Att F Technical Proposal-rtp v2.docx

RFP 27-87787

TECHNICAL PROPOSAL

ATTACHMENT F

The Indiana Department of Correction Health Services Division provides the highest available quality of care to incarcerated individuals. The Physical Health, Behavioral Health and Transitional Health Services provide various services within our facilities as well as coordinating services once released back into the community.

For sections that involve performance measures, the IDOC has the right to add, revise, or delete performance measures and audit tools during the course of the contract.

Instructions: Please provide answers in the shaded areas to all questions. Reference all attachments in the shaded area.

Respondent’s Name:

2.4.1 Scope of Work/General

The Indiana Department of Correction (IDOC) is seeking a health services Vendor that provides high quality, comprehensive health services to approximately 25,000-28,000 incarcerated individuals, including up to 1,000 detainees for Immigration and Customs Enforcement (ICE) at the Miami Correctional Facility over the term of the contract resulting from this RFP. These individuals are incarcerated in eighteen (18) adult correctional facilities and three (3) juvenile correctional facilities located throughout the State of Indiana. Transitional Healthcare services will also be provided through staff trained to assist parolees in ten (10) parole districts in obtaining community-based health services including addiction recovery, mental health services, and support for chronic conditions. A complete list of the IDOC correctional facilities along with the custody level of each facility is included in this RFP as Bidders Library– IDOC Facility Security Levels.

The IDOC is currently in the process of constructing a new correctional facility located in Northwestern Indiana. The new facility is projected to open in 2027. The IDOC and the Vendor will agree that an amendment will be entered into in order to address staffing arrangements and any other additional requirements.

All IDOC incarcerated individuals shall have access to services that meet their comprehensive health care needs. The health services to be provided are comprehensive and are to include, but not be limited to, primary care, nursing services, sick call, infirmary care, hospitalization, emergency care, maternal health care unit, chronic care, long term care, dialysis, hospice/palliative care, dental, optometry/optical, physical and occupational therapy, pharmacy services, laboratory services, mental health, illicit substance use/addiction recovery services, medication assisted treatment (MAT) for addiction, electronic health record (EHR) management, county jail claims management, interstate compact offsite request reviews, transitional health care, ancillary and support services, supplies and equipment, and administration.

The services provided are to meet or exceed Constitutional and community standards; the standards of the National Commission on Correctional Health Care (NCCHC); the standards of the American Correctional Association (ACA); Americans with Disabilities Act (ADA); applicable Indiana statutes (which include, but are not be limited to, IC 11-10-3 et al., and 11-10-4 et al); the applicable policies, procedures, and directives of the State of Indiana regarding the provision of health services to include, but are not limited to, IDOC Health Care Services Directives (HCSD) attached to this RFP as Exhibit LBidders Library - HCSD; recommendations of the Centers for Disease Control and Prevention (CDC); recommendations of the U.S. Preventive Services Task Force; all federal requirements, including any settlement agreement with the United States Department of Justice (DOJ), any court order applicable to Indiana, State policy, procedure, or health care service directive language shall have precedence over the Vendor’s language regarding the same in the event of any conflict between the two. The Vendor will follow all new IDOC Health Care Services Directives as issued. If any requirement of this RFP exceeds the standards of the ACA, NCCHC, CDC, or policies or procedures, the requirements of this RFP shall prevail. Technology solutions and processes proposed under this RFP must comply with statewide IT policies, including Indiana RAMP, IOT Information Security Framework, and State Digital Accessibility requirements.

Under current Indiana law IC 11-10-3-6, outpatient claims by medical providers are limited to a Medicare +4% rate, or in the event there is no Medicare reimbursement rate for the service, 65% of the claim. Most inpatient admissions are expected to be covered by either traditional Medicaid or HIP 2.0. Generally, inpatient hospital stays over 24 hours are covered by Medicaid.

The Respondent should respond to this specification with a statement that it agrees to meet and comply with the specification. The response should also include a narrative that supports Respondent’s ability to meet the scope of work by detailing prior experience, clients, and available resources related to the provision of medical services to institutions.

2.4.2 Administration

The Vendor shall provide the necessary corporate administrative functions such as time keeping, payroll, personnel functions, billing tasks, obligations payment, telephone, and fax lines for long distance calls, etc. Additionally, the Vendor shall provide sufficient regional administrative staff to provide effective administration, clinical oversight, and quality assurance oversight for this contract. The regional administrative staff will reside in Indiana full time to be near IDOC Central Office and IDOC facilities. The Vendor shall have in place, by the contract start date, the essential administrative personnel, and operational policies and procedures for compliance with contract specifications and administration of the health services program.

