County Executive Director of Administration Office: Fax:

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1 Office of the County Executive Tari Moore David Pyle, Purchasing Agent County Executive Alfred C. Wein, Jr. County Information Director of Administration Office: Fax: CECIL COUNTY, MARYLAND County Purchasing Office 200 Chesapeake Boulevard, Suite 1400, Elkton, MD ADDENDUM #1 RFP 16-08: Medical Service Program May 21, This addendum is hereby made part of the RFP/Contract Documents for the referenced proposal. Please note the following changes, corrections, and/or information and include the requirements stated herein in connection with this RFP/Contract. A. The RFP opening date shall be changed to JUNE 1, 2015 at the same place and time; no later than 1:30 p.m. B. DELETE; page 5, Anti-Bribery Affidavit C. DELETE; page 23, Section XII. Information Required in Proposal; first paragraph, last sentence; delete. with required Proposal Affidavit attached. D. Attached questions and responses and Pre-Proposal Attendance listing. E. The Detention Center Inmate Policy handbook has been placed on the website for review. 2. Please ensure the Addendum number is annotated on Page #28 and the Proposal Cost Sheet, Page #35 when submitting your proposal. 3. If you have any questions, please Elizabeth Hart at or call Thank You, David E. Pyle, CPPB Purchasing Agent Cecil County, Maryland Attached: Questions and Responses (17 pages)

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13 1. What is the County s targeted award date for the contract? 2. Please provide a copy of the current health services contract for the Cecil County Correctional Facility (CCF), including any exhibits, attachments, and amendments. 3. Please provide (by year) the amounts and reasons for any paybacks, credits, and/or liquidated damages the County has assessed against the incumbent vendor over the term of the current contract. 4. Are any of the facilities currently subject to any court orders or legal directives? If yes, please provide copies of the order/directive. 5. With regard to lawsuits pertaining to inmate health care at the CCCF, frivolous or otherwise: a. How many have been filed against the County] and/or the incumbent health care provider in the last three years? b. How many have been settled in that timeframe? 6. Please provide the following data regarding the size of the inmate population. a. Two years worth of facility-specific historical data b. Five-year population projections for the CCCF 7. Please provide two years worth of historical data on the number of intakes at the CCCF. 8. Does the County have any plans to change the mission, size, or scope of any of its facilities within the term of the contract? If so, please provide details (including timeframe) on the planned change. 9. Is the CCCF currently accredited by either the American Correctional Association (ACA) or the National Commission on Correctional Health Care (NCCHC)? If yes, please provide the following information. a. Most recent accreditation date for the facility. b. Copy of most recent accreditation audit report for the facility. 10. Please provide the contract-required health service staffing for the CCCF, by facility, shift, and day of the week. 11. Please also provide the actual health service staffing currently in place at the CCCF, i.e., any positions being provided and/or hours being worked over and above what is required by the contract. 12. Please provide a listing of the current health service vacancies by position for the CCCF. 13. Please indicate whether the County will be offering employment to any incumbent health care staff, e.g., to function as contract monitors, etc. If the County will be making any such offers, please identify the number and type of these positions, so bidders can factor this into our staffing proposals. 14. How many contract monitoring staff will the County maintain for the health services contract? 15. With regard to background checks, who is financially responsible for paying for this service: the County or the Vendor? 16. Will the County allow grandfathered credentialing for incumbent professional staff already employed or contracted by the current Vendor?

14 17. Are any members of the current health service workforce unionized? If yes, please provide the following. a. A copy of each union contract b. Complete contact information for a designated contact person at each union c. The number of union grievances that resulted in arbitration cases over the last 12 months 18. Please provide the wage/pay rates your incumbent health service vendor is paying to its staff at the CCCF. a. How old is this data? b. Where did this data come from, e.g., County records, data from the incumbent vendor, etc.? 19. Please confirm that the time health services staff members spend in orientation, in-service training, and continuing education classes will count toward the hours required by the contract. 20. How does the health unit staff at the CCCF currently access the Internet: through a facility network or through connectivity provided by the incumbent Contractor? Who is financially responsible for such Internet access? 21. Please identify with whom the incumbent vendor subcontracts to provide laboratory services. 22. With regard to hospitals: a. What are the designated emergency or 911 facilities (hospital or other urgent care provider) for the CCCF? b. What are the hospitals most frequently used by the CCCF? 23. How many (if any) offenders does the County currently have housed in community (non-cccf) longterm care facilities? 24. Please identify any specialty clinics currently conducted onsite, and indicate how many hours per week each clinic is held. 25. Please identify the number, type, and timeframes of any backlogs (e.g., chronic care clinics, offsite referrals, dental encounters, etc.) that currently exist at the CCCF. 26. Please provide the following information about medication administration. a. Who administers medications, e.g., RNs, LPNs, medical assistants? b. Where does medication distribution take place, i.e., do medication carts go to the housing units or do inmates come to the medical units? c. How often is medication distributed each day? d. How long does it take to perform the average medication distribution process? 27. How many medication carts will the CCCF make available for the use of the incoming vendor? 28. Does the CCCF currently maintain a Keep-On-Person (KOP) program? 29. Please provide copies of the following documents. a. The drug formulary currently in use at the CCCF b. The laboratory formulary currently in use at the CCCF c. A current pharmacy/formulary management report 30. On average, what percentage of CCCF inmates are prescribed psychotropic drugs each month? 31. What is the average number of inmates receiving pharmaceutical treatment each month for the following conditions? a. Hepatitis C b. HIV/AIDS

