9594CS22Q0062 - 7-20-22.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

RFQ IFB RFP

SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NAICS:

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

8 (A)

EDWOSB

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

RSC220013 57

9594CS22Q0062

William E. Hall, william.hall@csosa.gov 202-220-5717

Net 30

See Section F Same as Block 9

Court Services and Offender Supervision Agency Office of Financial Management 800 N. Capitol St., NW, Seventh Floor Washington, DC 20002-4260

See Continuation Pages

N/A

621111

$12.0 M

07/20/2022

08/17/2022

12:00 PM EST

Court Services and Offender Supervision Agency Office of Procurement 800 N. Capitol St., NW, Suite 7066 Washington, DC 20002-4260

9594CS22Q0062

RSC Medical Services

Continuation of SF1449

Blocks 19 through 24 Continued:

Block 25 Accounting and Appropriation Data:

To be Completed at Award

SECTION B - SUPPLIES OR SERVICES

B.1 Services. Contractor shall provide services in accordance with the Statement of Work (Section C).

B.2 Contract Type. This is a non-personal health care services Firm Fixed Price (FFP) Labor Hour (LH) type purchase order, under which the Contractor is an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment.) There are no materials or travel included in this purchase order.

B.3 North American Industry Classification System (NAICS) and Small Business Size Standard. The NAICS Code for this purchase order is 621111 Offices of Physicians (except Mental Health Specialists). The Small Business Size Standard is $ 12.0 M.

B.4 Contract Funding. The Contractor is not authorized to exceed the obligated value on this purchase order. Per Section F.1, this purchase order has a base period of twelve months and 1 twelve month Option Period.

B.5 Invoicing. This is a Firm Fixed Price (FFP) Labor Hour (LH) purchase order based on the pricing contained in Attachment J-7, Pricing Tables. The Contractor is expected to provide the

Item SOW Labor Category Quantity Unit Not-to-Exceed

Amount 0001 RSC Medical Services 1 Lot TBD

Item SOW Labor Category Quantity Unit Not-to-Exceed

Amount 1001 RSC Medical Services 1 Lot TBD

Base Period: 12 months after date of award

Option Period 1: 12 months after exercise of the Option Period

TBD Base and All Option Periods Not-to-Exceed Amount level of services identified in Attachment J-1, Staffing Schedule, on a daily basis, and invoice monthly, in accordance with the invoicing guidance contained in Section G.3, and only for those services actually provided.

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 Agency Mission. The Court Services and Offender Supervision Agency (CSOSA) is an independent, executive branch Federal Agency, established under Section 11232 of the National Capital Revitalization and Self- Government Improvement Act of 1997. The Act effectuated the reorganization and transition of functions relating to pretrial services, parole, adult probation and offender supervision in the District of Columbia to a Federal arena. The mission of the CSOSA is to increase public safety, prevent crime, reduce recidivism, and support the fair administration of justice in close collaboration with the community.

C.2 Background. The RSC is a residential facility that provides intensive assessments and reintegration programming for high-risk offenders and defendants (hereinafter referred to as "Resident s") with extensive substance abuse, withdrawal, mental health, co-occurring disorder, and psycho-sexual histories, who are under the supervision of CSOSA (pre-trial, probation, or parole). Residents referred to the RSC receive evaluation, counseling, treatment readiness, and referral services to other treatment facilities. The RSC can house 102 individuals (15 woman for 42 days and 87 men for 28 days) per day.

C.3 Scope of Work. The Contractor shall provide all necessary personnel, labor, and supervision required to provide a full range of medical services at the RSC in accordance with the requirements specified herein, on a firm, fixed unit price basis.

C.4 Description of Services. RSC medical services are designed to provide primary health care services to residents to promote a healthy environment within the facility. RSC strives to provide access to medical care for the purpose of supporting each resident's successful placement into an appropriate treatment program. To accomplish this goal, the Contractor shall provide on-site services 16 hours/day, 7 days per week in accordance with the Staffing Schedule provided as Attachment J-1. The services shall include, but not be limited to, providing physical examinations to include an oral health exam, psychiatric screenings and evaluations, infection control, laboratory testing, and medication administration/management, access to medical personnel (as necessary), health education and wellness programs, and health advice for each resident.

C.5 Medical and Psychiatric Service Requirements

C.5.1 The Contractor shall provide services in compliance with all federal and local regulations and professional standards that relates to the provision of medical and psychiatric services in a residential facility.

C.5.2 The Contractor shall comply with standards defined by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor (USDOL), the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), the American Correctional Association (Adult Community Residential Services, 4th edition), the Commission on Accreditation of Rehabilitation Facilities (CARF), unless specifically modified by the Government.

C.5.3 Pre-Admission Referral Review. The Contractor shall support the RSC admission determination process by reviewing referral documentation submitted on behalf of individuals recommended for program placement, when warranted.

