STATE OF NEW HAMPSHIRE

DEPARTMENT OF CORRECTIONS

64 SOUTH STREET

CONCORD, NEW HAMPSHIRE 03301

ADDENDUM # 3 TO PROPOSAL INVITATION #NHDOC 2025-05

TIME OF RFP OPENING: 2:00 PM DATE OF RFP OPENING: 4/07/2025

Date of Addendum: 3/31/2025

FOR: Comprehensive Healthcare Services

Question 1: RFP Section E, Page 38: We have reviewed the proposal format specifications on RFP page 38.

To ensure that we interpret these correctly, please provide the following information.

a) We understand that the body of the text in vendors’ proposals must be 12-point Times New Roman. However, in order to break up dense narratives and to make it easier for the Evaluation Committee to review our proposals, please confirm that vendors are permitted to use section headings and captions in different fonts and point sizes.

b) We understand that we may not alter or add company information to the current headers and footers in the RFP documents provided by the NH Department of Corrections. Please confirm that in documents created by the vendor (i.e., non-NH Department of Corrections documents), we can include any text we wish in the headers and footers, e.g., page numbers, section titles, company name, etc.

Answer 1: 1a: 1.2 Proposal Format: 1.2.1. states that bidder’s “should” follow the following format. We like to keep it consistent for scoring purposes.

1b: Documents from NH Department of Corrections must not be changed. Vendor documents should be an attachment related to specific sections of the RFP.

Question 2: RFP Section F, Page 41: This section lists “adverse legal judgments” under the scoring table for 50 points. However, there is nowhere else in the RFP that includes any directions or information around legal judgements. It also does not appear on the proposal check list (page 98). Please clarify what the requirement is under “adverse legal judgements”, if any, and exactly what bidders need to include in their proposals.

Answer 2 : Bidders do not necessarily include anything in the proposal. The NHDOC will be researching all respondents with regard to claims brought against them. It would be very appropriate for a bidder to address this in their Executive Summary.

Question 3: RFP Section F, Page 41: This scoring table titles “Organizational Capability” for 525 points.

Please confirm this is meant as an overall scoring the entirety of the bidders’ technical response and it is not meaning scoring for just the RFP Section 1.3.2.7, also titled, “Organizational Capability.”

Answer 3: The scoring table “Organizational Capability” has a total of 525 points assigned to it and it is for the ENTIRE proposal—not just a section of it.

Question 4: Section E, Page 39 of the RFP: Under Subsection 1.3.2.7, Organizational Capability, reads as a request to describe an overall capability by the bidder on a high level to take on the full scope of the RFP. Page 39 of the RFP, under Subsection 1.3.2.8, Organizational Approach, reads as a request to provide detailed responses with plans for how we will complete the required services and Exhibit B. Please clarify the following:

a) Does the Department wish for proposals to include detailed responses to each and every subsection of Section C, Scope of Services? Yes

b) If yes, should these responses be under Subsection 1.3.2.7 or 1.3.2.8? 1.3.2.7

c) Does the Department wish for proposals to include detailed responses to each and every subsection of Exhibit B, Scope of Work? Yes

d) If yes, should these responses be under Subsection 1.3.2.7 or 1.3.28? 1.3.2.,8

Answer 4: See above

Question 5: RFP Section A, Page 6: According to the RFP timeline, answers to questions are expected on March 26, 2025. The proposal is due, on paper, to the DOC office by April 1. To ensure that our proposal makes it on time, we would need to print by March 27th and ship by March 28th.

This only allows less than one full business day to review the likely voluminous information provided in the answers to questions, then thoughtfully incorporate the information into proposals, adjust pricing, etc.

a. Please reconsider the timeline and extend the due date by 1-2 weeks from the release of answer to questions to allow adequate time to incorporate new and important information bidders will need to present their best proposal to the Department.

b. Alternatively, please consider answering the questions on a rolling basis or earlier than March 26th.

Answer 5: See Addendum #1 for due date changes

Question 6: Proposal Check Sheet, RFP Page 98: The CJIS Security Policy is listed on the proposal content checklist. This appears to be a full policy and does not have any type of signature line or acknowledgement page. Please clarify what the Department wishes the bidders to include in their proposal to adhere to this requirement.

Answer 6 : Click on the link provided and navigate to “FBI CJIS Security Addendum.

There Bidders will find the document that needs to be signed and submitted.

Questions 7: Please provide information showing the current fill rate of positions (i.e., vacancy rate) required under the current contract.

Answer 7: As of 1/31/25, the current vendor vacancy rate for the current amount of contracted positions is 9.7%.

Questions 8: Please provide copies of any staffing reports that show fill rates and turnover trends over the past three years, or any other similar reports or data that are available.

Answer 8: We do not have that information available in the format requested.

Question 9: Section C; Pages 10, 14, 15, 18: Can the Department clarify the voluminous difference between the current staffing plan and the required RFP staffing plan for medical, dental, and mental health? Which staffing plan should bidders use as guidance when developing their proposed staffing plans for these three categories?

Answer 9: We do not understand this question.

Question 10: Proposal Check Sheet, Page 98 of the RFP – Please confirm that bidders only need to date and initial in wet ink the bottom right corner of the actual RFP pages or any official NHDOC-issued proposal documents where an initial and date line is provided and do not need to add dates and initials to vendor-generated technical proposal responses (i.e. executive summary, financial statements, job descriptions, 1.3.2.8 Organizational Approach and 1.3.2.7 Organizational Capability, etc.), which amounts to easily over 500 pages of content?

