addendum-2-rfp-doc-2025-05.pdf
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- Attached to
- Comprehensive Healthcare Services
- Solicitation number
- RFP DOC 2025-05
- Issued by
- Coos County, New Hampshire
About this file
This is Addendum #2 to RFP NHDOC 2025-05 issued by the State of New Hampshire Department of Corrections for Comprehensive Healthcare Services. The addendum modifies specifications in the original RFP concerning clinical laboratory services, phlebotomy services, staffing requirements, and invoicing procedures across multiple correctional facilities. Key modifications include updating references to lab test attachments published in Addendum 3, revising the CMS Laboratory Fee Schedule from July 2021 to January 2025, and expanding phlebotomy service requirements to include both the Southern Region (five times per week for up to 22 hours) and the Northern New Hampshire Correctional Facility (at least once weekly for up to four hours). The original RFP solicits comprehensive medical, dental, mental health, and clinical laboratory services for approximately 1,964 inmates across facilities including the NH State Prison for Men, Northern NH Correctional Facility, Secure Psychiatric Unit/Residential Treatment Unit, and NH Correctional Facility for Women. Proposals are due on April 1, 2025, with a vendor conference and facility tour scheduled for March 13, 2025. The initial contract term runs from July 1, 2025, through June 30, 2028, with an optional two-year renewal extending through June 30, 2030.
The staffing requirements total 43.35 full-time equivalent positions for FY 2026 forward, including one Chief Medical Officer, 2.3 staff physicians, 5.5 Advanced Practice Registered Nurses, one Medical Case Manager, one Addictionologist, 0.25 podiatrist, 0.85 phlebotomist, dental professionals, psychiatric staff, mental health clinicians, and administrative personnel. Pricing must adhere to RSA 623-C:2 and may not exceed 110 percent of the most current Medicare allowable rate, with vendors requested to provide best pricing for each laboratory test. The revised staffing matrix eliminates the Medical Case Manager position from administrative staff (reducing administrative staff from 5.0 to 3.0 FTE) and adds an Addictionologist while adjusting the phlebotomist FTE from 1.5 to 0.85. Vendors must submit completed proposals with this addendum initialed by the contract signatory. All modifications specified in this addendum supersede previously submitted documents, with all other RFP specifications remaining unchanged. Contract administration is handled by Barbara A. Mitera at DOC.bids_contracts@doc.nh.gov.
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Other files
| File | Type | Posted |
|---|---|---|
| Addendum_3_RFP DOC 2025-05.pdf | ||
| Addendum_2_RFP DOC 2025-05.pdf | ||
| Addendum_1_RFP DOC 2025-05.pdf | ||
| RFP DOC 2025-05.pdf | ||
| rfp-doc-2025-05.pdf | ||
| addendum-1-rfp-doc-2025-05.pdf | ||
| addendum-3-rfp-doc-2025-05.pdf | ||
| addendum-4-rfp-doc-2025-05.pdf |
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Text version
HELEN E. HANKS
COMMISSIONER
LISA M. STONE
DIRECTOR
STATE OF NEW HAMPSHIRE
DEPARTMENT OF CORRECTIONS
DIVISION OF ADMINISTRATION
P.O. BOX 1806
CONCORD, NH 03302-1806
603-271-5610 FAX: 888-908-6609
TDD ACCESS: 1-800-735-2964
www.nh.gov/nhdoc
Promoting Public Safety with Respect, Professionalism, Dedication and Courage as One Team
State of NH, Department of Corrections Page 1 of 2 Medical and Forensic Services Initials: ___________
Date: ____________
March 31, 2025
ADDENDUM # 2 to RFP NHDOC 2025-05
THIS DOCUMENT SHALL BE INITIALED BY THE CONTRACT SIGNATORY
AND SUBMITTED WITH THE VENDOR’S BID RESPONSE.
RFP: NHDOC 2025-05 Comprehensive Healthcare Services
Currently Reads:
5.1. Lab tests as identified in Estimated Budget/Method of Payment, EXHIBIT C.
5.2. Lab tests that Vendor may/can provide that are not listed in the EXHIBIT C, Clinical Laboratory Fee Schedule.
Change to Read:
5.1. Lab tests as identified in Lab Test attachment published in Addendum 3 to this RFP.
5.2. Lab tests that Vendor may/can provide that are not listed in Lab Test attachment published in Addendum 3 to this RFP.
