Consolidated Offeror Questions.docx

Consolidated Offeror Questions RFP 1301 Medical and Mental Health Services

The volume of pages in producing this request is prohibitive to provide in the allowed time frame of this RFP process.

FY22: 28

FY23: 22

FY24: 21

FY25: 22

FY26: 26

There were a large number of nursing positions that were open during the transition, as well as the training/orientation of the locums nursing staff was less than par for a period of time.

The proposed pharmacy vendor in the current medical Contractor’s response had to be updated/changed due to the proposed pharmacy vendor not having the appropriate licensing credentials in the State of Idaho. The current medical Contractor’s solution corrected the problem quickly and left no issues or concerns with patients receiving timely medications.

· ISCI 4 days per week for regular bus intakes. Special transports could happen any day of the week.

IDOC does receive, and the awarded Offeror will need to conduct, special intakes based on medical emergencies or necessity from county jails, as required, i.e., pregnant resident, level of care requirements, etc.

FY23: $54,161,707.11

FY24: $59,431,337.30

FY25: $66,031,529.30

FY26: $66,739,001.34

With regard to lawsuits (frivolous or otherwise) pertaining to inmate health care:

a. How many have been filed against the IDOC and/or the incumbent health care provider in the last three years?

b. How many have been settled in that timeframe?

a. See Q&A Attachment 15.

b. One (1) in 2023.

Please answer the following questions relating to Interstate Compact agreements among prison systems.

a. Does the IDOC participate in an Interstate Compact Program?

b. If yes, with which other states/jurisdictions does the IDOC have an agreement in place?

c. On average, how many Interstate Compact residents are housed in the IDOC facilities?

d. On average, how many IDOC residents are housed out of state at Interstate Compact partner facilities?

a. Yes, IDOC participates in Interstate Compact Programs.

b. Idaho has an agreement with the following states: Arizona, California, Colorado, Florida, Kansas, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, Ohio, Oklahoma, Oregon, South Carolina, Utah, Virginia, Washington, and Wyoming.

c. 30 residents

d. 30 residents

At these sites (IMSI AND PWCC), there is a team of General Population MH clinicians (state employees), in addition to the contract staff who manage the specialized mental health treatment units. These teams are expected to work cooperatively together, in their separate duties.

The one area where significant planning is required is “Primary Clinician” duties, wherein one site clinician is identified as managing all unscheduled issues (suicide watch visits, HSR follow ups, etc.). IDOC/Contract staff are encouraged to work as a site team to develop a mutually agreeable schedule of shared duties. If such an agreement cannot be created, each team is responsible for their own schedule.

The RFP references long-term care services, hospice services, and skilled nursing support for incarcerated individuals. Please clarify the Department's expectations regarding hospice care delivery. Specifically:

· Is the successful Offeror expected to provide hospice services directly through its clinical staff, through a contracted hospice provider, or through another model?

· Are hospice-related assessments, certifications, recertifications, and care planning currently performed by a third-party hospice organization?

· If so, please identify the current provider(s) and annual utilization.

· Currently hospice services are being provided internally by IDOC’s medical vendor with support from IDOC residents who are part of a specialized program who sit with terminally ill patients. All hospice patients reside in the infirmary at ISCI or PWCC.

Idaho Code §20-237B appears to require reimbursement at Medicaid rates for incarcerated patient care. Are Medicaid rates set for all offsite services?

Please clarify whether the Contractor may negotiate reimbursement rates above Medicaid rates when necessary to secure provider participation and maintain adequate network access? Can the state please confirm if Medicaid rates are 100% for everything offsite?

IDOC advises Offerors to review applicable Medicaid rates as needed. The Contractor may negotiate reimbursement rates above Medicaid rates when necessary to secure provider participation and create/maintain appropriate medical network access. IDOC cannot confirm if Medicaid rates are 100% for everything offsite.

ICIO: 1/1

ISCC: 2

MVTC: 0/0

SBWCC: 2/2

NICI: 1/1

ISCI: 0/13

IMSI: 0/8

SICI:0/1

PWCC: 8/8

To support the development of accurate pricing, will the State please provide the actual off-site medical expenditures for the calendar years 2024 and 2025 by the following categories? This should include total off-site spending.