Answer 10: Vendors do not need to initial the bottom right corner of their own documents. Initial and date where indicated.

Question 11: Proposal Check Sheet, Page 98 of the RFP – Vendors need to initial and date the bottom right-hand corner of each RFP page as provided. Where should vendors include these completed pages - within the technical proposal or standard terms and conditions proposal?

Answer 11: Leave documents in the order in which the RFP was written. The Technical Proposal (Exhibit B) is first. Attach all related documents. The Cost Proposal (Exhibit C) follows. All related Cost will be attached to Exhibit C and Proposal Check Sheet and Glossary is in the last section.

Question 12: Proposal Check Sheet, Page 98 of the RFP – Is it permissible to include the sealed technical proposal and the sealed terms and conditions proposal inside the same larger box, as long as they are separately sealed within?

Answer 12: Yes, you may put the sealed Technical Proposal in a sealed envelope and separately, a sealed Cost Proposal and have them delivered in one (1) single box/container.

Questions 13: Proposal Check Sheet, Page 98 of the RFP – The Department requires vendors to include addendum acknowledgement pages, if applicable, with their proposal response. Where should vendors include these pages - within the technical proposal or standard terms and conditions proposal?

Answer 13: File them behind the Request for Proposal package.

Question 14: Proposal Check Sheet, Page 98 of the RFP – This section instructs that originals can be typed or printed in black ink. Please confirm vendors are permitted to electronically type in the requested information onto RFP forms (including the price sheets), as long as the signature and/or initials with date are in original wet blue ink?

Answer 14: Yes, that is acceptable.

Question 15: As of 2022, the Department was in process of becoming NCCHC accredited. Has this been completed? Please provide any NCCHC accreditation details, including which facilities are accredited and their accreditation dates.

Answer 15: The NHDOC was never pursuing NCCHC accreditation. The Secure Psychiatric Unit, one unit of the NHDOC, had started that process. It has not been completed.

Question 16: As of 2022, the Department directly contracted with the TechCare EHR system. Is this still the platform in place today?

Answer 16: Yes

Question 17: RFP Section D, Page 34: This section states that “proposals must be submitted via E:Mail to:

doc.bids_contracts@doc.nh.gov; overnight/mail delivery service or in-person with proposals addressed as such:...” Can the Department please confirm if bidders are able to submit their response by email?

Answer 17: For this RFP Bidders may send their responses digitally but will also need to send the three (3) hard copies as described in Section D: 1 & 2

Question 18: Section A, RFP Page 6 of 102 indicates there are 185 patients within the Division of Rehabilitative Services. Which facilities comprise the Division of Rehabilitative Services?

Answer 18: North End Transitional Housing Unit (NEH/THU)

Concord Transitional Work Center (TWC)

Shea Farm, Transitional Housing Unit (THU)

Calumet House, Transitional Housing Unit (THU) mailto:doc.bids_contracts@doc.nh.gov

Question 19: Section A, RFP Page 5 of 102 identifies four Transitional Units. What is the patient population (number) in each of those units?

Answer 19: As 03/07/2025:

Calumet House: 51

CTWC: 77

North End House 38

Shea Farm 15

Total for all houses: 181

Question 20: Section C, RFP Page 10 of 102 identified 0.5 FTE Advanced Practice Registered Nurse assigned to the “Concord Campus”. The Concord Campus is not shown on the Location of Services in Section 1.3.1. of the RFP. Please advise which facilities comprise the Concord Campus.

Answer 20: New Hampshire State Prison for Men, New Hampshire Correctional Facility for Women, Secured Psychiatric Unit/Residential Treatment Unit, North End House Transitional Housing Unit, Concord Transitional Work Center.

Question 21: The Required Contracted Staff by Position, Site, and FTE charts found on Pages 10, 14, and 18 of 102 refer to “NCF”. Is NCF also known as NNHCF as listed on page 6 of 102?

Answer 21: Yes

Question 22: Section C, RFP Page 18 of 102 requires an NGRI Clinical Coordinator in the Central Office and includes that FTE in the total of 20 FTEs required for contracted Mental Health Staff.

RFP Page 20/102 also requires an NGRI Coordinator in the Central Office and includes that FTE in the total of 5 FTEs required for Administrative Staff. Are these two separate and distinct positions: NGRI Clinical Coordinator and NGRI Coordinator? Or does the department require only one NGRI position?

Answer 22: There is only one NGRI Coordinator position.

Question 23: RFP Exhibit C, Page 91: The chart showing FY 2026 Medical-Dental-Mental Health Contracted Positions on RFP Page 91of 102 has inconsistencies compared to the staffing required earlier in the RFP document, please clarify. For Example:

a) Page 91 requires 1.6 FTE Dental Assistants, but the chart on RFP Page 14 of 102 requires 1.85 FTEs.

b) Page 91 requires 2.0 FTE Dental Hygienists, but the chart on RFP Page 14 of 102 requires 1.75 FTEs.

Answer 23: The chart on page 91 is a total. The chart on page 14 is by position, site, and FTE.

For example there are 1.75FTE hygienist at NHSPM, SPU,RTU and NHCFW and .25FTE at NCF for a total of 2FTE

Question 24: Under the new contract, could you please confirm that vendors will supply staff for the Department’s own Medication-Assisted Treatment (MAT) clinic and that vendors will not need to provide their own policies and procedures to conduct MAT/MOUD services?