In the event that the Vendor also operates facilities elsewhere such as county jails or youth facilities in Indiana, the following positions shall not be shared with, or perform duties for, any other contract outside of the IDOC contract. These regional positions are to include Vice President of Operations (VPO), Medical Director, Director of Nursing (DON), Psychiatry, Mental Health, Quality Assurance, Transitional Healthcare, Addiction Recovery Services, and Dental Director.

Notwithstanding any provisions to the contrary, the IDOC reserves and retains the right to maintain and enter into arrangements through grants, contracts, or any other means for the provision of additional health services, including but not limited to grant funded programs, contracts with consultants to serve as senior medical and mental health consultants to provide services such as peer review, mortality review, case review, and contracts for purchasing pharmaceuticals and such other functions as may be deemed necessary by the IDOC.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Please describe the reports your time keeping system is capable of providing.

2.4.3 Staffing –MinimumStaffing Document

The Vendor will retain all staff necessary to provide health services within all IDOC facilities according to applicable standards. The IDOC highly prefers a staffing proposal that addresses retention, staffing vacancies, and coverage, in a realistic, practical, and thoughtful way.

Due to the importance of maintaining adequate staffing levels, the Vendor shall comply, at a minimum, with the staffing levels set forth in the Minimum Staffing Document attached to this RFP as Bidders Library – Staffing Document. The Minimum Recommended,Staffing Document, attached to this RFP sets the minimum staffing level the IDOC believes necessary for services. If the Vendor believes an increase in staffing is required to meet the specifications of this RFP or believes it can deliver more effective care with increased staffing, the Vendor may increase the staffing levels over those set forth in the minimum staffing document. The Vendor’s choice to increase staffing will be at the Vendor’s own cost. After being awarded the contract, when the staffing schedule is increased at the request of the IDOC, the State shall negotiate either an appropriate increase in the per diem or a reduction in the reimbursements due (such reimbursements include the reimbursements due the State by Vendor as specified in this RFP, for example, the reimbursement for contract monitoring, and the reimbursement for seat charges, in order to account for the increase. The aforementioned notwithstanding, a mutual re-structuring of the Minimum Staffing Document that is cost neutral shall not be cause for such a per diem renegotiation.

The Respondent shall complete a staffing plan for all facilities in a spreadsheet format that identifies the number and type of staff by shift. The plan should meet the expectations of this RFP as described in the Minimum Staffing Document. This “staff transition” applies to non-provider staff only. Any changes in nurse practitioners or physicians including site medical directors and psychiatrists must happen within sixty (60) days of the contract award.

The Respondent shall complete a staffing plan for all facilities in a spreadsheet format that identifies the number and type of staff by shift. This “staff transition” applies to non-provider staff only. Any changes in nurse practitioners or physicians including site medical directors and psychiatrists must happen within sixty (60) days of the contract award.

This staffing plan should include any administrative staff needed to initiate and to continue delivery of the health services required in this RFP. The plan must also indicate how coverage will be provided for staff on vacation or other scheduled leave of absence. Upon awarding the contract, the Vendor shall provide a final staffing plan for each IDOC facility. Deviations from the proposed plan must be approved by the IDOC Executive Director of Healthcare Operations and the Chief Medical Officer for IDOC. The staffing plan will be the basis for staffing throughout the Contract term. This plan will identify the minimum number of management and line staff positions by position title and scheduled hours of service for each position and each institution. The IDOC reserves the right to periodically review the Vendor’s staffing levels.

Any reallocation of positions that impact the staffing plan will be made by mutual agreement between the Vendor and the IDOC. In the event a mutual agreement cannot be reached, the decision of the RFP shall prevail. If, at any time, the staffing plan proves inadequate in practice to meet the incarcerated individuals’ health care needs, the Vendor must increase staff hours to provide the health care needs. The cost of these additional provider hours will be the sole responsibility of the Vendor. An exception to this would be any increase in staffing due to the IDOC’s compliance with a court order that requires additional staffing, or an increase necessary due to the opening of a new facility by the IDOC. In such case, the IDOC will negotiate an increase in the per diem with the Vendor.

To cover absences and leaves, the Vendor may have a higher-level staff cover the responsibilities of a lower-level staff; however lower-level staff (such as an LPN for an RN) is not permitted to cover for higher level staff. For example, in order for the Vendor to fulfill its contractual obligations to meet staffing or to fill vacancies, an LPN will not be able to substitute for an RN, a CNA may not substitute for an LPN, a mid-level provider may not substitute for a physician, and a nurse practitioner (different scope of practice) that is scheduled to see patients may not be counted toward RN coverage for that shift, etc. Hours of staffing for each position, by facility, are to be provided to the IDOC monthly. All vacancies and deficits of employee hours are to be determined by positions at each facility. Total hours of staffing provided for the facility as a whole will not meet this requirement. If substitution with a lower-level staff must be used on a temporary basis, the position will still be considered vacant.

For facilities with only one position within a department where that position is vacant, the Vendor must provide adequate coverage for that position to complete all required services.

