902646_Comprehensive_Medical_Services.docx

COUNTY OF ALAMEDA

REQUEST FOR PROPOSAL No. 902646 for

Comprehensive Medical Services

For complete information regarding this project, see Request for Proposal (RFP) posted at County of Alameda Procurement Portal [https://procurement.opengov.com/portal/acgov] or contact the County Thank you for your interest!

Contact Person: P. Biondi Phone Number: (510) 208-9613 Email Address: p.biondi@acgov.org General Services Agency (GSA) – Procurement

RESPONSE DUE

by 2:00 p.m.

on January 6, 2027 through Alameda County, GSA-Procurement County of Alameda Procurement Portal https://procurement.opengov.com/portal/acgov

CALENDAR OF EVENTS

ALAMEDA COUNTY GSA PROCUREMENT DEPARTMENT

AND THE ALAMEDA COUNTY SHERIFF’S OFFICE

REQUEST FOR PROPOSAL No. 902646

COMPREHENSIVE MEDICAL SERVICES

Please email your completed security form to P. Biondi – p.biondi@acgov.org

Mandatory Site Walk Through and Bidders Conference

Note: Bidders and personnel may only attend if they submit and pass the security clearance.

November 12, 2026, at 9:00 a.m. (Pacific Time)

Santa Rita Jail Santa Rita Jail Media Room 5325 Broder Blvd.

Dublin, CA 94568

At least one representative from the Bidder’s team must attend in order to be eligible to submit a bid response.

Written Questions Due via the “Question & Answer” tab of this project in the County of Alameda Procurement Portal November 13, 2026 by 5:00 p.m.

Response Due and Submitted through County of Alameda Procurement Portal

January 6, 2027 by 2:00 p.m.

Followed immediately by online Public Bid Opening which can be joined here:

Please click on the link: RFP No. 902646 Comprehensive Medical Services Public Bid Opening Meeting ID: 257 002 559 402 259 Passcode: ER2iQ3Q2

Dial in by phone tel:+14159153950,,194553335 Phone conference ID: 194 553 335# Join on a video conferencing device Tenant key: alamedacountyca@m.webex.com Video ID: 112 827 775 3

NOTE: All dates are tentative and subject to change.

Alameda County Vendor Outreach Wednesday, October 21, 2026 10:30 a.m. – 11:30 a.m.

TO ATTEND ONLINE:

Vendor Outreach Call-in: +1 415-915-3950 Conference ID: 504 517 635#

COME MEET ALAMEDA COUNTY’S

PROCUREMENT TEAM!

This public event is not specific to any RFP, where vendors can speak with GSA professionals, get to know them, and learn more about contracting opportunities with the County.

These are conducted on most Wednesdays. Dates and locations can be confirmed by checking at Upcoming Events [https://gsa.acgov.org/do-business-with-us/upcoming-contracting-events/]

COUNTY OF ALAMEDA

REQUEST FOR PROPOSAL No. 902646

SPECIFICATIONS, TERMS & CONDITIONS

for

COMPREHENSIVE MEDICAL SERVICES

TABLE OF CONTENTS

Page

ATTACHMENTS

STATEMENT OF WORK

INTENT

It is the intent of these specifications, terms, and conditions to describe qualified vendors who are interested and able to provide and coordinate comprehensive medical care services and associated systems of care for the justice-involved population at a correctional facility managed by the Alameda County Sheriff’s Office (ACSO). The selected vendor will provide medical services for the justice-involved population housed at the Santa Rita Jail (SRJ) facility located in Dublin, CA. The selected vendor must work cooperatively with ACSO, local hospitals, and the Alameda County Behavioral Health Department (ACBHD), which is responsible for providing mental health care to the justice-involved population. The provision of justice-involved health services by the Contractor must include comprehensive medical care including administering and prescribing medicine, women’s health, dental care, coordination with mental health care providers, clinic time, California-Advancing and Innovating Medi-Cal (CalAIM) Reentry coordination, and other services as more specifically identified in this RFP.

The County intends to award a three-year contract (with an option to renew for two years) to the bidder selected as the most qualified, responsible bidder whose response conforms to the RFP and meets the County’s requirements.

BACKGROUND

The County of Alameda was incorporated in 1853. It covers 738 square miles and extends from the eastern shore of San Francisco Bay to San Joaquin County. ACSO Detention and Corrections is managed by the County Sheriff, who is primarily accountable for the care, custody, and control of the justice-involved population housed in one detention facility - Santa Rita Jail (SRJ), 5235 Broder Boulevard, Dublin, CA 94568.

Approximately 52,000 justice-involved individuals are processed through the County’s detention and corrections facility each year. Due to the 2011 realignment of California’s Prison and Jail populations, the justice-involved population numbers at SRJ are in flux. The justice-involved population is cyclical, typically with a higher census during the winter months. This facility is considered a “new generation jail” in which as many services as possible are brought to the justice-involved individuals at the facility rather than bringing the individual to a separate medical facility.