C.5.3.1 Upon receipt of a referral package from RSC staff, the Contractor shall review the referral documentation to determine the individual's medical ability to successfully participate in the RSC program. When completing the review, the Contractor shall assess the following areas:

• Complicating Medical Conditions - to ensure the absence of any complicating medical conditions for which the individual will require frequent external medical appointments or specialized medical equipment.

• Medication Compliance - to ensure that any pre-existing medical or mental health conditions are adequately stabilized by appropriate medications.

• Ambulatory Abilities - to ensure the requisite ambulatory abilities and physical stamina required to participate in the RSC program.

• Self-Care - to ensure the individual's ability to provide basic self-care (i.e., hygiene, etc.) during the RSC program.

C.5.3.2 The Contractor shall complete the review and render a medical suitability decision, or request for additional medical information, to the RSC staff, in writing, within two business days of receipt of each referral package. When necessary, RSC staff will coordinate with the referral source to obtain any additional medical information requested by the Contractor.

C.5.3.3 Upon receipt of the additional information, the Contractor shall complete a secondary review and render a decision to the RSC staff, in writing, within one business day of receipt of the additional information. In the event that the referral source is unable to supply the requested information, the Contractor shall render a decision (based on the original referral documentation) within one business day of notification of the unavailability of additional information.

C.5.4 Intake Processing. To ensure suitability for RSC placement, the Contractor shall conduct comprehensive medical and psychiatric intake assessments between the hours of 8:30 and 4:00 PM, within twenty-four hours of an individual’s arrival at the RSC. (Note: No intake assessments will start after 4:00 PM and under no circumstance will an intake assessment continue after 10:30 PM.)

C.5.4.1 Scheduling Notification/Medical Log.

C.5.4.1.1 Scheduling Notification. As the number of residents scheduled for intake will vary each day, the RSC staff will provide the Contractor with a daily intake roster by 4:00 p.m. each day that identifies all planned admissions for the following day.

C.5.4.1.2 Medical Log. Residents arriving at the Medical Unit for services are required to sign-in on the Medical Intake Log. The Contractor shall monitor the log to ensure timely services are being rendered to all residents.

Once the services are rendered, the Contractor shall document in the log the date, time and type of service(s) completed and contact the designated Unit for resident pick-up from the Medical Unit.

C.5.4.2 Release Authorizations/Consent to Treatment. Prior to initiating the medical intake assessment, the Contractor shall obtain the resident’s signature on all required medical releases of information and consent to treatment documentation. In the event that a resident refuses to consent to the examination process (including laboratory services), the Contractor shall immediately notify the designated RSC staff member, who shall be responsible for resolving the issue. The Contractor shall not perform an examination on any resident without the resident's express consent, as evidenced by a signature on the consent forms.

C.5.4.3 Intake Recordation. Within five business days of the medical intake assessment, the Contractor shall record the complete medical intake assessment results (e.g., medical screening, baseline physical, and lab work) in the resident's treatment file and provide the assigned RSC Unit Manager with a signed form that indicates the medical intake assessment completion date and the resident's health status.

C.5.4.4 Assessment Protocol. Once signatures are obtained on the release and consent documentation, the Contractor shall administer a comprehensive assessment, which shall include, at a minimum, the following:

• Medical and Psychiatric Screening.

• Baseline physical, to include oral health exam, and test for communicable diseases “TB, Covid-19, etc., or as directed”.

• Co-occurring Disorders Resident Intake screening Medication Assessment.

• Addiction Stability.

• Routine blood work and urine specimens which will be sent out for laboratory testing within 24 hours (Monday through Friday) or within 72 hours (weekends and holidays).

C.5.4.4.1 Female Assessment Protocol. In addition to the complete physical examination provided to all residents during the intake medical assessment, female residents shall receive the following additional medical assessments:

• Gynecological and obstetrical history, including sexual activity and any rape history;

• Pregnancy test (urine or blood) for females of childbearing age and other tests as clinically indicated;

• Breast and pelvic examination. A female staff member shall be present when a male provider performs a breast or pelvic examination; and

• Pap smear; chlamydia, gonorrhea and other endo-cervical cultures from vaginal and/or anal orifices when clinically indicated.

C.5.4.4.1.1 Pregnancy.

C.5.4.4.1.1.1 When pregnancy is confirmed, the medical staff shall determine the stage of pregnancy (i.e., trimester). The medical staff shall provide the resident with the appropriate referral information for outside counseling services related to pregnancy options. If it is determined that the resident is beyond the second trimester, the resident's admission shall be denied.

C.5.4.4.1.1.2 If a resident informs the medical staff that she has decided to terminate the pregnancy, the medical staff shall follow the procedures outlined in the RSC Operational Instruction on Medical Services.

C.5.4.4.1.2 Birth Control. The medical staff shall provide female residents with the appropriate birth control information, if the resident expresses interest. However, birth control medication shall only be prescribed based upon a medical determination to treat:

• Menstrual irregularity caused by hormonal imbalance

• Symptoms related to menopause.