Currently Reads:
5.15.1. Phlebotomy services shall be provided by Vendor five (5) times per week for up to twenty-two (22) hours for the NH State Prison for Men (NHSP-M) to include: once (1) a week for the Secure Psychiatric Unit (SPU)/Residential Treatment Unit (RTU), Special Housing Unit (SHU), Close Custody Unit (CCU), and Community Corrections for Men. As well as one (1) time per week (up to five and a half (5.5) hours) at the NH Correctional Facility for Women (NHCF-W) and Community Corrections for Women, and up to two and a half (2.5) hours of additional phlebotomy services as needed combined total of phlebotomy hours shall be a total of thirty (30) hours.
Change to Read:
5.15.1. Phlebotomy services shall be provided by the vendor five (5) times per week for the Southern Region and at least once (1) a week for the Northern New Hampshire Correctional Facility. Up to twenty-two (22) hours for the NH State Prison for Men (NHSP-M) to include: once (1) a week for the Secured Psychiatric Unit (SPU)/Residential Treatment Unit (RTU), Special Housing Unit (SHU), Close Custody Unit (CCU), and Division of Rehabilitative Services for Men. As well as one (1) time per week (up to five and a half (5.5) at the NH Correctional Facility for Women (NHCF-W) and Division of Rehabilitative Services for Women, and up to two and half (2.5) hours of additional phlebotomy services as needed combined total of phlebotomy hours shall be a total of thirty (30) hours for the Southern Region. Phlebotomy Services will be provided for the Northern NH Correctional Facility a total of up to four (4) hours a week.
Currently Reads:
5.8 Vendors shall adhere to RSA 623-C:2, as amended effective July 1, 2015, pursuant to RSA 151, where the NH Department of Corrections shall pay no more than one hundred ten percent (110%) of the Medicare allowable
State of NH, Department of Corrections Page 2 of 2 Medical and Forensic Services Initials: ___________ rate. Vendors shall utilize the July, 2021 Centers of Medicare & Medicaid Services (CMS) Laboratory Fee Schedule detailed in Estimated Budget/Method of Payment, EXHIBIT C. Vendors are requested to provide the best pricing for each requested laboratory test not to exceed the allowable rate articulated in RSA 623.1-C:2.
Change to Read:
5.8 Vendors shall adhere to RSA 623-C:2, as amended effective July 1, 2015, pursuant to RSA 151, where the NH Department of Corrections shall pay no more than one hundred ten percent (110%) of the most current Medicare allowable rate. Vendors shall utilize the January 2025 Centers of Medicare & Medicaid Services (CMS) Laboratory Fee Schedule. Vendors are requested to provide the best pricing for each requested laboratory test not to exceed the allowable rate articulated in RSA 623.1-C:2.
Currently Reads:
10.1. Lab tests as identified in Estimated Budget/Method of Payment, EXHIBIT C.
10.2. Lab tests that Vendor may/can provide that are not listed in the EXHIBIT C, Clinical Laboratory Fee Schedule.
Change to Read:
10.1. Lab tests as identified in Lab Test attachment published in Addendum 3 to this RFP.
10.2. Lab tests that Vendor may/can provide that are not listed in Lab Test attachment published in Addendum 3 to this RFP.
Currently Reads:
10.8 Vendors shall adhere to RSA 623-C:2, as amended effective July 1, 2015, pursuant to RSA 151, where the NH Department of Corrections shall pay no more than one hundred ten percent (110%) of the Medicare allowable rate. Vendors Shall utilize the July , 2021 Centers of Medicare & Medicaid Services (CMS) Laboratory Fee Schedule detailed in Estimated Budget/Method of Payment, EXHIBIT C. Vendors are requested to provide the best pricing for each requested laboratory test not to exceed the allowable rate articulated in RSA 623.1-C:2.
Change to Read:
10.8 Vendors shall adhere to RSA 623-C:2, as amended effective July 1, 2015, pursuant to RSA 151, where the NH Department of Corrections shall pay no more than one hundred ten percent (110%) of the most current Medicare allowable rate. Vendors Shall utilize the January 2025 Centers for Medicare & Medicaid Services (CMS) Laboratory Fee Schedule. Vendors are requested to provide the best pricing for each requested laboratory test not to exceed the allowable rate articulated in RSA 623.1-C:2.
Currently Reads:
10.15 Phlebotomy services schedule:
Phlebotomy services shall be provided by the vendor five (5) times per week for up to twenty-two (22) hours for the NH State Prison for Men (NHSP-M) to include: once (1) a week for the Secured Psychiatric Unit (SPU)/Residential Treatment Unit (RTU), Special Housing Unit (SHU), Close Custody Unit (CCU), and Community Corrections for Men. As well as one (1) time per week (up to five and a half (5.5) at the NH Correctional Facility for Women (NHCF-W) and Community Corrections for Women, and up to two and half (2.5) hours of additional phlebotomy services as needed combined total of phlebotomy hours shall be a total of thirty (30) hours.