15 c. Hemophilia 32. Please provide monthly statistical data for each of the following categories. a. Number of inpatient offsite hospital days b. Number of outpatient surgeries c. Number of outpatient referrals d. Number of trips to the emergency department e. Number of ER referrals resulting in hospitalization f. Number of ambulance transports g. Number of dialysis treatments 33. Please provide annual spend amounts for the past two years for the following categories. a. Total offsite care b. Total pharmaceutical expenditures c. Laboratory services d. X-ray services 34. Under the new contract, who will be financially responsible for the following services: the County or the Contractor? a. Inpatient hospitalization b. Outpatient surgeries c. Other outpatient referrals d. ER visits e. Offsite dialysis f. Offsite diagnostics (lab/x-ray) g. Pharmaceuticals 35. Under the current contract, who is financially responsible for the following services: the County or the incumbent Contractor? a. Inpatient hospitalization b. Outpatient surgeries c. Other outpatient referrals d. ER visits e. Offsite dialysis f. Offsite diagnostics (lab/x-ray) g. Pharmaceuticals 36. Please confirm that under the new contract, the Contractor will not be financially responsible for any of the following services. a. Neonatal or newborn care after actual delivery b. Elective or mandated abortion c. Cosmetic surgery, including breast reduction d. Sex change surgery (including treatment or related cosmetic procedures) e. Contraceptive care including elective vasectomy (or reversal of such) and tubal ligation (or reversal of such) f. Extraordinary and/or experimental care g. Elective care (care which if not provided would not, in the opinion of the Medical Director, cause the inmate s health to deteriorate or cause definite and/or irreparable harm to the inmate s physical status) h. Autopsies i. Any organ (or other) transplant or related costs, including, but not limited to labs, testing, pharmaceuticals, pre- or post-op follow-up care, or ongoing care related to a transplant, etc.

16 j. Medications for the treatment of bleeding disorders, including, but not limited to Factor VIII and IX 37. Please confirm that the following costs will be included under any cap on offsite care. a. Inpatient hospitalization b. Outpatient surgeries c. Other outpatient referrals d. ER visits e. Ambulance transportation f. Offsite dialysis g. Offsite diagnostics (lab/x-ray) 38. With regard to the cap on offsite care: a. Please identify the cap amount for which the County wishes bidders to submit pricing. b. Please identify the amount of any offsite care cap in the current contract. c. For each of the past three (3) years, please indicate by how much (if at all) the County s offsite care expenses have exceeded the contracted cap amount. 39. Please identify the relative weight the County will assign to each scoring component listed in the RFP. 40. We are looking for the formula (or other methodology) that the County will use to evaluate, rank, and assign scoring points to bidders prices. For example, a formula commonly used in other correctional health care bid evaluations is as follows. Lowest price of all proposals x # points possible for Price component = Price Score Price of proposal being evaluated How will the County assign scores and/or relative ranking to bidders submitted prices? 41. Is the County willing to consider alternatives such as holding a portion of the successful Vendor s payment or establishing a reserve fund to the performance bond described in the RFP? The expense associated with implementing a performance bond as security is exorbitant, and will add unnecessarily to the contract price. 42. Please indicate the type and amount of performance guaranty provided by the incumbent health services contractor under the current contract. 43. Please indicate the order of precedence among the solicitation documents (e.g., the RFP, initial responses to questions, subsequent responses to questions, exhibits and attachments, etc.) so that in case of contradictory information among these materials, bidders know which of the conflicting data sets to use to create their narratives and calculate their prices. 44. Please provide more details on the annual aggregate cap as noted on page 13 of the RFP. Does this cap include a) offsite care and/or b) pharmaceuticals? How should vendors note the amount on the price sheets? 45. Please define overhead and burden, as per page 23 in the section titled Billing. 46. Please provide the weekly average number of a) work release and b) home detention inmates, respectively.

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