to Bloomberg, Louis Berger International, a unit of Louis Berger Group, got about $736 million to modernize a power system and rehabilitate the Kajakai Dam in Afghanistan. Whoa! We thought that dam only cost $305.5 million! Plus cost of fuel that US taxpayers also had to shoulder.
What is missing from this announcement? How much was the total contracts that LBG received in the last 20 years? Who’s paying the independent monitor? And for heaven’s sake, what lessons are we sending to other reconstruction capitalists doing awesome work for love of god and country?
The former president, chief executive officer, and chairman of the board of a New Jersey-based international engineering consulting company was sentenced today to 12 months of home confinement and fined $4.5 million for conspiring to defraud the U.S. Agency for International Development (USAID) with respect to billions of dollars in contracts over a nearly 20-year period, U.S. Attorney Paul J. Fishman announced.
Derish Wolff, 79, of Bernardsville, New Jersey, previously pleaded guilty before U.S. District Judge Anne E. Thompson to a superseding information charging conspiracy to defraud the government with respect to claims. Judge Thompson imposed the sentence today in Trenton federal court.
According to documents filed in this case and statements made in court:
Wolff, the former president and CEO of Morristown, New Jersey-based Louis Berger Group Inc. (LBG), and the former chairman of LBG’s parent company, Berger Group Holdings Inc. (BGH), led a conspiracy to defraud USAID by billing the agency on so-called “cost-reimbursable” contracts – including hundreds of millions of dollars of contracts for reconstructive work in Iraq and Afghanistan – for LBG’s overhead and other indirect costs at falsely inflated rates.
USAID, an independent federal government agency that advances U.S. foreign policy by supporting economic growth, agriculture, trade, global health, democracy, and humanitarian assistance in developing countries, including countries destabilized by violent conflict, awarded LBG hundreds of millions of dollars in reconstruction contracts in Iraq and Afghanistan as well as in other nations. LBG calculated certain overhead rates and charged USAID and other federal agencies these rates on cost-reimbursable contracts, which enabled LBG to pass on their overhead costs to the agency in general proportion to how much labor LBG devoted to the government contracts.
From at least 1990 through July 2009, LBG, through Wolff and other former executives, intentionally overbilled USAID in connection with these cost-reimbursable contracts. The scheme to defraud the government was carried out by numerous LBG employees at the direction of Wolff.
Wolff targeted a particular overhead rate, irrespective of what the actual rate was, and ordered his subordinates to achieve that target rate through a variety of fraudulent means. From at least as early as 1990 through 2000, Wolff ordered LBG’s assistant controller to instruct the accounting department to pad its time sheets with hours ostensibly devoted to federal government projects when it had not actually worked on such projects.
At an LBG annual meeting in September 2001, Salvatore Pepe, who was then the controller and eventually became chief financial officer (CFO), presented a USAID overhead rate that was significantly below Wolff’s target. In response, Wolff denounced Pepe, called him an “assassin” of the overhead rate and ordered him to target a rate above 140 percent, meaning that for every dollar of labor devoted to a USAID contract, LBG would receive an additional $1.40 in overhead expenses supposedly incurred by LBG.
In response, Pepe and former controller Precy Pellettieri, with Wolff’s supervision, hatched a fraudulent scheme from 2003 through 2007 to systematically reclassify the work hours of LBG’s corporate employees, including high-ranking executives and employees in the general accounting division, to make it appear as if those employees worked on federal projects when they did not. At his plea hearing on Dec. 12, 2014, Wolff admitted that Pepe and Pellettieri, at Wolff’s direction, reclassified these hours without the employees’ knowledge and without investigating whether the employees had correctly accounted for their time, and at times did so over an employee’s objection.
In addition to padding employees’ work hours with fake hours supposedly devoted to USAID work, Wolff instructed his subordinates to charge all commonly shared overhead expenses, such as rent, at LBG’s Washington, D.C., office to an account created to capture USAID-related expenses, even though the D.C. office supported many projects unrelated to USAID or other federal government agencies.