C.5.4.4.1.3 Mammogram. When clinically indicated, female residents shall be referred by the Contractor to a local community facility for a mammogram. These appointments shall be coordinated with the RSC Counseling Staff in order to arrange government provided transportation to and from appointments.

C.5.5 Psychiatric Intake Assessment.

C.5.5.1 The Psychiatrist shall conduct individual psychiatric assessments of those residents with a known history of mental illness to identify core psychiatric information to determine each resident's ability to respond to, and benefit from, treatment interventions. The purpose of these assessments shall include, but not be limited to, determining if the resident meets the acceptance criteria for admission into the RSC, confirming or ruling out prior psychiatric diagnoses, and assisting RSC staff in making recommendations and dispositions. During the assessment process the Psychiatrist may identify the need to prescribe or refill psychotropic medications. If the resident is already connected with a health care program that can provide access to prescription services, the Psychiatrist will collaborate with RSC staff to coordinate medication acquisition. If the resident is not connected with a health care program that can provide prescription services, the Psychiatrist will prepare a prescription, which will be processed in accordance with Section C.5.7.4.

C.5.5.2 Psychiatric Assessment Report. No later than one business day following completion of the psychiatric assessment, the Psychiatrist shall prepare and submit a report that summarizes the findings of the assessment utilizing the RSC Psychiatric Assessment form. The summary report shall, at a minimum, contain the following information:

• Resident Identification Information (Name, PDID Number, etc.);

• Report Due Date;

• Evaluation Date;

• Nature of the Evaluation Request (i.e., confirmation of a diagnosis, etc.); and

• Narrative Summary or Response to Assessment Request / Assessment

Results (including recommendations for how the case should be handled during continued RSC participation and subsequent treatment/supervision interventions).

Completed reports shall be incorporated into the resident's treatment file and a copy shall be hand delivered to the designated Unit.

C.5.6 Medical Detoxification. In the event that the medical intake assessment reveals a need for medical detoxification due to recent substance use, the Contractor's staff performing the assessment shall terminate the assessment and verbally notify the designated RSC staff member, who shall report to the Medical Services Unit to monitor the resident while the Contractor prepares written documentation to reflect the need for detoxification. Upon receipt of the documentation, the designated RSC staff member shall coordinate with the referral source to identify an appropriate detoxification placement.

C.6.7 Medication Intake Assessment. To ensure proper medical care is provided to residents during their RSC stay, the Contractor's medical intake assessment shall include an assessment of medications currently prescribed to each resident, and shall identify the need for any additional medications (prescription and non-prescription).

C.6.7.1 Residents who are admitted to the RSC with a current prescription and medication supply shall be required to turn over the medication to RSC staff during the intake process. The medication will be provided to the

Contractor for review during the medical intake assessment.

C.6.7.2 When reviewing medication brought into the facility by a resident, the Contractor shall adhere to all CSOSA policies and procedures related to container observation, medication compliance assessment, and refill procedures.

C.5.6 Treatment File Creation and Management. The medical intake assessment shall result in the creation of an individual resident medical treatment file that shall be organized as follows:

Section 1: Laboratory Reports Section 2: Diagnostic/X-Ray Reports Section 3: Medication and Treatment Information Section 4: Medical History Section 5: Psychiatric History Section 6: Medical Consultations Section 7: Dental (Note: even though the Contractor is not providing Dental services, if an RSC Resident is referred to dental services outside the RSC, the reason for that referral along with a copy of the dental provider’s report should be incorporated into the Resident’s medical treatment file.

Section 8: Other Medical Documentation Section 9: Administrative Documentation (Consents for Treatment, Releases of

Information, DC Healthcare Enrollment documentation, etc.)

C.5.6.1 Treatment File Entries. The Contractor is required to document all resident encounters in the resident's treatment file within one business day of the contact in accordance with the CSOSA policies and procedures governing RSC medical services. Resident encounters may include intake assessments, and routine or emergency appointments.

C.5.6.2 Treatment File Storage and Removal. The Contractor shall ensure that all treatment files are maintained within the Medical Services Unit. To ensure proper tracking of treatment files, the Contractor shall establish a treatment file protocol to ensure that access to treatment files by all staff members (RSC staff and medical staff) is controlled.

C.5.6.3 Treatment File Disposition upon Residents' Discharge. CSOSA shall provide the Contractor with written notification of each resident's departure date from the RSC. The Contractor shall ensure that all treatment files are surrendered to the appropriate RSC Unit Administrative Assistant within three business days of each resident's departure from the RSC. The Contractor is prohibited from maintaining information on RSC residents after the resident's discharge from the program.

C.5.6.4 Treatment File Maintenance. Each resident's treatment file must be maintained in accordance with Federal Confidentiality Regulations, 42 CFR, Part II.

