Department of Public Safety and Correctional Services

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1 Department of Public Safety and Correctional Services Office of the Secretary 300 E. JOPPA ROAD SUITE 1000 TOWSON, MARYLAND (410) FAX (410) TOLL FREE (877) V/TTY (800) STATE OF MARYLAND LARRY HOGAN GOVERNOR BOYD K. RUTHERFORD LT. GOVERNOR STEPHEN T. MOYER SECRETARY Amendment # 9 Inmate Medical Care and Utilization Services RFP Solicitation No. Q July 11, 2017 WILLIAM G. STEWART DEPUTY SECRETARY ADMINISTRATION J. MICHAEL ZEIGLER DEPUTY SECRETARY OPERATIONS This Amendment is being issued to change provisions of the RFP. All information contained in this Amendment is binding on all Offerors who respond to this RFP. The changes to the RFP are listed below. New language is underlined and marked in red bold (ex. new language) and language deleted has been marked with a bold strikeout (ex. language deleted). 1. Revise Section 3.5 (Consent Decrees and Litigation) by adding Sections 3.5.7, and as follows: The Department is a party to a Settlement Agreement dated May in a lawsuit filed by deaf inmates in the United States District Court for the District of Maryland, styled Jarboe, et al. v. Maryland Dept. Pub. Safety and Corr. Svcs., et al., Civil No. ELH claiming violations of the Americans with Disabilities Act. A copy of the Settlement Agreement is available at The Contractor shall fully comply with the provisions of the Settlement Agreement and shall indemnify the Department for any and all violations occurring during the course of the Contract arising from the failure of the Contractor to deliver medical care as required under the Settlement Agreement and this RFP. This indemnity obligation shall survive the termination or expiration of the Contract The Department is a defendant in a lawsuit filed by blind Inmates in the United States District Court for the District of Maryland, styled Brown v. Maryland Dept. Pub. Safety and Corr. Svcs., et al., The case was filed on May 2, The Contractor must comply with and cooperate with the Department to implement the requirements of any consent decree, memorandum of 07/11/17 Page 1 of 7

2 understanding or agreement between the Department and any entity concerning the delivery of Inmate healthcare services regardless of whether the consent decree, memorandum of understanding or agreement is currently in force or entered into during the Contract term. 2. Revise Section (Contractor Staffing) as follows: In addition to a staffing plan, the Offeror must provide an organization chart. The final organization chart submitted in response to RFP Tab F shall be subject to approval by the Chief Medical Officer and after approval shall be formalized as the Contractor s initial organization chart. The Offeror shall also provide an organizational chart for each SDA. Organizational charts may not be changed without the approval of the Chief Medical Officer. 3. Revise Section 3.7 (Contractor Management) by adding Section as follows: All Clinicians providing medical advice or consultation for any Inmate must be licensed in Maryland. 4. Revise Section (Contractor Staff Time Reporting) as follows: The Contractor shall use a web-based biometric timekeeping system which shall be available on the Go-Live date. Contractor shall provide use of the timekeeping system to the Other Healthcare Contractors at no charge. The current Contractor uses the Kronos timekeeping system. A time clock shall be available at each facility. If there are multiple entrances to a facility, a time clock shall be provided at each entrance. Currently, there are no time clocks at EPRU, HDU or SMRU. 5. Revise Section (Contractor Staff Disciplinary Actions) as follows: Within twenty-four hours of any disciplinary action taken by Contractor with respect to any Staff, or Contractor notice of any criminal charges against any Staff, or Contractor notice of action by any (including non-maryland) licensing board that limits the Staff s license, the Contractor shall simultaneously inform the DPSCS Chief Medical Officer and DPSCS DON of all disciplinary actions, including the identity of the individual, the reason for the disciplinary action, and the nature of the disciplinary action, criminal charges or licensing Board action. taken against any Staff who provides any services required under this Contract. The Contractor shall provide any documentation of the incident requested by the DPSCS Chief Medical Officer and DPSCS DON. Failure to report to DPSCS Staff disciplinary actions in accordance with this section may result in assessment of liquidated damages. 6. Revise Section and (Contractor Policies and Procedures) as follows: Prior to implementation, Tthe Department must approve all the policies and 07/11/17 Page 2 of 7

