FINAL Scope of Work for Dental Services at BCJJC (TL).pdf

217 East Redwood Street Baltimore, MD 21201

Aruna Miller Wes Moore Elizabeth Fox Tolentino Lt. Governor Governor Secretary

Phone: 410-230-3100 Toll Free: 1-888-639-7499 TDD: 1-800-735-2258

Scope of Work

On-Site Dental Services at Baltimore City Juvenile Justice Center

Solicitation No. /eMMA Solicitation No: 27-MS-BC-001/ BPM059330

The purpose of this Request for Quote is to procure a vendor to provide dental services to youth between the ages of twelve (12) and twenty (20) who are detained at Baltimore City Juvenile Justice Center (BCJJC). This is a small procurement to provide dental services to BCJJC youth until the larger procurement contract is finalized for these services. The Department intends to make one (1) award for dental services for a duration of six (6) months under this solicitation. The Contractor shall provide at least one dentist for Dental Clinics totaling up to sixteen (16) hours per week, with no more than a daily half-hour lunch period. The Contractor must provide Letters of Commitment from these dentists that legally bind them to work on the contract if the bidder wins. The Dentist must meet the minimum requirements as follows:

1. Graduated from an accredited school of dentistry.

2. Possess a current license issued by the Maryland State Board of Dental Examiners and be in good standing to practice dentistry.

3. Have three (3) years of full-time professional experience in the practice of dentistry with pediatric and adolescent patients, preferably with some experience in an institutional setting.

4. Possess a current Drug Enforcement Administration (DEA) Registration Number issued by the United

States Department of Justice DEA and a current Controlled Dangerous Substances (CDS) Registration number from the State of Maryland Department of Health, Office of Controlled Substances Administration (OCSA) to be able to prescribe Class II and Class III pain medication. Certification shall be maintained during the term of the Contract.

5. Possess a current certification in Cardiopulmonary Resuscitation and Emergency Cardiac Care from the

American Heart Association or the American Red Cross. Certification must be maintained during the term of the Contract.

Unless substitution or replacement is approved by the Contract Monitor, key personnel shall be the same personnel proposed in the Contractor’s Bid, which will be incorporated in the Contract by reference. Such identified key personnel shall perform continuously for the duration of the Contract. Key personnel may not be removed by the Contractor without the prior written concurrence of the Contract Monitor.

Contractor Responsibilities and Tasks Dental Clinics are preferably held on Tuesdays and Fridays between the hours of 8 AM and 5 PM. Dentists shall record time in and out of the facility on the Dental Clinic Sheet. Payment shall be made based on the actual number of hours worked on-site, as recorded on the Dental Clinic Sheet.

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Contractor shall provide comprehensive dental care to DJS youth, to include, at a minimum, the following services:

A. Preventive dental care

1. Complete an initial preventive dental care visit within fourteen (14) calendar days of admission for those youth who have not had a documented preventive dental care visit and oral examination within the past six (6) months. The preventive dental care visit shall include at a minimum an oral examination and provision of oral hygiene instructions and preventive oral education. The oral examination by the dentist includes obtaining the youth’s medical and dental history, charting the teeth, performing examinations of the head, neck, hard and soft tissues of the oral cavity using a mouth mirror, explorer, and adequate illumination, and performing and developing on-site X-rays as needed.

2. Perform prophylaxis procedures to include dental cleaning and, if indicated by the youth’s caries-risk assessment, fluoride treatment (at least once per year) and dental sealants. Prophylaxis procedures, performed by the Dentist, may occur at the time of the preventive dental care visit or at a follow-up visit, if time is limited.

3. Perform follow-up preventive dental care visits every six (6) months for youth remaining in DJS care for prolonged periods.

B. Provide treatment for acute and chronic dental conditions

1. Triage and schedule youth with acute dental issues as soon as possible and in accordance with the DJS

Dental Classification/Triage System.

2. Perform X-rays, routine restorations, extractions, and anterior root canals, and when necessary, perform or refer for non-routine services including crowns, partial dentures, dentures, bridges, and replacement of absent anterior teeth.

3. Evaluate and promptly treat dental pain and infection.

4. Order off-site laboratory services after consultation with the DJS Medical Director (for example, crowns and partial dentures), and invoice DJS for the actual cost of those laboratory services on a separate invoice.

