6._Exhibit_A-1_Service_Spec.pdf

California Department of Corrections and Rehabilitation (CDCR)/ Bid Number: SD23-00088 California Correctional Health Care Services (CCHCS) Exhibit A-1 Service Specifications

Rev. 8/25/2024

OCULAR PROSTHESIS SERVICES AND DEVICES

1. Contractor and/or Provider Qualifications

Contractor and/or Provider providing services to California Department of Corrections and Rehabilitation/California Correctional Health Care Services (CDCR/CCHCS) institutions within Region four (4) under this Agreement must have the minimum experience outlined below:

a. Minimum of twelve (12) continuous months of experience within the last three (3) years performing services similar in scope to those defined herein, in a public or private setting.

Internship/apprenticeship does not count towards the required experience.

b. Proficient in the English language and be able to communicate effectively, orally and in writing, CDCR/CCHCS patients and staff.

Contractor and/or Provider who fail to meet the minimum qualifications shall not be permitted to provide services. The institution Chief Executive Officer/Chief Medical Executive (CEO/CME) or designee shall state in writing the reason(s) Contractor and/or Provider does not meet minimum qualifications and submit it to Contractor and to CCHCS, Direct Care Contracts Help Desk at CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov. After notification of failure to meet minimum qualifications has been provided, CDCR/CCHCS shall not pay Contractor and/or Provider for any additional services identified as not meeting the minimum qualifications.

2. Licenses, Permits, and Certification Requirements

Contractor and/or Provider must have the required licenses, permits, and/or certifications as stated below and as required by law prior to providing services as outlined in this Agreement.

Contractor and/or Provider shall:

a. Possess and maintain throughout the term of this Agreement, a current and valid certification, accredited by the National Examining Board of Ocularists. Refer to California Code of Regulations (CCR), Title 22, Division 3, Subdivision 1, Chapter 3, Article 3, Section 51248, Ocularist.

b. Possess and maintain throughout the term of this Agreement, a current and valid Basic Life Support and/or Advanced Cardiovascular Life Support certification(s), accredited by the American Heart Association or the American Red Cross. Contractor shall ensure all medical and professional staff, and subcontractors are duly licensed, permitted, and/or certified, and absent of restrictions on said licensure, certification, and/or registration, as required by the applicable boards and by the laws of the State.

c. Provide copies of any current licenses, permits, and/or certifications for all medical and professional staff, and subcontractors providing services under this Agreement, to the institution CEO/CME or designee, to be kept on file at the institution, throughout the term of the Agreement. Contractor and/or Provider shall render current licenses, permits, and/or certifications to CDCR/CCHCS no 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 revoked, suspended, inactive, or not in compliance, CDCR/CCHCS may withhold payment mailto:CCHCSHealthcareContractsHelpDesk@cdcr.ca.gov

CDCR/CCHCS Bid Number: SD23-00088 Service Specifications Exhibit A-1

Rev. 8/25/2024 for services rendered during the expiration period and/or immediately terminate this Agreement.

d. Assume responsibility for verifying through the appropriate certification boards that no current or unresolved disciplinary actions have been taken by State authorities against Contractor or Provider assigned to CDCR/CCHCS, and that all licenses are active and void of misconduct.

CDCR/CCHCS may verify the status of Contractor and/or Provider assigned at its discretion.

3. Contractor and/or Provider Responsibilities

At the request of the institution CEO/CME or designee, Contractor and/or Provider shall render services and devices as permitted within the scope of practice for ocular prosthetic services and devices, in accordance with institution policies and procedures. Duties/responsibilities shall include, but are not limited to:

a. Adherence to CDCR/CCHCS and State laws, regulations, policies, and procedures, regarding patient confidentiality, written and electronic medical record documentation, and the release of patient records.

b. Ensure prosthetic equipment brought on-site for the performance of the contracted duties meets all regulatory compliance, and calibrations, including any requirements for sterilization.

