Questions and Answers

Transcription

1 Greenville County Procurement Services Division 301 University Ridge, Suite 100 Greenville, SC Professional Pharmacy Consulting Services and Prescription Medications RFP#69-05/17/17 Questions and Answers Issued: May 10, 2017 NOTICE TO VENDORS: The following revisions, additions, and clarifications are hereby made part of the Contract Documents for the above-referenced project and shall be taken into account in the preparation of all proposals and the execution of all work. Responders shall acknowledge receipt of these Questions and Answers in their proposals. Q1) Will there be an opportunity for a second round of questions if any answers in the first round of questions needs clarification? A1) There will be an opportunity until Monday, May 15, at 5:00 PM to request clarifications of any answers given in this document. Q2) Will Greenville County consider extending the due date for Submission of Response? A2) See Addendum #1. Q3) Please describe in detail how the Evaluation of Proposals will be scored and weighted including the number of points assigned to each evaluation category. A3) See Score Sheet in RFP document, page 33. Q4) Is Greenville County considering final BAFO presentations for finalists to be a part of this RFP process? If so, what would be the selection process for those participating in an in-person BAFO presentation? A4) No. This is a Request for Proposals and Greenville County may negotiate with highest scoring vendor. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

2 Q5) What are the current contracted pharmacy rates? A5) These are available through a Freedom of Information Act Request. Send request to nchasteen@greenvillecounty.org or bvires@greenvillecounty.org Q6) What is your current cutoff time for next-day delivery orders to be submitted to the pharmacy? Do you intend to keep this the same? A6) Currently, prescriptions must be submitted to the Pharmacy prior to 5pm; either by fax, remote provider entry, phone or mail in order to qualify for next- day delivery. County would like to keep the same cut-off time. Q7) What is the average number of prescriptions filled per month for your facilities? A7) Based on data from the year 2016; The average number per month of prescriptions filled for our entire facility was 2,513. Q8) Can you please provide the past 3 months data on script volumes and drug utilization (drug name and quantity) broken out by month including the fill dates with all patient information redacted? A8) The current contract vendor sends this information in a read only document spreadsheet with patient identifiable information attached. Each document contains approximately 260 pages per month, which for would be too labor intensive to grant this request. Q9) Can you please provide the past 3 months pharmacy invoices for review? A9) Yes. See Attachment A. Q10) What is the average pharmacy dollar amount spent monthly over the past 12 months? A10) In 2016, the average Pharmacy cost per month was $43, Q11) What is the percentage of stock medications vs. patient specific medications? A11) In March, the stock medication was 1% compared to patient specific medication. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

3 Q12) Do you receive stock medications in 30 count blister cards or is all stock in manufacturer s bulk bottles or another form of packaging? A12) Stock medications are generally sent in single unit dosing medication packs that are packaged the same way as the inmate specific medication. Occasionally, we will get a medication that is sent in alternate packaging; ie: OTC glucose chewable tablets are sent in original manufactures packaging (plastic bottle). Dandruff Shampoo is sent in a bottle. Q13) How many days worth of medication is typically dispensed for routine medication orders? (Ex: 7, 14, 30 days.) Would the county consider making a 7 day supply for routine medication orders a requirement of the RFP in order to significantly reduce the amount of waste medications that must be destroyed? A13) We receive all patient specific medication as a 14 day supply in the patients name when their medication is ordered as a long term medication. If a medication is ordered that has a shorter dosing period than 14 days, the full dose will be sent. The only exception to this would be a medication other than a pill that would not be conducive to come in a 14 day supply but rather a 30 day supply; ie: inhalers, powders, creams or lotions. The County will not make 7 day supplies a requirement of the RFP. It is up to each vendor to propose a method and schedule. Q14) May we have a copy of your current formulary? A14) Yes. See Attachment B. Q15) Please provide a sample of currently/commonly prescribed NDCs and the frequency in which medications are dispensed. A15) The 6 most commonly dispensed medications sent from the Pharmacy over the past 3 months and their prescription averages sent per month are: Quetiapine- 445 scripts per month; Lisinopril- 236 scripts per month; Trazadone- 250 scripts per month; Gabapentin- 253 scripts per month; Mirtazapine- 174 scripts per month; Oxcarbazepine- 174 per month. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