Answer 24: Vendors are expected to supply staff as specified in the RFP. The vendor is expected to follow all DOC policy as promulgated. Vendors shall not develop their own policies for practice at NHDOC.

Question 25: Does the Department currently have a contract with any local hospitals for the provision of care?

Answer 25: Yes, we do.

Question 26: What MAT medications are currently offered onsite?

Answer 26: Naltrexone, buprenorphine, methadone.

Question 27: Under the new contract, could you please confirm/state who will be financially responsible for these items: the Department or the vendor?

a. Hospitalization

b. Outpatient surgeries

c. Outpatient treatment

d. Other outpatient referrals

e. ER visits

f. Offsite dialysis

g. Pharmaceuticals

h. Office Equipment/Furnishings

i. Medical Supplies

j. Dental Supplies

Answer 27: a-f are NHDOC responsibilities. There is a cost sharing penalty for pharmaceuticals. For h, onsite furnishing are supplied. External furnishings are the responsibility of the vendor. The NHDOC pays for products in categories I and J.

Question 28: As noted on p. 30, section 6.9.2, can you please confirm that the Department is seeking vendors to propose its own Utilization Management Program?

Answer 28: Yes

Question 29: As referenced on p. 30, section 6.9.4, can you clarify whether the Department is seeking vendors to propose their own CQI program, or will vendors be required to conform to the Department’s existing CQI program?

Answer 29: The NHDOC has a process for CQI. The vendor is expected to follow it as well as the policies and procedures of the NHDOC. However, as different variables are identified, the CQI program may change. It is a dynamic process.

Question 30: On RFP Page 57 of 102, the “Required Contracted Medical Staff by Position, Site and Full- Time Equivalent” table requires a 1.0 FTE Medical Case Manager. On RFP Page 70 of 102, the “Required Contracted Administrative Staff by Position, Site and FTE” table also requires a 1.0 FTE Medical Case Manager. Please clarify whether these two titles are referring to the same position, i.e., is the RFP requiring a total of (a) only 1.0 FTE Medical Case Manager OR (b) 2.0 FTEs Medical Case Manager.

Answer 30: There is one Medical Case Manager.

Question 31: On RFP Page 68 of 102, the “Required Contracted Mental Health Staff by Position, Site and FTE” table requires a 1.0 FTE NGRI Clinical Coordinator. On RFP Page 70 of 102, the “Required Contracted Administrative Staff by Position, Site and FTE” table also requires a

1.0 FTE NGRI Coordinator. Please clarify whether these two very similar titles are referring to the same position, i.e., is the RFP requiring a total of (a) only 1.0 FTE NGRI Coordinator or (b) 2.0 FTEs—one “Clinical” and the other not.

Answer 31: There is one NGRI Coordinator.

Question 32: With regard to phlebotomy, the “FY 2026 Medical - Dental - Mental Health Contracted Positions” staffing grid on RFP Page 91 of 102 requires 1.5 FTEs, which equates to 60 hours per week. However, Item 10.15.1. on RFP Page 76 of 102 states, “…combined total of phlebotomy hours shall be a total of thirty (30) hours.” This equates to only 0.75 FTE. Please indicate which of these conflicting RFP requirements is correct for phlebotomists: (a) 60 hours/1.5 FTE or (b) 30 hours/0.75 FTE.

Answer 32: There will be an addendum to correct this. NHDOC is requesting a .85FTE (34 hours) Phlebotomist.

Question 34: The “Containment of pharmaceutical costs” performance measure on RFP pages 23 and 73 indicates the Contractor will incur a 50% cost-sharing penalty for a 10% or more increase in pharmacy costs over the same quarter in the previous year. Please provide the following information on this topic.

a. How many times was such a penalty assessed on the incumbent vendor during the current contract? 4

b. What was the total dollar amount of these assessed penalties? $146,096.22

c. Please provide the formula/methodology the NH DOC uses to calculate this pharmaceutical cost-sharing penalty. This is calculated by using the aggregate pharmaceutical costs compared to the same quarter in the previous year. If there is an increase of 10%, a cost sharing penalty is levied. We do remove any pharmaceuticals that were paid by a grant.

Answer 34: See above

Question 35: With regard to the “Adherence to NHDOC Formulary” performance measure on RFP pages 23 and 73, please provide a copy of the NH DOC formulary to which the Contractor will be expected to adhere.

Answer 35 New Hampshire Department of Health and Human Services Fee-for-Service Medicaid Preferred Drug List (PDL)

Question 36: Containment of pharmaceutical costs” performance measure on RFP pages 23 and 73 states, “Prescribed medications available to the residents via canteen will be paid for one hundred (100%) percent by Vendor if prescribed by providers.” Please provide a list of prescribed medications available to NH DOC residents via the canteens.

Answer 36: The Canteen list can be found on page 59 of this addendum

Question 37: On RFP Page 99 of 102, with regard to the “Certificate of Authority/Vote (COA/COV),” the Proposal Check Sheet instructions state, “The officer’s (contract signatory) signature should either be notarized or include a corporate seal…” However, on the form “Certificate of Authority # 1 for Corporations or LLCs (Non-specific, open-ended),” there is no place provided for a notary stamp/signature or a corporate seal. Please provide instruction on how bidders should address this discrepancy, for example the DOC could revise the RFP instructions to not require a notary or corporate seal, or direct vendors to create their own space at the bottom of the form for the notary or corporate seal, etc.

