5._Exhibit_A_SOW.pdf

California Department of Corrections and Rehabilitation (CDCR)/ Bid Number: SD23-00088 California Correctional Health Care Services (CCHCS) Exhibit A Scope of Work

Rev.8/25/2024 Page 1 of 8

OCULAR PROSTHESIS SERVICES AND DEVICES

1. Introduction/Services

a. This is an Agreement in which Contractor and/or Provider shall provide on-site Ocular Prosthesis Services and Devices on an as-needed basis to patients referred for such health care services from California Department of Corrections and Rehabilitation/California Correctional Health Care Services (CDCR/CCHCS) Institutions within Region four (4).

b. For purposes of this Agreement, “Contractor” is the party hereby contracting with CDCR/CCHCS and who is presumed to be qualified to have an active role under this Agreement as Provider of Ocular Prosthesis Services and Devices. Additionally, Contractor is also presumed to have a relationship with other providers for availability purposes in order to provide Ocular Prosthesis Services and Devices as needed to meet the requirements of this Agreement.

c. For purposes of this Agreement, the term “Provider” shall refer to any Provider who renders Ocular Prosthesis Services and Devices pursuant to this Agreement, as arranged through and/or associated with Contractor, as Contractor’s employee, independent contractor, and/or sub-contractor. Provider includes Contractor with respect to any instance or capacity, in which, Contractor is, or may be, acting as an Ocular Prosthesis Services and Devices Provider.

d. Contractor and/or Provider must provide all labor, equipment, supplies, staff, transportation, licenses, permits, certificates, and every other item of expense necessary, or incurred in providing Ocular Prosthesis services and devices, including any expense anticipated or incurred by Contractor and/or Provider associated with travel to and from an institution. This includes, but is not limited to lodging, food, or any other travel expenses, as well as any expenses associated with work-related training and shall be the sole obligation of Contractor and/or Provider incurring the expense. CDCR/CCHCS has no obligation to pay or reimburse any such expense incurred by Contractor and/or Provider. Any lost/damaged equipment costs due to CDCR/CCHCS negligence will be negotiated with CCHCS Direct Care Contracts Section (DCCS).

e. Services shall be provided at the direction of the Institution Chief Executive Officer/Chief Medical Executive (CEO/CME) or designee. For purposes of this Agreement, CDCR/CCHCS designee must be a civil service employee. The institution CEO/CME or designee retains professional and administrative oversight for services provided. The responsibility of CDCR/CCHCS to provide Ocular Prosthesis Services and Devices is limited to those services which are reasonable and medically necessary to protect life, prevent significant illness or disability, or alleviate severe pain that significantly disables the patient from reasonable independent function, and are supported by outcome data as being effective care.

f. Any service requested under this Agreement is subject to the prior authorization requirement and all other requirements, processes, and limitations expressed herein, such as the request and scheduling process, and/or other limitations and requirements as imposed by law.

g. Contractor and/or Provider shall perform services pursuant to this Agreement, and in accordance with CDCR/CCHCS policies and procedures, federal and state laws and regulations. Contractor and/or Provider shall, at all times, comply with standard safety precautions and maintain CDCR security measures and a safe work environment.

CDCR/CCHCS Bid Number: SD23-00088 Scope of Work Exhibit A

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h. Contractor and/or Provider must possess and maintain throughout the term of this Agreement, valid and unconditional licensure and/or board certification with no pending accusations from the applicable boards by which they are licensed and/or certified to practice in their area of medical specialty.

i. Contractor bears the responsibility for the provision of ocular prosthetic services and devices and performing any associated task in a manner consistent with the commonly accepted standard of care. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of Contractor and/or Provider. CDCR/CCHCS does not assume, agree to, or otherwise accept a duty to defend or indemnify a provider against any civil or criminal action arising out of or in association with this Agreement.

j. Contractor and/or Provider agrees that any excluded health care service or treatment needed for pre-existing conditions shall be provided only in the event that the condition has become exacerbated in such a manner that it poses a significant threat to the patient’s current health and if not treated would result in morbidity and/or mortality. Contractor and/or Provider acknowledges that the health care service or treatment must be recognized as medically necessary.

k. Contractor and/or Provider shall ensure that all ordered health care services and proposed surgical procedures shall be scheduled consistent with the severity of the medical need. Once scheduled, services shall be delivered at the time scheduled, unless unavoidable circumstances occur.

2. Contractor and/or Provider Responsibilities

a. Contractor and/or Provider must provide services to all institutions awarded on Exhibit B-1 Bid Rate Sheet, and meet the requirements specified in Exhibit A-1 Service Specifications.