4 Q16) How does Greenville County send prescription new orders and refills to the pharmacy vendor? , Fax, Remote Provider Order entry? If multiple methods are used, approx. what percentage of each type of transmittal applies? A16) Prescriptions for new orders and refill orders are typically sent by Remote provider order entry (85%). We do have some orders that are faxed (14%) and a few phone or mail in orders (less than 1%). Of those faxed, some are actually picked up at a back-up Pharmacy during after hours times. Q17) What is the current preferred method for delivery? A17) Either Fed Ex or UPS mail delivery for out of town Pharmacies or some type of drop off delivery service for closer Pharmacies is preferred. Q18) Please describe the frequency for medication deliveries to your facility by current vendor. A18) Deliveries occur Monday through Saturday usually in the morning but the required delivery is prior to 1pm. Q19) Are medical supplies (needles, syringes, diabetic test strips, etc.) for your location ordered from the current contracted pharmacy? A19) Medical supplies like these and others are sometimes ordered by us but not on a regular basis. We normally order all of our medical supplies from our own vendors. We do order Colostomy supplies and leg, foot and wrist braces more often. Q20) Who is the current after-hours back-up pharmacy (if utilized)? A20) CVS; either Mills Avenue or East North Street locations in Greenville. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

5 Q21) What is your current average daily inmate population? Can you please provide the inmate population for the past 12 months? A21) See chart below: APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR Average Adult Daily Population 1,362 1,435 1,416 1,434 1,451 1,439 1,401 1,327 1,226 1,272 1,324 1,306 Q22) How are the prescription returns from your facility currently handled? Do you currently receive credit for returned medications? Are there any restocking fees or minimum costs to qualify as a return? A22) We do not receive credit for returned medications because we do not use the blister packs and the current Pharmacy provider is located out of state. Our current Pharmacy pays for all return medications and disposes of them free of charge for us. Q23) Are release medications supplied to inmates upon parole or discharge? If so, how many days supply is provided? A23) If an inmate requests his medication upon release, we give them the remainder of their medication packet roll, as long as it is pre-packaged with the correct information on it and they have not been receiving it from our e-kit medication. Q24) What is the current process for notifying pharmacy of inmates release dates? A24) When a patient is released, the computer automatically discontinues their medication and notates them as released in our computer system that is also linked to CorrecTek. The Pharmacy sends a Weekly Active RX list a couple days prior to filling our regular 14 day medication fill for that week. We receive half of the jail one week (A-L) for a 14 day fill cycle and the other half (M-Z) the next week for their 14 day fill cycle. The Pharmacy County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

6 Manager compares the Active RX list to the computer and sends back the list of released inmates. Q25) Will it be required to ship inmate discharge/transfer medications to private residences or are they shipped to each correctional facility only for discharge/transfer patients? A25) We do not require discharged medications to be shipped to any private residences or transfer facility locations. They will be sent with the inmate at the time of release/ transfer if needed. Q26) Is your correctional facility accredited by the National Commission on Correctional Health Care (NCCHC) or American Correctional Association (ACA)? If not, do you expect to seek accreditation during the term of the contract? A26) The Greenville County Detention Center is not accredited, nor have we ever attempted to become accredited. The County has no plans to seek accreditation at this time. Q27) Please provide all current Accreditation for all facilities. A27) The Greenville County Detention Center is not accredited. We meet or exceed all South Carolina State Minimum Standards for Local Detention Facilities. Q28) Do the correctional facilities currently maintain a Keep-On-Person (KOP) Program? If so, please provide a list of KOP medications approved by facility. A28) Yes, we have a KOP program that is currently in use. The following medications would be the only ones prohibited from being used in the program: Narcotic or controlled substances, injections, medications in glass or metal containers unless life sustaining. Q29) What percentage of your inmates, if any, are Federal? Specifically, what percentages are under jurisdiction of each the US Marshals Service (USMS) and US Immigrations and Customs Enforcement (ICE)? A29) As of 5/2/17 we have 1 federal inmate. We only house federal inmates short term until they re moved to a designated facility. ICE inmates are only held for a period of 48 hours after their Greenville charges are satisfied. The numbers are approximately 2-4 per month. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

7 Q30) Are OTC medications for commissary provided by the Contracted Pharmacy? If not, where do they come from? A30) No, we have a contracted commissary vendor that is unrelated to the Pharmacy vendor. Q31) How are non-formulary requests approved? A31) Non- formulary prescriptions are ordered by our Practitioners, Physicians and Medical staff members. They are sent to the Pharmacy for order the same way as all of our prescription orders. Q32) Please describe your Non-Formulary Review process in detail. A32) We do not currently have a Non- Formulary review process but it is our expectation that our Pharmacy vendor notify us of any unusually high medication cost. Q33) Please describe the current destruction policy for all outdated/expired drugs. A33) With the exception of narcotic/ controlled substances, outdated/ expired medications are shipped back to the Pharmacy vendor for destruction. Narcotic/ controlled substances are wasted with the contracted Pharmacist during monthly inspections. Q34) Does your facility have a DEA License? If so, whose name(s) is(are) under licensure? A34) Yes, Dr. Martin E. Lutz and NP Michelle A. Eastergard both hold a DEA licensure for our facility. Q35) Please provide the following pharmacy information by year for the last three years: number of patients on HIV medication, number of patients on psychotropic medications, number of patients on Hepatitis C medications, number of patients receiving medications associated with hemophilia, HIV medication dollars, psychotropic medication dollars, hepatitis C medication dollars, and hemophilia related medications dollars. A35) Most of our patients that are treated for Hepatitis C are treated through our local free clinic. We have not come across enough hemophiliac patients in our facility in the last 3 years to keep them listed in our yearly reports. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