Answer 37: The form provided in this RFP is sufficient without notarization.

https://nh.primetherapeutics.com/documents/51139/51633/Preferred%20Drug%20List%20-%20Effective%202.3.2025/b3dc20e2-b37f-ffd3-c521-67328e136ef1 https://nh.primetherapeutics.com/documents/51139/51633/Preferred%20Drug%20List%20-%20Effective%202.3.2025/b3dc20e2-b37f-ffd3-c521-67328e136ef1

Question 38: Section 1.3.3.11 and the Proposal Check Sheet currently both require bidders to include the entire “Criminal Justice Information Services (CJIS) Security Policy” in their proposals. This is a 253-page manual with no place for the bidder’s signature. Previous RFPs required bidders to sign and submit the “Criminal Justice Information Services Security Addendum form,” which is a one-page form certifying that the bidder has reviewed and is familiar with the contents of the CJIS Security Policy manual. Please provide the following clarifications on this topic.

a. Does the DOC want bidders to recreate and include in our proposals the entire 253-page “Criminal Justice Information Services (CJIS) Security Policy” manual?

b. If yes, please indicate where in the 253-page manual the DOC wants bidders to place their signatures.

c. If no, does the DOC want bidders to include a completed and signed one-page “Criminal Justice Information Services Security Addendum form” with their proposals instead?

Answer 38: 38a: No, 38b N/A, 38c Please click on the link provided and navigate to FBI CJIS Security Addendum for the document needed to complete the CJIS requirement.

Question 39: There is a row for 1.5 FTE Phlebotomist in the “Contracted Positions” tables on RFP Pages 91-95. However, this position does not appear in either the “Required Contracted Medical Staff by Position, Site and Full-Time Equivalent” tables on Pages 10 and 57; or the “Required Contracted Administrative Staff by Position. Site and FTE” tables on Pages 20 and 70.

Please confirm that the NH DOC is requiring vendors to include 1.5 FTE Phlebotomist in their proposals.

Answer 39: There will be an addendum to correct this. NHDOC is requesting a .85FTE (34 hours) Phlebotomist.

Question 40: The “Required Contracted Mental Health Staff by Position, Site and Full-Time Equivalent” tables on Pages 18 and 68 require a 1.0 FTE Addictionologist. However, this position does not appear in the “Contracted Positions” tables on RFP Pages 91-95 and there is nowhere to list the rate for this position. Please either (a) provide corrected versions of RFP Pages 91-95 or (b) confirm that vendors are permitted to alter Pages 91-95 to include the Addictionologist position.

Answer 40: This has been corrected in Addendum 2

Question 41: To ensure a competitive bid process, Wellpath requests more time to complete an accurate and well-done proposal which is in the state's best interest. Will the NHDOC approve at least a 45-day extension to the proposal response deadline?

Answer 41: No.

Question 42: Who is responsible for final approval of medical furloughs and reprieves?

Answer 42: There is no such status in the State of New Hampshire.

Question 43: Is the current utilization management process handled electronically or on paper?

Answer 43: Electronically.

Question 44: Per facility, how time per month have calls required for a provider to return to the facility within one hour to complete a direct assessment?

Answer 44: On average, four times.

Question 45: Per the RFP, patients on four or more meds are reported quarterly at CQI. Does this include PRN medications?

Answer 45: Yes.

Question 46: How many new intakes occurred last year?

Answer 46: 758

Question 47: How many releases occurred last year?

Answer 47: 716

Question 48: How many releases occurred last year?

Answer 48: 716

Question 49: How many catastrophic admissions occurred last year?

Answer 49: This is not a category defined nor tracked by the NHDOC.

Question 50: What was the cost of all catastrophic admissions last year?

Answer 50: N/A

Question 51: How many regular admissions occurred last year?

Answer 51: See answer to question 46.

Question 52: What was the cost of all regular admissions last year?

Answer 52: This is not tracked.

Question 53: How many ER runs occurred last year?

Answer 53: 335

Question 54: What was the cost of all ER runs last year?

Answer 54: N/A—these costs are covered by the NHDOC.

Question 55: How many trauma cases went to the ER last year?

Answer 55: We do not track this.

Question 56: How many medivac (helicopter evacuations) occurred last year?

Answer 56: 0

Question 57: How many residents required LTACH or SNF placement last year?

Answer 57: This is an unclear question.

Question 58: What was the cost for all LTACH and SNF Placements last year?

Answer 58: See answer to question 57.

Question 59: How many active cancer patients were there last year?

Answer 59: 16

Question 60: How many patients were on each of the following: biologic medications, chemotherapy, hemophiliac medications, LAI (long-acting injectable), GLP-1, DOACs, SGLT2, ARNI, DAA?

Answer 60: This information can be found in the utilization report on page… of this addendum

Question 61: What was the total cost for all patients on each of the following: biologic medications, chemotherapy, hemophiliac medications, LAI (long-acting injectable), GLP-1, DOACs, SGLT2, ARNI, DAA?

Answer 61: Answer 60: This information is not available at this time.

Question 62: How many residents are over the age of 50?

Answer 62: 671

Question 63: How many patients incarcerated with the NHDOC facilities have been diagnosed with diabetes?

Answer 63: 270

Question 64: How many patients incarcerated with the NHDOC facilities have been diagnosed with hypertension?

Answer 64: 637

Question 65: Exhibit B, Section 11.9, Utilization Management & Section C, 6.9, Utilization Management:

The last sentence reads, “For details, please refer to UM guidelines.” Please provide access to the UM guidelines referenced.

Answer 65 The expectation is that the successful bidder will provide a description of how they provide this function.

