6._Exhibit_A-1_Service_Spec_Sample.pdf

California Department of Corrections and Rehabilitation (CDCR)/ California Correctional Health Care Services (CCHCS) Service Specifications

Bid Number: SD24-00021 Exhibit A-1

Rev. 6/10/2025

PROSTHETIC AND ORTHOTIC SERVICES AND DEVICES

1. Contractors and/or Providers Qualifications

Contractor and/or Provider providing services to California Department of Corrections and Rehabilitation/ California Correctional Health Care Services (CDCR/CCHCS) institutions 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 does not count towards the required experience.

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

Contractor and/or Provider(s) who fail to meet the minimum qualifications shall not be permitted to perform services. The Institution Chief Executive Officer/Chief Medical Executive/ (CEO/CME) or designee and/or facility Associate Director (AD) 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, Contract Support Team at m_contractsupport@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 American Board for Certification in Orthotics, Prosthetics & Pedorthics. Refer to California Code of Regulations (CCR), Title 16, Division 13.5.

b. Possess and maintain throughout the term of this Agreement, a current and valid Basic Life

Support (BLS) and/or Advanced Cardiovascular Life Support (ACLS) certification(s), accredited by the American Heart Association or the American Red Cross.

c. 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.

d. 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/AD 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 CCHCS/CDCR 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 for services rendered during the expiration period and/or immediately terminate this Agreement.

SAMPLE

mailto:m_contractsupport@cdcr.ca.gov

CDCR/CCHCS

Service Specifications

Bid Number: SD24-00021 Exhibit A-1

Rev. 6/10/2025

e. 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 Providers referred by 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 Providers assigned.

f. Contractor and/or Provider(s), regardless of vaccination or accommodation status, may be subjected to mandatory COVID-19 testing as required by CDCR/CCHCS. Contractor and/or Provider(s) shall follow further directions regarding the COVID-19 requirements released by

CDCR/CCHCS.

3. Contractor and/or Provider Responsibilities

At the request of the institution CEO/CME/AD or designee, Contractor and/or Provider shall render services and devices as permitted within the scope of practice for prosthetic and orthotic 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 submit qualifications of a proposed provider to the institution for approval as soon as possible but no more than five (5) business days before the provider’s report date. The institution CEO/CME/AD 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 a provider is dismissed or declined at an institution, Contractor shall immediately provide notification of the dismissal to the CEO/CME/AD or designee of all other institutions where said provider renders or plans to render services.

g. Contractor and/or Provider shall ensure that all ordered health care services shall be scheduled

Bid Number: SD24-00021 Exhibit A-1

Rev. 6/10/2025 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.

h. Contractor and/or Provider service responsibilities include, but are not limited to, initial patient evaluation, device fabrication, device molding, device fitting and adjustment, casting and cast changes, and/or application of dressings. Contractor and/or Provider shall be responsible for all follow-up care of custom prosthetic and orthotic devices to ensure proper fitting and function.

No compensation shall be made to Contractor and/or Provider for additional modifications and/or adjustments to the prosthetic and/or orthotic device. The CEO/CME/AD or designee has sole discretion, as to the acceptability of work rendered by the Contractor and/or Provider.

(1) Contractor and/or Provider shall deliver or have available the prosthetic and orthotic devices to the patient within six (6) weeks of approval after initial consultation.

(2) Contractor and/or Provider shall provide education on the proper care, cleaning, removal, and insertion of the prosthetic and orthotic 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 and/or outpatient health report.

(5) Contractor and/or Provider shall document the need for additional consultation, diagnostic, and/or treatment/surgical services and shall refer the patient back to the primary care physician for follow-up.

(6) Contractor and/or Provider shall provide warranty for prosthetic and orthotic devices.

Prosthetic devices provided shall be for a minimum of one (1) year from date of final fitting.

All orthotic devices shall be warranted for six (6) months from date of delivery. If it is determined by the institution that failure has occurred due to a defective prosthetic or orthotic 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 CEO/CME/AD or designee. If the failure cannot be corrected, Contractor shall issue a reimbursement of the cost of the prosthetic and orthotic device.

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

Bid Number: SD24-00021 Exhibit A-1

Rev. 6/10/2025

4. Acknowledgement of Duties

Contractor

As Contractor, I hereby certify that I have read the above Prosthetic and Orthotic Services and Devices – Contractors and/or Providers Qualifications; Licenses, Permits and Certification Requirements; and Contractor and/or Provider Responsibilities and that I understand the duties required to successfully perform the services stated herein.

Additional Provider Hired by Contractor

As Provider hired by Contractor, I hereby certify, that I have discussed the above for Prosthetic and Orthotic Services and Devices – Contractors and/or Providers Qualifications; Licenses, Permits and Certification Requirements; and Contractor and/or Provider Responsibilities with Contractor and that I understand the duties required to successfully perform the services stated herein.

Print Name of Contractor’s Representative Signature Date

Print Name of Provider Signature Date