Response to questions. Contract Officer: Rose Kee, CPPB, Senior Buyer, (757) , Company Name: Print Name: Title:

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1 ADDENDUM #3 City of Newport News RFP # MEDICAL SERVICES FOR INMATES April 4, 2011 Office of the Purchasing Director 2400 Washington Avenue, 4 th Floor Newport News, VA Phone: (757) / Fax: (757) Sealed proposals, subject to the conditions and instructions contained herein, will be received at the above office of the Purchasing Director, 4th Floor, City Hall, 2400 Washington Avenue, Newport News, Virginia, 23607, until the time and date shown below (local prevailing time), for furnishing the items or services described in the request for proposal. It is agreed and understood this will constitute addendum #3, and shall be made part of the original RFP document. Acknowledgement, showing receipt and acceptance of the changes is to be returned with your submittal. Addition: Response to questions. Contract Officer: Rose Kee, CPPB, Senior Buyer, (757) , rkee@nngov.com Company Name: Print Name: Title: Signature: Date: This Form Must Be Signed. RFP # Page 1

2 Response to Questions: 1. What is the Newport News City Jail s (NNCJ) targeted start date for the contract? ASAP 2. Are any of facilities currently subject to any court orders or legal directives? If yes, please provide copies of the order/directive. NO 3. How many lawsuits pertaining to inmate health care at the NNCJ frivolous or otherwise have been filed against the NNCJ] in the last three (3) years? NONE 4. Please provide two years worth of historical data describing the inmate population, broken down by gender and types of inmates (i.e. Federal inmates, US Marshalls, ICE, DOC, etc.). AVERAGE MONTHLY POPULATIONS WERE PROVIDED IN THE RFP. BREAKDOWNS REQUESTED HERE ARE NOT COLLECTED OR AVAILABLE. 5. What is the average length of stay (ALOS) at the NNCJ? 26 DAYS, HOWEVER A CONVICTED FELON MAY BE HERE UP TO 2 YEARS 6. Please provide a listing of the current health service vacancies by position for the NNCJ. 3 PART TIME LPN S 7. Are any members of the NNCJ current health service workforce unionized? If yes, please provide the following. NO 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 8. Please provide current wage/pay/reimbursement/seniority rates for incumbent health service staff at the NNCJ. CURRENT PAY RANGE IS $30,970 - $50, 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. NO SET STANDARD AT THIS TIME 10. Please provide the capacity and average daily population of the NNCJ s segregation units. THIS IS NOT EASILY BROKEN DOWN. DUE TO THE LINEAR STYLE JAIL SETTING, MUTLIPLE AREAS COULD BE CONSIDERED SEGREGATION IF NEED BE, AND GENERAL POPULATION AT OTHER TIMES. 11. Please provide an inventory of office equipment (e.g., PCs, printers, fax machines, copiers) currently in use at the NNCJ and identify which equipment will be available for use by the selected provider. BASIC OFFICE EQUIPMENT SUCH AS DESKS, CHAIRS FILE CABINETS ETC THAT ARE CURRENTLY IN PLACE WILL STILL BE AVAILABLE. THERE ARE ALSO 2 PC S AND 2 PRINTERS. THE FAX MACHINE CURRENTLY IS OWNED BY THE PHARMACEUTICAL COMPANY. 12. How does the health unit staff at the NNCJ currently access the Internet: through a facility network or through connectivity provided by the NNCJ? Who is financially responsible for such Internet access? THROUGH A FACILITY NETWORK AT NO COST. 13. How are optometry services currently provided: (a) onsite, with permanent NNCJ-owned equipment; (b) onsite, through mobile optometry (PLEASE IDENTIFY VENDOR); or (c) offsite? THERE CURRENTLY ARE NONE OTHER THAN EMERGENCIES SENT OUT TO THE HOSPITAL. RFP # Page 2