Contractor and/or Provider must provide the State with proof of any required training, licenses, permits, certifications, and any other required documents as stated in Exhibit A-1 Service Specifications and as required by law. Services will be performed only by the contractor and/or Provider who meet the requirements outlined in this Agreement.

b. Standards of Obligation

(1) Contractor and/or Provider must acknowledge and adhere to the CDCR/CCHCS medical staff bylaws, rules, regulations, policies, and procedures as directed by the institution CEO/CME or designee and comply with universal infection control precautions.

(2) Contractor and/or Provider recognize that CDCR/CCHCS acts in a fiduciary capacity to the State of California (the State) and that this fiduciary duty extends to the provision and management of medical health care services, mental health care services, and dental services for the patients of the State of California. To assist CDCR/CCHCS in its exercise of this duty, Contractor and/or Provider shall provide high quality services, consistent with the terms and conditions under this Agreement and consistent with established and commonly accepted standards and principles of medical practice. Nothing in this Agreement shall supersede the common law rules for the interpretation of established and commonly accepted standards and principles of medical practice.

c. Reports

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CDCR/CCHCS reserves the right to request that Contractor and/or Provider submit reports or information related to this Agreement. Report submission details shall be determined by CDCR/CCHCS. Such details may include, but are not limited to, the need for additional information pertaining to a provider; name, social security number, date of birth, etc. Non-compliance with requests for reports or information may result in termination of the Agreement.

The reports shall be submitted no later than forty-five (45) calendar days of request.

The reports shall be submitted in a secure HIPAA compliant electronic format (Microsoft Excel 2000 or newer version) and sent via electronic mail (email) to

CCHCSHealthCareContractsHelpDesk@cdcr.ca.gov. In the event that email is not available the reports can be sent via U.S. Mail to the following address:

California Correctional Health Care Services Attn: Direct Care Contracts Section P.O. Box 588500, Building D Elk Grove, CA 95758

d. Representatives

Contractor is responsible for establishing a designated representative(s) to work with DCCS staff to avoid unreasonable delay in the provision of the services delivered pursuant to this Agreement. Such representative(s) may be changed upon written notice to the other party.

e. Prior Authorization for Treatment

Excluding emergency care services, prior authorization must be obtained in writing from the institution CEO/CME or designee, in accordance with CCHCS’ Utilization Management (UM) Plan. Contractor and/or Provider shall complete and return all forms required by CDCR/CCHCS regarding treatment of patient. Authorization must be documented in the patient Electronic Health Record in all cases of essential services as well as any consultations by specialty physicians or diagnostic procedures not specifically stated in a CDCR/CCHCS prior authorization form. Except for emergency care, CDCR/CCHCS shall not render payment for services that do not have prior authorization; and/or if CDCR/CCHCS determined services were not medically necessary or if services were inappropriately delivered.

f. Experimental and Investigational Drugs and Procedures

Contractor and/or Provider shall not perform or administer to any patient any experimental or investigational treatment, therapy, procedure, or drug. Any such treatment, unless it is related to specific California legislative provisions, is prohibited under Penal Code, section 3502, and thus requires prior authorization from the appropriate institution CEO/CME or designee.

Contractor and/or Provider shall perform or administer only those health care services which are recognized as being in accordance with generally accepted professional medical standards, or as being safe and effective for use in the treatment of an illness, injury, or condition at issue.

g. Exclusions and Limitations

(1) Contractor and/or Provider agree that no health care service or treatment shall be provided consistent with the exclusions indicated in California Code of Regulations (CCR), title 15, section 3999.200. Contractor and/or Provider may request approval for individual case mailto:CCHCSHealthCareContractsHelpDesk@cdcr.ca.gov

Rev. 8/25/2024 exceptions for excluded or limited health care service or treatment by seeking prior approval of the institution CEO/CME or designee.

(2) Contractor and/or Provider shall be able to perform the tasks associated with providing the above health care services under the scope of their license and assume full responsibility for the provision of these services.

h. Required Notices

Except as otherwise provided in this Agreement, any notice required hereunder shall be deemed to be sufficient if sent via email or U.S Mail to CDCR/CCHCS contact information located in Provision 13. If U.S. Mail is used to give any notice required in this Agreement, notice shall be deemed as given on the day after it is deposited in the United States mail with First Class postage prepaid and addressed to CDCR/CCHCS. Only actual written notice will suffice for the purpose of meeting any notice requirement in this Agreement.