Question 66: Please provide the full roster of NHDOC’s healthcare policies and procedures and the Department’s Division of Medical & Forensic Services Policy, Procedure and Directives (PPDs). They are not currently available on the NHDOC website. Can the Department please provide access to all bidders?

Answer 66: PPDs are now available on the NHDOC website.

https://www.corrections.nh.gov/policy-procedure-directives

Question 67: Please provide (by year) the amounts and reasons for any non-staffing penalties/ liquidated damages the NH Department of Corrections has assessed against the incumbent vendor over the term of the current contract, or any other readily available information related to non-staffing penalties/liquidated damages assessed against the incumbent vendor to date.

Answer 67: 0

Question 68: Please provide a list of any pending class actions against the DOC or current contractor for these services requested in the RFP. There are no pending class actions.

Would any future Contractor have to implement any injunctive relief ordered by the Court in any previous litigation? There isn’t any current injunction that a contractor would have to implement from a previous litigation. It is always conceivable that a court could issue injunctive relief in any pending or future case that a contractor would have to implement.

Answer 68: see above

Question 69: RFP Exhibit C, Estimated Budget/Method of Payment: Please confirm that time spent by healthcare staff in orientation, in-service training, and continuing education classes will count toward any “hours worked” requirements of the contract.

Answer 69: Yes.

Question 70: RFP Exhibit C, Estimated Budget/Method of Payment: Please confirm that the awarded contractor has no financial responsibility for the following:

a) Processing and payment of community-based providers (e.g., specialists in the community) and hospital claims

b) Sourcing and delivery of pharmaceuticals

c) Direct patient care supplies and medical equipment

d) Provision of onsite ancillary services, including radiology, orthotics, prosthetics, EKG, dialysis, and other health-related support services

e) Any and all contracts for on and off-site medical service providers (other than those listed in the staffing requirements for the 43 full-time equivalent positions listed in Exhibit C of the RFP) including associated claims/invoices

Answer 70: The successful bidder is responsible only for services specified in the RFP.

Question 71: RFP Page 24, Section C.5, Onsite Clinical Laboratory and Phlebotomy Services: Please confirm our understanding that contractors will be responsible for all laboratory costs.

Answer 71: Yes, unless the bidder declines to include this in their proposal.

Question 72: RFP Page 96, Section 2.1 Method of Payment: Please confirm the methodology for deriving the contracted hourly rate will be based on the Loaded Yearly Compensation Rate submitted on Exhibit C, divided by 2080 hours.

Answer 63: Yes

Question 73: RFP Page 73: The “Pharmacy Cost” performance measure states that any increase of ten percent (10%) over the same quarter in the previous year will incur a penalty. Please confirm that this increase will be measured based on utilization and not based on increases in drug acquisition costs, which are not within the contractor’s control.

Answer 73: That is correct. The formula adjusts for inflation.

Question 74: RFP Page 73: In order for the Contractor to assess the potential “Operation Actions” listed in the far right column of the table, related to Pharmacy, please provide the following information, if available, or any other information that may be readily available to show:

a. a. pharmaceutical cost and utilization reports for the previous eight quarters (equal to a period of two years) to establish the baseline for containment of pharmaceutical costs

b. Off-formulary costs and utilization reports for the previous eight quarters (equal to a period of two years)

Answer 74: The utilization report can be found on page 91 of this addendum

Question 75: RFP Page 73: Please provide a full and complete list of all the over-the-counter medications available in the canteen, including any formulary medications.

Answer 75: The Canteen list can be found on page 59 of this addendum

Question 76: RFP Page 73: Please provide a full and complete list of all the items available in the canteen.

Answer 76: The Canteen list can be found on page 59 of this addendum

Question 77: RFP Page 67, Exhibit B Section 7. Required Mental Health Services: There is a sentence, "Included in this request is the need for staff to respond to court ordered competency evaluations, and related activities, known in NH as the Office of Forensic Examiners (FE)".

However, there are no other mentions of this RFP requirement, and it is not clear whether this is an error in the RFP or which staff position would be expected to perform these duties if actually required. Is it possible this item is in the RFP in error as a “left over” from a previous solicitation? If this service is required, we have the following questions surrounding this requirement:

a. Please clarify which staff position included within the RFP would be expected to perform court ordered competency evaluations and related activities and also identify the related activities expected.

b. Would this designated staff be connected to or part of the Office of Forensic Examiners?

c. Please define further and provide information about the Office of Forensic Examiners.

d. Please specify what other third-party groups, or businesses, or offices that are currently providing other staff to complete court ordered evaluations for the Office of Forensic Examiners, if any.

e. Are court ordered evaluations other than court ordered competency evaluations (such as evaluations for dangerousness or insanity) expected to be completed by the contractor staff?

g. Does this include evaluations for competency to stand trial, dangerousness to self/others, as well as NGRIs?

h. What assessments are utilized for these evaluations?

Answer 77: That is an error. This RFP is not requesting services for court ordered evaluations.

Question 78: RFP Page 67, Exhibit B 7. Required Mental Health Services indicates that “All sites have a broad range of outpatient mental health services offered to include……………group therapy, psychoeducational groups….”

a. Please provide a list of the curriculums or materials that are currently or expected to be used in the provision of group therapy or psychoeducational groups.

b. Please clarify who is responsible for providing these materials for group therapy or psychoeducational groups - the Department or the contractor?

c. Are there assessments utilized in group therapy and psychoeducational groups (e.g., ASI), and if do, who pays for them? How many individuals are treated on this unit a year?