3 14. How are dialysis services currently provided: (a) onsite, with permanent NNCJ-owned equipment; (b) onsite, through mobile dialysis (PLEASE IDENTIFY VENDOR); or (c) offsite? DIALYSIS PATIENTS ARE SENT TO THE HAMPTON ROADS REGIONAL JAIL AFTER THEIR FIRST TREATMENT, DONE USUALLY AT THE INMATES CURRENT SITE. 15. Who is financially responsible for providing dialysis services? If these services are identified as being provided offsite, is the cost part of the $180,000 cap for offsite services? ALL PRE- EGISTISTING ILLNESSES BECOME SELF-PAY TO THE INMATE. 16. Does Virginia law mandate any special rates (e.g., Public Aid, Medicare, Workers Compensation, or other discounted rates, etc.) for the offsite treatment of NNCJ inmates? If yes, please provide a copy of the statute, law, regulation, contract, or other legal document that requires community providers to accept such rates. NONE TO OUR KNOWLEDGE. 17. Does the NNCJ currently pay Medicaid rates? NO 18. On page 41 under Space at the Facility, Medical Housing Services is listed. Please provide the number of beds in Medical Housing. 12 REGULAR INMATE BEDS. THERE IS NOTHING SPECIAL ABOUT THIS CELL BLOCK OTHER THAN IT IS LOCATED NEXT TO THE MEDICAL OFFICE. 19. Is the NNCJ s Medical Housing considered an Infirmary as per NCCHC definitions, i.e., do the staffing levels, monitoring methodology, rounding frequency, etc., comply with NCCHC infirmary standards for Jails? NO. SEE # On average, how many inmates are housed in the Medical Housing/Infirmary on a daily basis? Does the NNCJ have a mental health unit, or beds assigned to mental health patients? If yes, please provide the number of such beds. YES On average, how many inmates are housed in the mental health unit on a daily basis? Regarding mental health services, will the medical provider s formulary be mandatory for the grant funded prescribing providers? THAT MAY NEED TO BE NEGOTIATED 24. Please provide the following information about medication administration. a. Who administers medications, e.g., RNs, LPNs, medical assistants? LPN S b. How are medications distributed, i.e., pill line or med pass? MED PASS c. Where does medication distribution take place, i.e., do medication carts go to the housing units or do inmates come to the medical units? NURSES GO TO THE HOUSING UNITS. d. How often is medication distributed each day? 3 TIMES PER DAY e. How long does it take to perform the average medication distribution process? IT VAIRES BASED ON NUMBER OF STAFF AVAILABLE TO DISTRIBUTE. 25. How many medication carts will the NNCJ make available for the use of the incoming vendor? THAT IS UP TO THE PHARMACY PROVIDER. 26. Please provide copies of the following documents. a. The formulary currently in use at the NNCJ N/A b. A current formulary management report N/A 27. Please provide monthly statistical data for each of the following categories. MOST OF THESE STATS WERE ANSWERED IN A PREVIOUS ADENDUM (#2). NO OTHER BREAKDOWN IS AVAILABLE. a. Number of inpatient offsite hospital days RFP # Page 3

4 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. Average number per month of inmates undergoing dialysis treatments 28. Please provide historical health services cost data broken out into at least the following categories. PREVIOUSLY PROVIDED. a. Total offsite care b. Total pharmaceutical expenditures c. Laboratory services d. X-ray services 29. We understand from the Questions and Answers provided on March 29, 2011 that the local Fire Department provides ambulance services free of charge for the NNCJ. Will the County use the Fire Department s free ambulance services through the entirety of its contract with the awarded NNCJ medical services provider? AT THIS POINT, THERE IS NO INTENTION OF CHANGING THIS ARRANGEMENT. 30. Regarding pharmacy services, page 37 of the RFP states Currently pharmacy services are contracted independently. The Sheriff s Office shall evaluate the economic feasibility of including these services as an option for a turn-key operation. Please confirm that the medical services vendor is responsible for the cost of medications. Also, if called in to interview and provide our pricing, are we to offer pharmacy services as a main piece of our proposal or a pricing option? A TURN KEY PROPOSAL. 31. Please detail where the NNCJ would like vendors to include the $180,000 cap for offsite services. Should vendors break the $180,000 cap between the offsite care and pharmacy line items or make the cap its own line item? SEPARATE LINE ITEM. 32. Where should vendors put the cost of pharmaceuticals that are not covered by the $180,000 cap? SEPARATE LINE ITEM. 33. Please provide the name and contact information for the NNCJ s current pharmaceutical provider. WESTWOOD PHARMACY (RICHMOND, VA). 34. Would the NNCJ consider a cap on all pharmaceutical costs? If yes, please provide the cost of all pharmaceuticals (including chemotherapy drugs, HIV/AIDS, and blood coagulation disorder drugs) in the past year. NO 35. Please confirm that under the new contract, the Contractor will not be financially responsible for any of the following services. a. Autopsies CONTRACTOR WILL NOT BE. b. 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. THIS CANNOT BE A 100% GUARANTEE, BUT HIGHLY UNLIKELY. 36. Please confirm that the following costs will be included under any cap on offsite care. YES a. Inpatient hospitalization b. Outpatient surgeries RFP # Page 4