SRJ

SRJ is the detention facility currently operated by ACSO. There are 17 housing units, and the facility can hold approximately 3,538 justice-involved individuals. This facility’s current average daily population is 1,500 individuals. The justice-involved population is held under contract with local, State, and Federal governments. Approximately 120 of these individuals are women. The facility includes the following areas where medical services are to be provided:

Main Clinic: Many medical services for the justice-involved population are provided at the medical clinic on the premises. The dedicated clinic area includes exam rooms, a dental clinic, and a trauma area. On average, 80 justice-involved persons are seen daily in the clinic, 400 individuals weekly, 1,600 justice-involved persons monthly, and approximately 20,000 justice-involved persons yearly. The main clinic is housed in the Core Building and contains a 20-room outpatient-housing unit (OPHU) with a total capacity of 25 beds that can accommodate convalescent care, intravenous treatment, centralized detoxification, psychological observation, on-site dialysis, and management of non-ambulatory patients.

Intake and Receiving: This holding area allows for the separation of individuals by classification and gender. A complete intake-screening clinic screens an average of 100 justice-involved persons in a 24-hour period. Mandatory tuberculosis testing is a component of the intake screening process. Pregnancy testing is conducted on a voluntary basis, and diabetes testing is conducted on an as needed basis.

SCOPE

ACSO requires a highly qualified vendor to provide comprehensive health care services for the SRJ justice-involved population. The Contractor will be responsible for justice-involved health care services immediately upon acceptance into ACSO’s custody through the intake processes at the SRJ facility, and throughout the term of custody. The selected vendor will be responsible for facilitating, paying, and coordinating all medical services provided to the justice-involved population. For services provided at outside medical sites, the Contractor will arrange and pay for outside services.

BIDDER QUALIFICATIONS

Contractor must be able to safely and securely provide and coordinate comprehensive medical care services and associated systems of care to meet the needs of the justice-involved population at the ACSO’s detention and corrections SRJ facility. Bidder must be qualified and experienced in providing comprehensive medical care services in a correctional, or a similarly secure environment. Information on the required documentation to support minimum qualifications is in Exhibit A – Bid Response Packet.

BIDDER Minimum Qualifications

a. Bidder has been regularly and continuously engaged for at least three years in providing comprehensive medical services for a population of similar size and complexity to the population at SRJ – documentation of similar size and complexity must be included, and comparability of services shall be determined at the sole discretion of the County, which must be clearly demonstrated in the bid response packet.

b. Bidder has provided services in a facility accredited with National Commission on Correctional Health Care (NCCHC) (Please refer to Exhibit D for all of the NCCHC standards of care referenced in this RFP) or a similar healthcare facilities accreditation program for at least three years, which must be clearly demonstrated in the bid response packet.

c. Bidder must possess all permits, licenses, and professional credentials necessary to supply products and perform services specified under this RFP. Unless noted otherwise in the RFP, for example the item(s) stated above, including any Addendum, Bidder is not required to submit copies or verification of the permits, licenses and credentials; however, Bidder must provide such proof if requested by County.

SPECIFIC SERVICE REQUIREMENTS

The selected bidder will be expected to provide the following services as a Contractor:

1. Contractor understands and commits to using reasonable efforts to meet all applicable 2026 NCCHC accreditation standards, along with any updates to NCCHC accreditation standards that occur during the term of the Agreement, and to collaborate with the County and facility staff in the preparation and submission of a timely application for NCCHC accreditation for services provided in the County of Alameda as well as the maintenance of such accreditation. Please refer to Exhibit D for specific standards referred to in the RFP.

2. Services - Contractor must provide comprehensive health care services for justice-involved individuals housed at the SRJ facility, including preventative services. Health care services provided under this RFP must be delivered in a manner consistent with applicable federal and state constitutional requirements and must meet or exceed generally accepted community standards of medical care. The Contractor must provide care that avoids deliberate indifference to serious medical needs and supports timely access to clinically appropriate services for all justice-involved individuals. All clinical encounters must be provided in a manner that reasonably projects confidentiality and privacy of care, consistent with security needs and the NCCHC standard for Confidentiality and Privacy Care.

Contractor will charge the ACSO based on an Average Daily Population (ADP) of 1,100 – 1,700. If the ADP exceeds the ADP range each month (over 1,700), ACSO will pay the Contractor a per diem rate per individual for the number of individuals exceeding the ADP, to be reconciled quarterly. If the ADP falls below the ADP range each month (below 1,100), the same per diem rate will be credited to ACSO using the same calculation for each month, reconciled quarterly.

Clinical decision-making regarding the diagnosis, treatment, and management of patient care must remain the responsibility of licensed health care professionals acting within their scope of practice. When custody, operational, or security considerations will impact the timely delivery of medically indicated care, the Contractor must have an established escalation process to promptly notify appropriate ACSO leadership and seek resolution in a manner consistent with patient safety, applicable laws, and 2026 NCCHC Jail Standards.