C.5.7 Sick Call. The Contractor shall ensure that residents have access to medical care, as necessary, during their RSC stay by operating a "Sick Call" system. Sick Call is an organized method for treating a resident's health problems through a regularly scheduled triage procedure.

C.5.7.1 Sick Call Requests. The Contractor shall ensure the availability of Sick Call requests by placing request forms and a locked box or other securely locked document receptacle in a visible area on each occupied residential unit within the RSC. RSC staff will ensure that all residents are oriented to the process for requesting medical appointments during the intake and orientation process.

C.5.7.2 Sick Call Hours. The Contractor shall provide appropriate staff to ensure Sick Call coverage seven days per week, during the hours of 7:30 to 9:30 AM and 4:00 to 6:00 PM, or as otherwise required based on need.

C.5.7.3 Review and Triage Procedures. The Contractor shall ensure that Sick Call requests are reviewed at least twice each day, in accordance with the Government's policies and procedures governing RSC Medical Services.

C.5.8 Individual Psychiatric Intervention/Consultation Services. The Psychiatrist shall schedule and provide individual consultation and follow-up to residents. Staff will request review of medication(s) prescribed by using the RSC Psychiatric Consultation Request Form.

C.5.8.1 Purpose. The purpose of these consultations shall include, but not be limited to, confirming or ruling out prior psychiatric diagnoses, and assisting CSOSA staff in making recommendations and dispositions.

C.5.8.2 Psychiatric Contact Note. No later than one business day following a consultation, the Psychiatrist shall complete a Psychiatric Contact Note, which shall be filed in the resident’s treatment file and contains, at a minimum, the following information:

• Resident's Identification Information (Name, PDID Number, etc.).

• Consultation Focus, Session Date, and Time.

• Summary of the Consultation to include a Narrative Summary of any significant information relevant to the resident's participation in the group.

C.5.8.3 Psychiatric Progress Notes. No later than one business day after a follow-up consultation, the Contractor shall complete a Psychiatric Progress Note, which shall be filed in the resident's treatment file and contains, at a minimum, the following information:

• Resident's Identification Information (Name, PDID Number, etc.),

• Consultation Focus, Session Date, and Time, and

• Summary of the Consultation to include a Narrative Summary of any significant information relevant to the resident's response to medication.

C.5.9 Medication Management Services.

C.5.9.1 The Contractor shall be accountable for all aspects of the medication management services, to include, but not be limited to, prescribing, dispensing, inventory control, ordering, order verification (upon receipt from the supplier), and disposal/return of unused medication. The Contractor shall have in place a written policy or guidelines on how medications are managed and shall comply with all federal and local laws concerning the acquisition, storage and access to pharmaceuticals. Additionally, the Contractor, utilizing a government vehicle provided for this purpose only, shall retrieve prescriptions ordered from pharmacies associated with private insurers.

C.5.9.2 During each resident's participation in the RSC program, the Contractor shall support the RSC's efforts to connect residents with publicly-funded medical care and medication services or private insurance, as appropriate.

To accomplish this goal, the Contractor shall:

• Ensure that all eligible, uninsured residents complete the paperwork necessary to enroll in the District of Columbia's Health Care System (i.e., DC Healthcare Alliance) within 72 hours of admission.

• Ensure that all residents infected with HIV or AIDS are processed for enrollment in the DC AIDS Drug Assistance Program (ADAP) within 72 hours of admission.

• Retrieve ordered prescriptions from pharmacies associated with private insurers utilizing a CSOSA provided vehicle.

C.5.9.3 CSOSA Formulary. The Contractor shall prescribe medications from CSOSA's approved formulary. At no time shall the Contractor procure or administer medications that are not purchased by or ordered through CSOSA. CSOSA is not responsible for medications ordered that are not listed on the formulary. With the exception of the medications that are identified as "stock meds" on the CSOSA formulary, the Contractor’s prescriptions shall be resident specific.

C.5.9.4 Medication Tracking. All medication requests shall be presented to the designated Medical Staff for dispensation from the on-site medication supply or for acquisition from the Government's pharmacy source. The Contractor is responsible for maintaining a log of medication utilization by resident, as well as complete inventory control of all medications in the possession of the Contractor.

C.5.9.5 Prescriptions.

C.5.9.5.1 The Contractor shall prepare a prescription, and use the CSOSA order forms to place orders for medications. The Contractor shall complete the:

• Resident's First and Last Name,

• Resident's PDID number,

• Resident's Unit Assignment

• Medication name, dosage, and frequency of administration,

• Number of refills,

• Date the prescription was issued,

• Signature of the Contractor staff member authorized to issue the prescription, and

• Resident's allergies or sensitivities.

C.5.9.5.2 In the event that a resident requires medication prior to his/her connection with the DC Healthcare Alliance, the Contractor is permitted to prescribe medications contained in the RSC Formulary. When ordering medication from the approved formulary, the Contractor shall take measures to ensure that each resident is prescribed only the amount required for dispensation prior to connection with DC Healthcare. Certain HIV/AIDS medications are available in 3-day and 7-day supplies (as indicated on the formulary). The Contractor shall take measures to ensure that such dosages are prescribed, when medically appropriate.

