5._Exhibit_A_-_Scope_of_Work_5-9-24.pdf

California Department of Corrections and Rehabilitation (CDCR)/ Bid Number: SD23-00080 California Correctional Health Care Services (CCHCS) Exhibit A

Scope of Work

Rev. 5/9/2024 Page 1 of 10

PORTABLE DIAGNOSTIC SLEEP TESTING SERVICES

1. INTRODUCTION/SERVICES

A. This is a Statewide Agreement in which Contractor shall provide on-site Portable Diagnostic Sleep

Testing (PDST) services on an as-needed basis to patients referred for such medical services from the California Department of Corrections and Rehabilitation (CDCR) Institutions.

B. Contractor shall provide all labor, materials, staff, transportation, license, permits and every other item of expense necessary, unless otherwise stated. Services shall be provided under the direction of the Institution’s Chief Executive Officer and Chief Medical Executive (CEO/CME) or designee. For purposes of this Agreement the CDCR designee must be a civil service employee. The Institution CEO/CME or designee retains professional and administrative responsibility for services rendered.

C. Contractor must be able to perform the tasks associated with providing medical services as noted in the heading under the scope of their license. Contractor must possess all Portable Diagnostic Sleep Testing equipment and must be able to provide diagnostic analysis. Under no circumstances can any portion of this medical service be subcontracted. Subcontracting shall be cause for termination of the Agreement. Contractor will be required to render health services as stated below and as required by law on an as-needed basis. Contractor will perform services in accordance with Federal and State laws and regulations and CDCR Policies and Procedures and shall at all times comply with universal safety precautions and maintain CDCR security measures and a safe work environment.

D. Contractor agrees that, unless otherwise stated, all expenses associated with travel to and from the

Institution, lodging, and all training expenses for services shall be borne by Contractor and will not be reimbursed by CDCR. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of Contractor.

E. CDCR/CCHCS Medical Standards of Care shall be used as a reference. CDCR/CCHCS Medical

Standards of Care means InterQual® Criteria, published by McKesson Health Solutions, LLC, except to the extent they conflict with the Health Care Department Operations Manual (HCDOM), except to the extent the InterQual® Criteria or the HCDOM conflicts with the California Code of Regulations Title 15, Division 3, Chapter 1, Subchapter 4, Article 8, and California Code of Regulations, Title 15, Division 3, Chapter 2. Requests for InterQual® criteria should be directed to um@cdcr.ca.gov and the HCDOM is available at the following link: http://cchcs.ca.gov/hcdom/. In the event CDCR/CCHCS adopts another objective standard for Utilization Management (UM) review to screen Patient health care regarding prior authorization, inpatient admissions, and other types of UM review, the institution shall notify Contractor and/or Provider of the new standard no less than Thirty (30) calendar days before the new standard is implemented.

2. CDCR INSTITUTION RESPONSIBILITIES

A. Institution’s medical staff or designee shall ensure that the Request for Service is clearly and completely filled out providing contact person’s name and phone number, Patient’s name and CDCR identification number and Ordering Physician.

B. Institution’s medical staff or designee shall ensure the sleep testing is performed in a timely manner of receiving WP200/300 equipment.

CDCR/CCHCS

Bid Number: SD23-00080 Exhibit A

Rev. 5/9/2024 Page 2 of 10

C. Institution’s medical staff or designee shall instruct Patient on sleep testing procedure to ensure completion of service.

D. Institution’s medical staff or designee shall inform Contractor and cancel any service request(s) immediately upon Patient’s approval to transfer to another Institution.

E. Institution’s medical staff or designee shall cancel or change a service request for any reason including Emergency Security Situation such as lockdown without incurring any liability up to twenty-four (24) hours of PDST service request.

F. The Institution’s medical staff and/or designee will be responsible for returning the equipment to

Contractor for processing of recorded data using the shipping method specified and shipping materials supplied in a manner specified during training.

G. CDCR/CCHCS shall reimburse Contractor if equipment is damaged due to unauthorized alterations, misuse, use of unauthorized agents, vandalism or negligence by the State or its officer, agents, employees or Patients. Contractor and CCHCS Direct Care Contracts Section (DCCS) agree to negotiate for reimbursement on a fair market value, replacement value and equipment age, etc. As part of the negotiation process, Contractor shall provide an estimate and verification documentation of the cost to replace the equipment model to CCHCS Direct Care Contracts Section.