Contractor’s services must include the following minimum levels of service:

a. Intake (receiving) Health Screening - Intake health screening must be performed for all justice-involved individuals by a licensed registered nurse (RN) at the time of booking as soon as possible following admission, no later than six (6) hours after admission, in accordance with applicable NCCHC Receiving Screening standard, State, and local requirements. Booking takes place intermittently but is heaviest on the P.M. shift. The intake (receiving) health screening process must be designed and implemented to minimally accomplish the following:

(1) Identify and address any urgent or emergent health needs of individuals being admitted, including conditions requiring immediate medical, mental health, or dental intervention.

(2) Identify and address any known or readily observable health needs requiring follow-up medical, dental, and/or mental health services.

(3) Identify individuals who appear potentially contagious and ensure appropriate infection control measures, isolation, and follow-up in accordance with public health requirements.

(4) Obtain medical clearance when clinically indicated, including for housing placement, restraint use, intoxication, withdrawal risk, or other circumstances requiring health authorization.

(5) Conduct mandatory tuberculosis testing that must be started at intake in accordance with State and local standards.

(6) Contractor must have an intake pre-screening procedure for mental health issues and referrals.

b. Fourteen-Day Health Appraisal (Initial Health Assessment (IHA) - An IHA must be performed by a licensed RN of all incoming justice-involved individuals, which is fully compliant with ACSO protocols and requirements. An IHA must be performed as soon as possible following admission, but no later than fourteen calendar days after admission, in accordance with applicable NCCHC Initial Health Assessment standard, State, local, and facility standards. The IHA must include at a minimum:

(1) Review of the receiving (intake health records).

(2) Collection of additional clinical data by a licensed RN to complete a comprehensive health history, including follow-up of any abnormal findings identified during the receiving screening or subsequent encounters.

(3) Recording of vital signs by a licensed RN, including height and weight.

(4) A hands-on physical examination, appropriate to the individual’s gender, age, and identified risk factors, performed by a licensed provider or licensed RN.

(5) Laboratory and/or diagnostic testing as clinically indicated and order by the provider.

c. Sick Call (Non-emergent Health Care Requests and Services) - Justice-involved individuals must have access to essential health care services at all times. At a minimum, a licensed RN and a physician must be on duty at all times.

Consistent with applicable NCCHC Nonemergent Health Care Requests and Services standard, all individuals, regardless of housing assignment, shall be provided the opportunity to submit written or electronic non-emergent health care requests at least daily. The Contractor shall ensure that responses to health care requests are timely and sufficient to meet the health needs of the patient population, including a face-to-face encounter conducted by a qualified health care professional (QHCP), within twenty-four (24) hours of receipt by health staff, unless clinical judgment requires a more urgent response.

Contractor must conduct sick call examinations. Contractor must conduct sick call Monday through Friday. Sick call must be held in the medical rooms located in the SRJ housing areas of the facility. Additional sick call hours will be added as required to meet patient demand and clinical need.

d. Health Care Plans (Care Planning and Continuity of Care) – The Contractor must ensure that justice-involved individuals being treated at SRJ, including those receiving ongoing, chronic or specialized care, have individualized health care plans developed and Implemented by qualified health care professionals. Justice-involved individuals being treated at SRJ must have health care plans with identified health needs clear treatment goals and objectives, planned interventions, and follow-up requirements with policies, and procedures for documenting goal achievements. The IHA must be documented, monitored, and updated in the health record to support continuity, coordination, and quality of care in accordance with applicable NCCHC Continuity, Coordination, and Quality of Care During Incarceration standard, state, and local requirements.

e. Chronic Disease Management Program – Contractor must maintain a written chronic disease management program with site-implemented clinical protocols in accordance with NCCHC Chronic Disease Management and Specialized Health Care Services standard. The program must include, at a minimum, cardiovascular disease (including hypertension, hyperlipidemia), diabetes, HIV, liver disease (including hepatitis, cirrhosis), lung disease (including asthma, COPD), seizure disorders, and other special health care needs requiring treatment plans. Documentation in the health record must demonstrate that providers follow protocols as clinically indicated, including follow-up frequency based on disease control and goals, monitoring and status assessment, indicated diagnostic testing, patient education, and clinical justification for deviation from protocol.

f. Best Practices - Quality Improvement and Compliance Support - Provide ongoing recommendations to ACSO and ACBH to support evidence-based practices , continuous quality improvement (CQI), policy , policy development, and regulatory compliance. This includes assistance with policy, procedural, legal, and compliance updates necessary to remain aligned with NCCHC CQI Program standard other applicable federal, state, and local laws or standards for the entire duration of any contract.

g. Leadership and Administrative Oversight - Administrative leadership services must have cost accountability and if requested, justify medical care and responsiveness to the justice-involved individuals, and the ACSO. Administrative leadership shall support an organized and coordinated system of health care delivery, ensure that clinical decisions are made by qualified health care professionals based on patient care needs, and provide appropriate oversight and performance monitoring, consistent with applicable NCCHC Responsible Health Authority and Designated Health Staff standard.