On Nov. 5, 2010, Pepe and Pellettieri both pleaded guilty before then-U.S. Magistrate Judge Patty Shwartz to separate informations charging them with conspiring to defraud the government with respect to claims. Also on that date, LBG resolved criminal and civil fraud charges related to Wolff’s and others’ conduct. The components of the settlement included:
a Deferred Prosecution Agreement (DPA), pursuant to which the U.S. Attorney’s Office in New Jersey suspended prosecution of a criminal complaint charging LBG with a violation of the Major Fraud Statute; in exchange, LBG agreed, among other things, to pay $18.7 million in related criminal penalties; make full restitution to USAID; adopt effective standards of conduct, internal controls systems, and ethics training programs for employees; and employ an independent monitor who would evaluate and oversee the company’s compliance with the DPA for a two-year period;
a civil settlement that required the company to pay the government $50.6 million to resolve allegations that LBG violated the False Claims Act by charging inflated overhead rates that were used for invoicing on government contracts; and an administrative agreement between LBG and USAID, which was the primary victim of the fraudulent scheme.
In the settlement, the government took into consideration LBG’s cooperation with the investigation and the fact that those responsible for the wrongdoing were no longer associated with the company.
Media reports say that a car bomb went off at 5:40 pm local time in front of the U.S. Consulate General in Irbil, in northern Iraq today. An unnamed senior State Department official told ABC News it was a vehicle-borne improvised explosive device (VBIED). Other reports say the target was the local cafe near the consulate. The AP reports that no consulate personnel or local guards were wounded. There are local casualties but the number has not been officially released. McClatchy’s Mitchell Prothero in Iraq reports that “the entrance to the consulate appeared to have been struck by a bomber on foot.”
U.S. Consulate Erbil (Irbil) is headed by FSO Joseph Pennington who assumed his duties as Consul General in northern Iraq in July 2013.
IRBIL, Iraq (AP) — Car bomb explodes outside US Consulate in northern #Iraq city of Irbil
WaPo covered the ambushed and abduction of four Americans and an Austrian employed by Crescent Security Group, a small private security firm in Iraq in July 2007. In March 2008, U.S. authorities were reported to be in possession of five severed fingers, four of which belong to private security contractors. In May 2008, the FBI identified the remains of the kidnapped contractors. This case was originally filed on March 22, 2010, Munns et al v. Clinton et al; case number 2:2010cv00681.
Via Opinion from the Court of Appeals for the Ninth Circuit, filed on Mar 20, 2015 (pdf):
The panel affirmed the district court’s dismissal of the plaintiffs’ equitable claims due to lack of standing and their federal benefits claims due to lack of jurisdiction, and vacated the district court’s dismissal of the due process and takings claims for withheld back pay and insurance proceeds in an action brought against United States government officials by family members and a coworker of three Americans who were kidnapped and killed while providing contract security services during the United States military occupation of Iraq.
This case arises from the kidnappings and brutal killings of three Americans who were providing contract security services during the United States military occupation of Iraq. The plaintiffs, who include family members and a former coworker of these three men, brought suit against United States government officials to challenge policies governing the supervision of private contractors and the response to kidnappings of American citizens in Iraq (“policy claims”). They also claim the government is withholding back pay, life insurance proceeds and government benefits owed to the families of the deceased contractors (“monetary claims”).
The district court dismissed the policy claims for lack of standing and for presenting nonjusticiable political questions. It dismissed the monetary claims for failure to establish a waiver of the government’s sovereign immunity from suits for damages and for failure to state a claim for which relief could be granted. We hold that the plaintiffs have not shown they are likely to be harmed in the future by the challenged policies. They therefore lack standing to seek prospective declaratory and injunctive relief regarding those policies. We further hold that the plaintiffs have failed to allege a governmental waiver of sovereign immunity that would confer jurisdiction in the district court over their monetary claims. Finally, we hold that the United States Court of Federal Claims has jurisdiction over the plaintiffs’ claims for withheld back pay and insurance proceeds, and we direct the district court to transfer those claims under 28 U.S.C. § 1631. We thus affirm in part and vacate in part and remand.