3. CONTRACTOR’S RESPONSIBILITIES

At the request of the Institution’s CEO/CME or designee, Contractor shall provide Portable Diagnostic Sleep Testing services utilizing the limited to brand WatchPAT 200 or 300 (WP200/300), Home Sleep Testing device. The WP200/300 uses a proprietary Peripheral Arterial Tone signal (PAT) to provide simple, accurate and reliable sleep apnea testing and is an approved measure in the American Academy of Sleep Medicine (AASM) Home Sleep Apnea Testing (HSAT) Clinical Practice Guidelines.

Contractor’s responsibilities shall include, but are not limited to:

A. Equipment

1. To avoid disruption of PDST services, Contractor must have at a minimum of fifty (50) WP200/300 devices in stock and readily available to provide PDST services continuously and effectively to the institutions listed on Exhibit B-1, Rate Sheet.

2. Prior to the start of this Agreement, Contractor must submit an inventory list of WP200/300 devices to the DCCS assigned contract analyst; each piece of equipment must possess a verifiable serial identification number for tracking purposes and/or reimbursement.

3. Contractor shall also provide all supplies required to provide PDST services including but not limited to the finger probe, tamper-proof bracelet, snoring and body position sensor, watch pad and any and all other equipment/materials/supplies required to adequately perform and provide PDST services at no additional charge. All required disposable supplies are inclusive with the rates specified in Exhibit B-1, Rate Sheet.

4. All PDST equipment must be received by the requesting institution within seven (7) calendar days from the initial date of request. Any damages incurred during the mailing and/or shipping process

Rev. 5/9/2024 Page 3 of 10 to the Institution shall be borne by the contractor. If the Institution finds the equipment is not in good working order, Contractor shall ship a replacement via priority shipping at no additional charge within one (1) business day.

B. Shipping

1. Contractor shall properly identify the requested equipment addressed to the appropriate

Institution medical staff or designee with the following information:

a) Name of Patient;

b) CDCR Identification Number;

c) Ordering Physician; and

d) Contact’s name and phone number.

2. All cost for shipping including mailing materials and supplies shall be at Contractor’s sole expense. Contractor shall include a return shipping label with each device sent to the institution.

3. Contractor shall adhere to the Institution’s chain of custody process starting from the time the equipment is sent to the Institution until the time the equipment is returned to Contractor for data analysis and diagnostic reports completion.

C. Training

1. All training will be performed at Contractor’s expense and shall be included in the per service charge provided in the Exhibit B-1, Rate Sheet.

2. Contractor must provide the State with proof of any required training, licenses, permits, certifications and any other required documents as stated in Exhibit A Provision 5 Licenses, Permits, and Certification Requirements, and as required by law to provide services under this Agreement. Services will be performed only by Contractor who meets the requirements outlined in this Agreement.

3. At the discretion of the Institution’s CEO/CME or designee, Contractor shall provide training to

Institution’s medical staff and/or designee. Training shall be available to the Institution through the CCHCS Lifeline:

http://lifeline/HealthCareOperations/MedicalServices/Pages/Resources.aspx.

4. Contractor shall train or provide training materials to the designated Institution’s medical staff and/or designee on the care of the equipment, instruct on the distance parameters and settings to administer sleep testing service prior to its use to ensure that the equipment is in good working order. If an error message appears on the watch pad display, live support provided by Contractor is to be contacted.

5. Contractor shall provide training on the appropriate storage and packaging of equipment for return shipping. The need for training services can vary over the term of this Agreement due to hiring of additional or replacement of the designated Institution’s medical staff and/or designee.

6. It shall be the responsibility of the Institution’s medical staff and/or designee to contact Contractor to request training for any and/or all identified Institution staff on the use of the PDST WP200/300 equipment, materials, and supplies.

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D. Live Support

1. Contractor shall have a toll free telephone number and a contact person available by telephone twenty-four (24) hours a day including weekends and holidays for the duration of the Agreement.

Telephone answering device (i.e., message machines) and an answering service are not acceptable for Live Support and their use may be cause for termination of this Agreement.

2. Contractor shall provide interpretative services as permitted within the scope of their practice for Sleep Medicine.

E. Reports

CDCR/CCHCS reserves the right to request that Contractor provide reports or information related to this Agreement as needed by CDCR/CCHCS. Reports submission details shall be determined by

CDCR/CCHCS.

1. Contractor shall provide a written analysis and recommendation(s) for sleep disorders including diagnosis, analysis of the data from the test conducted using the equipment and an analysis of Contractor’s computer technology and software.