h. Food Services - Special and Medically Indicated Diets - Provide clinical review and recommendations for all medically indicated and special needs diets. Contractor dietary recommendations and related processes must adhere to the medical dietary standards outlined in California Code of Regulations (CCR) Title 15, Section 1248, as they may change from time to time, and mist support the provision of nutritionally adequate, medically appropriate diets consistent with applicable NCCHC Nutrition Services standard.

i. Services On Site Outpatient Housing Unit Care - SRJ - Contractor must appropriately utilize the space available for use, including 25 beds in 20 rooms at SRJ to provide infirmary-level care services, in accordance applicable NCCHC Infirmary-Level Care standard. Contractor operations at the Outpatient Housing Unit (OPHU) at a minimum must include:

(1) Continuous physician on-site, 24 hours per day, 168 hours per week, Monday through Sunday, including holidays.

(2) Contractor must provide on-site supervision in the OPHU by a licensed registered nurse, 24 hours a day, 168 hours per week, Monday through Sunday, including holidays.

(3) Contractor must provide 24 hour nursing services, 168 hours per week, Monday through Sunday, including holidays.

(4) Contractor must maintain and provide an on-site copy of the Manual of Nursing Services.

(5) Separate, individual, complete and confidential medical records maintained for each individual in the contractor’s care.

j. Suicide Prevention Program – Coordinate with ACBHD, as the lead agency, in the Suicide Prevention Program. At a minimum, the contractor’s responsibilities must include:

(1) Participation in program meetings and collaboration to provide pre-screening and crisis intervention.

(2) Contractor must provide a physician to participate in the Suicide Prevention Program, including review of issues related to suicide prevention and assistance in addressing and resolving of identified concerns in accordance with applicable NCCHC standards.

(3) Contractor must work cooperatively with ACBHD and SRJ staff as appropriate.

(4) Contractor must remain clinically responsible for the health and well-being of the individuals in the Contractor’s care, including medication management, monitoring of vitals, assessment of medical needs, and confirmation of well-being in accordance of with applicable NCCHC Suicide Prevention and Intervention standard.

k. Dental Services - Provide emergency, medically necessary, and non-emergency dental services, including but not limited to extractions and dental hygienic cleanings in accordance with applicable NCCHC Oral Care standard, state, and local requirements. Dental services must be provided a minimum of 80 hours per week at SRJ unless a lesser number of hours is agreed to in writing by the Contracts Lieutenant.

(1) Based on the individual’s length of stay, clinical need, and treatment priorities listed, Contractor must provide the following dental services:

(a) Oral Screening by a trained professional will be performed as soon as possible. Notwithstanding the timing of the oral screening, instructions on oral hygiene and preventative oral education must be given within 14 days of admission, and a licensed dentist must perform an initial oral examination.

(b) Relief of pain and treatment of acute infections or dental conditions, including but not limited to hemorrhage, toothaches, loose or knocked out (avulsed) teeth, abscesses, and dry sockets after extractions.

(c) Extraction of unsalvageable teeth as clinically indicated and appropriate to the individual’s length of stay and treatment priorities.

(d) Repair of injured or carious teeth as clinically indicated and appropriate to the individual’s length of stay and treatment priorities.

(e) Removal of oral irritation conditions that may lead to malignancies (if in custody term is prolonged beyond the current average stay of 32 days.

i. Root Canals – Root canal treatment on posterior teeth (bicuspids and molars) must be provided, and such teeth will be extracted when clinically indicated. All root canals are to be completed at an off-site facility. Justice-involved individuals requiring definitive root canal treatment for anterior teeth, which are restorable with available restorative materials, may receive a root canal if the justice-involved individual’s overall dentition must fit the following conditions:

· The retention of the tooth is necessary to maintain the integrity of the dentition.

· The tooth has adequate periodontal support and a good prognosis for long-term retention and restorability.

· The tooth is restorable using American Dental Association (ADA) and the Contractor’s approved methods and materials and does not require extensive restoration including either a pin or post retained core build up.

· There is adequate posterior occlusion, either from natural dentition or a dental prosthesis, to provide protection against traumatic occlusal forces.

(f) Dental hygiene services and exams for individuals in custody for a year or more, once yearly, as clinically appropriate.

(2) Contractor must provide triage, prioritize and then schedule patients to requesting or identified as needing dental care. Patients requiring oral attention will be scheduled to see the dentist as soon as possible based on clinical priority. Dentist staff must prioritize evaluation and treatment of patients with emergent dental issues.

(3) For more complex procedures or specialized dental procedures, i.e. wisdom tooth extraction, Contractor must notify the Contract Lieutenant or the Contract Lieutenant’s designee for a referral to an outside oral surgeon in accordance with the procedures set forth in Section p., Item No. 1, Acute Care Needs.

