Attachment 2-Performance Work Statement Telehealth_Amend 4.pdf

Solicitation Attachment 2: Performance Work Statement FCI Sheridan – Comprehensive Medical Services

15BFA024R00000030

I. Background

The Federal Bureau of Prisons (BOP) was established in 1930 to provide more progressive and humane care for Federal Inmates, to professionalize the prison service, and to ensure consistent and centralized administration.

Today, the BOP is responsible for the custody and care of approximately 159,116 Federal Inmates. The Federal prison system is a nationwide system of prisons and detention facilities for the incarceration of Inmates who have been sentenced to imprisonment for Federal crimes and the detention of individuals awaiting trial in Federal court. It is the mission of the BOP to protect society by confining Inmates in the controlled environments of prisons and community-based facilities that are safe, humane, cost-efficient, and appropriately secure, and that provide work and other self-improvement opportunities to assist Inmates in becoming law-abiding citizens.

As an agency under the Executive Branch of the United States Government, the BOP receives an annual appropriation of funds to accomplish its assigned mission. The public trust demands that this annual appropriation be prudently managed. Thus, dollars spent to maintain the health of the Inmate population must reflect the agency’s best efforts to obtain cost-effective healthcare consistent with community standards.

In meeting the healthcare needs of a growing Inmate population, the BOP provides essential medical, dental, and mental health services to Federal Inmates with BOP resources. When a medical need arises which cannot be provided within prison walls by BOP resources, referrals are then made to community-based providers. It is the goal of this solicitation to establish a contractual agreement that will provide necessary professional and facility services for both inpatient admissions and outpatient encounters.

The Field Acquisition Office intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services as set forth in this solicitation/contract. The Federal Correctional Institution (FCI) (hereinafter referred to as “institution(s)”) is located in Sheridan, Oregon and includes the following institutions:

• Federal Correctional Institution-Male Offenders, Care Level II & III

• Federal Detention Center – Male Offenders, Care Level II

• Federal Prison Camp-Male Offenders, Care Level II

Presently, the institution is identified as Care Level 2 BOP facility. This medical classification indicates institutions house inmates that are stable outpatients who require primary or specialist evaluations, monthly to every 6 months. Criteria for categorizing an Inmate in the Care Level 2 category is included as Attachment 4:

Medical Care Level Classification. Despite this description of the general health of the Inmate population, the need for Inmate healthcare may arise at varying levels of complexity. Classification and designation of Inmates is the sole responsibility of the BOP and may change at any time without consideration to the contractor.

A mileage restriction has not been placed on this acquisition. The BOP reserves the right to determine if the proposed driving distances/conditions to community-based providers pose an unacceptable cost or security risk and to find such offers unacceptable.

II. Statement of Output

Within this Performance Work Statement (PWS), necessary services are described in terms of output rather than specific task assignments. The BOP desires to make an award to the offeror who can provide the best value, considering the diversity of available services and price, among other criteria. Therefore, the Government may award any or all line items, may withhold award of any or all line items, or may award to an offeror who proposes less than the full complement of services contained in this solicitation. Accordingly, output items 1 and 2 are optional deliverables while output items 3, 4, and 5 are applicable to all services provided. Offerors are encouraged to submit comprehensive proposals committing to provide all output listed in the solicitation.

Offerors who propose less comprehensive approaches will be evaluated accordingly.

Output #1: Provide inpatient and outpatient facility services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery of healthcare to members of the general public. (Cross-reference pricing categories 1a and 1b.)

Output #2: Provide professional services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery of healthcare to members of the general public. (Cross-reference pricing categories 2a, 2b, 2c, 2c1, 2d1, 2d2, 2d3, 2d4, and 2d5.)

Output #3: Submit properly-priced invoices for services rendered.

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restrictions on the release of information.

Output #5: Maintain open avenues of communication, facilitating the exchange of information between the contract provider, contract facility, and the Government regarding the contract services.

III. Specific Requirements

Output #1: Provide inpatient and outpatient facility services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery of healthcare to members of the general public.

Output #1 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements apply. Throughout the performance of this contract, the contractor shall not utilize any provider that appears in the List of Excluded Individuals/Entities (LEIE) maintained by the U.S. Department of Health & Human Services.