8 2014: HIV patients on meds = 60; patients on psych meds = 3,839; HIV med pricing = $127,663.81; psych med pricing = $1, : HIV patients on meds = 70; patients on psych meds = 4,914; HIV med pricing = $141,003.92; psych med pricing = $2, : HIV patients on meds = 37; patients on psych meds = 5,355; HIV med pricing = $78,577.23; psych med pricing = $1, (Jan- Mar): HIV patients on meds = 9; patients on psych meds = 1,317; HIV med pricing = $17,405.31; psych med pricing = $ Q36) Of inmates receiving Hepatitis C treatment, what is the nature of the treatment? Please list medications used to treat over the past three years. A36) Most of our patients that are treated for Hepatitis C are treated through our local free clinic. If they are already a patient with the clinic, they continue to be seen and treated as a patient at the clinic. We have not seen any patients yet that have been under treatment from their own primary care Physician for Hepatitis C. Q37) Does your facility currently use a barcode electronic order reconciliation and medication return management system? A37) We have a barcode scanning system for medication pass but not for this. Q38) Does the current pharmacy vendor use a FDA-registered re-packager to ensure compliance with federal regulations for Correctional Health stock medications? A38) It would be the responsibility of any vendor awarded the GCDC process to ensure they meet all necessary requirements or regulations outlined by the appropriate boards, such as but not limited to, SC Board of Pharmacy, DEA, etc. Q39) Will failure to provide proof of compliance with Federal regulations deem a bidder non-responsive and therefore ineligible for an award? A39) It would be the responsibility of any vendor awarded the GCDC process to ensure they meet all necessary requirements or regulations outlined by the appropriate boards, such as but not limited to, SC Board of Pharmacy, DEA, etc. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

9 Q40) Does your Detention Center maintain an Emergency Drug Box? If so, please provide a list of medications to be contained in the Emergency Drug Boxes. A40) Yes, all prescription medication that is not sent labeled patient specific are shipped in e-kits. The medications in the e-kits are sent for emergency use in one time dose medication packs, injection vials or single dosing packages whenever possible. We also have an Emergency Red bag used by Advanced Providers for use in emergency situations. These medications contained in the e-kits/ emergency bag are: Atenolol, Clonidine, Coumadin, HCTZ, Lisinopril, Metoprolol, Norvasc, Nitro, Glipizide, Metformin, Trazodone, Diphenhydramine injectable, Epi-Pen injection, Haldol, Hyoscamine, Ondansetron, Phenergan injection, Tamiflu (seasonal), Lidocaine Viscous, Permethrin Lotion 5%, Silvadene cream, Augmentin, Ciprofloxacin, Clindamycin, Doxycycline, Macrobid, Rocephin injection, Lidocaine injection, Bactrim DS, Keflex, Geodon injection, Haldol Lactate injection, Haldol Decanoate injection, Glucagon injection, Atropine Injectable, Amiodarone injectable, EPI 1:10 injection, Benadryl/Diphenhydramine injection, Lasix injection, Promethazine injection, Narcan injection, D50W injectable. Q41) Please provide a list of your current Stock Medications. A41) We avoid prescription stock medication as much as possible, the majority of our stock medication is OTC stock medication. This medication is also shipped in individual one time dose medication packaging whenever possible. We do have insulin for diabetics, TB test injections, and Tetanus shots. We carry a small amount of Librium, Tramadol, Klonopin, Ativan and Tylenol 3. Q42) How many med carts are currently in use by your correctional facility? A42) Five medication carts are in use to complete medication passes throughout the facility. Q43) Please outline the quantity of medications carts needed for each facility (if required)? A43) Five medication carts are required for the entire facility to complete medication passes. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