5 c. Other outpatient referrals d. ER visits e. Offsite dialysis f. Offsite diagnostics (lab/x-ray) 37. Does the NNCJ have a minority business (MBE)/women-owned business (WBE)/small business (SBE) target percentage or dollar amount that each vendor should meet when submitting their proposal? THE CITY CANNOT REQUEST THIS AND THIS IS NOT A REQUIREMENT; HOWEVER, THE CITY STRONGLY ENCOURAGE VENDORS TO SUBCONTRACT WITH SWAM COMPANIES ACCORDING TO PAGE 9 OF THE RFP DOCUMENT. 38. The MBE/WBE/SBE form in the RFP requires that vendors provide the total dollars that are subcontracted in the proposal. Should we include these dollar amounts in (a) our initial technical proposal or (b) when called to interview and provide our full price? BECAUSE THIS IS A PROFESSIONAL SERVICES RFP, PLEASE REPORT ESTIMATE PERCENTAGES. DOLLARS WILL BE REQUESTED DURING THE INTERVIEW. 39. When implementing a new electronic medical record (EMR), we recommend beginning all EMR implementation activities six (6) months after the contract award to allow a smooth transition for the client. What timetable would the NNCJ prefer for the implementation of the EMR? THAT CAN BE NEGOTIATED, BUT AS SOON AS POSSIBLE. 40. Will the NCCJ provide a blueprint of the layout of the health care units [medical and mental health] in both facilities, and the intake area, in order to facilitate the pricing of the installation of the EMR system? FOR SECURITY REASONS, THIS IS NOT POSSIBLE. 41. Who will be financially responsible for the costs of dropping necessary data lines for the implementation of the EMR? NEWPORT NEWS SHERIFF S OFFICE 42. Will the NNCJ require EMR access in the Mental Health Unit of the building? If yes, how many user stations will be needed? YES, Regarding the discussion of the Per Diem Rate on page 49, please clarify the formula noted in the event the average daily population is less than 550 for any month. The example states 601, in this case is this number actually 499? WE STAND CORRECTED. IT SHOULD STATE On page 33, in Section 11.C Specialty Providers, the RFP requires The Contractor shall submit a written form for approval by the Operations Bureau Chief entitled "Specialty Referral Request." Said form is to be utilized each time the physician writes a request for a specialty physician consultation. This request for a Jail Operations Bureau Chief to approval offsite referrals may be in opposition to NCCHC standards. Please confirm that the City wants the proposed vendor to receive pre-approval from the Operations Bureau Chief for all offsite medical consultations. IF THIS IS NOT AN EMERGENCY SITUATION, THERE MAY BE AN OPTION TO SEND THE INMATE SOMEWHERE ELSE PRIOR, THAT WOULD BE THE NEED FOR THE APPROVAL. 45. On page 54, in Table B (Line Item Pricing), the Pharmacy line item has a note that directs the proposal to see note 2 below. There is only one note on the form. Please provide the details of note 2. THAT IS A TYPO. THERE IS NO NOTE 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. SEE PAGE 5, PARAGRAPH 18 OF THE CONDITIONS AND INSTRUCTIONS. AT THIS POINT, THIS IS SUFFICIENT. ORDER OF RFP # Page 5

6 PRECEDENCE IS USUALLY ADDRESS IN THE CONTRACT DOCUMENT WHEN WE GET TO THAT POINT. 47. Please identify the relative weight the NCCJ will assign to each scoring component listed in the RFP. THE CITY OF NEWPORT NEWS DOES NOT USE SCORING. OUR PROCESS IS DEFINED AS OUTLINED ON PAGES 55 AND 56 OF THE RFP. 48. On page 7 of RFP Addendum #2 (Q&A), the NNCJ provided 2010 and 2011 medical care budget information. Can you please tell us the month and date the 2011 Year-to-date information closes? The FY 2011 will end June 30, In Addendum #2 on Page 7, you list 2011 Year to-date figures. Could you please provide the period of time that covers, what is the beginning of the period and what was the end date that was used to provide the totals? or Did the fiscal year 2011 begin July 1, 2010 or is it the calendar year which began 1/1/11? The Fiscal year begins July 1, Also, thru what date was the data accumulated. Was it March 28 th the date of the Addendum or another time period? The data reflects July 1, 2010 March 15, How many months does the 2011 year-to-date data represent? See response to above. 50. In the future does Newport News plan on expanding the medical area, i.e., having booking, classification, and medical located in another area? If so, is there a timeline that can be shared. THERE ARE NO PLANS ON THE TABLE FOR ANY OF THIS. ALL OF THIS IS FROM TIME TO TIME DISCUSSED AS POSSIBILITIES, BUT NO HARD PLANS HAVE BEEN MADE. THERE IS NO TIMELINE EITHER, IF ANY OF IT WERE TO OCCUR. 51. The following question has not been answered: 5. Off-site statistics by number and charges for 2010 by type of service i.e., hospital admission, ER runs, outpatient surgeries, specialty consultations, MRI, etc YTD-actual The only answer provided is a line from p. 7, "Out of Facility Care 480, ,064" Would you please clarify? We do not have a breakdown of all the off-site charges. They are all put into one charge code. RFP # Page 6