(4) For elective or non-urgent dental care that can be safely deferred based on clinical judgement, Contractor will provide appropriate referral information and discharge guidance upon the patient’s release to support continuity of care.

l. Special Needs of Pregnant and Postpartum Women - Care for the special needs of pregnant and postpartum women, in accordance with applicable NCCHC Care of Pregnant and Postpartum standard, state and local requirements, including, but not limited to:

(1) Optional Screening and testing for pregnancy are available at the time of booking the justice-involved individual of reproductive age into the facility.

(2) Care must be provided in accordance with Pregnant Female Protocols established by statute regulation and ACSO Policies and Procedures. Any new or revised protocols must be approved in writing by the ACSO prior to implementation.

(3) When clinically indicated, referrals to and coordination with community community-based Medication Assisted Treatment (MAT) programs, including methadone Opioid and Alcohol Use Disorder treatment providers experienced in the special needs of pregnant/postpartum clients must be provided when clinically indicated.

(4) Prenatal education and counseling must be provided as clinically appropriate.

(5) Coordination of specialized medical services, if requested by the ACSO, Contractor must provide verification by supplying copies of written agreements with service providers to assure the continuous availability of the full range of routine and emergency obstetrical services including management of high-risk pregnancies and conditions.

(6) Doula services that meet obligations under AB 732 -AB-732 Reproductive Dignity for Incarcerated Individuals Act.

m. Family Planning Services - Providing family planning services pursuant to California Penal Code Sections 3409, 4023.5, and other federal, state, and local laws and regulations. Family planning services shall be provided in a manner that ensures access to clinically appropriate counseling, information, and services, consistent with applicable NCCHC Care of the Pregnant and Postpartum and Access to Care standards.

n. Prosthesis/Eyeglasses - Provide and make payment for medically necessary medical and dental prosthesis and eyeglasses, as clinically indicated. Provision of such items shall be based on clinical need, support functional health and safety, in accordance with applicable NCCHC Access to Care standard, State, and local requirements.

o. Consulting Services and Medical Equipment - Contractor must be responsible for making arrangements and payments for all consulting medical specialty services and special medical equipment (i.e., braces, crutches, etc.) as clinically indicated. Special medical equipment must be defined as durable medical equipment (DME) as set forth under Medicare Part B plans and includes, but is not limited to diabetic supplies, canes, crutches, walkers, commode chairs, wheelchairs, home type oxygen equipment, traction equipment, etc. As further defined, DME is equipment which:

(1) Can withstand repeated use.

(2) Is primarily and customarily used to serve a medical purpose.

(3) Is generally not used useful to a person in the absence of illness or injury.

(4) Is appropriate for use in the SRJ housing area, based on clinical needs and security considerations.

(5) The use of any DME within the Facilities will require the approval of the ACSO. For any major medical equipment, including but not limited to beds and seat lift mechanisms, Contractor must meet with ACSO to discuss the clinical need and determine if ACSO will purchase and retain ownership of the equipment. All consulting services and special medical equipment shall be ordered based on clinical judgment, coordinated as necessary with custody staff, and documented in the individual’s health record.

p. Hospital Care - Make arrangements to provide payments for all medically necessary in-patient and outpatient treatment required following booking. For the following services, Contractor must enter into agreements with and use the providers agreed to by the ACSO:

(1) Acute Care Needs - Medical emergencies that require care outside of the facility, for which there is unavailability of specific services, hospitalization for the acute care needs of all justice-involved individuals is primarily provided by Alameda Health System and Highland Hospital located in Oakland, however, Contactor may use another provider with the written consent of the ACSO.

(2) Emergency Room - Emergency room care for SRJ individuals is currently provided by Stanford Health Care located in Pleasanton. Contactor may use Eden Medical Center in Castro Valley for trauma injuries. Use of other emergency department providers, Contractor needs written consent by the ACSO.

(3) Mental Health Services - Mental health care for all justice-involved individuals is provided by ACBHD, through its Adult Forensic Behavioral Health division, although some acute services may be provided through an outside services provider as applicable. Contractor must work in collaboration with ACBHD and any outside mental health services provider to ensure timely access to care, continuity of treatment and coordination of medical and mental health services.

All hospital and specialty care referrals shall be based on clinical judgment, coordinated with custody staff as necessary, and documented in the individual’s health record, consistent with applicable NCCHC Emergency Services and Response Plan and Hospital and Specialty Care standards, State, and local requirements.

q. Emergency Services and Response Plan - Contractor must maintain and fund a written health services emergency response plan specific to SRJ, approved by the Contracts Lieutenant or their designee, and coordinated with ACSO custody emergency procedures. Consistent with NCCHC Emergency Services and Response Plan standard, the plan must address emergency response roles and communication; access to emergency equipment and medications, including AED/cardiac response equipment as applicable; after-hours emergency coverage; emergency transport and hospital transfer processes; and periodic review and drills as required by policy. Contractor must make every effort to take the best course of action prior to activating the EMS system.