5. Refer youth to dental care in the community for dental needs that cannot be provided on-site (for example, posterior root canals, ongoing orthodontic follow-up, impacted wisdom teeth, surgical extractions, dental emergencies such as a knocked-out or fractured tooth or jaw fracture).

C. On rare occasions and if available, respond to nursing or physician staff if called regarding a dental emergency or critical dental care question.

D. Consult with health care staff on coordinating care and treatment of youth.

E. Review past dental records of youth and maintain current dental records by appropriately documenting each youth’s dental history, oral examination, assessment/diagnosis, and dental treatment plan in the youth’s medical file.

F. Record any significant dental problems for each youth on the Problem List in the youth’s medical file.

G. Complete the DJS Dental Encounter and Order Form after each patient visit and write orders for any necessary monitoring, nursing care, special diets, medications, and/or required follow-up care.

H. Perform all services while adhering to accepted infection control practices and within the guidelines of Standard

Precautions as set forth by the Centers for Disease Control and Prevention (CDC), www.cdc.gov, and the Maryland Occupational Safety and Health (MOSH) Bloodborne Pathogen Standard, www.dllr.state.md.us/labor/mosh, as it pertains to dental services. This includes ensuring that dental instruments are sterilized, the dental examination room is kept clean, and sharps are properly disposed of according to CDC and MOSH guidelines.

I. Maintain a sharps inventory for the Dental Clinic by performing sharps counts at the beginning and end of each clinic day with assistance from the dental assistant.

J. Provide the following program administration and management services:

1. Ensure that BCJJC is following Regulatory Guidelines for Dental Radiation Machines by the Maryland

Department of the Environment (MDE) Radiological Health Program.

2. Maintain a log of processing solution changes (at least every three (3) months) and maintenance and cleaning of the X-ray machine.

3. Provide lead aprons to patients to protect them from radiation scatter.

4. Ensure that dental personnel are monitoring radiation exposure by wearing radiation badges and maintaining a log of radiation badges.

5. Cooperate with facility dental inspections every three (3) years by the Maryland Department of the Environment.

K. Supervise dental support staff and sign off on their time report.

L. Review appointment schedules to ensure evaluation and follow-up of youth needing dental care and assist nursing staff in triaging youth.

M. Ensure that all necessary dental supplies are in stock and that all dental and X-ray equipment and instruments are in good working order. If not, coordinate with the BCJJC Nursing Supervisor, DJS Medical Director, or DJS Dentist to order supplies or maintenance/repair of equipment.

N. Participate in meetings periodically or as medically necessary with the DJS Medical Director, DJS Health

Administrator, DJS Dentist, DJS Director of Nursing, Facility Nursing Supervisor, and/or Facility Superintendent (or designee) to discuss and formulate the direction of dental care.

O. Meet at least yearly with the DJS Medical Director, DJS Dentist, DJS Health Administrator, and Contract

Monitor or designee to discuss the Contract, provision of dental care services, and any challenges or problems that arise.

Key Staff General Substitution Provisions

The following provisions apply to all the circumstances of staff substitution.

1. The Contractor shall demonstrate to the Contract Monitor’s satisfaction that the proposed substitute personnel have qualifications at least equal to those of the personnel for whom the replacement is requested.

The Contractor shall provide the Contract Monitor with a written substitution request that shall include:

a) a detailed explanation of the reason(s) for the substitution request;

b) the resume of the proposed substitute personnel, signed by the substituting individual and his/her formal supervisor;

c) the official resume of the current employee for comparison purposes; and

d) any required credentials identified in this Solicitation.

http://www.cdc.gov/

2. The Contract Monitor may request additional information concerning the proposed substitution. In addition, the Contract Monitor, and/or other appropriate State personnel involved with the Contract Monitor may interview the proposed substitute personnel prior to deciding whether to approve the substitution request.

3. The Contract Monitor will notify the Contractor in writing of: (i) the acceptance or denial, or (ii) contingent or temporary approval for a specified time limit, of the requested substitution. The Contract Monitor will not unreasonably withhold approval of a requested key personnel substitution.

A. Replacement Circumstances

1. Voluntary Staff Replacement:

The Contractor shall submit a replacement request to the Contract Monitor at least fifteen (15) calendar days prior to the intended date of change. Except in a circumstance described in section four of this clause, a replacement may not occur unless and until the Contract Monitor approves the replacement in writing.