3 procedures of the Contractor pertaining to the delivery of services under the Contract prior to implementation that are in addition to Departmental policies and procedures. The Contractor s Policies and Procedures must (1) be consistent with Department Policies and Procedures; (2) comply with ACA, NCCHC, and MCCS standards and applicable Maryland statutes, regulations, policies, and guidelines; and (3) take into account any restrictions or requirements placed on licensure by the respective licensing boards. Disputes about conflicts between Department and Contractor policies and procedures will be decided by the DPSCS Contract Manager or the DPSCS Chief Medical Officer, as appropriate, and the decision shall be final. Current Department Policies and Procedures, including Clinical Services and Inmate Health Manuals may be found at: The Department currently has Health Manuals on the following topics: Administration, Chronic Disease, Infection Control, Infirmary Care, Inmate Deaths, Medical Evaluations, Medical Records, Pharmacy Services, Pregnancy Management, Sick Call, and Substance Abuse Draft Policies and Procedures manuals shall be described in the Contractor s Technical Proposal. Only those Policies and Procedures that are in addition to the Department s Policies and Procedures and shall be submitted to the DPSCS Chief Medical Officer and DPSCS Director of Nursing electronically no later than thirty-five (35) days after Contract Commencement. When submitting the draft policies and procedures for review, the Contractor will highlight those portions of its policy and procedure manuals that are not covered in DPSCS manuals. The DPSCS Chief Medical Officer and DPSCS Director of Nursing shall have up to fifteen (15) days to review the manuals and provide comments. The Contractor shall notify the DPSCS Chief Medical Officer and DPSCS Director of Nursing, within ten (10) days of receipt of the comments, that the Final Policies and Procedures manuals with the agreed upon corrections are electronically available. 7. Revise Section (Reports, Databases, Meetings, Minutes, Agendas) as follows: All documents, databases, and data contained in the documents or databases created or maintained under the Contract are the sole property of the Department and shall be transferred at the termination of the Contract in an unlocked format to allow continued use of the documents, data, and databases by the Department and any successor Contractor. Contractor shall have no proprietary right to the documents, databases, or data. Except as required for the delivery of DPSCS Inmate health services, the Contractor may not share any data obtained under the Contract or analysis of such data without the prior written consent of the Chief Medical Officer. This includes sharing such data even if it is not identified as DPSCS data. Any Contractor analysis of DPSCS medical trends whether or not required under the Contract or requested by the Department shall be included in the document management system proposed by the Offeror without the need for a request by the Department. 07/11/17 Page 3 of 7

4 8. Revise Section 3.18 (Reports, Databases, Meetings, Minutes, Agendas) by adding Section as follows: Contractor shall ensure the integrity of all data provided to the Department under the Contract. 9. Revise Section 3.21 (Physician On Call Coverage) as follows: The Contractor shall have physicians or CRNPs on-call 24 hours per day, seven days per week On-call physicians or CRNPs shall deliver on-call and Emergency coverage whenever a physician is not present at an institution. The on-call physician or CRNP shall respond by telephone within fifteen minutes of the telephone call for service and shall provide direction to the caller. If requested to do so by the ACOM or if the situation warrants direct Assessment, the on-call physician or CRNP shall report to the institution within one hour after notification. Any call to an on-call physician or CRNP shall be appropriately documented within the EPHR or appropriate patient chart. The documenter shall take precaution in how this conversation is documented to avoid risk management issues, i.e., documenter shall state facts and offer no opinions regarding physician response. On-call physicians or CRNPs shall document all encounters, including On-site, remote and after hours consultations in the EPHR within 12 hours. If the 12 hour timeframe falls on other than a Business Day, the documentation must occur by the close of the next Business Day The Contractor shall maintain an updated on-call Physician list to be posted as required in all Infirmary, Dispensary and sick call areas and distributed to all Other Healthcare Contractors. This list shall identify the on-call physician or CRNP by name, and include the physician s or CRNP s contact phone number(s), and, if applicable, text/ address In addition to the on-call Physician or CRNP, a back-up or secondary on-call Physician or CRNP shall be identified, with the same types of contact information as above, in case unforeseen circumstances preclude the primary on-call Physician or CRNP from responding within the timeframe required in this section. 10. Revise Section (Infirmary Beds for Somatic Health) as follows: The Contractor shall provide treatment to Inmates with acute and sub-acute medical problems, or other medical or health problems that are unmanageable in the general population in Infirmaries designated by the Department, unless hospitalization is determined to be medically necessary. If the condition is determined to exceed the scope of the skill and/or available equipment of the Contractor s Staff, hospitalization at an Off-site medical facility may be medically indicated. The Contractor shall give priority to Bon Secours when in-patient care beyond emergency room service is indicated. Bon Secours is currently the only hospital with a secured ward for the treatment of Inmates. 07/11/17 Page 4 of 7