r. Disaster – The Contractor must ensure provisions of comprehensive medical care services during a natural disaster, or declared state of emergency, or declared state of local health emergency. Contractor must develop, maintain, and implement a written contingency plan to provide essential medical services following a natural disaster, or declared state of emergency, or declared state of local health emergency, including coordination with custody and external response agencies, in accordance with NCCHC Emergency Services and Response Plan standard, State, and local requirements.

s. AIDS/HIV Services - Contractor must cooperate with the Alameda County Public Health Department’s Office of HIV Care and Prevention, as well as local planning bodies and community groups – Oakland Transitional Grant Area (TGA), HIV Education and Prevention Project of Alameda County (HEPPAC), East Bay Getting to Zero (EBGTZ), and Alameda AIDS Research Coalition (AARC) to support ongoing HIV/AIDS education, prevention and linkage within the Detention and Corrections facilities. AIDS/HIV testing must be provided as clinically indicated consistent within current community standards of care or upon the ACSO staff request, pursuant to Labor and Health and Safety Codes. All HIV testing must be done in accordance with state law and informed consent requirements. When clinically indicated, the Contractor shall support referral, follow-up, and continuity of care, including coordination with public health and community providers.

t. Ancillary Services - Provide and arrange for laboratory, diagnostic tests, and other ancillary health services as clinically required. Ancillary services may be performed off-site when necessary but must preferably be provided on-site whenever feasible. Laboratory services performed on site must include, but are not limited to:

(1) Dipstick Urinalysis

(2) Finger stick blood glucose

(3) Pregnancy Testing

(4) Stool Blood Testing

(5) Contractor will provide medically- necessary diagnostic laboratory testing through the approved laboratory. Whenever possible, laboratory tests will be conducted on- site. Laboratory testing includes routine, special chemistry, and toxicology analysis as clinically indicated.

(6) Contractor will coordinate with the approved laboratory to ensure timely specimen pickup, processing, and delivery of accurate reporting within 24 hours, when clinically appropriate.

(7) Within 24-48 hours, the physician, or other qualified healthcare professional will review the date and initial laboratory data upon receipt of test results. Once reviewed, the results must be filed in the patient’s health record, and a plan of care must be established as appropriate. Critical or crisis level results must be reported immediately to the supervising physician or responsible provider for timely clinical action.

u. Radiology Services – Contractor must enter into agreements with and use radiology providers approved by the ACSO to provide on- site radiology services. Contractor must provide a list of at least one (1) other radiology providers within Alameda County. ACSO shall not unreasonably withhold approval of any provider not previously approved. No approval under this service shall be unreasonably withheld by the ACSO. Radiology services will include but are not limited to the following as clinically indicated:

(1) X-Ray Services

(2) Ultrasound Services

(3) Sonograms

(4) Doppler Studies

(5) Holter monitor studies

(6) Contractor must use the on-site digital X-ray facility, staffed by a qualified X-ray technologist, to maximize use of on-site X-ray services, unless clinical circumstances require off-site imaging.

(7) A board-certified or board-eligible radiologist will interpret all X-rays and radiology results. The site physician will review all initial radiology results, document findings in the individual’s health record, and develop and implement a follow-up care plan as clinically indicated.

v. Electrocardiogram Services

(1) Contractor must provide ECG services on site and is responsible for all equipment supplies, and maintenance required to perform these services in accordance with applicable NCCHC On-Site Diagnostic Services standard, state, and local requirements.

(2) Contractor must have all studies reviewed and interpreted by a qualified provider – including a physician, nurse practitioner, or physician’s assistant, acting within their scope of practice, and may have a cardiologist provide an over-read as deemed clinically appropriate. ECG results must be documented in the individual’s health record, reviewed by the site provider, and incorporated into the plan of care as clinically indicated, in accordance with applicable NCCHC On-Site Diagnostic Services standard, State, and local requirements.

w. Dialysis

(1) Contractor must enter into agreements with and use providers made available by the ACSO to provide on-site dialysis services, including equipment, labor, and supplies. Contractor must provide a list of at least one (1) other dialysis provider within Alameda County. ACSO shall not unreasonably withhold approval of any provider suggested by Contractor. Should previously approved providers not be available, the use of a provider not previously approved by the ACSO must be approved by the Contract Lieutenant or the Contract Lieutenant’s designee. No approval under this section shall be unreasonably withheld by the ACSO. Hemodialysis services will be provided three (3) times per week, or more frequently if clinically indicated to justice-involved individuals who have been medically determined to require such treatment. Dialysis services shall be provided in a manner that ensures timely access, continuity of care, patient safety, and medical oversight, in accordance with NCCHC Chronic Disease Management and Specialized Health Care Services standard.