2. After the completion of service, Contractor shall submit and provide two (2) legible copies of the PDST evaluation report with recommendation(s). The complete report shall be sent by electronic mail and/or fax as determined by the Institution’s CEO/CME or designee, within seven (7) business days after equipment is returned to Contractor. The submitted report shall consist of the testing analysis, diagnosis and recommendation of treatment to include, but not limited to the following:

a) Date of Service;

b) Patient Demographics (e.g., patient name, date of birth, CDCR #, institution);

c) Description of analysis provided;

d) Printed name, Title, and signature of staff performing analysis; and

e) Recommendation of equipment and equipment settings for treatment if the test suggests the presence of sleep apnea.

F. Additional Reports

1. CCHCS reserves the right to request that Contractor provides additional reports or information as needed. The reports requested may include the need for additional information pertaining to Contractor.

2. The reports shall be submitted in electronic format (Microsoft Excel 2000 or newer version) and sent via electronic mail to CCHCSHealthCareContractsHelpDesk@cdcr.ca.gov. In the event that electronic mail is not available the reports can be sent via U.S. Mail to the following address:

California Correctional Health Care Services

Contract Support Team, Direct Care Contracts Section P.O. Box 588500, Building D

Elk Grove, CA 95758

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G. Personnel

1. For the purposes of this Agreement, Contractor’s personnel are not considered by CDCR/CCHCS to be State employees. Any actions claimed and filed by Contractor’s personnel for unemployment, tax withholdings, lost wages or revenues, workers’ compensation, injuries or illness are to be considered the responsibility of Contractor to defend and pay all costs associated with that defense or settlement of those claims.

2. Contractor agrees to allow CDCR/CCHCS, in CDCR/CCHCS’ sole discretion the right to:

a) Approve any of Contractor’s personnel in advance of the personnel being used to render services under the Agreement;

b) Disapprove the initial or continuing use of Contractor’s personnel due to the personnel violating the terms of the Agreement;

c) Disapprove the initial or continuing use of Contractor’s personnel when personnel violate

CDCR/CCHCS custody and/or safety requirements and rules, along with having criminal convictions, actions pending and/or in process;

d) Disapprove the initial or continuing use of a contractor’s personnel who has been terminated from and/or in process of being terminated from a State, County or local agency when done for disciplinary reasons as an employee; and

e) Disapprove the initial or continuing use of Contractor’s personnel due to personnel having been released from providing contracted services with another State, County, or local agency for violating the terms of the contracts, or failure to perform services as needed.

4. CONTRACTOR’S QUALIFICATIONS

Contractor assigned to CDCR Institutions must have the minimum experience outlined below:

A. Physicians evaluating Portable Diagnostic Sleep Testing data are required to possess a Board Certification in Sleep Medicine issued by the American Board of Internal Medicine or the American Board of Sleep Medicine as well as a minimum of two (2) years of experience in Sleep Medicine.

B. Patient health care is of paramount importance. Accuracy in communications is critical to ensure timely, correct care is provided. Therefore, any Contractor providing services through this Agreement must be proficient in the English language and be able to communicate effectively with CDCR/CCHCS. All Contractors must be able to speak and understand oral and written communication and write effectively in the English language. Any Contractor who fails to meet the minimum qualifications shall not be permitted to perform service. The Institution’s CEO/CME or designee shall state in writing the reason(s) Contractor does not meet minimum qualifications and submit documentation to Contractor and the CCHCS, Direct Care Contracts Section, Contract Support Team. After notification of failure to meet minimum qualifications has been provided, CDCR/CCHCS shall not pay Contractor for any additional hours worked identified as not meeting the minimum qualifications.

5. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

A. Prior to providing services as outlined in this Agreement, Contractor shall possess and maintain throughout the term of this Agreement, a current and valid license, issued by the California Department of Consumer Affairs, Medical Board of California, with a board certification in Sleep Medicine in order to perform these contracted services in the State of California.

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B. Contractor shall provide copies of any required license(s), permits, and/or certification(s) to the Institution’s CEO/CME or designee to be kept on file at the Institution throughout the term of this Agreement. Contractor shall ensure that all required licenses, permits, certifications, and any other requirements outlined herein are current and in effect at all times during the term of this Agreement.

C. In the event the required licenses, permits, and/or certifications are to expire, Contractor shall provide current/renewed license(s), permit(s) and/or certification(s) to CDCR/CCHCS not less than thirty (30) calendar days prior to their expiration. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CDCR/CCHCS may withhold payment for services rendered during the expiration period and/or immediately terminate this Agreement.