For the purpose of clarity, the Minimum Recommended Staffing Document set forth in this RFP is the minimum staffing that must be met by the Vendor; however, the Respondent in its proposal may add staffing to this plan as it deems necessary to meet the service, standards, and expectations set forth herein.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should provide a staffing proposal that will meet or exceed health outcome requirements outlined in this RFP.provides at a minimum the staffing set forth in the Minimum See the Staffing Document attached to this RFP as Bidders Library – Staffing Document.

2.4.4 Staffing – Staffing

The Vendor shall provide adequate and sufficient health care personnel necessary to perform the various services in accordance with the specifications of the State’s Request for Proposal (RFP).

The Vendor shall, monthly, provide the State with an itemized list of the hours worked at each IDOC facility, by position, for each of the positions listed in the Minimum Staffing Document. This should only include positions listed in the Staffing Schedule. The Vendor shall also report the overtime hours by existing employees used by the Vendor to cover vacant positions, indicating if the overtime was mandatory or volunteer. These hours shall be reported as Full-Time Equivalents (FTE) and fractions of FTEs. Supporting payroll and automated time-keeping information that demonstrates and verifies filled and unfilled hours per position shall be provided by Vendor.

The staffing schedule will reflect staffing requirements in FTE hours for each position, including fractions of FTE hours. As a result, FTE hours worked in excess of the scheduled minimum FTE hours for a position at one facility shall not be used to offset a deficit of FTE hours for the same position at another facility.

The Vendor will use all reasonable efforts to fill vacancies. A vacant position is one that is not permanently filled or positions of staff that are on extended medical leave, military leave, or for any other reason the staff filling the position are not present for 30 days or more. The official start date of the vacant position will be considered the actual fill date and the end of the vacancy. Furthermore, the Vendor may not consider an accepted position as filled until the person occupying the position actually begins IDOC training. A vacant position will not be considered filled if the Vendor re-assigns existing staff, including staff from the regional office, or uses current staff in excess of a full-time equivalent to cover the position.

To temporarily cover vacant positions, the Vendor may use part time, temporary, agency, locum, PRN, and overtime hours by existing employees, so long as the person meets the qualifications and licensing for the position. When existing employees are used by the Vendor to cover vacant positions, only FTE hours worked in volunteer or non-mandatory overtime by an existing employee shall count 100% toward covering the FTEs of a vacant position. The Vendor shall track and report to the IDOC all mandatory and volunteer overtime related to covering vacancies.

If substitution with a lower-level staff must be used on a temporary basis, the position will still be considered vacant. (e.g., an NP for an MD).

Consistent failure by Contractor to meet the Minimum Staffing Document set forth in this RFP, or as amended by mutual agreement of the parties, may result in the termination of the contract resulting from this RFP.

The IDOC values experienced staff and recognizes that involuntary overtime may lead to burnout and an increased turnover rate. The Vendor must establish a retention plan to retain capable staff.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should provide a narrative, along with any supporting documentation, of how it proposes to meet this specification including narrative of how it intends to handle vacancies to comply with the specifications set forth herein.

2.4.5 Staffing – Qualifications

All staff hired or provided through this contract must be appropriately qualified, and licensed or certified to perform the services required and must work within their respective scope of practice. The Vendor is expected to verify and maintain credentials and current licensure on file in the facility where the individual is performing services. The Vendor is required to submit the names and positions of all new possible hires to the Quality Assurance Managers prior to an offer. It is the responsibility of the employee providing these services to ensure that the facility has an up-to-date license or certificate. For physicians, advanced practice nurses, physician assistants, and dentists, these licenses shall include both federal and state permits to issue controlled substances. Physicians shall be Medicaid eligible within 90 days of the start of the contract.

The Vendor will not employ health care professionals whose licenses or certifications restrict them to working inside prisons only. Physicians must comply with Medication Assisted Treatment options in every IDOC facility for the treatment of substance use disorders and must maintain a current DEA registration that include Schedule III authority to prescribe buprenorphine for opioid use disorder.

The Vendor will assess the skills of all professional staff to assure competency to provide required services. Nursing staff and unlicensed assistive personnel will demonstrate and document skills on a specific check list applicable to each professional level prior to their assignment and yearly thereafter. The Vendor will establish a privilege list as a component of credentialing for physicians, nurse practitioners, and physician assistants. The credentialing process must be provided to the IDOC prior to the start of the contract. All clinical staff approved by the Credentialing Committee must have a credential review and approval by the CMO or designee as its final step. All staff must complete annual training in trauma-informed care, including recognizing signs of trauma, de-escalation techniques, and referral protocols.