C.5.9.6 Controlled Substances. Due to the nature of the RSC program, the Contractor shall not prescribe any controlled substances for use by residents, nor shall the Contractor approve the admission of referred individuals who require administration of such controlled substances. For purposes of this purchase order, "controlled substances" are those substances that are identified in Schedules I through V of the US Controlled Substance Act of 1970.

C.5.9.7 Medication Protocol. Any medication brought into the RSC by a resident shall not be administered until the medication is identified by the Medical staff and the Physician's written order for approval is documented in the resident's treatment file. Medication not approved shall be stored and returned to the resident at the time of discharge.

C.5.9.8 Medication Administration. The Contractor shall ensure that all medications are administered in accordance with the prescribing physician's orders.

The Contractor shall ensure that "watch-take" procedures are implemented when each resident takes medication(s). Once the resident appears to have taken the required medication(s), the Contractor shall require the resident to open his/her mouth to ensure that the medication was ingested. Additionally, the Contractor shall ensure that policies and procedures are in place to address issues related to the dispensing of medications. Medications will be dispensed by the Medical Staff on the RSC Units in accordance with an agreed upon schedule.

C.5.9.9 Psychiatric Medication

C.5.9.9.1 Psychiatric Medication Management. The Contractor shall provide a full range of psychiatric medication management services including writing prescriptions for treating diagnosed psychiatric disorders, and monitoring and adjusting dosage or medication types for residents that are prescribed medicines for treating diagnosed psychiatric disorders.

C.5.9.9.2 Psychiatric Medication Monitoring. The Contractor shall follow-up with residents or RSC staff to routinely monitor and adjust dosage or medication types for residents that are prescribed medications for treating diagnosed psychiatric disorders. The Contractor shall identify the resident's name, PDID#, unit #, and amount of time spent following up with each resident on the form provided by CSOSA, which is then filed in the resident's treatment file.

C.5.9.10 Medication Management at Discharge. The Contractor shall routinely review the RSC daily census to determine when a resident who is taking medication will be discharged from the program.

C.5.9.10.1 Medical Discharge Summary Form. Seventy-two hours prior to the resident's date of discharge, the Contractor shall prepare the resident's Medical Discharge Summary form. This form details the resident's conditions(s) and prescribed medications, dosage levels, and dispensing frequency. The Contractor shall provide this summary to the resident's case manager for inclusion in the residents discharge package.

C.5.9.10.2 Discharge Prescriptions. Seventy-two hours (i.e., 3 calendar days) before the resident's discharge from the RSC, the Contractor shall prepare a prescription for a thirty day supply of medication by completing the CSOSA medication order form.

C.5.10 Laboratory Services. The Contractor shall perform routine laboratory testing and services to support the effective delivery of medical services within the RSC. The Contractor is also responsible for ensuring the laboratory results are filed in the resident's treatment file within three business days of receipt and provide the COR with an electronic copy of all order forms monthly.

C.5.10.1 CSOSA Laboratory. To ensure proper tracking of laboratory expenditures, all laboratory services ordered by the Contractor must be listed on the CSOSA RSC Laboratory Services contract listing. CSOSA will not reimburse the Contractor for laboratory services that are not on the CSOSA RSC Laboratory Services contract listing.

C.5.10.2 Blood Sugar Monitoring. The Contractor shall ensure that residents who require monitoring of daily blood sugar levels are tested each morning before the breakfast meal is served, and at other times as considered medically necessary. The

Contractor shall coordinate the escort of residents who require daily blood sugar level monitoring with the RSC Shift Supervisor or the On Duty Floater.

C.5.11 Health and Wellness Education. The Contractor shall provide ongoing health and wellness education for residents that are either self-referred or referred by a medical staff member. The health and wellness education shall include, but not be limited to, the following topics: Hypertension, Cholesterol, Hepatitis C, Obesity, Asthma, Hypercholesterolemia, HIV/AIDS disease, Adult Immunizations, sexually transmitted diseases, and Diabetes. The Contractor shall collaborate with the COR to determine the frequency and scope of each health or wellness education session for the RSC residents.

The Contractor should use health and wellness education materials provided by the government from nationally recognized groups/organizations.

C.5.12 Urgent/Emergency Procedures. The Contractor shall provide staff that are trained to respond to medical crisis situations and emergencies, and the medical staff shall have unimpeded access to providing care and making decisions about the medical care of any resident whose condition may result in death, organ failure or a severe life-altering situation without immediate medical intervention.

C.5.12.1 The medical staff shall be notified immediately when medical emergencies arise at the RSC. In the case of life-threatening emergencies, the medical personnel shall immediately implement the appropriate medical protocols.

C.5.12.2 When non-life-threatening medical emergencies occur at the RSC, the RSC staff shall notify the medical staff in order to respond to the emergency.