D. Contractor shall assume responsibility for verifying through the appropriate licensing boards that no current or unresolved adverse actions have been taken by the State licensing authorities against any Contractor assigned to CDCR/CCHCS, and that all licenses are active and void of misconduct.

CDCR/CCHCS may, at its discretion, verify the current status of Contractor assigned.

6. CREDENTIALING VERIFICATION

For PDST services provided on-site at CDCR institutions, Contractor and its Provider(s) shall comply with the following credentialing and privileging requirements:

A. Credentialing and Privileging Requirements – Adult Institutions

For services provided on-site at an adult institution, Contractor and its Providers shall comply with all credentialing and privileging requirements:

1. Contractor shall compile and ensure that its Providers complete the credential and privileging package.

2. Contractor shall submit a completed MD-App electronic credential and privilege application and associated documentation to CCHCS Credentialing and Privileging Support Unit (CPSU).

3. Contractor and its Providers shall comply with all CPSU requirements, policies, and procedures.

Services cannot commence until the credentialing process and approval is completed by CPSU.

4. Contractor shall ensure all of its Providers possess current and up-to-date credentials and privileges at all times. Contractor shall renew its Providers credentials and privileges every two

(2) years by submitting a completed MD-App electronic credential and privilege application prior to expiration date.

5. The institution CEO/CME or designee will notify Contractor by telephone, email, and/or fax once credential and privilege verification has been completed to arrange for an effective date for Contractor and its Provider to render services to the institution.

6. Refer to the document titled, “Credentialing - Adult Institutions Type of Medical Services by

Specialty” for licensure and certification requirements for the appropriate health care service classification requirements. The document is available at the following link:

http://www.cdcr.ca.gov/Divisions_Boards/Plata/Credential_Verification.html.

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It shall be the responsibility of Contractor to reference this document when services are requested to ensure that any changes in credentialing requirements are met.

7. REQUEST FOR SERVICE

A. Services may be requested on an as-needed basis, in accordance with CDCR policies and procedures, which may or may not conform to CDCR shift divisions.

B. The State reserves the right to award multiple Agreements for back-up purposes. When services are needed, CDCR may, at the discretion of the Institution’s CEO/CME or designee, choose one of the options below when contacting Contractors to request services. For all options detailed below, Contractor shall respond to a request for services within the standard two (2) hour response time unless otherwise stated by the Institution. CDCR may extend the standard response time at the discretion of the Institution’s CEO/CME or designee, dependent upon the urgency of the request for services. The response time shall be included on the request for service. CDCR/CCHCS reserves the right to accept a response from a lower ranked Contractor after the response time has elapsed if the Institution has not begun further canvassing efforts on the matrix.

1. The Rank 1 Contractor must be contacted before an Institution is authorized to contact the Rank 2

Contractor, and this process continues until the Institution has met its needs;

OR

2. Institution may contact multiple Contractors in order of the matrix as long as this begins with the lowest ranked Contractors (e.g. Ranks 1-5). If the first group of Contractors contacted does not respond within the allotted time, or if none of the contractors are able to provide services, the next group of Contractors (e.g. Ranks 6-10) can be contacted. This process will be repeated based on the number of Agreements awarded and start over each time the Institution contacts Contractor to request services.

8. RESPONDING TO A REQUEST FOR SERVICE

A. The Institution’s CEO/CME or designee shall approve in advance all Contractors assigned to the Agreement. If any Contractor is unable to perform any portion of this Agreement due to illness, resignation, or factors beyond Contractor’s control, Contractor shall immediately notify the Institution CEO/CME. Failure to do so may be cause for termination of this Agreement.

In the event that any contractor is dismissed or declined at a CDCR Institution, Contractor shall inform DCCS and the CEO/CME or designee, at any other Institution of which the said Contractor provides service of this fact upon notification of the dismissal.

B. Contractor shall respond to the Institution request for services within the stated response time and submit the following documents:

1. Contractor’s current Resume/Curriculum Vitae, which shall include the following information:

a) “To and from” dates (month and year) for all employment history;

b) Education shall include the following information as applicable to the service type: name and location of university or college, business, correspondence, trade, or service school; course of study; units completed (semester/quarter); diploma, degree or certificate obtained; and date completed;

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c) Name of organization for which work was performed;

d) Supervisor name and contact information for each job;

e) All relevant work history including classification/job title, job duties performed, and any other information necessary to determine qualifications of Contractor;

f) If the applicant has provided services to CDCR/CCHCS previously, the Provider must include the name of the specific Institution, to and from dates of service, and immediate supervisor’s full name and telephone number; and

g) At least two (2) professional references and their contact information.