Before being allowed to work with IDOC incarcerated individuals, including incarcerated youth, the Vendor’s employees and contracted staff shall be subject to the security clearance policy and procedure of the IDOC. All employees of the Vendor including subcontractors shall undergo a thorough background check (e.g., criminal history background check, including a driver’s license check and fingerprinting, sex offender registry check, employment verification, educational verification, license or certificate verification, and in appropriate cases Children Protective Services check, in limited cases, credit history check, drug screen or any other screen or check deemed necessary by the Vendor or the IDOC.) Subsequent criminal history background checks shall be completed at least every four (4) years on current contract employees who have contact with incarcerated individuals. Entry to the IDOC facilities will be prohibited unless all staff including regional, administrative, PRN, and temporary staff such as locum tenens, have completed a background check. The IDOC will be financially responsible for any criminal / character / personal background check it performs; however, the Vendor shall be responsible for background checks that are performed to ensure Vendor’s staff is maintaining all required professional licensing and industry requirements to perform the health care services being provided. If the Vendor deems a particular screen or check as necessary, but the IDOC does not, the Vendor will pay for the screen.

The IDOC will retain the right to require the Vendor to exclude from working at any IDOC facility any employee of the Vendor who is deemed incompetent, insubordinate, or objectionable by the IDOC. If the IDOC invokes this right, the Vendor shall remove the employee immediately. The Vendor will agree not to hire or rehire any former employee of the Vendor or previous Vendor, or former employee of the IDOC, who was removed for cause, or resigned with prejudice.

The IDOC reserves the right to refuse entry onto its facility grounds an employee of the Vendor whom it has found to be in violation of the facility’s policies and procedures, charged or adjudicated in violation of state law in connection with the employee’s conduct toward a resident of the facility, prohibited from working with children pursuant to I.C. 4-13-2-7 et seq. or under investigation for violation of state law in connection with the employee’s conduct toward an incarcerated individual of the facility. If the IDOC invokes this right the Vendor shall remove the employee immediately.

Any person performing work under the contract agrees to adhere to all IDOC procedures, policies, and codes of conduct. All staff employed by the Vendor including subcontractors, both full and part-time, must abide by the IDOC’s dress code.

The Vendor is responsible for all actions and work performed by its subcontractors and all staffing stipulations applicable to the Vendor’s staff apply to subcontractors.

Personnel files of all Vendor employees shall be on file at the facility, outside the secure perimeter. IDOC is responsible for providing a secure space where the Vendor may maintain these files. When necessary, the Vendor will provide pertinent or demographic information from the personnel files to the Warden or Investigations and Intelligence staff which is needed to complete an investigation.

The IDOC considers the hiring of the Health Services staff to be critical to the success of the health care delivery program. Therefore, the Vendor must comply with the following expectations:

· Recruitment efforts should concentrate on attracting quality candidates who also possess correctional experience.

· Health Services Administrators (HSA) must have at least a 4-year undergraduate degree (preferably concentrating in health care administration and budget) and strong health care supervisory and management or nursing experience acceptable to IDOC.

· HSAs must be assigned to all facilities. A full-time HSA and a full-time Assistant HSA must be assigned to major facilities

· Directors of Nursing, and Assistant Directors of Nursing at major facilities, must be Registered Nurses and minimally have adequate experience in nursing and administration to support placement. A Baccalaureate degree is preferred.

· Newly employed HSAs, Directors of Nursing, and Medical Directors must have an assigned mentor to train these employees on Health Care Services Directives and the performance measures.

· Site Medical Directors must be board certified or board eligible (exceptions may be made for existing staff if hired by Vendor).

· Requirements for addiction recovery staff and mental health staff are found in HCSD 4.03A/Y and HCSD 4.01A/Y.

The IDOC reserves the right to approve or deny any individual or business that the Vendor intends to employ to serve IDOC, regardless of whether it is an independent contractor or a subcontractor. The Vendor must obtain written approval from the IDOC specific Executive Directors of Health Services/CMO for key staff prior to their starting date. Key positions include all regional office staff listed above, all facility HSAs, Medical Directors, and Directors of Nursing. The IDOC Executive Directors of Health Services/CMO will be provided with the curriculum vitae of the medical directors the Vendor intends to employ. The Vendor must advise the IDOC Executive Directors of Health Services, CMO, and the appropriate IDOC Health Services Quality Assurance Manager prior to dismissing or changing the location of any key positions including but not limited to HSA, DON, Clinicians, Regional Staff, etc. within twenty hours (24) of a change.

The Vendor must notify the IDOC Executive Directors of Health Services, CMO, and the Quality Assurance Managers whenever key staff members are on a leave of absence. This includes the VPO, directors of medicine, nursing, dentistry, addiction recovery and mental health, including the chief psychiatrist. The notification must include the dates of the planned or anticipated leave and should identify the staff member who will be covering the key position. The facility’s Health Services Quality Assurance Manager must be notified of any leave of absence from the facility’s Health Services Administrator (HSA), the Director of Nursing (DON), or the Medical Director.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should provide a narrative, along with any supporting documentation, of how it proposes to meet this specification.