3. Request for Services

a. Contractor and/or Provider agree to provide on-site direct health care services as arranged with the institution CEO/CME or designee upon request, in accordance with each institution’s policies and procedures. Normal hours of clinic operation are Monday through Friday between the hours of 7:00 a.m. and 4:00 p.m. (PST).

b. Contractor shall have a telephone number and email address, as well as a designated representative available by telephone and/or email during normal business hours, Monday through Friday (excluding holidays), 8:00 a.m. to 5:00 p.m. (PST) for the duration of the Agreement. Telephone answering devices (i.e., message machines) and answering services are not permitted, and their use may be cause for termination of this Agreement. The initial contact shall be by telephone and CDCR/CCHCS will follow-up with email.

c. The State reserves the right to award multiple Agreements for back-up purposes. When services are needed, CDCR/CCHCS may, at the discretion of the institution CEO/CME or designee, choose one of the options below when contacting Contractors to request services.

1) The Rank 1 Contractor must be contacted prior to an institution authorization to contact the Rank 2 Contractor, this process continues until the institution has met its needs; or

2) Institution may contact multiple Contractors in order of the bid matrix as long as this begins with the lowest ranked Contractors (e.g. Ranks 1-3). If the first group of Contractors contacted do not respond within two (2) hours or if none of the contractors are able to provide services, the next group of Contractors (e.g. Ranks 4-6) can be contacted. This process will be repeated based on the number of Agreements awarded and will start over each time the institution contacts Contractors to request services.

d. Contractors with multiple agreements for the same service and same institution shall be obligated to provide services at the same rates in the primary contract until all the obligations under the primary contract are attained before the secondary or subsequent contract can be in effect. The only exception to this provision occurs when the rate(s) in a subsequent agreement is lower than those of the primary agreement; the State then has the sole right to determine which rate(s) will be applied.

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e. Contractor acknowledges that the institution may request services at any time, including weekends and holidays.

4. Responding to a Request for Service

a. Contractor shall respond to institution request for services within the standard response time of two (2) hours, unless otherwise stated by CDCR/CCHCS. CDCR/CCHCS may extend the response time, at the discretion of the institution CEO/CME or designee, and 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 higher ranking Contractor(s) after the response time has elapsed.

b. Contractor and/or Provider shall respond to the institution request for documentation, which may include but is not limited to: copies of any current and valid licenses, permits, and/or certifications, unless already on file. A response without the necessary or requested supporting documentation as described above may be deemed as non-responsive and the next ranked Contractor(s) will be contacted.

5. Scheduling

a. Contractor and/or Provider shall ensure that all ordered services have prior authorization in accordance with institution UM and are mutually agreed upon between the institution CEO/CME or designee and Contractor.

b. At the time of scheduling, institutions shall provide Contractor and/or Provider with an estimated period of 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’s fluctuations in CDCR patient population. However, CDCR/CCHCS shall endeavor to provide five (5) business days’ notice prior to cancellation of clinics.

c. Contractor shall provide services to the institution at the time mutually agreed upon between the institution Contract Liaison or designee and Contractor.

6. Overtime Pay Rate Allowances

No overtime pay will be authorized under this Agreement.

7. Holiday Pay Rate Allowances

No holiday pay rate will be authorized under this Agreement.

8. Telephonic Consultations

No telephonic consultations will be authorized under this Agreement.

9. Orientation and Training

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At the discretion of each institution, Contractor and/or Provider agrees that prior to reporting to work at the institution; all providers shall complete orientation/training as specified below at Contractor’s sole expense:

a. On-site Institution Orientation/Training

Contractor agrees that all providers shall attend on-site orientation and any other required training (i.e. annual block training and Learning Management System [LMS]) prior to reporting to work at the institution. Orientation/training is designed to assist providers to become familiar with the operations of the institution, its medical facilities, and title 15 of the CCRs. To maintain continuity of services and ensure safety for all workers, Contractor shall make available to the institution only those providers who have completed the orientation.

b. Self-Certification Orientation Process

This process may be utilized in place of attending an on-site institution orientation based on institution approval. The parties agree that there will be no reimbursement for assigned providers who have been approved to utilize the Self-Certification Orientation Process.

(1) Contractor shall obtain a copy of the Health Care On-Site Contractor’s Orientation Handbook from institution and return the signed copy of the CCHCS Orientation Acknowledgement form once complete.

(2) Contractor shall be responsible for ensuring that all providers complete the orientation and sign the Self-Certification Acknowledgement.

