Addendum 4.pdf

July 2, 2024

ADDENDUM NO. 4

CORRECTIONAL MEDICAL HEALTH SERVICES FOR THE YAMHILL COUNTY

CORRECTIONAL FACILITY AND YOUTH SERVICES CENTER

PROPOSALS DUE: July 17, 2024

The Request for Proposals (RFP) listed above is modified as set forth in this Addendum. The original RFP Documents and any previously issued addenda remain in full force and effect, except as modified by this Addendum, which is hereby made part of the RFP. Proposers shall take this Addendum into consideration when preparing and submitting its bid.

ADDITIONAL CLARIFICATIONS

Item No. Location Q&A

4.1 Section C, Scope of

Work

Question: In the past year how many of each have occurred

• Provider visits

• Nursing visits

• ER visits

• Outside provider visits of all kind?

County Response:

• Provider visits---219

• Nursing visits---8370

• ER visits---58

• Outside provider visits of all kind---28

4.2 Section C, Scope of

Work

Question: In the past 3 years, what were the annual costs associated with the following:

• HIV, AIDs, and Hep C medications (a combined number is great)

• Outside medical patient care

• Dental care

• Ambulance services?

County Response:

• HIV, AIDs, and Hep C medications--- $18,873.34 total for the past 3 years

• Outside medical patient care--- $54,037.18 (this includes outside labs and imaging; some still pending)

• Dental care---$1,354 within the last year

• Ambulance services---$8,831.50 within the last year (some still pending)

4.3 Section C, Scope of

Question: What is the current staffing schedule when the facility is fully staffed?

(current staffing matrix)

County Response: The current provider’s staffing matrix was included as Exhibit A to their contract, which was included in Addendum No. 2.

4.4 Section C, Scope of

Question: How long does the fingerprinting and background check process take? AKA, how long from when a medical staff member is hired to when they are cleared to work?

County Response: Medical staff are fingerprinted prior to their first day. It is then approximately 3-5 days before we get a response back from the State. Staff are escorted until their CJIS clearance is approved.

4.5 Section C, Scope of

Question: Can you share a list of current employees (redacting identifying information) with the following data:

• Position

• Hours worked per week

• Credential

• Rate of pay

• Tenurer?

County Response: The information requested in item 4.5 is obtainable directly from the provider, MedTrust, LLC.

4.6 Section C, Scope of

Question: Under what circumstances do medical staff interact with inmates without the physical presents of deputies?

County Response: The County does not assign deputies to medical staff. Medical staff is alone with the AICs unless the AIC is classified maximum, or otherwise upon request.

4.7 Section C, Scope of

Question: How do you ensure the safety of medical staff when they interact with inmates without the physical presence of deputies?

County Response: The County has cameras located throughout the facility. Additionally, medical staff are each provided with radio communication for assistance when needed.

4.8 Section C, Scope of

Question: Is routine pregnancy care treated on site presently?

County Response: Yes.

4.9 Section C, Scope of

Question: What are the average number of pregnant inmates in the facility routinely?

County Response: On average, the County sees 1-2 pregnant women per year.

4.10 Section C, Scope of

Question: Does the facility use a local methadone clinic for prescribing and administering methadone? If so, which clinic?

County Response: No, there is not a local methadone clinic in McMinnville. A Great Circle mobile van comes to McMinnville to dose patients; however, if they are in custody, methadone is given on a case-by-case basis.

4.11 Section C, Scope of

Question: How does the Mental Health staff and Medical Department share information about patients? Do they share a charting platform? Is there some other mechanism for viewing mental health notes?

County Response: Medical and Mental Health share the same charting system, which makes all notes available to see. Medical and Mental Health also share information about patients via daily communication.

4.12 Section C, Scope of

Question: Section C.3.10 describes the discharge process. What aspects of the discharge process are handled by the mental health staff and what aspects are desired to be handled by the medical vendor?

County Response: Mental health staff have their own discharge procedures that are separate and distinct from the jail providers procedures.

4.13 Section C, Scope of

Question: Does the county transport inmates to a dentist or does a dentist come into the facility? Is there physical room in the facility to bring a dentist in, and is the county open to that option?

County Response: The County does not have dedicated dental services in-house and would prefer to keep all dental care outpatient only.

The County facilitates transport for all outside medical appointments, including dental.

4.14 Section C, Scope of

Question: Section C.3.8 under “DENTAL” the RFP indicates the dentist should “preserve salvageable teeth”. Which of the following types activities does the county expect the dentist to routinely perform:

• Fillings

• Extractions

• Crowns

• Root canals?

County Response: Dental services are for those procedures deemed emergent by the provider.

4.15 Section C, Scope of

Question: Is the county looking for the medical vendor to take on all, some, or none of the administrative burden associated with receiving, analyzing, organizing, and paying invoices from outside providers? How does it work now and what does the county want to see change?

County Response: Medical provider receives, processes, and pays all outside vendor invoices. The County would like the administration of invoicing to continue to be the responsibility of the provider.

4.16 Section C, Scope of

Question: Does the county receive Medicaid rates, by law, for services rendered by outside providers including hospitalization, outside clinics, ERs, and ambulance services?

County Response: The County will not be providing a legal analysis of current Medicaid law. Proposers are expected to have a working knowledge of Medicaid, Medicare, and the Oregon Health Plan in relation to Oregon correctional facilities (see Section D.2.2 (C) (4)).

4.17 Section C, Scope of

Question: Can you explain the ways in which the Oregon 1115 Waiver and Oregon Senate bill 4002 currently impact the operations of your medical department, and the ways in which you expect them to impact the department in the future.

County Response: The impact of current and past legislation is unknown. Proposers are encouraged to discuss the impacts with their own counsel.

4.18 Section C, Scope of

Question: Section C.3.6 References court ordered blood draws. Is it the county’s expectation that the medical vendor will conduct evidentiary blood draws?

County Response: The County may require court ordered blood draws from the provider at the County’s discretion.

4.19

Section C, Scope of

Question: Section C.3.8 refers to “emergent specialty care service”. Is this referring to ER visits, outside provider visits, or something else?

County Response: Emergent specialty care refers to any outside medical service procedure deemed emergent by a provider.

4.20 Section C, Scope of

Question: Pg 10 says “The Provider’s staff will have an ongoing duty to report law enforcement contacts to the County.” We’re unclear as to what this is referring to. Can you elaborate and clarify?

County Response: If medical staff has contact with a law enforcement agency outside the scope of their employment, they need to immediately report that contact to the County.

4.21 Section C, Scope of

Question: Pg 16 Section D.6 says “Include a sample invoice that will match your cost estimate and discuss your ability to provide adequate back-up to aggregate costs charged.” Can you clarify what is meant by “adequate back-up to aggregate costs charged?” We’re not certain what this is referring to.?

County Response: Adequate back-up documentation will support the invoice as presented in the proposer’s proposal.

4.22 Section C, Scope of

Question: Can the county share the contract between the current medical vendor and Yamhill County, along with any active addendum?

County Response: The County’s current medical provider contract was attached to Addendum No. 2.

4.23 Section C, Scope of

Question: What is the current medical records system (electronic or paper charts)?

County Response: CoEMR

END OF ADDENDUM