2.4.6 Staffing – Administration/Executive

The Vendor shall identify the key corporate staff to be involved in managing the contract. The Vendor must have regional or central capability to supervise, manage, and monitor the health services program. The Vendor shall employ at a central or regional location within the state, at minimum, the personnel in the list below. If the Vendor intends to hire existing leaders or employees to serve the IDOC healthcare team, IDOC Executive Directors of Health Services or CMO must approve the hire. If the Vendor intends to hire existing staff in certain positions, please indicate such for each position.

· An executive with experience in a comprehensive health care program to oversee all aspects of the contract. The IDOC expects this to be a Vice President of Operations (VPO) or similar position.

· A full-time statewide Medical Director licensed in Indiana and Board Certified who will be responsible for managing clinical issues and overseeing the formulary, utilization management, and peer review programs. The statewide Medical Director will also review hospitalized incarcerated individuals and manage formulary exception requests and the utilization management program. The statewide Medical Director shall oversee the training of new physicians and physician extenders. The statewide Medical Director will work closely with the IDOC CMO. Recommended staffing for the Vendor’s Regional Office includes:

· One Associate Regional Medical Director to assist the statewide Medical Director in managing clinical matters including processing formulary exceptions and off-site referral requests, training and mentoring new physicians, and covering physician vacancies. The ARMD must be board certified or eligible.

· A full-time Statewide Director of Nursing (RDON) who will be responsible for all aspects of the nursing program including the nursing orientation and nursing competencies. Minimum of a Bachelor of Science in Nursing (BSN) and strong leadership skills are mandatory for this position. If the current RDON does not have a BSN, consideration may be given.

· A full-time statewide psychologist Behavioral Health Director to oversee addiction recovery and mental health treatment and all associated policies.

· A full-time statewide, Associate Regional Director of Mental Health. The individual should have a Masters’ level clinical degree.

· A Chief Psychiatric Director responsible for assuring that psychiatric services meet community standards of practice and managing formulary exceptions for psychotropic medication. Board certification is required.

· A Regional Dental Director who will be responsible for assuring all dental services covered in this RFP are delivered in a timely manner and will manage the dental prosthetic prior approval (PPA) process. The Regional Dental Director may be assigned to a facility, however; this director must conduct site visits at each facility with on-site dentistry at least once a year.

· Regional Managers to manage the day-to-day operations of the contract, ensure the Vendor’s employees are adequately trained, and to addresses issues and concerns raised by the IDOC in a timely manner.

· A full-time Regional Director of Transitional Healthcare responsible for Transitional Healthcare facilitators and liaisons and assuring transitional care for releasing persons is provided.

· A full-time Quality Assurance Professional who will be responsible for managing the continuous quality assurance program and serve as the point of contact for sentinel event reviews.

· A Hospital Case Manager who will be responsible for discharge planning for hospitalized individuals.

· Transitional Healthcare Facilitators and Transitional Healthcare Liaisons staffing in accordance with Staffing Control Document (SCD). The purpose of the Transitional Healthcare Facilitators is to provide transitional healthcare planning for releasing incarcerated individuals. The purpose of the Transitional Healthcare Liaison is to immediately engage with referred parolees upon release and provide access to community services. This requires the THF and THL to review upcoming releasing incarcerated individuals for medical, mental health, and substance use concerns that will affect their ability to successfully transition to their community.

· Two full-time Administrative Assistants, one supporting physical health and one supporting behavioral health.

· A full-time Regional Director of Addiction Recovery Services to oversee the daily operations of all modalities of substance use treatment at all adult and DYS facilities. Minimum requirement of a 4-year degree, State Professional License, and/or a Certified Alcohol and Drug Addiction Consultant (CADAC) certificate and leadership experience. The Regional Director of Addiction Recovery Services works in concert with the IDOC Director of Addiction Recovery Services.

· Two full-time Medication Assisted Treatment (MAT) Coordinators to oversee the daily operations of MAT at all facilities.

· One full-time Telehealth Coordinator & Data Coordinator.

· One full-time Manager of Systems Integration.

· A point of contact for all IT and data related issues.

· A regional infection control nurse.

· A grievance/correspondence coordinator.

· Women/Youth/Infant Service coordinator.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should also include with its proposal a proposed staffing plan for the services utilizing the “full time equivalent” or “FTE” methodology.

2.4.7 Staffing - Staff Training

The Vendor must ensure that all staff receive a comprehensive new‑employee orientation that includes introduction to the Facility, the assigned health services area, and the employee’s specific role. This orientation must also include training for individuals new to corrections on appropriate interaction within a correctional environment, including instruction on prohibitions against fraternization, improper relationships with incarcerated individuals, and trafficking.