0. Inpatient

0. 2024

0. 2025

0. Observation

1. 2024

1. 2025

0. Emergency Transportation

2. 2024

2. 2025

0. Emergency Room

3. 2024

3. 2025

0. Dialysis

4. 2024

4. 2025

0. Radiology

5. 2024

5. 2025

0. One Day Surgery

6. 2024

6. 2025

0. Office Visits

7. 2024

7. 2025

IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

Please provide historical utilization statistics for the past two (2) years regarding off-site services, including but not limited to:

· Total number of ER visits by facility

· Number of ER visits that resulted in inpatient admissions

· Number of ambulance transfers by facility

· Number of non-ambulance transfers

· Number of 911 transfers

· Number of Life Flight/helicopter transfers

· Number of inpatient admissions

· Number of inpatient days

· Number of hospital observations

· Number of one-day surgeries

· Number of office specialty visits by provider type Number of off-site radiology exams by type (e.g., CT scan, MRI, etc.)

IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

To ensure proposers can construct a realistic pharmacy cost model, will the State please provide the actual pharmacy expenditures for the calendar years 2024 and 2025 by the following categories? This should include total pharmacy spending.

a. HIV

7. 2024

7. 2025

b. HEP C/B

7. 2024

7. 2025

c. Psychiatric

i. 2024

ii. 2025

d. Oncology

i. 2024

ii. 2025

e. Biologicals

iii. 2024

iv. 2025

f. MAT

i. 2024

ii. 2025

g. Other

i. 2024

ii. 2025

IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

Please provide the following information for the calendar years 2024 and 2025:

· Average number of incarcerated individuals on psychotropic medication(s) each month

· Average number of incarcerated individuals on HIV/AIDS medication(s) each month

· Average number of incarcerated individuals on hepatitis medication(s) each month

· Average number of incarcerated individuals on hemophilia medication(s) each month

· Average number of incarcerated individuals with diabetes each month IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP for items 1, 2, 4, and 5.

The average number of residents on HCV medications each month is approximately 85. Approximately eight new residents begin treatment each week.

Please provide the following information for the past two (2) years:

1. Average number of incarcerated individuals on psychotropic medication(s) each month

2. Average number of incarcerated individuals on HIV/AIDS medication(s) each month

3. Average number of incarcerated individuals on hepatitis medication(s) each month

4. Average number of incarcerated individuals on hemophilia medication(s) each month

5. Average number of incarcerated individuals with diabetes each month

1. Please identify the following current providers:

· Pharmacy services

· Laboratory services

· Stat Lab Services

· Mobile X-ray services

· Biohazardous waste removal services

· Shredding services

· Medical gas services

· Office Supply vendor

· Network Copier Lease

2. If applicable, please provide the diversity spend vendors.

3. Are X-ray services provided using on-site equipment or through a mobile X-ray provider?

4. If there is on-site X-ray equipment, is it film or digital?

5. Who is responsible for biohazardous waste removal services – the County or the Contractor? What is the number of biohazard pick-ups per month?

6. Who is responsible for shredding services – the County or the Contractor?

7. Who is responsible for providing medical gas – the County or the Contractor?

8. Who is responsible for purchasing office supplies and equipment: The County or the Contractor?

Responses are in bold

1. The following are provided by the current medical contractor under a potential contract situation and not provided by IDOC or through an IDOC contract, unless otherwise indicated:

· Pharmacy services – Clinical Solutions Pharmacy (CSP)

· Laboratory services - BioReference

· Stat Lab Services – sent to St. Alphonsus (for the Treasure Valley)

· Mobile X-ray services – Bedside X-ray

· Biohazardous waste removal services - SteriCycle

· Shredding services – provided by IDOC through a state contract

· Medical gas services - Norco

· Office Supply vendor – not known by IDOC

· Network Copier Lease – not known by IDOC

1. If applicable, please provide the diversity spend vendors. This is not a requirement of IDOC.

1. Are X-ray services provided using on-site equipment or through a mobile X-ray provider? Both. Most of the prison facilities have x-ray availability onsite.

1. If there is on-site X-ray equipment, is it film or digital? Digital

1. Who is responsible for biohazardous waste removal services – the County or the Contractor? The contractor. What is the number of biohazard pick-ups per month? Unknown to IDOC as it is managed by the current medical contractor.