Change to Read:
10.15 Phlebotomy services schedule:
Phlebotomy services shall be provided by the vendor five (5) times per week for the Southern Region and at least once (1) a week for the Northern New Hampshire Correctional Facility. Up to twenty-two (22) hours for the NH State Prison for Men (NHSP-M) to include: once (1) a week for the Secured Psychiatric Unit (SPU)/Residential Treatment Unit (RTU), Special Housing Unit (SHU), Close Custody Unit (CCU), and Division of Rehabilitative Services for Men. As well as one (1) time per week (up to five and a half (5.5) at the NH Correctional Facility
Medical and Forensic Services Initials: ___________ for Women (NHCF-W) and Division of Rehabilitative Services for Women, and up to two and half (2.5) hours of additional phlebotomy services as needed combined total of phlebotomy hours shall be a total of thirty (30) hours for the Southern Region. Phlebotomy Services will be provided for the Northern NH Correctional Facility a total of up to four (4) hours a week.
1.1. Required Contracted Medical Staff by Position, Site and Full-Time Equivalent (FTE)1:
Facilities/Locations Position2 #FTE
ALL SITES
Chief Medical Officer (CMO) 1.0 Staff Physician(s) 2.3
Advanced Practice Registered Nurse (APRNs)3 5.5 Medical Case Manager 1.0
Podiatrist 0.25 NHSP/M Medical Assistant 1.0
NCF Medical Assistant 1.0 Required Contracted Medical Staff by Position, Site and FTE 12.05
1.1. Required Contracted Medical Staff by Position, Site and Full-Time Equivalent (FTE)1:
Facilities/Locations Position2 #FTE
ALL SITES
Chief Medical Officer (CMO) 1.0 Staff Physician(s) 2.3
Advanced Practice Registered Nurse (APRNs)3 5.5 Medical Case Manager 1.0
Podiatrist 0.25 Phlebotomist 0.85
NHSP/M Medical Assistant 1.0 NCF Medical Assistant 1.0
Required Contracted Medical Staff by Position, Site and FTE 12.9
Medical and Forensic Services Initials: ___________
1.1. Required Contracted Administrative Staff by Position. Site and FTE⁸:
Facilities/Locations Position9 #FTE
Central Office
Program Manager 1.0 Administrative Assistant 1.0
Quality Improvement Analyst (QIA) 1.0 Medical Case Manager 1.0
NGRI Coordinator 1.0
Required Contracted Administrative Staff by Position, Site and FTE 5.0 8 One (I) FTE = forty (40) hours 9 Submitted proposals shall include job descriptions for each required contracted administrative staff matrix.
7.1. Required Contracted Administrative Staff by Position. Site and FTE⁸:
Facilities/Locations Position9 #FTE
Central Office Program Manager 1.0
Administrative Assistant 1.0 Quality Improvement Analyst (OIA) 1.0
Required Contracted Administrative Staff by Position, Site and FTE 3.0
Medical and Forensic Services Initials: ___________
FY 2026 Medical - Dental - Mental Health Contracted Positions
Healthcare Contracted Positions #of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 1.5 $ % $ Sub-Total Positions 43 $
Total Medical - Dental - Mental Health Contracted Positions $ Notes: # of FTE's x Loaded Yearly Compensation Rate = Total
Medical and Forensic Services Initials: ___________
FY 2027 Medical - Dental - Mental Health Contracted Positions
Positions #of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 1.5 $ % $ Sub-Total Positions 43 $
Medical and Forensic Services Initials: ___________
FY 2028 Medical - Dental - Mental Health Contracted Positions
Positions # of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 1.5 $ % $ Sub-Total Positions 43 $
Medical and Forensic Services Initials: ___________
OPTIONAL RENEWAL
FY 2029 Medical - Dental - Mental Health Contracted Positions
Medical - Dental - Behavioral Health Contracted Positions
#of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost%
(included in Loaded Yearly Compensation
Rate
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer (CPO) 1 $ % $ Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $ Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 1.5 $ % $ Sub-Total Positions 43 $
Total Medical - Dental - Behavioral Health Contracted Positions $
Medical and Forensic Services Initials: ___________
FY 2030 Medical - Dental - Mental Health Contracted Positions
Medical - Dental - Behavioral Health Contracted Positions
#of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost%
(included in Loaded Yearly Compensation
Rate
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer (CPO) 1 $ % $ Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $ Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 1.5 $ % $ Sub-Total Positions 43 $
Medical and Forensic Services Initials: ___________