Note: Contact information shall be current and include a valid telephone number and/or e-mail address.

C. Copies of any current and valid license(s), permits, and/or certification(s) as stated and as required by law, refer to Exhibit A Provision 5, Licenses, Permits, and Certification Requirements.

D. Responses to phone and fax inquiries without the requested documents may be deemed as non-responsive and the next ranked Contractor(s) will be contacted.

9. SCHEDULING

A. Contractor shall ensure that all Portable Diagnostic Sleep Testing Services have prior authorization in accordance with Institution UM and are mutually agreed upon between the Institution’s CEO/CME or designee and Contractor.

B. At the time of scheduling, Institution shall provide Contractor with an estimated time the institution anticipates the need for contracted services. This will be a good faith estimate based on the circumstances known to CDCR/CCHCS at the time of the request. It is not a guarantee of business and is subject to change depending on CDCR/CCHCS needs and fluctuations in the patient population. However, CDCR shall endeavor to provide five (5) business days’ notice prior to cancellation of scheduled services.

C. Contractor shall provide services to Institution at a time mutually agreed upon between the institution specialty scheduler, contract liaison, or designee and Contractor; and shall report for beginnings/endings of scheduled services in accordance with the policies and procedures of the requesting institution.

10. CANCELLATION

A. Contractor and its Providers shall give advanced written notice to the institution CEO/CME or designee prior to cancellation of scheduled services, if for reasons other than illness, as follows:

1. For scheduled services: one (1) week written notice

2. For all other scheduled services: at least twenty-four (24) hours written notice

11. OVERTIME PAY RATE ALLOWANCES

No overtime pay rate will be authorized under this Agreement.

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12. HOLIDAY PAY RATE ALLOWANCES

No holiday pay rate will be authorized under this Agreement.

13. INSPECTIONS

Inspections shall be carried out by the Institution’s CEO/CME or designee, quarterly during the Agreement term to check on the quality and quantity of work and determine acceptability of work performed before Agreement payment will be approved. The Institution Contract Analyst shall document any inconsistencies/issues found during the quarterly audits and shall report any issues to the CCHCS Direct Care Contracts Section, Contract Support Team at CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov for resolution assistance if required.

14. FAILURE TO PERFORM

A. CDCR/CCHCS shall routinely evaluate the work performance of Contractor to determine if CDCR standards and Departmental/Institutional policies and procedures are being maintained. Any contractor who fails to perform or who are physically or mentally incapable of performing the required duties as required by this Agreement shall not be permitted to perform service. The Institution’s CEO/CME or designee, shall state in writing the reason(s) Contractor did not meet the required policies or standards and submit a copy to Contractor and to the CCHCS Direct Care Contracts Section, Contract Support Team at CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov

B. CDCR/CCHCS shall not pay Contractor for any services performed by Contractor, which are deemed unacceptable in accordance with the required services contemplated by this Agreement.

C. Failure to provide services on three (3) or more occasions may result in termination of the Agreement or the Institution not having to contact a Contractor prior to contacting the other Contractors for the duration of the Agreement term. CCHCS Headquarters Direct Care Contracts Section Staff Services Manager III or designee has the sole discretion in this decision.

15. DEPARTMENT OF CORRECTIONS AND REHABILITATION CONTACT INFORMATION

A. Should questions or problems arise during the term of this Agreement, Contractor should contact the following offices:

1. Billing/Payment Issues:

California Correctional Health Care Services Healthcare Invoicing Section

P.O. Box 588500 Elk Grove, CA 95758 Phone Number: (916) 691-0699

Email: HISProgramSupport@cdcr.ca.gov

2. Scope of Work/Performance Issues:

(Please refer to Exhibit H - List of Participating CDCR Institutions)

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The Institution contract representative can be contacted Monday through Friday from 8:00 a.m.

to 4:00 p.m. The Institution’s contract liaison or his/her designee shall pre-arrange all needed services to assure continuity of care and to minimize the disruption of CDCR’s workload.

3. General Agreement Issues:

California Correctional Health Care Services – Direct Care Contracts Section

P.O. Box 588500, Building D Elk Grove, CA 95758 Phone Number: (916) 691-0698

Fax Number: (916) 691-3948 CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov