Exhibit_A_Scope_of_Work_Rev._10-4-24.pdf

Proposal Number: SD23-00094 California Department of Corrections and Rehabilitation (CDCR)/ Exhibit A California Correctional Health Care Services (CCHCS) Scope of Work

ELECTROCARDIOGRAPH (ECG) EQUIPMENT AND CARDIOLOGIST OVER-READ

AND INTERPRETATION SERVICES

1. Introduction/Services

a. This is a Statewide Agreement in which the Contractor shall provide on-site Electrocardiograph (ECG) Equipment and Cardiologist Over-read and Interpretation Services upon request to patients referred for such medical services from California Department of Corrections and Rehabilitation (CDCR) Institutions.

b. Contractor and/or Provider shall provide all labor, equipment, supplies, licenses, permits, certificates and every other item of expense necessary to provide ECG Equipment and Cardiologist Over-read and Interpretation Services. Services shall be provided for patients on-site upon request and under the direction of the Institution’s Chief Executive Officer (CEO)/Chief Medical Executive (CME) or designee.

For the purpose of this Agreement, CDCR/CCHCS designee shall be a civil service employee. The Institution’s CEO/CME or designee retains professional and administrative oversight for the services rendered.

c. Contractor and/or Provider shall possess ECG Equipment (machine) with wireless capabilities and provide Cardiologist Over-read and Interpretation services, and shall provide diagnostic analysis.

Contractors agrees that all of Contractor’s Provider(s), herein referred to as Providers, will be required to render direct health services under this Agreement on an as-needed basis. Contractors and/or Providers shall perform services in accordance with Federal and State laws, rules, regulations and CDCR Policies and Procedures.

d. Contractor and/or Provider shall perform the tasks associated with providing the above health care services under the scope of their licenses and assume full responsibility for the provision of these services. All services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor and/or Provider.

e. Services shall be provided upon request and at the direction of the institution’s CEO/CME or designee.

Prior authorization for Cardiac Event Monitors shall be obtained and documented in the patient’s health record for those excluded health care services treatments listed in the California Correctional Health Care Services (CCHCS) Medical Standards of Care and National Standards for the service provided under this Agreement. See Provision 2(e), Exclusions and Limitations.

f. Contractor and/or Provider agrees that all, unless otherwise stated, expenses associated with travel to and from an institution, lodging, and all training expenses, such as Continuing Medical Education for Contractor and/or Provider, shall be borne by Contractor or Provider and will not be reimbursed by CDCR/CCHCS. All services performed outside of the scope of this Agreement will be at the sole risk and expense of the Contractor.

g. Any equipment costs for lost/damaged reimbursement due to CDCR negligence will be negotiated with CDCR/CCHCS Direct Care Contracts Section (DCCS). However, Provision (h) below pertains only to ECG equipment furnished pursuant to this Agreement. Provision (h) does not pertain to ECG machines provided by the Contractor prior to this Agreement.

h. CDCR/CCHCS shall be responsible for the cost of all supplies necessary to the operation of ECG rental machine(s) (i.e., ECG paper, mounting cards, silver nitrate electrodes, ink styles, etc.) including freight.

This excludes start-up supplies provided by the Contractor at no charge to CDCR/CCHCS.

i. CDCR/CCHCS has the option of purchasing ECG supplies from Contractor but is under no obligation to do so. Prior to the start of this Agreement, Contractor shall submit their Supplies List with Cost of ECG supplies to the CDCR/CCHCS Contract Analyst.

CDCR/CCHCS Exhibit A Scope of Work

2. Contractor and/or Provider Responsibilities

a. Contractor’s and/or Provider’s Responsibilities

(1) Services and all requirements as stated below and as required shall be provided for contracted services, at the request of the Institution’s CEO/CME or designee. The services shall include, but are not limited to the following:

(a) Contractor and/or Provider shall be able to adequately provide services to all institutions awarded on Exhibit B-1, Bid Rate Sheet, and meet the requirements specified in Exhibit A-1, Service Specification. Contractor and/or Provider shall provide the state with proof of any required training, licenses, permits, certifications and any other required documents as stated in Exhibit A-1, Service Specifications, and as required when providing services under this Agreement. Services will be performed only by Contractors and/or Providers who meet the requirements outlined in this Agreement. Refer to Exhibit A-1, Service Specifications for Contractors and/or Providers Responsibilities.

(b) The DCCS shall approve in advance all required Provider(s) assigned to the Agreement. If any Provider is unable to perform due to illness, resignation, or factors beyond the Contractor’s control, the Contractor shall immediately submit qualifications of proposed substitute personnel to DCCS for approval. Failure to do so may be cause for termination of this Agreement. DCCS shall be notified of any additions or corrections to the Contractor’s list of prospective personnel at least thirty (30) business days before the Provider’s start date.

(c) Contractor shall request approval from CDCR/CCHCS for all equipment utilized under this Agreement prior to shipment to the institution. Prior approval shall be sent to DCCS and shall include year, make, model, and equipment specifications.

(2) Reports

CDCR/CCHCS reserves the right to request that Contractor/Provider submit reports or information related to this Agreement. Reports submission details shall be determined by CDCR/CCHCS. Such details, may include, but are not limited to, the need for additional information pertaining to Contractor’s providers, services, equipment inventory, and utilization, etc. Non-compliance with requests for reports or information may result in termination of the Agreement. The reports shall be submitted no later than five (5) business days of the request.

The reports shall be submitted in a secure HIPAA compliant electronic format (Microsoft Excel 2000 or the most current version) and sent via electronic mail to cchcshealthcarecontractshelpdesk@cdcr.ca.gov. In the event that electronic mail is not available, the reports can be sent via U.S. Mail to the following address:

California Correctional Health Care Services Attn: Direct Care Contracts Section P.O. Box 588500, Building D Elk Grove, CA 95758

b. Standards of Obligation

(1) Contractor and/or Provider recognizes that the CDCR/CCHCS acts in a fiduciary capacity to the State of California and that this fiduciary duty extends to the provision and management of medical health care services, mental health care services, and dental services for the CDCR/CCHCS patients. To assist CDCR/CCHCS in its exercise of this duty, Contractor and/or Provider shall provide high quality services, consistent with the terms and conditions under this Agreement and consistent with established and commonly accepted standards and principles of medical practice. Nothing in this

Scope of Work

Agreement shall supersede the common law rules for the interpretation of established and commonly accepted standards and principles of medical practice.

(2) Contractor and/or Provider agrees to acknowledge and adhere to the CDCR/CCHCS medical staff rules, regulations, policies and procedures, and comply with infection control precautions.

(3) To avoid unreasonable delay in services delivered pursuant to this Agreement, Contractor and CDCR/CCHCS shall each designate a specific representative(s) for the purpose of communication between the parties. Such representative(s) may be changed upon written notice within twenty-four

(24) hours to the other party.

c. Authorization

Authorization for Treatment

Contractor and/or Provider agree that, excluding emergency care services, prior authorization for Cardiac Event Monitors shall be obtained in writing from the respective Institution’s CEO/CME or designee, in accordance with CDCR/CCHCS’ Utilization Management (UM) Plan. Contractor and/or Provider shall complete and return all forms required by CDCR/CCHCS regarding treatment of CDCR/CCHCS patients.

Authorization shall be documented in the CDCR Patient’s medical record in all cases of essential services before considering any non-emergency treatment, or any consultations by specialty physicians or diagnostic procedures not specifically stated in a CDCR/CCHCS prior authorization form.

d. Required Notices

Any notice required hereunder shall be deemed to be sufficient if mailed to CDCR/CCHCS at the address below in Provision 15 California Department of Corrections and Rehabilitation Contact Information. If the mail is used to send any notice required in this Agreement, notice shall be deemed received on the day after it is deposited in the United States mail with First Class postage prepaid and addressed to CDCR/CCHCS. Only actual written notice will suffice for the purpose of meeting any notice requirement in this Agreement.

3. CONTRACTOR’S AND/OR PROVIDER’S QUALIFICATIONS

Please refer to Exhibit A-1, Service Specification for details

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor and/or Provider shall possess and maintain throughout the term of this Agreement, all licenses, permits, and certification requirements noted in Exhibit A-1, Service Specification for details.

5. CREDENTIALING AND PRIVILEGING REQUIREMENTS

a. Credentialing and Privileging Requirements

For services provided at CDCR Institutions, the Contractor and/or Provider shall comply with the following credentialing and privileging requirements:

(1) Contractor shall compile and ensure that it’s Provider(s) complete the credentialing and privileging package.

(2) Contractor shall submit a completed MD-App electronic credential and privilege application and associated documents to CDCR/CCHCS Credentialing and Privileging Support Unit (CPSU).

Scope of Work

(3) Contractor and its Provider(s) shall comply with all CPSU requirements, policies, and procedures.