C.5.12.3 Under no circumstances may RSC staff refuse to cooperate with medical staff directives when the Physician, PA, or RN determines a medical emergency situation exists.

C.5.12.4 The COR shall be notified of all medical emergencies by the Contractor or designee; the Contractor shall document such incidents in the resident’s treatment file as soon as practicable.

C.5.12.5 The Contractor shall provide the COR with a written report of all life-threatening medical emergencies within eight hours of occurrence and within 48 hours of all non-life threatening medical emergency occurrences consistent with CSOSA’s policy for recording reporting unusual occurrences and incidents.

C.5.12.6 The medical staff shall call 911 to arrange for an ambulance. After which, the medical staff shall notify the designated RSC staff member and onsite lead security official to notify them of the ambulance's pending arrival.

C.5.12.7 When addressing urgent/emergency needs, the Contractor shall operate in accordance with the CSOSA policies and procedures governing RSC medical services.

C.5.12.8 Psychiatric Emergency Response. The Psychiatrist, when on-site, shall be available to provide services in emergency or crisis situations. An emergency or crisis may occur at any time which may require the need for involuntary commitment or placement (FD12) of a resident. Specifically, an emergency is defined in this section as a situation in which the resident presents a danger to self, others, or property.

C.5.13 Communicable Diseases. The Contractor shall ensure that RSC residents suspected of having a communicable disease at any time are screened. At the Physician's discretion, residents may be referred for laboratory testing (i.e., urinalysis, blood test, radiology, etc.)

C.5.14 Infection Control.

C.5.14.1 Infection Control Precautions. The Contractor shall consider all residents as potentially infected with blood borne pathogens and adhere rigorously to infection control precautions required to minimize the risk of exposure to the blood and body fluids by the Contractor, residents, and RSC staff. The medical staff shall use the appropriate barriers and precautions to prevent skin and mucous membrane exposure to blood or other body fluids of anyone. Gloves should be worn when in contact with blood and body fluids, and for performing venipuncture and other vascular access procedures. The medical staff shall change gloves after contact with each patient and wear protective eye wear or face shields during procedures that are likely to generate droplets of blood or other body fluids. Protective clothing or outerwear shall be worn during procedures that are likely to generate splashes of blood or other body fluids.

C.5.14.2 Universal/Standard Precautions. All Contractor personnel, by virtue of their employment at the RSC, are subject to infectious exposure of various pathogens. As such, all Contractor staff shall ensure they enact utilization of the CSOSA Exposure Control Policy for TB and Blood borne Pathogens (provided upon Purchase order Award) in addition to the Standard Precautions Policies issued for:

Hand Hygiene, Respiratory Hygiene/Cough Etiquette, Medical Equipment, Environmental Cleaning, Injection Safety, Personal Protective Equipment, and the applicability of OSHA blood-borne pathogens standards (29CFR 1910.1030) as applicable to the patient population historically seen and triaged at the RSC during intake process.

C.5.15 Sexual Assault on Residents. In the event a resident reports a sexual assault, the Physician or Medical Staff shall document fully the complaint and subjective/objective finding9s) in the appropriate section of the resident's medical record and immediately notify the RSC COR and Shift Supervisor by phone.

C.5.16 Referral for Outpatient/External Services. When medically warranted, the Contractor shall make appointments and prepare medical documents for RSC residents to receive specialty medical care at hospitals or Outpatient facilities in Washington, DC.

Before making referrals to outpatient/external medical service providers, the Contractor shall ensure that the resident has medical insurance which will cover the outpatient/external medical services. Once the Contractor secures an appointment for outpatient/external medical services for the resident, the Contractor shall send immediate written notification to the designated RSC staff for coordination of transportation/escort services.

C.5.17 Therapeutic/Special Diet Orders. When medically appropriate, and at no cost to the Contractor, the Contractor shall order therapeutic diets (i.e. therapeutic, special, religious, food allergies, heart-healthy diets, etc.) for RSC residents. In the performance of this purchase, the Contractor shall ensure that only the Contractor's Physician orders therapeutic/special diets. Upon preparation of each order, the Contractor shall provide it to the designated drop-off location for RSC processing.

C.5.18 DC Healthcare and HIV AIDS ADAP Enrollment.

C.5.18.1 Within 72 hours of RSC admission, the Contractor shall ensure that all eligible, uninsured residents complete the paperwork necessary to enroll in the District of Columbia's Health Care System (i.e., DC Healthcare Alliance). The Contractor shall ensure that the required paperwork is submitted to the appropriate agency for processing. The Contractor shall track the application status to ensure that the resident receives the necessary insurance identification number and card prior to being discharged from the RSC.

C.5.18.2 During each resident's participation in the RSC program, the Contractor shall support the RSC's efforts to connect residents with publicly-funded medical care and medication services or private insurance, as appropriate, in order to provide medical care and medication services not provided by the RSC.