5 The Contractor shall operate Infirmaries in the following locations. MCIW is the only infirmary for female Inmates with 24 beds. The other licensed medical Infirmaries are for male Inmates as follows: Facility Beds ECI 22 JCI 6 JRI 21 MCIH 17 MTC 48 WCI Revise Section (Intake Triage and Screening) as follows: The Intake Screening shall include a urine screening test for Chlamydia and Gonorrhea for all Inmates. Blood tests for STIs (including RPR) shall be initiated within 72 hours of Admission for male Inmates and two hours for female Inmates. Blood drawn for routine STI testing will also be tested for HIV and HCV unless the Inmate specifically states the Inmate does not want the test. The Contractor shall assure that written permission to draw blood samples includes a statement that blood drawn for routine STI testing will also be tested for HIV and HCV, unless the Inmate specifically states the Inmate does not want the test. The Contractor shall use the DPSCS Consent/Refusal of Medical Treatment Form. 12. Revise Section (19) ( Medication) as follows: Providing an automated bar coded medication dispensing system at BCBIC and the HUB in Jessup that identifies which medications have been dispensed to which Inmate, when and by which Clinician or Healthcare Professional; and 13. Revise Section (Medication) as follows: For all DPDS facilities, Clinicians shall order first dose medications during the Intake Screening and Clinicians or Healthcare Professionals shall administer the first dose of all newly prescribed medications as part of the Intake Screening within 24 hours of Admission, unless quicker administration is deemed medically required. All Inmates requiring medication must receive such medication during the Intake Screening. For all other DPSCS facilities, Clinicians or Healthcare Professionals shall administer the first dose of all newly prescribed and received medications by the end of the shift during which the medication was received. For any prescription for a stock medication, the stock medication shall be used to initiate therapy. 07/11/17 Page 5 of 7

6 14. Revise Section (Specialty Care General) as follows: Except as provided in section and , the Contractor is responsible for all medical On-site and Offsite specialty care, including hospitalizations, whether that Offsite care is considered medical care, mental health care, dental care, emergency, or scheduled care. Any legal action, late fees, interest, etc. for unpaid claims or partial claim payment shall be the exclusive responsibility of the Contractor. This responsibility survives the expiration or termination of the Contract for any services that were performed during the Contract term. 15. Revise Section (Specialty Care Vision Services) shall be revised as follows: Except for Inmates with a suspected or confirmed diagnosis of diabetes or severe vascular hypertensive or lipid disorders, Inmates under 50 years of age shall be examined by the Optometrist no more frequently than every 24 months. Inmates age 50 and older or Inmates with a suspected or confirmed diagnosis of diabetes or severe vascular hypertensive or lipid disorders shall be examined by the Optometrist at least every 12 months. In the event of identification of special needs which arise prior to the defined frequency intervals, such as traumatic injury, disease, or disorder which impacts vision, the Inmate may be evaluated by the Optometrist more often than specified and referred to an ophthalmologist based upon demonstrated clinical need. In case of an eye emergency, transient, or other visual loss, infection or pain, the Contractor shall immediately evaluate the Inmate and if medically indicated, make a referral to an ophthalmologist within twenty-four (24) hours for a follow up Assessment. Annual digital retinal imaging shall be required for Inmates with diabetes, glaucoma or hypertensive retinopathy or other eye pathology. 16. Revise Section (Specialty Care Audiology) as follows: The hearing testing program requires at a minimum the use of a tuning fork except for Inmates 22 and younger for whom an audiometer shall be required for testing. and The required equipment shall be available in all facilities other than pre-release facilities. For Inmates 22 and older, hearing testing audiometric examinations shall be conducted with the Inmate s periodic physical exam,. unless If the Inmate demonstrates a significant level of hearing loss, an audiometric exam shall be required. The Contractor shall conduct hearing screenings related to school evaluations for juveniles in accordance with the American Civil Liberties Union (ACLU) settlement agreement in Duvall v. Hogan. All hearing tests results shall be documented in the EPHR. 17. Revise Section (Medical Diets) as follows: The Contractor shall supply order any medically required dietary supplements (e.g., Ensure) which shall be supplied by the Pharmacy Contractor. 07/11/17 Page 6 of 7

7 18. Revise Section 3.63 (Inmate Worker Screening Program) as follows: The Contractor shall perform such screenings, diagnostic studies, and preventive services, including vaccinations, as are required for Inmates with work assignments as required by DPSCS policy for work and program assignments. Contractor shall complete these screenings as part of the 7 Day Intake Physical within five (5) Business Days of the request for a screening and shall document the screenings in the EPHR. Clearances for work and program assignments provided to Custody shall be typewritten and shall be provided within 24 hours of the completion of the screening. 19. Revise Section (Utilization Management) as follows: The Contractor s UM nurses will provide (1) daily infirmary UM reviews via telemedical rounds at ECI, JCI, MCIH, MTC, and WCI; (2) in person On-site reviews each Monday, Wednesday and Friday at JCI, MCIW and MTC infirmaries; (3) Off-site inpatient hospital UM reviews 3 days per week at Bon Secours; and (4) Off-site inpatient UM reviews 3 days per week at any Baltimore area hospital in which Inmates are in the intensive care unit and for which the Contractor is the payor. 20. Revise Attachment V(Liquidated Damages) with respect to damages assessed for Staff Disciplinary Actions as follows: Section Liquidated Damages Description Threshold Failure to report Staff disciplinary action to DPSCS as required under Section % Liquidated Damages Amount $100 per occurrence Performance Standard An occurrence is each day the Contractor fails to report staff disciplinary action, criminal charges or licensing Board action to DPSCS 07/11/17 Page 7 of 7