Services cannot commence until the credentialing and privileging process and approval is completed by CPSU.

(a) Contractor shall ensure all of its Provider(s) possess at all times current and up-to-date credentials and privileges. Contractor shall renew its Providers credentials and privileges every two (2) years by submitting a completed MD-App electronic credential and privilege application, prior to expiration date.

(4) Institution’s CEO/CME or designee will notify the Contractor by telephone and/or email, once credential and privilege verification has been completed to arrange for an effective date for Contractor and its Provider to gain entrance and render services at the institution.

(5) Refer to Health Care Department Operations Manual, Chapter 1, Article 4, Section 6, Appendix 6, Specialty Licensed Medical Provider Professional Requirements for Credentialing and Privileging Approval for licensure and certification requirements for the appropriate health care service classification requirements. The document is available at: https://cchcs.ca.gov/policies/

It shall be the responsibility of the Contractor to reference this document when services are requested to ensure that any changes in credentialing requirements are met.

6. REQUEST FOR SERVICE

a. The Contractor and/or Provider agrees to provide direct health care services as arranged with the Institution’s CEO/CME or designee upon request. Normal hours of clinic operation are Monday through Friday between the hours of 6:00 a.m. and 5:00 p.m.

b. The Contractor and/or Provider shall respond to a request for services within a two (2) hour response time unless otherwise stated by the institution. CDCR/CCHCS may extend the standard response time at the discretion of the Institution’s CEO/CME or designee, dependent upon the urgency of the request for services. The response time shall be included on the request for service. CDCR/CCHCS reserves the right to accept a response from other Contractor(s) after the response time has elapsed.

c. The Contractor and/or Provider shall have a toll-free telephone number and a contact person available by telephone during normal business hours Monday through Friday 8:00 a.m. to 5:00 p.m., Pacific Time, for the duration of this Agreement. Telephone answering devices (i.e., message machines) and answering services are not acceptable and their use may be cause for termination of this Agreement.

(Refer to Exhibit A-1, Service Specification, for requirements).

d. Contractors with multiple agreements for the same service and same institution shall be obligated to provide services at the same rates in the primary contract until all the obligations under the primary contract are attained before the secondary or subsequent contract can be in effect. The only exception to this provision occurs when the rate(s) in a subsequent agreement is lower than those of the primary agreement; the State then has the sole right to determine which rate(s) will be applied.

e. Contractor acknowledges that the institution may request services at any time, including weekends and holidays, if needed for emergency services.

7. RESPONDING TO A REQUEST FOR SERVICES

The Contractor and/or Provider shall submit copies of the following documents:

a. Provider’s current résumé/curriculum vitae, which shall include the following information:

(1) “To and from” dates (month and year) for all employment history;

Scope of Work

(2) Education shall include the following information as applicable to the service type: name, and location of university or college, business, correspondence, trade, or service certificate obtained and date completed;

(3) Name of organization for which work was performed;

(4) Supervisor name and contact information for each job;

(5) All relevant work history including classification/job title, job duties performed and any other information necessary to determine qualifications of Providers;

(6) If the applicant has provided services to CDCR/CCHCS previously, the Provider shall include the name of the specific Institution, to and from dates of service and immediate supervisor’s full name and telephone number; and

(7) At least two (2) professional references and their contact information.

8. SCHEDULING

a. At the time of scheduling, CDCR/CCHCS shall provide the Contractor and/or Provider with an estimated time the institution anticipates the need for the contracted services. This will be a good faith estimate based on the circumstances known to CDCR/CCHCS at the time of the request. It is not a guarantee and is subject to change depending on CDCR’s fluctuations in the CDCR/CCHCS patient population.

However, CDCR shall endeavor to provide five (5) working days’ notice prior to cancellation of clinics.

b. Contractor shall provide services to institution at a time mutually agreed upon between the Institution Contract Liaison or designee and Contractor.

9. CANCELLATION

Contractor shall give advanced notice to the Institution’s CEO/CME or designee prior to cancellation of scheduled clinics/services, if for reasons other than illness, as follows:

a. For scheduled clinics: one (1) week written notice; or

b. For all other scheduled services: minimum of twenty-four (24) hours’ notice.

c. Contractor shall coordinate a new scheduled time for the clinic, if needed.

10. OVERTIME PAY RATE ALLOWANCES

No overtime pay will be authorized under this Agreement.

11. HOLIDAY PAY RATE ALLOWANCES

No holiday pay will be authorized under this Agreement.