C.6 Other Requirements

C.6.1 Supply.

C.6.1.1 First Aid Kit. CSOSA shall provide a First Aid kit that is adequate and appropriate for emergency response for a residential treatment facility. As First Aid kit items are consumed or reach their expiration date, the Contractor shall notify the COR so replacement items can be ordered.

C.6.1.2 Required Medical Supplies. The Contractor shall maintain sufficient quantities of medical items and supplies required to meet the routine, urgent, and emergency medical needs of RSC residents. These items will be supplied to the Contractor by CSOSA. Requests for replacement medical items and supplies shall be submitted to the COR.

C.6.2 Employee Removal. CSOSA reserves the right to direct the Contractor to remove an employee from the work site for failure to comply with the performance standards and the Contractor shall initiate immediate action to replace that employee to maintain continuity of services at no additional cost to CSOSA.

C.6.3 Scheduling. It is the responsibility of the Contractor to coordinate a schedule for medical staff coverage so that medical services and security of the medical services unit are maintained in accordance with the Staffing Schedule (Attachment J-1). This includes coverage during vacations, unscheduled leave, daily breaks and lunch periods.

The Contractor shall provide a monthly schedule of coverage to the COR no later than the fifteenth business day of each month for the coming month. In the event that CSOSA identifies insufficient staff coverage, the COR (or his/her designee) shall contact the Contractor via telephone. The Contractor shall ensure resolution of the issue within one hour of notification.

C.6.4 Overtime. Overtime is not authorized and therefore the Government will not reimburse the Contractor for any overtime hours.

C.6.5 Holiday Hours. The Contractor's cost of holiday services shall be included in the medical staff hourly rate.

C.6.6 Staffing. The Contractor shall staff 100 percent of the medical positions required by commencement of purchase order performance.

C.6.7 Subcontractors. The Contractor cannot subcontract any of the purchase order requirements specified herein, without the written approval of the CO.

C.6.8 Standards of Conduct. The Contractor shall be responsible for maintaining satisfactory standards of employee competency, conduct, appearance, and integrity and shall ensure that all its employees adhere to the Standards of Conduct (Attachment J-2) and meet all applicable health requirements.

C.6.9 Discipline. The Contractor shall also be responsible for taking such disciplinary action as necessary when its employees fail to meet the purchase order standards or performance requirements.

C.7 Personnel Requirements. The Contractor shall provide medical coverage by using a combination of full-time (FT) providers, part-time (PT) providers, and backfill (pro re nata (PRN)) providers. All positions are expected to be manned during the hours specified in the Staffing Schedule (Attachment J-1). PRN providers shall be required to undergo the same security screening as FT and PT providers, therefore the Contractor is encouraged to qualify an appropriate number of potential PRN providers for each position, in advance, so as to ensure that they are able to provide immediate response.

C.7.1 Required Labor Categories. The Contractor shall staff the following labor categories to provide services under this purchase order:

• Physician

• Psychiatrist

• Physician Assistant (PA)

• Registered Nurse (RN)

• Medical Records Clerk (MRC)

C.7.2 CSOSA Timekeeping System. To assist the CSOSA in monitoring Contractor performance, all Contractor staff shall utilize the time keeping system provided by CSOSA to record the beginning and end of each tour of duty and all breaks (meals or otherwise). Contractor staff will be trained on how to use the timekeeping system. The CSOSA timekeeping system does not replace the requirement for the Contractor to utilize the Contractor’s timekeeping system for payroll and other purposes, to include providing timecards with the monthly invoice.

C.7.3 General Personnel Requirements. The Contractor shall ensure that all staff hired to perform under this purchase order are personally reliable, and are duly licensed or certified to perform duties associated with this purchase order. Contractor staff shall:

• Be a citizen of the United States of America, or be lawfully permitted to reside in the United States and possess a valid work permit.

• Be at least 21 years of age and must be able to withstand the physical demands of the job and be capable of responding to emergency situations

• Be able to clear the CSOSA background investigation

• Be able to speak English fluently, and read and write the English language

• Be deemed drug free by the Contractor before being hired to perform services under this purchase order

• Submit to random drug testing by the Contractor, for which the Contractor shall provide the test results to CSOSA upon request.

• Adhere to the terms of this purchase order.

• Maintain current, full and unrestricted licensure, where applicable.

• Provide quarterly updates on all purchase order staff license/certification.

• Be prohibited from providing services to RSC residents after expiration or revocation of privileges or licensure

• Sign a Non-Disclosure Agreement prior to starting work on the purchase order

C.7.4 Physical Standards

C.7.4.1 Physical Demands. The work requires frequent and prolonged walking, standing, sitting, and stooping. The Contractor's staff may be required to react swiftly to violent or potentially violent people. Physical stamina in all of its forms (mental, climatic, etc.) is a basic requirement of this position. Any individual who cannot adequately perform the duties assigned with regards to the physical requirements of the position will not be qualified to work under this purchase order.