If proposed, the contractor shall provide facility services on an as-needed basis in a manner which adheres to community standards of quality and cost-effective medical care. The services required to satisfy Output #1 may include inpatient facility and outpatient facility, including emergency room services. Inpatient visits for non-emergency services shall require private room accommodations with available space for up to three armed or unarmed guards per Inmate.

It is the institution’s preference to obtain the services of facilities that are accredited by The Joint Commission.

Offerors utilizing facilities which maintain accreditation by The Joint Commission shall submit a copy of the current accreditation certificate as part of the offeror’s technical proposal. If an offeror intends to utilize a facility which is accredited or certified by any other recognized professional accrediting body, the offeror shall submit documentation validating this accreditation or certification as a part of its proposal.

The offeror’s technical proposal shall discuss in detail the diversity of services, as well as the proximity of facility providers to the institution, that it is capable of providing to achieve Output #1.

Output #2: Provide professional services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of healthcare to members of the general public.

Output #2 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements shall apply. Throughout the performance of this contract, the contractor shall not utilize any provider that appears in the LEIE.

Community-Based Services

Professional services resulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, surgical center, physician’s office, etc.). If proposed, the contractor shall provide the services of professional medical staff who have appropriate educational qualification, experience, licensure, and board certification (where required) to achieve Output #2. This output specifically excludes the provision of radiological interpretations of BOP-provided films, images, or other media.

The following specialties may be provided via telehealth, contingent upon an acceptable offer. The BOP reserves the right to award all, some or none of the following telehealth services:

List requested telehealth services here.

Tele-Triage Cardiologist Dermatologist Endocrinologist Gastroenterologist General Surgeon Neurologist Nephrologist Rheumatologist Urology Oncology Orthopedist Orthopedic Surgery Otolaryngology Pain Management Podiatry Prosthetics/Orthotics

It is the institutions’ preference to obtain telehealth services from providers that maintain privileges within facilities identified within Output #1.

If the contractor performs telehealth services, the following minimum requirements shall apply:

Telehealth Services: The contractor shall provide Telehealth services during the hours of 7:00 am through 3:00 pm. The contractor shall provide timely, secure, and clinically appropriate Telehealth services resulting in completed virtual encounters, accurate documentation, and patient care instructions.

Teletriage Services: Teletriage services shall be provided 24 hours per day, 7 days per week, including weekends and holidays ensuring continuous access without interruption. The contractor shall perform clinical assessment and acuity determination, producing accurate triage determinations, timely escalation of emergent cases, and documented care recommendations.

If requested by the Contracting Officer (CO), the contractor shall be required to document primary source verification of the credentials for each provider including: current license from the appropriate State Board of Medical Examiners, education from professional schools or universities, evidence of completion of internships and/or residences as appropriate.

With the exception of Tele-triage Services, appointments for specialty care should be available within 14 calendar days from the date of referral to the specialty provider whenever possible. This practice promotes the safety and security of the Federal prisoner, the escorting correctional staff, and the general public. The medical urgency of any referral must receive consideration in the scheduling and delivery of professional services.

For prescriptions to be filled by the institution’s pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the approved Attachment 9 - BOP Formulary. Updated BOP Formularies will be posted to bop.gov. Requests for exemptions shall be submitted to the Contracting Officer’s Representative (COR), who shall obtain the required approvals. As part of the Discharge Instructions, the issuance of sample medication to any Federal Inmate shall be prohibited.

In the event it becomes necessary for the Government to cancel a scheduled visit, the institution will provide the contract provider with 48-hour written or verbal notice prior to canceling a visit. However, certain circumstances beyond the control of the institution (e.g., fog or other Acts of God, institution disturbances, etc.)

may dictate the cancellation of a scheduled visit with less than 48 hours written or verbal notice.

The offeror’s technical proposal shall discuss in detail the diversity of services, as well as the proximity of professional providers to the institution.

Institution-Based Services

As an additional tool to satisfy Output #2, professional services may be performed within the confines of the institution. If the resulting contract does not provide for telehealth consultation or all the outpatient institution service clinics listed, the institution reserves the right to pursue such contracts. The institution also reserves the right to determine the manner of an Inmate’s referral, i.e., via outpatient institution service clinic, via community-based referral, via telehealth consult, or any other method the institution determines to be reasonable and appropriate.