CDCR/CCHCS institutions reserve the right to request verification of equipment compliance prior to equipment being brought into the institution, and throughout the term of this Agreement as necessary. CDCR/CCHCS is not responsible for ensuring storage or compliance of the equipment. Equipment shall not be stored overnight at an institution.

c. Provide a minimum of twenty-four (24) hours written notice prior to bringing into the institution any prosthetic equipment that has not specifically been authorized by CDCR/CCHCS institution. Approval must be obtained by the institution prior to arrival.

d. Possess a minimum number of providers to provide services to all institutions awarded on Exhibit B-1 Bid Rate Sheet, who meet the requirements specified in Exhibit A–1 Service Specifications.

e. If Contractor and/or Provider is unable to perform due to illness, resignation and/or factors beyond Contractor’s control, Contractor shall immediately submit qualifications of proposed provider to the institution for approval. The institution CEO/CME or designee, shall approve, in advance, proposed providers assigned to this Agreement. Failure to do so may be cause for termination of this Agreement. The institution shall be notified of any changes to Contractor’s list of providers at least five (5) business days before the provider’s report date.

f. If Provider is dismissed or declined at an institution, Contractor shall immediately provide notification of the dismissal to the institution CEO/CME or designee at any other institution, of which said provider renders services.

g. Contractor and/or Provider shall ensure that all ordered health care services are medically necessary and 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. Contractor and/or Provider shall be able to perform the tasks associated with providing the above health care services, and assumes full responsibility for the provision of these services.

Rev. 8/25/2024

h. Contractor and/or Provider shall evaluate each patient and provide custom ocular prosthetic devices to match a patient's companion eye, if necessary. Contractor and/or Provider is responsible for fabricating, shaping, fitting, inserting, and maintaining custom ocular conformers, ocular prostheses, and scleral shells for patients with ocular conditions.

Contractor and/or Provider shall be responsible for all follow-up care of the custom ocular prosthetic devices to ensure proper and accurate fitting within the eye socket. No compensation shall be made to Contractor and/or Provider for additional modifications and/or adjustments to the ocular prosthetic device. The institution CEO/CME or designee has sole discretion, as to the acceptability of work rendered by Contractor and/or Provider.

(1) Contractor and/or Provider shall deliver or have available the ocular prosthetic device to the patient within fifteen (15) business days after initial consultation.

(2) Contractor and/or Provider shall provide education on the proper care, cleaning, removal, and insertion of the ocular prosthesis device to the patient and CDCR/CCHCS staff.

(3) Contractor and/or Provider shall make appropriate recommendations concerning the patient examined and follow referring physician’s orders. Contractor and/or Provider shall ensure that evaluations and documentation meet all requirements and standards set by the institution.

(4) Contractor and/or Provider shall ensure patient notes, consultation and progress reports are documented, as required, in the patient Electronic Health Record System and/or outpatient health report.

(5) Contractor and/or Provider shall appropriately document the need for additional consultation, diagnostic, and/or treatment/surgical services using CDCR 7230 Interdisciplinary Progress Notes form and shall refer the patient back to the primary care physician for follow-up.

(6) Contractor and/or Provider shall provide warranty for the ocular prosthetic device and services performed for a minimum of one (1) year from date of final fitting. If it is determined that failure has occurred due to a defective ocular prosthetic device or workmanship, Contractor and/or Provider shall correct the failure at no additional expense to the State. Correction shall occur during normal State business hours, upon request, by the institution CEO/CME or designee. If the failure cannot be corrected, Contractor shall issue a reimbursement of the cost of the ocular prosthetic device.

(7) Contractor and/or Provider shall maintain continuity of all work performed. Contractor and/or Provider shall repair/maintain new and existing ocular prosthetic devices upon request of the institution CEO/CME or designee. Contractor and/or Provider shall make every effort to provide the same Ocularist on an ongoing, as-needed, basis for the term of this Agreement.

Reimbursement shall be made only for ocular prosthetic devices not under warranty and shall be paid by the State in accordance with the CCR, Title 22, Division 3, Subdivision 1, Chapter 3, Article 7, Section 51519, Eye Appliances.

Rev. 8/25/2024

4. ACKNOWLEDGEMENT OF DUTIES

a. Contractor

As Contractor, I hereby certify that I have read the above Ocular Prosthesis Services and Devices Service Specifications including Contractor and/or Provider Qualifications; Licenses, Permits and Certification Requirements; and Contractor and/or Provider Responsibilities and that I understand the duties/responsibility required to successfully perform the services stated herein.

b. Additional Provider hired by Contractor

As the Provider hired by Contractor, I hereby certify, that I have discussed the above Ocular Prosthesis Services and Devices service specifications including Contractor and/or Provider Qualifications; Licenses, Permits and Certification Requirements; and Contractor and/or Provider Responsibilities. I understand the duties/responsibilities required to successfully provide the services stated herein.

Print Name of Contractor’s Representative Signature Date

Print Name of Provider Signature Date