1. Who is responsible for shredding services – the County or the Contractor? Answered above.

1. Who is responsible for providing medical gas – the County or the Contractor? Contractor

1. Who is responsible for purchasing office supplies and equipment: The County or the Contractor? Routine office supplies are the responsibility of the Contractor. Office furniture (desks, task chairs, bookcases, etc.) is provided by IDOC through coordination with the facility leadership and their budget for the fiscal year.

Funding Assumptions and Pricing Structure Clarification: The RFP appears to introduce or expand several requirements that may materially increase the cost of contract performance versus the requirements of the current contract, including, but not limited to, nutrition services, backlog reduction efforts, SORA-related requirements, staffing penalties, face-to-face refusal encounters performed by RNs, expanded psychiatrist coverage, MOUD services, Hepatitis C treatment, ISMP staffing requirements, possible pharmaceutical dispensing model changes, and 24/7 RDU/intake nursing coverage.

To assist offerors in developing responsive and sustainable pricing, please clarify:

a) Does the Department anticipate that funding necessary to support these enhanced requirements will be included in future legislative appropriations and budget requests?

b) Has the Department identified specific requirements within the RFP that may be subject to future funding availability or phased implementation?

c) Would the Department prefer or permit offerors to identify and separately price any of these significant cost drivers in their proposals for evaluation and budget-planning purposes?

d) In the event funding is not obtained for certain new or expanded requirements, does the Department anticipate modifying the scope of services, implementation timelines, staffing expectations, or performance requirements accordingly?

This clarification will help offerors ensure that proposed pricing appropriately aligns with the Department's anticipated scope of services and funding expectations over the contract term.

a) Yes, IDOC will be requesting increased legislative appropriations and budget requests for the increased services.

b) No, there are no provisions that are based upon future funding or phased implementation identified at this time.

c) No. All current requirements are part of the full scope of work, the Offerors pricing must be fully burdened to include all requirements.

d) Potentially, but this would be captured in a BAFO (Best and Final Offer) if funding is not obtained prior to award, or through a contract amendment mutually agreed upon by IDOC and the Contractor.

1. Who is responsible for the purchasing of the influenza vaccine: the County or the Contractor?

2. If responsible, will the Contractor have to purchase & administer the influenza vaccine to the custody officers?

3. Has the health department provided the influenza vaccine in the past?

4. Who is responsible for the purchasing of the covid 19 vaccine: the County or the Contractor? If the contractor, will the Contractor be reimbursed?

1. The Contractor will be responsible for influenza vaccine purchase.

2. No. IDOC staff have the ability to receive influenza vaccinations through their medical benefits.

3. No, it has been purchased and provided by the current medical contractor.

4. The contractor is responsible and it is not reimbursed by IDOC.

1. What has been the utilization for STAT Labs for the past 12 months? Who is the lab vendor and courier being used for STAT services?

2. What is the utilization for X-rays, Ultra-sounds, mammogram in the past 12 months?

3. Who provides translation/interpretation services?

1. With regard to utilization, IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP. Stat lab services answered above.

2. IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

3. IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

1. Average number of incarcerated individuals who accepts the influenza vaccine each year

2. Average number of incarcerated individuals who accepts the covid-19 vaccine each year For both questions, IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

1. During the past two (2) years, what is the average number of individuals receiving dialysis treatments?

2. How much has been spent annually on dialysis over the past two (2) years?

3. What is the average weekly number of treatments?

4. Are dialysis services provided on site or off site?

5. Please identify the on-site and/or off-site dialysis provider.

1. Reference HSR Reports provided for 2024, 2025, and Jan-Jun 2026 – Q&A Attachment 12a-c.

2. IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

3. IDOC does not currently possess this information and will not be able to obtain it in the timeframe of this RFP.

4. Dialysis services are provided onsite, as outlined in the RFP.

5. Currently provided by Rendevor through a contract with the current medical contractor.

We would appreciate clarification regarding whether offerors may submit supplemental attachments to support responses required under Section 3.2.4, Part 4, particularly within Submittal Form B.

For example, the Qualifications and Experience section requests descriptions of proposed personnel qualifications, credentials, and experience. Given the five-page limitation for this section, providing comprehensive information for multiple proposed positions is not feasible within the allotted space. Supporting documentation such as position descriptions and resumes would provide the most complete demonstration of personnel qualifications and relevant experience.

Would offerors be permitted to submit job descriptions and resumes as separate attachments in support of this section, and if so, would those attachments be excluded from the five-page limitation?