If the contractor performs outpatient institution service specialty clinics at the institution, the following minimum requirements shall apply. Contract services shall be provided outpatient institution service within the Health Services Department of the institution. Consultations shall be limited to the chief complaint on the BOP consultation form.

Services shall include diagnosis and treatment of medical conditions with appropriate referral, if necessary, to a specialist at the contract medical facility. Scheduling of clinics shall be subject to the mutual agreement of the institution and the contract provider. The institution will schedule Inmates for outpatient institution service clinics. Providers performing institution-based services shall be licensed to practice medicine in the State of Oregon. Providers performing these services shall apply for clinical privileges at the institution. All clinical privileges shall be appropriate to the qualifications of the provider and the resources of the facility where care is provided. Any clinical privileges granted due to the award of this contract shall be contingent upon the continuation of this contract and upon the physician’s continued affiliation with the contractor or any subcontractor. Continuation of privileges at the institution shall be at the sole discretion of the institution. Non-physician providers shall maintain active licenses from the State of Oregon, as applicable.

The following specialty clinics/sessions may be conducted at the institution, contingent upon an acceptable offer. The BOP reserves the right to award all, some or none of the following outpatient institution service clinics:

Cardiology General Surgeon Ophthalmologist Orthopedist Orthopedic Surgeon Psychiatry Urologist Oral Surgeon Optometrist Mobile MRI Mobile CT

In the event it becomes necessary for the Government to cancel a scheduled visit, the institution will provide the contract provider with 48-hour written or verbal notice prior to canceling a visit. However, certain circumstances beyond the control of the institution (e.g., fog or other Acts of God, institution disturbances, etc.)

may dictate the cancellation of a scheduled visit with less than 48 hours written or verbal notice. In the event it becomes necessary for the contract provider to cancel a scheduled visit, the contractor may provide qualified replacement professional staff or may reschedule a mutually agreed upon replacement session. Prior to utilizing replacement staff, the contractor must obtain preliminary clearance from the CO or COR, in accordance with the security and privileging requirements of this contract.

All contract personnel providing services within the confines of the institution shall have a complete background investigation conducted in accordance with BOP Program Statement 3732.01, “BOP Identifications and Background Investigation.” All contract providers and other applicable staff who will enter the institution to perform services on a recurring basis shall be required to attend a four-hour institution orientation course held at the institution or a mutually acceptable site. A “refresher” orientation must be completed annually. The contractor’s costs for contract staff to attend this training shall be the responsibility of the contractor. The CO or COR will be responsible for scheduling training for all applicable contract staff.

Output #3: Submit properly-priced invoices for services rendered.

Overview. Upon completion of a treatment encounter, the contractor shall prepare and submit proper invoices for services rendered under this contract. For the purpose of this contract, a specific definition for what documentation constitutes an invoice is provided below. A proper invoice shall include the information specified in FAR Deviation 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial 15.Services, paragraph (g). Services shall be invoiced in accordance with the terms and conditions of the contract, including the payment rate structures specified in the contract.

Invoice/Medical Claims Adjudication. The institution will employ a process of invoice/medical claims adjudication to ensure, at a minimum, that the services billed by the contractor were properly authorized and ordered by the institution, are appropriately coded in compliance with Medicare coding policies (where applicable), are properly priced in accordance with the terms and conditions of the contract, and do not represent duplicate billings for payments already made. In addition, the institution may utilize the services of a third-party medical claims adjudicator to review medical claims submitted by the contractor under this contract.

When requested by the institution, the contractor shall comply with all reasonable requests for additional invoice/medical claim/medical record documentation. All invoice payments shall be made by the institution and any disagreements regarding the paid amount of any invoice shall be resolved directly with the institution.

Invoice Definitions.

Line Items 1a - Inpatient Facility Services, 1b - Outpatient Facility Services, 2a - Inpatient Physician Services, 2b - Outpatient Physician Services, and 2d1 - Outpatient Institution Services - Other Physicians: At the outset of this contract, an invoice for services rendered under Line Items 1a, 1b, 2a, 2b, and 2d1 shall be a paper version of an invoice containing not more than 50 individual medical claims. Each invoice shall be supported with paper copies of Universal Billing (UB) 04 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms, as applicable, for each medical claim included in the invoice.