Answer 78 The NHDOC is responsible for selecting and purchasing the curricula for all therapy groups.

Question 79: RFP Page 67, Exhibit B 7. Required Mental Health Services indicates the inpatient services are offered at the SPU and residential treatment is currently offered at the RTU and Wellness Units including Focus (substance use disorder), and the ISOT (Intensive Sexual Offender Treatment) unit.

a. Please identify and/or provide access to the curriculum and materials currently in use to provide these inpatient or residential treatment services.

b. Please clarify if the contractor is responsible for or expected to provide any of these or related curricula or materials.

c. Please provide a list of the curriculums or materials that are currently or expected to be used in the provision of sex offense treatment.

d. Please clarify who is responsible for providing these materials used in sex offense treatment

- the Department or the contractor?

e. Are there assessments utilized in sex offense treatment (e.g., the Acute/Static-99-R), and if do, who pays for them? How many individuals are treated on this unit a year?

Answer 79: The NHDOC is responsible for selecting and purchasing the curricula used in all behavioral health programs.

Question 80: RFP Page 31, Section C, 7.1 Administrative Rules, Policies, Regulations and Policy and Procedures Directives: The RFP has an embedded link to a webpage for additional information on the policy. However, when clicking on the link, it produces a “Page Not Found” message. Can the Department please provide the corrected link to access PPD 371?

Answer 80: RFP Resources | NH Department of Corrections https://www.corrections.nh.gov/resources/bids-contracts/rfp-resources

Question 81: RFP Page 91: The chart showing FY 2026 Medical-Dental-Mental Health Contracted Positions has inconsistencies compared to the staffing required earlier in the RFP document.

An addictionologist is required in the RFP narrative but is not shown on the pricing forms.

Please clarify.

Answer 81: 1FTE addictionologist is being sought. The form will be updated in an addendum.

Question 82: Please clarify and list all of the specialty services that will be offered on site at the NHDOC facilities.

Answer 82: Current on-site specialty clinics include, but are not limited to: ZIOpatch, Electrocardiogram (EKG), ultrasound, x-ray, orthotics and prosthetic, phlebotomy, orthopedics, and optometry.

Question 83: RFP Page 69: Exhibit B Section 7.3.2 states, “Outpatient Mental health services may include mental health services, substance use disorder treatment services, and sexual offender treatment.”

a. Please identify or provide access to specific information about what curricula are utilized, or expected to be utilized to provide substance use disorder treatment services and sexual offender treatment?

b. Additionally, please clarify who is responsible for this curriculum - the Department or the contractor?

Answer 83 NHDOC is responsible for the selection and purchase of all evidence-based curricula.

Question 84: RFP Page 29, Section 6.8.7 states that, “Vendor shall enter information into the Department supplied electronic health/dental record according to all the Departments’ policy and procedure directives and to the design of the EHR.”

a. Can the Department please identify what the current EHR system is and does the Department anticipate continuing use of the current EHR for the foreseeable future (i.e., the term of the forthcoming contract)?

b. Does the EHR system support appointment scheduling by any Centurion staff at any site?

Answer 84: The current EHR is TechCare 4.5. We are actively transitioning to 5.0.

Scheduling is provided by NHDOC Staff

Question 85: RFP Page 71, Exhibit B, 9. Key Medical, Dental and Mental Health Performance Indicators include areas where there are both NHDOC and Contractor staff responsible to collaborate or to perform the activities timely in order to meet the performance measure, or where NHDOC processes must function perfectly to support compliance. Will the Department assess the contractor’s compliance with the performance measure related exclusively to contractor’s staff’s compliance and exclude any noncompliance arising from non-contractor systems or staff functioning imperfectly (i.e., beyond the contractor’s control)?

Answer 85: The performance will be assessed based on performance measures specified in the contract.

Question 86: RFP Page 71, Exhibit B, 9. Key Medical, Dental and Mental Health Performance Indicators Performance Measure for Polypharmacy includes “all individuals on four or more prescribed medications.” Please clarify if this includes all potential prescriber disciplines (dental, medical, psychiatry) or if this measure is by each discipline.

Answer 86: It is based on the total number of prescriptions per patient regardless of prescriber.

Question 87: RFP Page 71, RFP Exhibit B Section 9. Key Medical, Dental, and Mental Health Performance Indicators: Under the Performance Measure Pharmacy Waste states that, “All prescribing providers will adhere to NHDOC workflow regarding ordering medications and by adhering to NHDOC pharmacy parameters for reordering and for initial prescribing of medications to reduce waste.” Please provide information about what these workflows are and if the pharmacy provides noncompliance reports and medication order expiration reports.

Answer 87: Workflows will be covered in orientation. Reports mentioned will be provided by NHDOC.

Question 88: Is the Department currently obtaining or planning to obtain HIV or Hepatitis C medications or any others from a 340B program such as an STD grant?

Answer 88: We are a 340B registered entity.

Question 89: Please provide the number of patients currently on HIV medications.

Answer 89: 10

Question 90: Please provide the average number of patients treated per year for Hepatitis C for the last three years.

Answer 90: 130

Question 91: Please provide the name of the most used and preferred Hepatitis C medication(s) in the last three years.

Answer 91: Epclusa

Question 92: Please provide the number of patients currently on Hepatitis C medications.

Answer 92: 19

Question 93: Please provide the number of patients currently on psychiatric medications.

Answer 93: 923

Question 94: Please provide the number of patients currently on any prescriptions that the pharmacy dispenses monthly, in the last year.