Job descriptions and resumes submitted in support of the Offeror’s technical proposal will count towards the Offeror’s page limits. The Offeror must submit these attachments using the provided Submittal Form template.

These examples should be included by the Offeror as appropriate in the narrative responses.

The Cost Proposal Submittal Form C states that the proposed per diem rate must remain firm and fixed for the initial contract term, which is defined as the first three years of the contract. However, Section 12 of the RFP appears to permit inflationary adjustments to the per diem rate during the second and third years of the initial contract term.

Please confirm that the PIPD rate entered on Submittal Form C should represent the offeror’s proposed rate for the first year of the initial contract term, and that the rate may subsequently be adjusted during years two and three in accordance with the inflation adjustment methodology described in Section 12 of the RFP?

If this interpretation is incorrect, please provide guidance regarding how offerors should account for the permitted inflationary adjustments when completing the Cost Proposal form.

The Per Diem rate should represent the Offeror’s cost for the initial term, without any inflationary adjustments, for evaluation purposes.

Medical (LTC & Infirmary), Medical Annex, and Units 7-16.

a. Please list any other agencies or jurisdictions (e.g., US Marshals, ICE, federal BOP, other states or counties, etc.) for which the IDOC houses individuals.

b. Please indicate the average number of individuals the IDOC houses for each of these agencies or jurisdictions.

c. How are authorizations for offsite services handled for each of these agencies or jurisdictions?

d. How is the cost of offsite services handled for each of these agencies or jurisdictions?

a. None. These agencies may have hold/detainer/warrant/pending cases, but if they are in IDOC custody, they are serving an IDOC required sentence.

b. N/A

c. N/A

d. N/A

a. Can the IDOC be any more specific with the timelines for opening these two facilities?

b. What is the status of each facility with regard to construction, equipping the units, etc.?

c. Which of the following methods is the IDOC planning to use to populate the two new facilities? (A) Move residents from other existing IDOC facilities, keeping the overall system population level the same with no increase in the number of overall residents statewide. OR (B) Populate the new facilities with newly incarcerated individuals and overflow residents currently housed out of state, in county jails, etc., resulting in an increase to the overall system population.

d. Will the IDOC be closing any existing facilities once the two new ones open?

e. Will either new facility include any special housing or treatment units, such as a dedicate SUD treatment unit or therapeutic community?

f. The current annual escrow account amounts are $500,000 for medical and $250,000 for IT. We also see the RFP requires a $300,000 one-time medical escrow account to be created. However, won’t the annual amounts of both the medical and IT escrow accounts need to permanently increase to account for the ongoing needs of the two new facilities? Please describe how the IDOC wants Offerors to handle these long-term increases (e.g., build into our proposal pricing, negotiate a future contract amendment, etc.).

g. Does the IDOC want Offerors to include the cost of staffing, equipping, and operating the two new facilities in our proposal pricing?

h. If the preceding answer is NO, please confirm the IDOC will negotiate a far and equitable contract amendment with the awarded Offeror to account for these costs once the new facilities are near to being opened.

a. As outlined in Exhibit 2 – Facilities List, the Pocatello CRC will already be operational prior to the Service Commencement Date. The Per Diem that Offeror’s propose for the Per Diem 2 rate should include the staff necessary to operate PCRC as well as the other five CRC locations. With regard to the New Women’s Facility, it is currently planned to open early in 2028 (approximately Feb).

b. PCRC is progressing ahead of schedule with building completion slated for November 2026 and move-in dates planned for mid to late December 2026. The New Women’s Prisons is progressing as planned with footings completed and two of the housing units currently framed.

c. IDOC will fill both the PCRC and New Women’s Prison with resident from within existing prisons or CRCs. IDOC will backfill with already sentenced individuals currently residing in county jails.

d. No. No IDOC facilities will be closed.

e. Yes. This question is addressed/answered on page 23 and 41 (Alex enter the question #)

f. IDOC already anticipated the need to increase the Medical Escrow Account in the RFP and set that amount at $500,000. IDOC is amending the RFP to require the awarded Offeror to pay an additional $30,000 one-time, to cover IT costs for the new women’s prison, which will be deposited into the IT Escrow Account, timeline as determined by IDOC.

g. Amendment 1 to the Submittal Form C – Cost Proposal, contains new spaces to enter in this information.

h. N/A

Male: 833 Female: 176 Total: 1009