In November 2006, while working for Crescent, contractors Munns, Young and Cote were assigned to guard a 46-truck convoy traveling from Kuwait to southern Iraq. The plaintiffs allege that on the day of the convoy, Crescent issued the men substandard military equipment and ordered other security team members not to accompany them on the convoy, and that Iraqi security team members slated to join the convoy failed to show up for work, leaving only seven contractors to guard the convoy. When the convoy stopped at an Iraqi police checkpoint, 10 armed men approached and, along with the Iraqi police, took five of the contractors captive, including Munns, Young and Cote. The men were held for over a year, until their kidnappers brutally executed them sometime in 2008.
The plaintiffs trace the contractors’ kidnappings and murders to Crescent’s failure to adequately prepare and supervise its personnel in Iraq. They allege Crescent’s deficient conduct was “officially sanctioned” by the Secretary of State through an unlawful order issued by the Coalition Provisional Authority (CPA) overseeing the U.S. occupation. CPA Order 17 allegedly gave “blanket immunity [to contractors] from all prosecution,” granting them a “license to kill” with impunity and permitting contractors to “circumvent the authority of Congress, the Courts, and the Constitution.”2 Additionally, the plaintiffs say they heard rumors that CPA Order 17, and the consequent lawless behavior of some security contractors, may have been the motivation behind the kidnappings.
Circuit Judge Reinhardt:
The more troubling and painful question is what the role of our government should be if and when terrorist groups like ISIS or Al Queda capture an American citizen and hold him hostage, and whether the government may, or should, impose any limitation on the rights of the citizen’s family or friends to communicate with that group or pay a ransom. It is significant that the government has told this court that currently there are no policies preventing private individuals from making efforts to secure the release of relatives who are held captive abroad. More important however from the standpoint of the legal rules that govern us, the parties bringing the action – relatives of contractors’ employees “brutally killed,” as Judge Fisher puts it, in the Middle East – seek no damages resulting from that policy but simply seek to have the policy declared unlawful. They ask that the government be enjoined from implementing the policy in the future. Again, even assuming that contrary to what the government tells us, such a policy exists, we cannot under well established legal rules render a decision that will be of no immediate benefit to the individuals bringing the lawsuit. Because the plaintiffs have no relatives currently in the Middle East, or currently in greater danger from terrorist groups than any of the rest of us, we again face only a hypothetical question – the kind that courts do not answer
Read in full online here or download the opinion in pdf file here.
The Crisis Management Training office out of FSI has a running tally of posts evacuated in the last two decades but it’s not available to the public. The 2016 budget justification for USAID and the State Department does include a list of posts that went on evac status in FY2013 and FY2014. I think I’ve covered all the post evacution on this list except for the one in Los Cabos, Mexico (how did I miss that?)
Also note that in June 2014, Embassy Baghdad personnel were “temporarily relocated” both to the Consulate Generals in Basra and Erbil and to the Iraq Support Unit in Amman, Jordan but that personnel movement does not appear to be considered an “evacuation.” Might that be because Iraq constitute a different/separate congressional funding request?
Fiscal Year 2013 Evacuations (October 2012-September 2013)
Bangui, Central African Republic
Fiscal Year 2014 Evacuations (October 2013-September 2014)
EDCS funding is heavily influenced by unpredictable evacuations that may occur as a result of natural disasters, epidemics, terrorist acts, and civil unrest. Recent demands include Sierra time Leone’s Ebola-related emergency evacuation and the evacuation of the embassy in Ukraine due to the ongoing conflict.
EDCS also funds certain activities relating to the conduct of foreign affairs by senior Administration officials. These activities generally take place in connection with the U.S. hosting of U.S. Government-sponsored conferences, such as the UN and OAS General Assemblies, the G-20 Summit, the Nuclear Security Summit, the U.S.-China Strategic and Economic Dialogue, the Asian-Pacific Economic (APEC) Summit, and the NATO Summit. In FY 2014, the U.S. hosted the U.S. – Africa Leaders’ Summit. In FY 2015, the U.S. will begin the two-year Chairmanship of the Arctic Council. In FY 2016, the Department will host the Nuclear Security Summit.
Other EDCS activities include presidential, vice presidential, and congressional delegation travel overseas; official visits and official gifts for foreign dignitaries; representation requirements of senior Department officials; rewards for information on international terrorism, narcotics trafficking, transnational organized crime, and war crimes; as well as the expansion of publicity efforts.