This information is not tracked as medications are prescribed and dispensed as appropriate and needed per patient need.

Question 95: Please clarify – is the Department currently purchasing medications from MMCAP?

Answer 95: Yes.

Question 96: Please clarify – is the Department currently utilizing any long-acting medications for MAT such as Brixadi, Vivitrol, or Sublocade? If so how many patients have received these medications on a monthly basis, over the last year?

Answer 96: Vivitrol is available, but no one is currently on it. We do not use Sublocade, so the answer is zero.

Question 97: Please provide the current monthly drug spend and the current monthly drug spend on non-formulary medications.

Answer 97: We cannot obtain this number currently.

Question 98: The RFP requires bidders to factor costs for certain medications and usage into their cost assumptions. To assist bidders in their pricing proposals, please provide any monthly reports breaking down drug utilizations that include drug costs based on therapeutic category, i.e.

Psych, HIV, Hep C, Diabetes, MAT, etc.?

Answer 98: The vendor does not pay for any medications as NHDOC has its own licensed pharmacy and pharmacy staff.

Question 99: RFP Page 24, Section 5.1 refers to a list of laboratory tests as identified on Exhibit C, Clinical

Laboratory Fee Schedule. We could not find a specific list of tests on Exhibit C. Please provide this information.

Answer 99: The list of lab tests can be found on page 61 of this addendum

Question 100: RFP Page 15, Section C, 1.7.6 states that “Deviations from dental treatment guidelines shall be subject to the Utilization Management process” and 1.7.14 also references dental treatment guidelines. Can the Department please provide the dental treatment guidelines being referenced here?

Answer 100: Please refer to oral and dental health PPDs on the NHDOC website.

Question 101: RFP Page 58, Exhibit B, Section 6.1 Medical Staff: The RFP states that “On-call services are part of the expectation to ensure continuity of care 24 hours a day for 365 days a year.

This does include facility visits after hours, weekends, and holidays for admissions and urgent/emergent care.” Can the Department please clarify what admissions activities occur after hours, weekends and holidays and at what frequency would that require a facility visit from an on-call provider?

Answer 101: Admission activities occurring outside of normal business hours are rare.

Approximately six per month.

Question 102: RFP Page 58, Exhibit B, Section 6.2 Mental Health Staff: The RFP states that “Psychiatric providers and are expected to provide sick call services and on call services to ensure continuity of care 24 hours a day. This includes facility visits after hours, weekends, and holidays for admissions, urgent and emergency care.” Can the Department please clarify what admissions activities occur after hours, weekends and holidays and at what frequency would that require a facility visit from an on-call provider?

Answer 102: Admission activities occurring outside of normal business hours are rare.

Approximately six per month.

Question 103: RFP Page 58, Exhibit B, Section 6.2 Mental Health Staff: The RFP states, “A psychologist position is being sought to provide assessment, evaluations, testing, management of special populations, and crisis intervention.” Can the Department clarify what types of assessment, evaluations, testing are expected or typical and does the Department or the Contractor provide the required testing materials?

Answer 103: Personality testing, intelligence testing, neurocognitive testing, and developmental testing. The vendor would provide all of the necessary testing tools and materials.

Question 104: RFP Page 58, Exhibit B, Section 6.2 Mental Health Staff: The RFP states “Licensed Alcohol and Drug Counselors (LADC) are part of the search for services to provide assessment and treatment for those with substance use disorders.” In addition, the table in RFP Section 7.1 Required Contracted Mental Health Staff by Position, Site and FTE shows

1.0 LADC at NHSP-M and 1.0 LADC at NHCF-W.

a. Can the Department clarify what substance use related activities, tasks, or responsibilities are expected by these LADC staff?

b. Does the Department provide related assessment or treatment materials (such as the ASI or substance use treatment/MAT curricula) or is the Contractor expected to provide the materials?

Answer 104: a. Assessment and treatment activities. Treatment activities can be on an outpatient or a residential treatment basis. ASAM criteria is used in the NHDOC. The NHDOC selects and purchases the curricula for substance use disorder treatment.

Question 105: Page 60, Exhibit B, Section 6.8.5 references Contractor participating in the Department’s Division of Medical & Forensic Services multi-disciplinary end of life care program. Please provide access to information about this end-of-life care program.

Answer 105: Hospice services are provided in accordance with our PPD.

Question 106: RFP Page 60, Exhibit B, Section 6.8.7 references the contractor providing treatment as part of the infirmary care program. Please provide access to information about the infirmary care program or provide a description of the program.

Answer 106: The NHDOC prison infirmaries are used for pre and post-surgical observation, behavioral health isolation, wound care, convalescent care, management of acute illnesses, and problems that cannot be managed appropriately and safely in housing units.

Question 107: RFP Page 61, Exhibit B, Sections 6.8.8 and 6.8.9 references “Contractor /Department’s Division of Medical & Forensic Services mutually agreed upon Utilization Management Program”. Please provide access to or information about the current Utilization Management Program.

Answer 107: The expectation is that the vendor, in their response, outline how they do

UM.

Question 108: RFP Page 61, Exhibit B, Section 6.8.14 requires that, “Contractor shall provide clinical management of these conditions consistent with the Department’s Division of Medical & Forensic Services specific programs, procedures and protocols.” Please provide access to information about these specific programs, procedures and protocols.

Answer 108: PPDs can be found on the NHDOC website. All bidders should be reminded that clinical management is a dynamic process, and we anticipate that new programs, procedures, and protocols will have to be developed.