C.7.4.2 Physical Fitness. The Contractor shall encourage its employees under this purchase order to maintain a fitness program. Physical well-being will assure employees are able to tolerate the stress level associated with the positions and physically fit to respond to emergencies.

C.7.4.3 Communicable Disease/TB Testing. The Contractor shall ensure that all Contractor staff assigned to this purchase order are tested for Tuberculosis and, in the case of a positive test, medically cleared as non-infectious and fit for duty, prior to starting employment at the RSC. Tuberculosis testing shall take place annually thereafter. Results of all tests shall be available for CSOSA review upon purchase order award and each option period award. CSOSA encourages the Contractor to require its staff to maintain current immunizations (i.e., influenza, hepatitis, tetanus, etc.). The Contractor shall remove from performance under this purchase order any staff members that are found or suspected to be suffering from a communicable disease, disorder, or respiratory problem which has the unmitigated ability to infect others.

C.7.5 CPR Certification. The Contractor shall ensure that each medical staff member, except the Medical Records Clerk, is certified in cardiopulmonary resuscitation (CPR) and maintains a current CPR certification. Medical staff with no, or an expired, CPR certification shall be prohibited from performing services under this purchase order.

C.7.6 Crisis Intervention. The Contactor shall ensure that all medical staff are trained to respond to health-related situations, to include universal precautions and suicide prevention.

C.7.7 CSOSA Policies and Procedures. The Contractor shall ensure that all personnel assigned to the RSC adhere to applicable CSOSA policies and operational procedures.

C.7.8 Medical Staff Drug Testing Requirements. All Contractor staff assigned to this purchase order will be subject to pre-employment, random, and reasonable suspicion drug tests. In the event the Government has a reasonable suspicion that a Contractor employee is under the influence of alcohol or drugs, the Contractor will be notified and the Contractor will ensure that an appropriate and timely (within 24 hours) drug test is conducted. The assignment of all Contractor staff shall be contingent upon his/her successful completion of the background investigation, drug testing, and tuberculosis testing requirements. A copy of the attached "Consent to Release Information Form", which authorizes CSOSA to view drug and tuberculosis test results, shall be signed by each member of the Contractor's staff and be available for CSOSA review upon request.

An individual assigned to this purchase order, or an applicant, who has a verified positive drug test or tuberculosis test, refuses to be tested, attempts to alter or substitute the specimen, fails to appear for testing without an approved deferral, (which constitutes refusal to test), or who refuses to sign the “Consent to Release Information" form shall be immediately removed and disqualified from providing services under the purchase order.

C.7.9 Medical Staff Records. The Contractor shall maintain for CSOSA review, onsite at the RSC, sufficient documentation regarding Contractor staff personnel qualifications to perform under this purchase order. This documentation shall include, at a minimum but not be limited to, copies of current licenses, current certifications, to include CPR, and communicable, TB, and other health related test results or immunization records.

C.7.10 Medical Staff Labor Category Requirements

C.7.10.1 Physician. The Physician shall be a General Practitioner, Internist, or Family Practitioner who shall provide direct medical care and clinical oversight of the medical services and staff associated with this purchase order. The Physician shall also write prescriptions, coordinate external medical services, and provide written medical summaries for use by other RSC staff. The Physician may also be required to provide guidance and technical assistance to ensure that RSC’s medical services are performed in accordance with national, state, and local regulations and best practices.

C.7.10.1.1 Physician Qualifications. The Physician shall possess:

• Either a Doctor of Medicine or a Doctor of Osteopathy degree from an allopathic or osteopathic medical school in the United States or Canada approved by a recognized accrediting body in the year of the physician's graduation, or a

• Doctor of Medicine or Doctor of Osteopathy degree from a foreign medical school that provided education and medical knowledge equivalent to accredited schools in the United States. Comparability must be demonstrated by permanent certification by the Education Commission for Foreign Medical Graduates (ECFMG), or a fifth pathway certificate for American students who completed premedical education in the United States and graduate education in a foreign country

• A current, full, and unrestricted license to provide medical services in a State, District of Columbia, the Commonwealth of Puerto Rico , or a territory of the United States

• A minimum of five years of verifiable experience as a licensed physician

• Experience as a licensed physician working in either a residential treatment , community corrections, re-entry or correctional facility, public health clinic, or federally-qualified health center, is preferred

• Certification from the American Society of Addiction Medicine (ASAM), or

• A minimum of three years of experience treating individuals with substance abuse problems, is preferred.

C.7.10.1.2 Physician Scope of Responsibility. The Physician selected must have extensive experience providing the full range of diagnostic, preventive and therapeutic medical services to an offender/defendant population. The Physician shall conduct baseline physicals, gynecological examinations, testicular examinations, colorectal examinations, and tuberculin testing; write prescriptions, make referrals for laboratory and radiology services, prepare orders, complete written medical record documentation, perform medical…