(2) If the need for dialysis increases, Contractor must work collaboratively with the ACSO-approved providers and ACSO to manage services within the jail to accommodate any increased patient volume, including utilization of two (2) dialysis chairs, staffing adjustment, scheduling modifications, and coordination of care as clinically indicated. Contractor shall must ensure that dialysis care is integrated into the patient health record, monitored for effectiveness and complications, and coordinated with off-site specialty and hospital services when necessary.

x. Diagnostic Records - The County anticipates a transition to a new electronic health records (EHR) EPIC record system. While the County intends for EPIC contract negotiations, readiness, implementation, and go-live to align with the contract start date, the Contractor acknowledges that EPIC implementation timelines may occur prior to, concurrently with, or extend beyond the contract start date based on County readiness, vendor dependencies, and regulatory or operational considerations. If the EPIC EHR system has not gone live as of the contract start date, Contractor must provide and utilize their own EHR system upon start of the contract. Upon EPIC go-live, Contractor must convert over to the EPIC EHR system at the Contractor’s expense and must deliver all historical and active patient medical records from their EHR system.

y. The Contractor must cooperate fully with the County, its EHR implementation partners, and EPIC in all phases of planning, readiness, implementation, testing, training, data migration, and go-live activities, regardless of the final implementation timeline. Failure to cooperate with EHR transition activities or to maintain continuity of care during EHR implementation may be deemed a material performance issue under breach of the Contract.

z. Contractor must provide diagnostic results electronically through the EHR system. If the County transitions to the EPIC records system, the contractor will be required to use this system after the transition occurs. Laboratory and Radiology reports will be integrated into the patient’s health record via secure electronic interface functionality when available. If a results interface is not used or temporarily unavailable, diagnostic, results may be manually entered, and/or reports scanned or uploaded into individual’s health record , provided that documentation is complete, accurate, timely, and legible.

aa. EPIC Licensing Fees and Costs. Upon installation and implementation of the EPIC System by the County, the Contractor shall be responsible for the payment of all applicable annual fees, licensing fees, subscription fees, maintenance fees, renewal fees, and other recurring costs associated with the continued operation, access, and use of the EPIC System. The amount and allocation of such costs to be paid by the Contractor. Any agreed-upon costs and payment terms shall be documented in writing and incorporated into the Contract, as applicable.

ab. Electronic-consultation – The County strongly recommends the Contractor, at their own expense, use electronic consultation (e-consult) to provide near real time access to consultations with a panel of medical specialists. Using e-consult, Contractor’s on -site physicians, and mid-level providers can access specialists in any one of the 24 specialties and 35 subspecialties available through e-consult, including infectious disease, orthopedics, and cardiology. These e-consult services may be used to support the clinical decision making, including confirming the need for an off off-site specialty referral or providing specialty guidance to support appropriate on-site management thereby reducing any unnecessary off site referrals while ensuring timely clinically appropriate care. All e-consults requests, specialist recommendations, and resulting clinical decisions must be documented in the patient’s health chart. When an off-site referral is clinically indicated and approved, appointments must be scheduled and coordinated in a timely manner, and follow-up care shall be documented to ensure continuity and coordination of care, in accordance with NCCHC Access to Care (J-A-01), Hospital and Specialty Care, and Continuity, Coordination, and Quality of Care During Incarceration standards. E-Consult consult is not a substitute for actual medical diagnosis.

ac. Detoxification from Drugs and Alcohol - Provision of detoxification and withdrawal management services must be provided in accordance with the applicable NCCHC state and local standards. Contractor must implement evidence-based protocols for the identification, monitoring, and treatment of individuals experiencing or at risk for substance withdrawal, including alcohol, opioids, and other substances, to ensure patient safety and timely clinical intervention.

Contractor must provide an Opioid Use Disorder maintenance/detoxification program or a clinically equivalent community-based MAT program and must obtain and maintain all licenses certifications and regulatory approval required to operate the program. Services must be provided by qualified health care professionals, with appropriate medical oversight, documentation, and continuity of care.

Contractor must assure that justice-involved pregnant women with histories of substance abuse or dependency are evaluated on-site by registered nurses immediately upon identification and referred within four (4) hours for high-risk obstetrical evaluation. Contractor must coordinate and pay for enrollment and assessment services, and continuation of care for pregnant individuals with opioid use disorder, including referral to methadone maintenance or other approved MAT programs, and must ensure coordination with obstetrical and specialty providers to support maternal and fetal health, in accordance with NCCHC Services for Substance Use Disorder and Care of the Pregnant and Postpartum Patient standards.

ad. California Advancing and Innovating Medi-Cal Program (CalAIM) - The CalAIM program is mandated by the State of California and the Federal government. Contractor must coordinate and provide pre-release health services and care management, as applicable, to support continuity of care for the justice-involved individuals at Santa Rita Jail upon reentry to the community, consistent with DHCS CalAIM Justice-Involved guidance and NCCHC Access to Care and Continuity, Coordination, and Quality of Care During Incarceration standards. Contractor must maintain minimum staffing for CalAIM designated services including but not limited to Medi-Cal application assistance, 30-day supply of release medications, mental health and substance use disorder treatments. and These services may be reduced and/or eliminated if funding for CalAIM services is withdrawn by the state or federal government. The ACSO reserves the right to modify and/or terminate CalAIM services and/or positions listed in the staffing matrix and shall provide a 30-day written notification to the Contractor.