Question 109: RFP Page 61, Exhibit B, Section 6.8.16 requires the contractor to provide chronic care services “as described in the chronic care clinic treatment guidelines approved by the Department.” Please provide access to the current chronic care clinic treatment guidelines approved by the Department.

Answer 109: PPDs are now available on the NHDOC website.

Question 110: RFP Page 62, Exhibit B, Section 6.8.20 requires the contractor to provide care of the “pregnant patient in accordance with the Department’s policies and guidelines”. Please provide access to these policies and guidelines.

Answer 110: They are available on the NHDOC website. PPDs are now available on the NHDOC website. https://www.corrections.nh.gov/policy-procedure-directives

Question 111: RFP Page 62, Exhibit B, Section 6.8.23 Chief Medical Officer: This area states that the CMO position “clinically supervises all licensed health staff when the Department implements any new health delivery initiatives such as point of care ultrasound, or telehealth….”

a. Can the Department please clarify if point of care ultrasound or telehealth development/expansion are initiatives currently being implemented or are initiatives the Department wants the new contractor to pursue or implement?

b. Is point of care ultrasound equipment currently available to medical providers or does the Department expect the contractor to provide this equipment?

Answer 111: We are not seeking the contractor to initiate these programs or provide the equipment. However, we expect the contractor to support new treatment initiatives to reduce both costs and external consults. Ultrasound services are currently provided by

NHDOC.

Question 112: RFP Section C: General Scope of Services 1.3.30 states, “CMO will publish clinical practice guidelines to include but not limited to management of foreign body ingestion, withdrawal management, palliative care, standards by sex and age for physicals and laboratory services, and others based on correctional healthcare and other informed national healthcare standards.” Can the Department provide access to current clinical guidelines being used for all of these areas?

Answer 112: Some are available in PPDs on the NHDOC website. Others, need to be developed.

Question 113: RFP Exhibit B, 7. Required Mental Health Services states, “In response to this section, indicate the treatment modalities that will be implemented to meet the needs of this population.” Can the Department please indicate any preferred treatment modalities expected and any currently in use expected to continue?

Answer 113: Medication management, group therapy, assessment and diagnosis, psychoeducation, individual therapy and milieu management.

Question 114: RFP Page 8, Section 7.2 of the RFP, it states, “Psychiatric providers and are expected to provide sick call services and on call services to ensure continuity of care 24 hours a day.

This includes facility visits after hours, weekends, and holidays for admissions, urgent and emergency care.” Please clarify if these services can be provided via telehealth?

Answer 114: It is dependent on the situation and policy. For example, a patient in restraints may require the provider to come in periodically.

Question 115: RFP Page 8, Section 7.2 of the RFP it states, “A psychologist position is being sought to provide assessment, evaluations, testing, management of special populations, and crisis intervention.” Are there specific psychological assessments/batteries the department would like to see utilized?

Answer 115: It will be based on patient need. That is why we are seeking an expert in psychological testing.

Question 116: RFP Page 17, Section Required Mental Health Services, it stated that modified therapeutic communities are a part of the correctional facilities.

a. What modified therapeutic communities are there now, how many individuals do they hold, and what curriculum do they use? Who pays for the curriculum?

b. Does the women’s facility use a specific curriculum for groups? If so, what is it, and who is responsible for the cost?

Answer 116: The NHDOC currently has Wellness Units for mental health issues and Focus Units for substance use disorders. Curricula is selected and paid for by the NHDOC. We do use curricula that is based on women’s needs.

Question 117: RFP Page 68, Required Contracted Mental Health Staff: Are mental health clinicians required to be fully licensed?

Answer 117: Yes.

Question 118: RFP Page 68, Required Contracted Mental Health Staff: Is the psychologist required to be fully licensed?

Answer 118: Yes.

Question 119: RFP Exhibit B Section 14. General Service Provisions 14.6 Contractor Employee Information/Background Checks 14.6.3 states that “NHDOC shall notify Contractor of any potential Contractor and/or sub-contractor employee(s) who does not comply with the criteria identified below.” However, the next subsection below 14.6.4 lists the exclusion criteria, which would be criteria to exclude staff from hire, not criteria for staff to comply with for hire. Can the Department clarify if there are additional criteria missing from 14.6.3 that staff will need to comply with?

Answer 119: We will conduct a procedural review of all background checks and reserve the right to make decisions based on that information.

Question 120: RFP Page 26, General Services Provisions: This area discusses the equipment, tools, and utilities required for this program.

a. Please specify exactly what computer hardware is considered "usual and customary equipment" that will be provided by NHDOC versus what must be furnished by the contractor. Computers and peripherals shall be purchased by the contractor in accordance with NH DoIT specifications which will be provided to the successful bidder.

b. Will existing hardware (computers, printers, scanners) be available for contractor use, or must all new equipment be provided? It depends on the location of the contractor staff.

Contractor staff based in offices that are not on NHDOC property will have to have all necessary equipment for their work purchased by the contractor. Those staff able to use NHDOC space will have access to a printer. In all cases, the contractor needs to purchase computers/laptops for their staff.

c. Are there specific hardware specifications or standards that contractor-provided equipment must meet? Yes. Please see a.

d. What time and attendance system is currently in use, and can it be integrated with contractor systems? Yes, the state has a time and attendance system. It is not available to the contractor staff currently, but we are receptive to discussions upon contract award.,

e. Will NHDOC provide and manage server space for contractor applications, or must the contractor provide and…