10 Q44) What reports are currently being utilized by Greenville County? What additional reports will be required? Can Greenville County provide examples of current monthly reports provided by current pharmaceutical services vendor? A44) The County would be open to various reports available from the vendor and examples of available information would be beneficial for the review process. At minimum, the County requires monthly: Total Pharmacy cost; credits; total number of RX orders; number and percent of patients on medical RX; number, percent and cost of HIV patients and meds; number, percent and cost of psychotropic patients and meds; number of nonformulary psychotropic meds; number, percent and cost of juvenile patients and meds, number of non formulary medication orders; expense per patient; e-kit expenses, stock expenses; top 20 patients by cost; top 20 meds by cost (all); top 20 meds by price (non psych/ HIV); top 20 meds by price (psychotropic), controlled med list, local pharmacy price breakdown. Q45) Please clarify whether monthly or quarterly site visits will be required? Pg. 5, Section 3.0, #10 references quarterly pharmacy audits and Pg. 6, Section 4.0, Pricing, a. references once per month site visits. A45) Monthly on-site Inspections, with written feedback to the Pharmacy liaison, are required from a Pharmacist and should be provided by the contract Pharmacy vendor. Q46) Are there any current committee meetings that would require a pharmacist or other vendor representative to attend? If so, what is the frequency of those meetings? Are the meetings required to be attended in person or will video/teleconferencing be permitted? A46) Quarterly committee meetings are required that would include the Inspecting Pharmacist and at least one representative from the contracted Pharmacy vendor. It is requested that meetings be conducted in person. Q47) Please provide the current pharmacy related Policies & Procedures for all facilities. A47) See Attachment C. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

11 Q48) Will Greenville County consider specifying a required pricing model for all vendors to follow in their price proposal in order to compare all proposals evenly using the same price criteria. A48) See Addendum #2. Q49) Please provide the current staffing model for on-site employees who setup and distribute medications to inmates in their housing units. Specifically, the number of employees employed for this purpose, hours worked per week including which shift(s) each employee works, and the cost Greenville County is currently paying incumbent vendor for this service. Include all personnel which will be the employee of the contractor (med techs, auxiliary staff, support/clerical staff, and Administrative staff). A49) The current vendor utilizes one Medication Department Supervisor that is a full time 40 hour/week employee working Monday through Friday on 1 st shift. One Medication Department Leader is a full time 40 hour/week employee working a split 2 nd /3 rd shift Monday through Friday schedule. There are no auxiliary, clerical or administrative staff employees. There are currently 16 medication technicians who are part time staff. Some of these staff work full time hours. We cannot give you specific hours for these staff because they do not have set schedules and their hours fluctuate. We will give you the hours needed to run the medication pass and times below. a. 3 Medication areas to pass in the AM & PM requiring 3 passers. b. Each area takes 3.5 to 4.5 hours to pass each area. c. 1 Medication pass in the afternoon requiring 1 passer to all areas. d. 1 Medication pass in the evening requiring 1 passer to all areas e. Medication pull on 3 rd shift requires 2 pullers, takes 8 hours total. Please note that this is what the current provider uses. There may be a better/more economical way of completing our medication passes. Q50) Do current on-site employees have any required licenses or certifications in order to perform their job duties? A50) It is recommended that all staff conducting medication pass inside the facility have some type of medical training/ certification. This may include, but is not limited to: Pharmacy Technician, Registered Medical Assistant, Certified Nursing Assistant, Patient Care Technician and of course any level of Nurse. County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)

12 Q51) Are current employees for med distribution staff eligible for rehire by the A51) Yes. new contractor if deemed appropriate for new staffing model? Q52) Are there non-compete agreements in place for any of the existing A52) No. employees? If so, which positions? Q53) Please provide the current monthly payroll/salary expenditure for all employees of the current vendor hired to staff the positions at the Greenville County Detention Center. Does this cost include the cost of benefits for all employees staffed for these positions? A53) We do not have access to this information. What each vendor pays their employees and what benefits are offered is between the vendor and the employee. Q54) Please specify the number of computers, medication carts, and barcode scanning equipment to be supplied by the vendor. (Reference RFP Pg. 5, Section 3.0, #7). A54) 5 medication carts are to be supplied by the vendor. All computers, laptops and scanners are supplied by the County of Greenville in order to meet Information System Department requirements for security. Q55) Pg. 15, Terms and Conditions, #19 MBE/WBE Participation Affirmative Action states vendors should indicate MBE/WBE areas of involvement. Will Greenville County consider adding any proposal scoring points for a designated percentage of the contract for MBE/WBE involvement in order to encourage Affirmative Action in contract compliance? A55) Please see Score Sheet, Page 33, which will be used to evaluate responses to this solicitation. END OF QUESTIONS AND ANSWERS County Square 301 University Ridge Suite 100 Greenville, SC Fax (864)