All Vendor employees, and any contracted staff who have contact with incarcerated individuals, including youth, must complete initial training (Contract Preservice) during their first week of employment. Required topics include administrative processing such as fingerprinting, ID issuance, and TB testing (2.0 hours); facility entry and exit procedures and ADP/Code of Conduct (2.5 hours); Use of Force (1.5 hours); Communication and Mental Preparation (1.5 hours); Personal Protection (7.5 hours); Legal Authority of Searches (1.0 hour); Basic Security Principles (1.5 hours); Strip and Cavity Searches (1.0 hour); Pat, Frisk, and Modified Frisk Searches (7.5 hours); and Use of Restraints (4.0 hours). Staff already certified in CPR/First Aid may be exempt from IDOC‑provided CPR/First Aid training but must submit proof of certification to their training coordinator within five days of employment.

Following Contract Preservice, each staff member must complete 75 hours of on‑the‑job training. Afterward, staff are required to complete a self‑study program consisting of assigned eLearning modules and a final electronic examination. The self‑study program must be completed within 30 days of the staff member’s start date, and all required training must be completed before the employee may work unsupervised. Staff who fail to complete any portion of required training will be dismissed from the training program, and any request for reinstatement must be approved by the Executive Director of the Division of Workforce Engagement.

In addition to all initial training requirements, the Vendor’s employees and any contracted employees must maintain all required certifications and complete ongoing training in accordance with the Department’s policies.

After initial training, all staff must complete annual in‑service training totaling a minimum of 40 hours per fiscal year. This curriculum will include classroom instruction and vendor‑provided training. Any vendor‑provided training must be documented and submitted to the training coordinator for entry into the learning management system. Staff may complete annual eLearning modules if they do not reach 40 hours through combined classroom and vendor‑provided training.

All qualified health care professionals with direct contact with incarcerated individuals, adult and youth, must be certified in CPR/AED through an accredited organization such as the American Heart Association, Emergency Care and Safety Institute, or the Red Cross. Vendors are required to purchase their own Certification Cards at no cost to the IDOC for certification. The IDOC does provide this training to all Vendor and contract staff if requested.

The Vendor shall adhere to any and all changes deemed necessary by the IDOC based on the needs of the Department.

Records of new employee orientation and annual training must be maintained. Once a month the HSA or designer must forward to the IDOC training staff and the assigned Quality Assurance Manager a summary of training activities completed during the previous 30 days. All required annual training must be completed by June 30th of each year.

The Vendor is expected to provide IDOC staff with the following in-service training:

· Trauma Informed Care, at a minimum of once a month, in the Division of Youth Services (DYS) Making a Change (MAC) Academy.

· Suicide Prevention/Interventions overview at all five (5) regional training locations at a minimum of once a month during Phase Three (3) of the New Employee Training Process.

· Suicide Prevention/Intervention overview during In-Service Training at all Training Departments throughout the State.

· Suicide Prevention/Intervention overview for youth at a minimum of once a month at the MAC Academy at the Correctional Training Institute once a month.

· Vendor will provide at a minimum of two (2) times per year an instructor certification program for Suicide Prevention/Intervention and Trauma Informed Care for IDOC Staff. Lesson plan requires the approval from the Executive Director of Workforce Engagement before utilizing.

· For sites with paid Suicide Watch Companions, mental health staff will assist by delivering the Suicide Prevention and Behavioral Health components of training.

IDOC provided training will be provided free of charge to the Vendor, but the Vendor will be responsible for all per diem costs, travel, and salary of Vendor’s employees who attend the training.

All staff must complete EHR user training within 30 days of hire and annually thereafter. The vendor will conduct quarterly EHR audits to ensure compliance with documentation standards and data security.

The Vendor is responsible for ensuring appropriate personnel are “Fit Tested” so care can be provided to incarcerated individuals with communicable illnesses.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should provide a narrative, along with any supporting documentation, of how it proposes to meet this specification.

2.4.8 Staffing - Recruitment and Retention and Minimum Salary Requirement

The Vendor shall have the responsibility for determining the compensation, terms and conditions of employment or engagement and benefits, and for paying all compensation and other benefits to the personnel. Hourly rates of compensation for each category of personnel, including independent Contractors, shall be submitted to the IDOC on an annual basis. IDOC staff may act as advisors to the Vendor in determining compensation and benefits.

The IDOC desires a stable and effective workforce through the effective recruitment of professionals, the expedient replacement of professionals when vacancies occur, and greater retention of professionals once hired, thereby resulting in greater stability in the Vendor’s performance.

In the event the Vendor hires a professional medical position from staff currently employed and assigned to the IDOC health services contract by the current Vendor for health services, the Vendor shall pay the employee no less than the most current salary the employee was paid by the current Vendor for health services, or the median hourly wage for the position and location of the position, whichever is greater. This requirement is limited to employees hired by the Vendor (Respondent to this RFP) during the period of three months immediately before or immediately after the contracted start date of the contract resulting from this RFP and only applies if the Vendor hires the employee to fill the same position it did for the current Vendor under the current contract. The minimum salary shall include the same PTO (paid time off).