Following written notification to the contractor by the CO that a third-party medical claims adjudication service will be utilized by the institution, an invoice for services rendered under the Line Items identified in the previous paragraph shall be a paper invoice. Each invoice shall not detail more than 50 individual medical claims which have been electronically transmitted to the BOP’s medical claims adjudicator via American National Standards Institute (ANSI) 837 format that also conforms to Medicare and Health Insurance Portability and Accountability Act of 1996 (HIPAA) electronic billing standards. For each medical claim included on the invoice, the contractor shall reference, at a minimum, the following information: Task Order number, Inmate name, register number, date of service, provider of service name and NPI number, billed code, and contract amount billed. Medical claims detailed in the invoice shall be listed first in descending order by the Task Order number, second in alphabetic order by the Inmate’s last name, and third by ascending date of service (i.e., earliest to latest) when more than one medical claim is present for the same Inmate within the same invoice. A copy of the invoice including the same fields listed above will also be provided to the institution in Microsoft Excel or comma-separated values (CSV) format. The electronic copy of the invoice shall be submitted to the institution using an encrypted email service.

If the contractor’s proposal encompasses the provision of oral surgery and/or dental procedures, only those medical claims which represent adjunctive dental care will be submitted by the contractor to the medical claims adjudication contractor for processing. Oral surgery and/or dental procedures which are not considered to be adjunctive dental care will be submitted to the institution for verification.

The contractor shall not submit a medical claim for processing that the contractor knows or has reason to believe contains inaccurate, incomplete, or misleading information. Additionally, the contractor shall only submit Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) provided by medical service providers. Medical claims which contain inaccurate, incomplete or misleading information shall be held by the contractor and not submitted until such time as all lines are deemed to be accurate and complete. At that time, the contractor may proceed with submitting the medical claim for processing and invoicing the institution for all services represented by that medical claim.

Outpatient Institution Services - Line Item 2d2 - Optometrist, Line Item 2d3 – Oral Surgeon, Line Item 2d4 – Mobile MRI, and Line Item 2d5 – Mobile CT: Invoices for services rendered under Line Item 2d2 Optometrist, Line Item 2d3 Oral Surgeon, Line Item 2d4 Mobile MRI and Line Item 2d5 Mobile CT, shall be a paper invoice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing applied, and the extended total amount due. The BOP will not use the services of a third-party medical claims adjudicator for verification of these services.

Telehealth Services – Line Item 2c – Telehealth, Line Item 2c1 – Tele-triage: Invoices for services rendered under Line Item 2c – Telehealth services and Line Item 2c1 – Tele-triage services, shall be a paper invoice detailing the date(s) of service provided and the per consultation price.

Provider Information

Submission of Provider Data to the BOP’s Medical Claims Adjudicator: Within 10 calendar days after notification that a third-party medical claims adjudication service will be utilized by the institution, the contractor shall provide the BOP’s medical claims adjudicator with a complete list of provider information, which will enable the medical claims adjudicator to accurately identify the correct payable amount for any provider performing services under the Contract. Specific informational requirements are provided in Attachment 8-A: List of Provider Information Requirements. Provider information supplied to the BOP’s medical claims adjudicator should be appropriately marked to identify the data as proprietary information so that it may be adequately protected by the BOP and its contracted medical claims adjudicator. Provider information shall be submitted directly to the BOP’s medical claims adjudicator. As individual providers are added to the contractor’s network, the contractor shall provide the information listed on the List of Provider Information Requirements to the medical claims adjudicator no less than three business days prior to filing claims electronically for services rendered by such new providers.

National Provider Identifier (NPI) Numbers: The contractor shall utilize only providers who have a current NPI number.

Technical Data for Submission of Medical Claims: Prior to the submission of an invoice to the institution, the contractor shall electronically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP’s medical claims adjudicator. Any claims submitted to the medical claims adjudicator’s claims clearinghouse with missing or invalid provider information will be automatically rejected in a 277CA Claims Acknowledgement message noting the missing or invalid provider information received.

After the contractor’s electronic transmission to the BOP’s medical claims adjudicator, the contractor shall promptly submit a paper copy of the invoice to the institution. The contractor will also post the ANSI 837 file in an FTP site set up and maintained by the BOP’s medical claims adjudicator. Address information for the submission of a paper claim to the BOP’s medical claims adjudicator is provided in Attachment 8-B:

Information Requirements for Medical Claims, along with other pertinent details.