(1) CalAIM Claim Services – Contractor must utilize and support a third party contractor and/or EPIC to do the following:

(a) Prepare and submit claims for in-custody medical services reimbursable under CalAIM from federal and state Medi-Cal Funds via the Department of Health Care Services or the Medi-Cal Managed Care Plan via Kaiser Permanente or the Alameda Health Alliance.

(b) Ensure claims are accurate, complete, and submitted within ninety days from the date of the provision of services when eligibility is determined and all necessary information has been provided to the third party biller in order for a clean claim to be submitted.

(c) Monitor claims status and follow-up as necessary to ensure payment is received.

(d) Resubmit claims that are denied or require additional documentation.

(e) Reconcile payments received with submitted claims to ensure accurate accounting.

ae. Medi-Cal County Inmate Program (MCIP) - coordinate and facilitate MCIP eligibility of inmates and Medicaid payment for Medi-Cal covered services by using reasonable best effort to facilitate MCIP eligibility. Contractor must provide County and/or designated third-party billing contractor with all documentation that may be required to facilitate claiming of or reimbursement for the cost of Medi-Cal services covered by the county. https://www.dhcs.ca.gov/provgovpart/Pages/MIP.aspx

(1) Contractor must notify the County of any inmate who may have a hospital stay longer than 24 hours. County will begin the process of obtaining Medi-Cal or any other third-party coverage and reimbursement. Contractor must provide all necessary information in the medical file as may be needed to secure coverage and reimbursement.

af. Comprehensive MAT Services -

(1) Comprehensive MAT services for individuals diagnosed with or clinically indicated for treatment of Opioid Use Disorder (OUD) while in Santa Rita Jail (SRJ). MAT services must include screening, clinical assessment, initiation, continuation, and maintenance of FDA approved medications for OUD (including all forms of buprenorphine, methadone, and naltrexone), as clinically indicated.

(2) MAT services must be delivered in accordance with generally accepted medical and correctional health standards of care, including guidance issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the standards implemented by the National Commission on Correctional Healthcare (NCCHC), and the Americans with Disabilities Act (ADA). Additionally, the contractor must ensure continuity of MAT for individuals entering SRJ already receiving such treatment and must coordinate with community-based treatment providers and reentry partners to support continuity of care upon release, consistent with California justice-involved reentry initiatives administered by the California Department of Healthcare Services (DHCS Justice-Involved Reentry Initiative).

ag. Hearing/Language Interpreters - Contractor must be prepared, have available, and coordinate the use of qualified and hearing and language interpreters to ensure that health screening and the provisions of medical services are accessible to all justice-involved individuals in accordance with NCCHC, state, and local standards. Contractor must provide and bear all costs associated with hearing and language interpreter services required for medical care, which must include all intake screenings, health assessments, clinics and clinical encounters, sick call, specialty clinics, diagnostic services, and all medical related appointments, as needed, required and/or requested by the justice-involved individual.

Interpreter services must be provided in a manner that ensures effective communication, patient understanding, informed decision-making, and continuity of care, and shall be appropriately documented in the health record when utilized, consistent with NCCHC Access to Care standard. Only when absolutely necessary, and after reasonable efforts by the Contractor to secure interpreter services, may the Contractor request assistance from ACSO in order to meet this obligation.

ah. COVID-19 Testing – Contractor must supply and administer COVID-19 testing and vaccinations for justice-involved patients upon when symptoms are reported, or when clinically indicated, in accordance with NCCHC Infection Prevention and Control standard, local, State, and federal public health guidance, including requirements issued by the California Department of Public Health (CDPH) and the Centers for Disease Control and Prevention (CDC).

ai. Infection Prevention and Control and Environmental Inspections - Consistent with NCCHC Infection Prevention and Control standard, Contractor must implement a site-specific Infection Prevention and Control Plan, evaluated at least annually by the responsible physician or designated provider, and must maintain documentation of required infection control activities, including sterilizer use and maintenance logs and monthly documented inspections of health service areas confirming that clinical areas are clean and sanitary and that equipment is inspected and maintained.

aj. On-Site Specialty Clinic and Ancillary Services – The County has historically utilized a range of on-site specialty clinic services and frequencies to meet population needs. Bidders may reference such service categories in their proposals but are encouraged to recommend service levels supported by clinical rationale. Clinic descriptions for specialty clinics are as indicated below. The specialty clinics to be provided are:

(1) Optometry

(2) Orthopedics

(3) Physical Therapy

(4) Obstetrics

(5) AIDS/HIV

(6) Radiology

(7) Tuberculosis

(8) Asthma

(9) Diabetes

(10) Hypertension

(11) Seizure

(12) Lipid and Coumadin

(13) Ultrasound

(14) Dialysis

(15…