12. INSPECTIONS

Inspections shall be carried out by the Institution’s CEO/CME or designee at various times during the Agreement term to check on the quality of work and determine acceptability of work performed before Agreement payment will be approved.

Scope of Work

13. FAILURE TO PERFORM

a. CDCR/CCHCS shall routinely evaluate the work performance of the Contractor and/or Provider assigned to CDCR/CCHCS to determine if CDCR/CCHCS standards and departmental/institutional policies and procedures are being maintained. Any Contractor and/or Provider who fails to perform, does not meet the minimum qualifications, or incapable of providing the required service of this Agreement shall not be permitted to perform services. The Institution’s CEO/CME or designee shall state in writing the reasons the Contractor and/or Provider did not meet the required policies or standards and submit a copy to the Contractor and to the CDCR/CCHCS Direct Care Contracts Section Help Desk, by e-mailing to:

cchcshealthcarecontractshelpdesk@cdcr.ca.gov. CDCR/CCHCS shall not pay Contractor for any services performed by Contractor and/or Provider which are deemed unacceptable in accordance with the requirements of this Agreement.

b. Failure to provide services on three (3) or more occasions may result in termination of the Agreement or the Institution not having to follow the Request for Service Provision 6 for the duration of the agreement term. CDCR/CCHCS Headquarters Direct Care Contracts Staff Services Manager III or designee has the sole discretion to make this decision.

14. SUSPENSION OR STOP WORK NOTIFICATION

a. CDCR/CCHCS may, at any time, for any reason, issue a notice to suspend performance or stop work under this Agreement. The initial notification shall be a written directive issued by the CDCR/CCHCS.

Upon receipt of said notice, the Contractor and/or Provider are to suspend and/or stop all, or any part, of the work called for by this Agreement.

b. Written confirmation of the suspension or stop work notification with directions as to what work (if not all) is to be suspended and how to proceed will be provided within thirty (30) calendar days of the written notification. The suspension or stop work notification shall remain in effect until further written notice is received from CDCR/CCHCS. The resumption of work (in whole or part) will be at the discretion of CDCR/CCHCS and upon receipt of written.

c. Upon receipt of a suspension or stop work notification, the Contractor and/or Provider shall immediately comply with its terms and take all reasonable steps to minimize or halt the incurrence of costs allocable to the performance covered by the notification during the period of work suspension or stoppage.

d. Within thirty (30) calendar days of the issuance of a suspension or stop work notification, CDCR/CCHCS shall either:

(1) Cancel, extend, or modify the suspension or stop work notification; or

(2) Terminate the Agreement as provided for in the Right to Terminate clause of the Agreement.

e. If a suspension or stop work notification issued under this clause is cancelled or the period of suspension or any extension thereof is modified or expires, the Contractor and/or Provider may resume work only upon written approval of CDCR/CCHCS.

f. If the suspension or stop work notification is cancelled and the Agreement resumes, changes to the services, deliverables, performance dates, and/or contract terms resulting from the suspension or stop work notification shall require a written amendment to the Agreement signed by both parties.

g. CDCR/CCHCS shall not be liable to the Contractor and/or Provider for loss of profits because of any suspension or stop work notification.

Scope of Work

15. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION CONTACT INFORMATION

Should questions or problems arise during the term of this Agreement, the Contractor shall contact the following offices:

a. Billing/Payment Issues:

Goods/Durable Medical Equipment Sacramento Regional Accounting Office Attention: Accounts Payable “A” P.O. Box 187015 Sacramento, CA 95818-7015 Email address: APA.invoices@cdcr.ca.gov

Services/Procedures California Correctional Health Care Services Healthcare Invoicing Section P.O. Box 588500, Building D-2 Elk Grove, CA 95758 Phone Number: (916) 691-0699 Email address: m_HISProgramSupport@cdcr.ca.gov

b. Scope of Service/Performance Issues:

Refer to Exhibit H, List of Participating CDCR Institutions.

The Institution Contract Liaison for each Institution can be contacted Monday through Friday, 8:00 a.m.

to 4:00 p.m. The Institution Contract Liaison or his/her designee shall pre-arrange all needed services to assure continuity of care and to minimize the disruption of CDCR/CCHCS’ workload.

c. General Agreement Issues:

California Correctional Health Care Services Direct Care Contracts Section P. O. Box 588500, Building D-2 Elk Grove, CA 95758 Phone Number: (916) 691-0698 Email address: cchcshealthcarecontractshelpdesk@cdcr.ca.gov