Procedures for Filing Corrected Medical Claims

A corrected claim is a replacement of a previously submitted claim with claim line level denials or issues.

Previously submitted claims that were completely rejected or denied should be sent as a new claim rather than a corrected claim.

Facility Services: If it becomes necessary to file a corrected medical claim for facility services, the contractor shall electronically transmit the information found on each individual corrected medical claim via ANSI 837i format only, to the BOP’s medical claims adjudicator. Institutional Provider corrected claims should include a value of ‘7’ (Replacement of Prior Claim) in Loop 2300, Segment CLM05‐3.

Physician/Professional Services: If it becomes necessary to file a corrected medical claim for professional services, the contractor shall electronically transmit the information found on each individual corrected medical claim via ANSI 837p format only, to the BOP’s medical claims adjudicator. Professional Service Provider corrected claims should include a value of ‘7’ (Replacement of Prior Claim) in Loop 2300, Segment CLM05‐3.

After the contractor’s submission to the BOP’s medical claims adjudicator, the contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to the institution. Invoices for corrected medical claims shall be clearly marked as such and shall be separate from routine invoices. Invoices or credit memos for corrected medical claims shall detail information pertaining to the original medical claim submission (including any amount(s) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim submission or reflect the credit amount due for the corrected medical claim submission.

Payment by the Institution: The institution will pay all invoices directly to the contractor. If the invoiced amount of a medical claim exceeds the adjudicated amount of that medical claim, the institution will take an administrative deduction from the invoice. The institution will provide written notification to the contractor when an administrative deduction is taken from an invoice payment.

If the contractor is in disagreement with the paid amount of a medical claim, the contractor will provide written notification to the institution of the disagreement along with the reasons why the contractor believes the medical claim was paid incorrectly. The institution will interface between the contractor and the medical claims adjudicator to bring resolution to any disagreements. If it is determined that a medical claim was paid incorrectly by the institution, interest on the underpayment will be paid when required by the Prompt Payment Act.

Timeliness of Medical Claims

Claims shall be submitted/invoiced within 90 calendar days after an Inmate’s discharge or outpatient encounter or other service provided under this contract. Medical claims which are submitted/invoiced beyond the 90-day requirement shall constitute a performance deficiency under this output and shall be documented in the contractor’s Performance Assessment Report in the Contractor Performance Assessment Reporting System (CPARS). Medical claims which are submitted/invoiced within the acceptable time but are found to contain errors or require further justification, will be rejected and shall be resubmitted/re-invoiced by the contractor within 30 calendar days from the date of rejection. Upon resubmission, invoices for corrected medical claims shall bear the new date of submission.

No later than the 10th of each month, the contractor shall initiate the billing review process by examining its records from the preceding months, including those of all subcontracted providers, to identify an estimated amount of expenditures for services rendered. Using the information gathered through this review, the contractor shall prepare and submit a written monthly estimate of Fiscal Year Obligations. The monthly estimate shall itemize projected amounts by fiscal year and by month, and shall include, at a minimum:

1. Dates of Service

2. Provider

3. Inmate Name

4. Register Number

5. Estimated Amount

6. Billed Amount

Each date of service shall be recorded on its own line. If an inmate has multiple encounters, each encounter shall be listed separately. Each monthly estimate shall address a single month only and shall not be combined with other months. Monthly estimates from prior periods shall be updated as additional services are rendered.

The contractor shall provide the written estimate to the institution no later than the 15th of each month. As invoices are paid, the contractor shall promptly remove them from subsequent estimates. The contractor shall use its best efforts to ensure all estimates submitted to the Government are accurate.

To ensure adequate funds are reserved before the fiscal year ends, the contractor shall provide early estimates for the final two months of the year. Specifically, the contractor shall submit an estimate of services anticipated for August no later than July 15th, and an estimate of services anticipated for September no later than August 15th.

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restrictions on the release of information.

Upon request, authorized BOP staff shall have access to and obtain copies of all Inmate medical records to include evaluation and treatment reports prepared and maintained by the contract facility and/or contract providers. Inmate medical records will be subject to review by the institution for validation of payment and verification of services rendered. Release of information shall only be made in accordance with community standards, Joint Commission regulations, and the Privacy Act of 1974. Any request(s) for copies of an Inmate’s medical records by the Inmate or a third party shall be directed to the COR for processing.