(3) Contractor shall maintain the signed copies (new and renewed) of the CCHCS Orientation Acknowledgement and provide to CDCR/CCHCS upon request.

10. Inspections

Inspections shall be carried out by the institution CEO/CME or designee, at various times 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.

11. Failure to Perform

a. CDCR/CCHCS shall routinely evaluate the work performance of Contractor and/or Provider to determine if CDCR/CCHCS standards and departmental/institutional policies and procedures are being met. Any Contractor and/or Provider who fails to perform or who is physically or mentally incapable of performing the required duties as required by this Agreement shall not be permitted to perform services. The institution CEO/CME or designee shall state in writing the reasons Contractor and/or Provider did not meet the required policies or standards and submit a copy to the DCCS Help Desk at CCHCSHealthCareContractsHelpDesk@cdcr.ca.gov.

b. CDCR/CCHCS shall not pay Contractor and/or Provider for any services performed by Contractor and/or Provider which are deemed unacceptable in accordance with the requirements of this Agreement.

c. Failure to provide services on three (3) or more occasions may result in termination of the mailto:CCHCSHealthCareContractsHelpDesk@cdcr.ca.gov

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Agreement or the institution not having to follow the Request for Service Provision (3)(c) for the duration of the Agreement term. DCCS Staff Services Manager III (SSMIII) or designee has the sole discretion to make this decision.

12. Suspension or Stop Work Notification

a. CDCR/CCHCS may, at any time, for any reason, issue a written notice to suspend performance or stop work under this Agreement. Upon receipt of said notice, Contractor and/or Provider are to suspend and/or stop all, or any part, of the work called for by this Agreement.

b. Written confirmation of the suspension or stop work notification with directions as to what work (if not all) is to be suspended and how to proceed will be provided within thirty (30) calendar days of the written notification. The suspension or stop work notification shall remain in effect until further written notice is received from CDCR/CCHCS. The resumption of work (in whole or part) will be at the discretion of CDCR/CCHCS and upon receipt of written confirmation.

c. Upon receipt of a suspension or stop work notification, Contractor and/or Provider shall immediately comply with its terms and take all reasonable steps to minimize or halt the incurrence of costs allocable to the performance covered by the notification during the period of work suspension or stoppage.

d. Within thirty (30) calendar days of the issuance of a suspension or stop work notification, CDCR/CCHCS shall either:

1) Cancel, extend, or modify the suspension or stop work notification; or

2) Terminate the Agreement as provided for in the Right to Terminate clause of the Agreement.

e. If a suspension or stop work notification issued under this clause is cancelled, or the period of suspension or any extension thereof is modified or expires, Contractor and/or Provider may resume work only upon written approval of CDCR/CCHCS.

f. If the suspension or stop work notification is cancelled, and the Agreement resumes, changes to the services, deliverables, performance dates, and/or contract terms resulting from the suspension or stop work notification shall require a written amendment to the Agreement signed by both parties.

g. CDCR/CCHCS shall not be liable to Contractor and/or Provider for loss of profits because of any suspension or stop work notification.

13. Amendments

The State is executing this Agreement for a period of thirty-six (36) months. If it is determined to be in the best interest of the State, the State may extend the term of the Agreement for an additional twelve (12) months through an amendment signed by both parties. Rates submitted in this Agreement shall remain in effect for any amendment throughout the term of the Agreement.

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14. Department of Corrections and Rehabilitation Contact Information

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

a. Billing/Payment Issues:

Goods/Durable Medical Equipment Sacramento Regional Accounting Office Attention: Accounts Payable “A” P.O. Box 187015 Sacramento, CA 95818-7015 Email address: APA.invoices@cdcr.ca.gov

Services/Procedures California Correctional Health Care Services Attention: Healthcare Invoicing Section PO Box 588500 Elk Grove, CA 95758 Phone Number: (916) 691-0699 Email address: m_HISProgramSupport@cdcr.ca.gov

b. Scope of Work/Performance Issues:

Refer to Exhibit H - List of Participating CDCR Institutions for addresses and telephone numbers. The institution contract liaison can be contacted Monday through Friday from 8:00 a.m. to 4:00 p.m. The institution contract liaison or designee shall pre-arrange all needed services to assure continuity of care.

c. General Agreement Issues:

California Correctional Health Care Services Direct Care Contracts Section P.O. Box 588500 Elk Grove, CA 95758 Phone Number: (916) 691-0698 CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov mailto:APA.invoices@cdcr.ca.gov mailto:m_HISProgramSupport@cdcr.ca.gov mailto:CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov