6-DHHS25038 Attachment B Scope of Work.docx
DOCX document 4 MB Posted
- Attached to
- Audiology Services
- Solicitation number
- DHHS25038
- Issued by
- Utah
About this file
This Scope of Work document outlines audiology services for the Utah Department of Human Services (DHHS) at Utah State Correctional Facility (USCF) and Central Utah Correctional Facility (CUCF). The contractor shall provide comprehensive on-site audiology services including basic and comprehensive hearing evaluations, hearing aid evaluations with air, bone, speech, and discrimination testing, tympanometry, acoustic reflex testing, pure tone audiometry, and additional tests as requested with prior written approval. Services include on-site testing and hearing aid fitting for inmates diagnosed with moderate or significant hearing loss, with recommended hearing aids to be provided and installed during the initial on-site visit. The contractor must deliver ordered hearing aids within 7 to 10 days of order placement and complete off-site repairs within two weeks. All test results and recommendations must be submitted to the DHHS Scheduling Coordinator within 5 business days of service completion. The contractor is responsible for on-site repair and adjustment of hearing aids at no additional charge and must maintain access to the DHHS Electronic Health Record System for patient information review.
The contractor must hold a current Utah Division of Professional Licensing Audiologist License with no disciplinary actions and comply with the Speech-Language Pathology and Audiology Licensing Act (Utah Code 58-41) and the Hearing Instrument Specialists Licensing Act (Utah Code 58-46a), submitting copies of current licenses annually. A 15 percent discount applies to additional services requested by DHHS. The contractor must submit quarterly reports detailing outcome measures including the percentage of scheduled services fulfilled within 7-10 business days, percentage of test results submitted within 5 business days, percentage of hearing devices delivered and fitted within 14 calendar days, number of repairs completed during on-site visits, and percentage of delivery delays. Monthly invoices must include the contractor's name, payment address, phone number, contract number, invoice number and date, and detailed service information including hours worked. All contractor and subcontractor employees must submit background information including names, birth dates, driver's license numbers, and social security numbers, and must comply with all security measures when entering prison property.
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Other files
| File | Type | Posted |
|---|---|---|
| 8-DHHS25038 Attachment F Score Sheet.xlsx | XLSX spreadsheet | |
| 5-DHHS25038 Attachment C (a) Conflict of Interest Form.pdf | ||
| 4-DHHS25038 Attachment C (b) Conflict of Interest Certification UGE.pdf | ||
| 3-DHHS25038 Attachment D W9.pdf | ||
| 7-DHHS25038 Request for Proposal.docx | DOCX document | |
| 1-DHHS25038 Attachment A DHHS Client Service Terms.docx | DOCX document | |
| 10-DHHS25038 Attachment E Technical Response.docx | DOCX document | |
| 2-DHHS25038 Attachment H Submission Checklist.docx | DOCX document | |
| 9-DHHS25038 Attachment G Cost Proposal Sheet.xlsx | XLSX spreadsheet | |
| 11-DHHS25038 Attachment I CHS Addendum.docx | DOCX document |
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Text version
ATTACHMENT B: SCOPE OF WORK
Audiology Services
Article 1
PURPOSE
1.1 Purpose. The purpose of this contract is to provide all-inclusive audiology services to inmates of the DHHS, Utah State Correctional Facility and Central Utah Correctional Facility including on-site hearing evaluations, fitting and maintenance of hearing aids, and minor repairs.
Article 2
QUALIFICATIONS
| 2.1 | Qualifications. The Contractor shall: |
| (1) | have and maintain a Utah Division of Professional Licensing, Audiologist License (with no disciplinary actions), and provide services in accordance with the Speech-Language Pathology and Audiology Licensing Act, Utah Code §58-41, and the Hearing Instrument Specialists Licensing Act, Utah Code §58-46a; |
(2) submit copies of current Utah professional licenses to DHHS annually; and
(3) notify DHHS in writing immediately of any restriction, suspension, revocation, or other disciplinary action affecting any required license.
Article 3
SERVICE REQUIREMENTS
3.1 Services. The Contractor shall:
(1) conduct the following audiology services:
(A) basic hearing evaluation;
(B) hearing aid evaluation including air, bone, speech, and discrimination;
(C) comprehensive audiometric examination;
(D) tympanometry;
(E) acoustic reflex;
(F) pure tone audiometry; and
(G) any additional tests requested by the audiologist, subject to prior written approval by DHHS and the Contractor shall apply a 15% discount to such services;
(2) conduct all services, including testing and hearing aid fittings, on-site;
(3) submit inmate test results, reports, and recommendations directly to DHHS Scheduling Coordinator after the test/evaluation is completed;
(4) during the on-site visit, provide and install the recommended hearing aid(s), for any inmate diagnosed with moderate or significant hearing loss;
(5) provide DHHS with written confirmation of the order and deliver the product within 7 to10 days of order being placed;
(6) repair or adjust hearing aids and related equipment on-site at no additional charge, and provide a brief written description of the issue and the inmate’s offender number during the next DHHS on-site visit;
| (7) | provide a receipt to DHHS, including the anticipated delivery date and ensure delivery within two weeks for hearing aids requiring off-site repairs; |
| (8) | update DHHS with delivery status and notify reasons for delay or inability to meet the delivery timeline; |
| (9) | have access to the DHHS Electronic Health Record System to review patient information, as needed; |
| (10) | submit to DHHS the names, birth dates, driver's license numbers and social security numbers of all current and new employees of the Contractor as well as those of any subcontractor employees engaged in performing services under this Agreement; |
(11) ensure all employees, the Subcontractor and Subcontractor’s employees entering prison property cooperate with all security measures; and
(12) be responsible for the Subcontractor’s performance standards and payment.
Article 4
OUTCOMES
| 4.1 | Expected Outcomes. The Contractor shall provide comprehensive, accurate, and timely all-inclusive audiological services to ensure that inmates with hearing loss receive the support necessary to participate in correctional programs and activities. |
| 4.2 | Outcome Measures. DHHS shall track the following outcome measures: |
| (1) | percent of scheduled on-site audiology services fulfilled within 7–10 business days of request; |
(2) percent of audiology test results and recommendations submitted to DHHS within 5 business days of the on-site service date;
(3) percent of recommended hearing devices delivered and fitted within 14 calendar days of the initial fitting during the on-site visit;
(4) number of hearing aid repairs completed during on-site visits; and
(5) percent of delays in hearing device delivery.
| 4.3 | Reporting Requirement. The Contractor shall submit quarterly reports to the DHHS designee as follows: |
| (1) | in a format provided or approved by the DHHS designee; |
(2) on or before 30 days after the end of each quarter; and
(3) the report must include:
(A) results and data for each of the outcome measures in 4.2;
(B) summary of services provided, including number of inmates tested, evaluated, and provided with hearing aids or repairs;
(C) any identified barriers to service delivery and proposed corrective actions; and
(D) status update on any corrective action plans, if applicable.
Article 5
BILLING REQUIREMENTS
5.1 Billing. The Contractor shall submit monthly invoices to the DHHS designee that include:
(1) the Contractor’s name, payment address, phone number, and signature;
(2) contract number;
(3) invoice number;
(4) invoice date; and
(5) details of services billed including hours worked.
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