Notwithstanding the above restrictions on the release of information, medical record information shall be provided to the institution to enhance Inmate recovery as well as continuity of care. For inpatient admissions, a faxed report documenting treatment plans will be submitted to the institution Medical Records Department no later than 8 am each day. This form with the requested information will be provided to the institution by the contractor. At the completion of treatment, the contractor shall provide the institution with documented discharge instructions, as provided by the attending physician.

Copies of all lab, x-ray, EKG, progress notes and emergency room working notes shall also accompany the patient or be faxed immediately to the COR. A written report by the attending physician which documents the circumstances of the inpatient treatment, outpatient procedure, or other consultation shall be provided to the COR within ten business days of the inpatient discharge, outpatient procedure, or other consultation. All lab and consultations pending at time of discharge shall be faxed to the COR upon receipt but not later than ten calendar days past discharge.

Output #5: Maintain open avenues of communication, facilitating the exchange of information between the contract physician, contract facility, and the Government regarding the contract services.

The contractor shall provide a Point of Contact (POC) who shall be responsible for facilitating the contractor’s delivery of health services under this contract. The POC shall have sufficient clinical knowledge to enable preliminary technical consultation, with referral to a specialist if necessary. The contractor shall designate this individual in writing to the CO prior to the start date of the contract. Alternate POC’s may be designated;

however, the contractor must identify those times when an alternate shall be the primary POC (i.e., after-hours and weekend referrals).

There shall be an open line of communication between the contractor, its representatives, and the institution to ensure that only those services ordered by the institution are provided, unless required for intervention in a life-threatening emergency. In the event of a life-threatening emergency, the contractor shall contact the COR within a 24-hour period or the next normal working day. All institution referrals shall be the sole responsibility and decision of the Government. No Inmate may be transferred to another medical facility, with exception of emergency cases, without advanced approval by authorized institution medical staff.

A contract provider may discuss with the Inmate patient only the diagnosis and possible treatment options directly related to the written consultation provided by the institution. The contract provider should not guarantee any future treatment to the Inmate or discuss future appointment dates. All consultant recommendations should be sent to the institution for review by the Primary Care Provider Team (PCPT) and/or Clinical Director (CD). The BOP PCPT and/or CD is under no obligation to follow consultant recommendations. All patient care information and/or treatment plans will be reviewed by the PCPT/CD and the final disposition will be relayed to the Inmate in accordance with BOP policies and procedures. In the event further care is approved, the contractor will be notified by the institution. The contractor shall not perform any treatment/procedures unrelated to the reason for consultation without receiving prior authorization from the institution.

IV. Enhancements to the Basic Contract Requirements

Offerors are encouraged to propose enhancements to the basic contract requirements which will facilitate the institution’s ability to conform to the BOP’s stated mission. Due to security concerns inherent in transporting an Inmate into the community for medical care, it is the institution’s preference to treat Inmates within the confines of a secure perimeter whenever possible. Offerings which assist the institution in mitigating security concerns are considered beneficial to the Government and will be evaluated for merit. Enhancements are not additional line items. Pricing for offered enhancements must be absorbed in the line item structure established within Section 2. Offerings of enhancements that are separately priced line items will not be considered or accepted.

The Government reserves the right to reject any offered enhancements that are determined not to be in the best interest of the Government.

The offeror’s technical proposal shall discuss in detail any such enhancements proposed, including relevant terms and a detailed discussion of the merits of offered enhancements.

V. Prison Rape Elimination Act (PREA)

Institution Health Services staff are responsible for assessment, examination, documentation, and treatment of Inmate injuries arising from incidents of sexual abuse, including testing when appropriate for pregnancy, HIV, and other sexually transmissible infections. Where indicated, medical staff, trained in the collection of sexual assault evidence (e.g., “rape kit”) should conduct an examination for physical evidence that may be used later in formal investigations, or refer the Inmate to trained healthcare professionals from the local community or at the local community facility equipped (in accordance with local laws) to evaluate and treat sexual assault victims.

Should there be a need for the institution to refer the Inmate out into the community to a trained healthcare professional, the offeror’s technical proposal shall discuss in detail the protocol (including but not limited to, the facilities who offer these services, examiners’ certifications, and local laws/requirements) to help meet this requirement.