A professional medical position for purposes of this specification includes any position requiring a person to be licensed or credentialed as any of the foregoing as a requirement.

Upon reasonable prior notice, the IDOC may review the employment applications, resumes, and personnel files of the personnel during regular business hours. At the request of the IDOC, the Vendor shall provide a list of the names, home addresses, and telephone numbers of all personnel.

The Vendor shall provide copies of subcontracts and payroll hours by facility each month.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. The Respondent shall respond and describe the ways in which it will ensure a stable and effective workforce to service the needs of this proposal, such a description should address items including, but not limited to, Salary, Benefits, PTO, Vacation time, Flexible Work Schedules, Continuing Education, Work/Life Balance initiatives and other benefits offered to retain staff. Respondent must include a list of the minimum salaries and benefits it will pay for the professional medical positions listed herein for staff providing services under this contract.

2.4.9 Reception Screening Services

The Indiana Department of Correction primarily receives new and returning incarcerated individuals at the:

· Rockville Correctional Facility (adult female),

· Reception and Diagnostic Center (adult male), and

· Indiana State Prison (males sentenced to death)

· Logansport Juvenile Intake/Diagnostic Facility (juvenile males)

· Laporte Juvenile Correctional Facility (juvenile females/YIAs)

· Pendleton Juvenile Correctional Facility (YIAs)

However, parole violators may be received at any IDOC facility, and the Vendor is expected to provide reception screening services to these incarcerated individuals at the facility where they are housed. Incarcerated individuals who are pregnant may go directly to Indiana Women’s Prison and are expected to receive the reception screening as appropriate. Youth Incarcerated as Adults (YIA) go directly to the Pendleton Juvenile Correctional Facility if male, and directly to the Laporte Juvenile Correctional Facility for intake process with the Division of Youth Services, if female.

The Vendor is expected to provide physical health, mental health, dental health, and addiction recovery staff at all intake facilities.

All adults and youth are to receive a point of entry and arrival screening, tuberculosis screening, intake health appraisal completed by a nurse practitioner, physician assistant or physician, mental health screening, substance use disorder screening, dental screening, syphilis risk assessment, HIV and Hepatitis C testing. Access to Care and Co-Pay information is to be provided to every incarcerated individual verbally and in writing. (HCV/HIV and syphilis testing are performed by the IDOH at no cost to the Vendor).

All incarcerated adults will be screened for suicide risk at intake immediately upon arrival in accordance with HCSD 4.03A,” Adult Mental Health Services.” In addition, Facility Staff receiving a new incarcerated individual will also obtain information regarding conduct and demeanor during transport from the transport officer or staff. Information obtained from transport staff must be recorded in the appropriate spaces on the point of entry form. Facility staff in the intake area must not rely exclusively on an incarcerated individual’s denial that they are suicidal; any behavior or actions which suggest the incarcerated individual is at risk of suicide or self-injurious behavior must be documented and the nursing staff notified.

Mental health trained nursing staff will assess each incarcerated individual and complete the suicide potential screening template of the nursing intake section, on the suicide/Behavioral Health screen template in the electronic medical record. Whenever an incarcerated individual responds “yes” to any bolded question or whenever the incarcerated individual has answered “yes” to five or more questions, the nurse will immediately contact the designated QMHP for guidance regarding management. No incarcerated individual will be assigned to a housing unit until the intake suicide risk assessment has been completed.

In accordance with HCSD 4.03Y, “Youth Mental Health Services,” youth will be screened as soon as possible after arrival by mental health trained nursing staff. When emergency mental health treatment needs are reported by the youth, they must immediately be evaluated by a qualified mental health professional (QMHP) or a mental health trained nurse who has consulted with a QMHP. Medications must be continued, and a psychiatrist must be available to intake staff at all times.

Within 24 hours of arrival, the youth shall receive a mental health screen conducted by mental health trained staff including administration of the MAYSI-2 and Limits of Confidentiality. Within 72 hours of arrival, a youth must receive a mental health intake appraisal conducted by a QMHP. Youth who disclose sexual victimization or perpetrating sexual abuse (regardless of location) must be offered a follow-up meeting with mental health staff within 14 business days of the intake screening.

IDOC also receives Diagnostic Youth, youth who are before the court for a disposition who may be temporarily committed to IDOC for evaluation and determination of proposed assignment. Diagnostic Youth may only remain a DYS facility for 14 days or less. Contractual staff will evaluate the youth and complete a diagnostic evaluation within that time frame.