FY 2026 Medical - Dental - Mental Health Contracted Positions
Positions #of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Addictionologist 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 0.85 $ % $ Sub-Total Positions 43.35 $ % $
Medical and Forensic Services Initials: ___________
FY 2027 Medical - Dental - Mental Health Contracted Positions
Positions #of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Addictionologist 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 0.85 $ % $ Sub-Total Positions 43.35 $
Medical and Forensic Services Initials: ___________
FY 2028 Medical - Dental - Mental Health Contracted Positions
Positions # of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost % (included in Loaded
Yearly Compensation
Rate)
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Addictionologist 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer
(CPO) 1 $ % $
Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $
Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist .85 $ % $ Sub-Total Positions 43.35 $
Medical and Forensic Services Initials: ___________
FY 2029 Medical - Dental - Mental Health Contracted Positions
Medical - Dental - Behavioral Health Contracted Positions
#of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost%
(included in Loaded Yearly Compensation
Rate
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Addictionologist 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer (CPO) 1 $ % $ Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $ Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 0.85 $ % $ Sub-Total Positions 43.35 $
Medical and Forensic Services Initials: ___________
FY 2030 Medical - Dental - Mental Health Contracted Positions
Medical - Dental - Behavioral Health Contracted Positions
#of FTE's
Loaded Yearly Compensation
Rate
Indirect Cost%
(included in Loaded Yearly Compensation
Rate
Total
Chief Medical Officer 1 $ % $ Staff Physician(s) 2.3 $ % $ Medical Case Manager 1 $ % $ Addictionologist 1 $ % $ Podiatrist 0.25 $ % $ APRN(s) 5.5 $ % $ Medical Assistant(s) 2 $ % $ Chief Dental Officer (CDO) 1 $ % $ Oral Surgeon 0.25 $ % $ Staff Dentist(s) 2.6 $ % $ Dental Assistant(s) 1.6 $ % $ Dental Hygienist(s) 2 $ % $ Chief Psychiatric Officer (CPO) 1 $ % $ Staff Psychologist 1 $ % $ Staff Psychiatrist(s) 3 $ % $ Psychiatric Nurse Practitioner(s) 6 $ % $ Mental Health Clinician(s) 5 $ % $ LADC(s) 2 $ % $ NGRI Clinical Coordinator 1 $ % $ Program Manager 1 $ % $ Administrative Asst. 1 $ % $
QIA 1 $ % $
Phlebotomist 0.85 $ % $ Sub-Total Positions 43.35 $
Medical and Forensic Services Initials: ___________
Medical and Forensic Services Initials: ___________
Contractor Name Contractor Address NHDOC 2025-05 Medical-Dental Behavioral Health Professional Services
Dates of Service: MM/DD/YY through MM/DD/YY Invoice Date Invoice Number
Service Position Per Diem (hrs.
worked) Filled FTE's Total Amount
Medical
Chief Medical Officer (CMO) $ Staff Physician $ Medical Case Manager $ Podiatrist $
APRN $
Medical Assistants (MA) $ Phlebotomist $
Dental
Chief Dental Officer (CDO) $ Oral Surgeon $ Staff Dentist(s) $ Dental Assistant(s) $ Dental Hygienist(s) $
Behavioral Health
Chief Psychiatric Officer (CPO) $
Staff Psychologist $ Staff Psychiatrist(s) $ Psychiatric Nurse Practitioner(s) $
Mental Health Clinician(s) $ LADC(s) $ NGRI Clinical Coordinator $ Addictionologist $
Administrative
Program Manager $ Administrative Asst. $
QIA $
Total Hours Worked & FTE's $ Total Amount Due* $
*Contractor time sheets shall be attached for all per diem positions showing all hours actually worked.
Medical and Forensic Services Initials: ___________
Contract Administrator: Barbara A. Mitera Email: DOC.bids_contracts@doc.nh.gov and Barbara.A.Mitera@doc.nh.gov
TEL. NO.: 603/271-7468
NOTE: ALL CHANGES TO BID SOLICITATION NOTED IN ADDENDUMS WILL SUPERSEDE PREVIOUSLY
SUBMITTED DOCUMENTS AND MUST BE SUBMITTED WITH THE BID. ALL OTHER SPECIFICATIONS
REMAIN UNCHANGED AND VALID.
BIDDER________________________________ ADDRESS ____________________________
BY _______________________________
(this document must be signed)
________________________________ TEL. NO.____________________________
(please type or print name)
Please visit: https://das.nh.gov/purchasing/vendorresources.aspx and click on “Bid and Proposals” for complete bid and addendums or go to: https://www.corrections.nh.gov/resources/bids-contracts and search by bid number.
ADDENDUM # 2 to RFP NHDOC 2025-05
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