The Vendor is expected to obtain the following minimum assessments or diagnostic tests as part of the reception screening evaluation for incarcerated individuals living with certain chronic health conditions:

· Asthma: Pulmonary Function testing

· Cardiac disease: EKG

· HIV: HIV RNA, Cd4 count, CBC, chemistry panel, lipid panel and chest x-ray (regardless of TB skin test results)

· Hypertension: urinalysis (dipstick may substitute), blood glucose, potassium, creatinine, calcium, hematocrit, lipid panel, and EKG.

· Dementia screening, when applicable.

Adults and youth must be questioned regarding personal or family history of heart disease and any symptoms such as dizziness, shortness of breath, or chest pain while exercising. Observations should document behavior including state of consciousness, mental status, appearance, conduct, tremor, and sweating during intake.

Reception screening for females, both adult and youth, shall include pregnancy testing, and screening for gonorrhea and Chlamydia. Gynecological examinations will be conducted as part of the Intake Health Appraisal. Pap smears are to be completed if the female is age 21 or older. Pap smears should be conducted for youth under the age of 21 if the youth has a history of previous abnormal cervical cytology/histology and if clinically indicated.

Incarcerated individuals will be assigned to an appropriate medical, behavioral health, and disability status code.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondent should provide a narrative, along with any supporting documentation, of how it proposes to meet this specification.

2.4.10 Transfer Screening Services

Transfer screening occurs every time an incarcerated individual transfers between IDOC facilities. The purpose of this screen is to create a checks and balances system designed to maintain continuity of care. The screening includes a brief review of the health record and a face-to-face interview with the incarcerated individual. The transfer screening must incorporate a review of the problem list, tuberculosis (TB) screen, medication review, suicide risk assessment, and any other unique aspects of care. A Snellen vision screen must be completed for incarcerated individuals and youth transferring from an intake facility. When indicated, appointments for chronic care follow up should be scheduled no later than 90 days after the previous chronic care clinic visit or intake health appraisal. An explanation of procedures for accessing physical health, behavioral health, dental services, and the grievance system shall be provided to incarcerated individuals verbally and in writing upon their arrival at the facility. This screening must be completed within 12 hours of arrival of an incarcerated individual to a facility with 24/7 nursing coverage and within 24 hours at a facility with less than 24/7 nursing coverage.

The Respondent shall respond to this specification with a statement that it agrees to meet and comply with the specification. Respondents should provide a narrative, along with any supporting documentation, of how it proposes to meet this specification.

2.4.11 Routine Primary Care Services

IDOC believes a program that focuses on clinical quality metrics, and preventative care is in the best interest of all of its patients and the most cost-effective approach (e.g., CD4 and VL in HIV patients, warfarin program, HgbA1C monitoring, FIT testing, lipid testing etc.,)

Routine primary care services must be provided in a timely manner and in a clinic setting by qualified health care professionals. The Vendor shall provide on-site primary health care and preventative services in accordance with the standards, policies, procedures, and statutes listed in this RFP.

The Vendor shall provide on-site all primary health care and preventative services, including but not limited to daily triage of incarcerated individuals’ health complaints, provision of sick call, routine non-invasive diagnostic procedures, chronic care clinics, medication administration, and identification and referral of conditions requiring secondary and tertiary services.

The Vendor will administer an immunization program based on the recommendations of the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices (ACIP) and in accordance with IDOC policy (See Specification 2.4.17, Infection Control, for more details regarding immunizations).

Each facility must have a physician on-call after normal business hours, and on weekends and holidays.

The frequency and duration of sick call must be sufficient to meet the health needs of the facility’s population in accordance with applicable standards and policies.

Sick call is care for an ambulatory incarcerated individual with health care requests who is evaluated and treated in a clinical setting. Sick call applies to nurse sick call and provider sick call visits. It is also the system through which each incarcerated individual reports and receives appropriate health services for non-emergency illness or injury. Sick call shall be conducted by an on-site licensed nurse following established nursing protocols, with oversight by a Registered Nurse, mid-level practitioner, or physician, and shall include diagnosis, treatment, and referral services as appropriate.

The IDOC utilizes a written “health care request form” (HCRF) to permit incarcerated individuals and adjudicated youth to request health care services. These health care request forms must be collected and reviewed (triaged) daily. Each HCRF must be logged and stamped with the date and time received.

Most health care request forms require a face-to-face meeting with professional staff. All health care requests that note any clinical symptom must be seen face-to-face within 24 hours.

IDOC expects routine referrals to take place in a timely manner. The IDOC expects the Vendor to comply with the maximum waiting periods as defined in but not limited to Health Care Service Directives 2.01A/Y, 3.01A/Y, 2.21A/Y, and 4.03A/Y.

The Vendor may use nursing assessment protocols to facilitate the management of some acute conditions. Nursing protocols may not include prescription medication unless the protocol is for an emergent, life-threatening condition.