2. Staff Replacement Due to Vacancy:

The Contractor shall replace key staff whenever a vacancy occurs due to the sudden termination, resignation, or leave of absence due to an extraordinary personal circumstance of such staff, incapacitating injury, illness or physical condition, or death.

Under any of the above circumstances, the Contractor shall identify a suitable replacement and provide the same information or items required within fifteen (15) calendar days of the of the actual vacancy occurrence or from when it was first learned by the Contractor that the vacancy would be occurring.

B. Staff Replacement Due to an Indeterminate Absence:

If any key staff has been absent from his/her job for a period of ten (10) calendar days due to injury, illness, or other physical condition, leave of absence under a family medical leave or extraordinary personal circumstance, and it is not known or reasonably anticipated that the individual will be returning to work within the next twenty

(20) calendar days to fully resume his/her job duties, before the 25th day of continuous absence, the Contractor shall identify a suitable replacement and provide the same information or items required under the Contract.

However, if this person is available to return to work and fully perform all job duties before a replacement has been authorized by the Contract Monitor, at the option of the Contract Monitor, the original staff may continue to work under the Contract, or the replacement staff will be authorized to replace the original staff notwithstanding the original staff’s ability to return.

C. Directed Staff Replacement:

The Contract Monitor may direct the Contractor to replace any staff who is perceived as being unqualified, non-productive, unable to fully perform his/her job duties due to full or partial Incapacity or extraordinary personal circumstance, disruptive, or who has committed a major infraction(s) of law or agency or Contract requirements. Normally, a direct replacement would only occur after prior notification of problems with requested remediation. If, after such remediation, the Contract Monitor determines that the staff performance has not improved to the level necessary to continue under the Contract, if possible, at least fifteen (15) calendar days’ replacement notification will be provided. However, if the Contract Monitor deems it necessary to remove the offending individual with less than fifteen (15) calendar days’ notice, the Contract Monitor can direct the removal with a timeframe of less than fifteen (15) calendar days, to include immediate removal.

In circumstances of directed removal, the Contractor shall provide a suitable replacement for approval within fifteen (15) calendar days of the notification of the need for removal, or the actual removal, if that occurs first.

If deemed appropriate in the discretion of the Contract Monitor, the Contract Monitor shall give written notice of any personnel performance issues to the Contractor, describing the problem and delineating the remediation requirement(s).

The Contractor shall provide a written Remediation Plan within ten (10) calendar days of the date of notice and implement the Remediation Plan immediately upon written acceptance by the Contract Monitor or revise and resubmit the plan to the Contract Monitor within five (5) calendar days, as directed in writing by the Contract Monitor.

Should performance issues persist despite the previously agreed-to Remediation Plan, the Contract Monitor will give written notice of the continuing performance issues, and either request a new Remediation Plan within a specified time limit or direct the substitution of personnel whose performance is at issue with a qualified substitute, including requiring the immediate removal of the key staff at issue.

Replacement or substitution of personnel under this section shall be in addition to and not in lieu of the State’s remedies under the Contract.

Dental Equipment and Supplies

All dental equipment and supplies are provided by DJS. BCJJC has a dental suite for the Contractor to provide dental services. The dental suite will be:

1. temperature-controlled;

2. well-ventilated

3. well-lit;

4. accessible to electrical outlets; and

5. equipped with a suitable dental chair, X-ray machine, dental supplies, dental drills, and other dental tools.

Document in the medical chart of each youth seen. DJS is utilizing paper health records until such time that electronic health records are in place. The clinic visit note shall contain at a minimum:

1. Youth’s name and date of birth;

2. Date and time of clinic session;

3. Reason for visit;

4. Pertinent history;

5. Objective findings;

6. Assessment and plan including diagnosis, required treatment, follow-up, or referral for further care; and

7. Signature of provider.

Dental Charting Documents

Provide the dental charting forms that will be used by the Contractor for documenting the dental clinical encounter, including the dental and medical history, examination of teeth and surrounding tissue, assessment and treatment plan.

These forms shall be submitted to DJS with the bid submission and must be approved by the DJS Medical Director prior to implementation.

A. Add any significant dental diagnosis to the youth’s master problem list in the medical chart.

B. Complete the DJS Dental Encounter and Order Form after each patient visit and write orders for any necessary monitoring, nursing care, special diets, medications, referrals, and/or required follow-up care. Orders must be legible and must include date, time, and signature.

C. Complete the dental clinic log, which is maintained by nursing and dental staff for the list of the youth to be seen at each dental clinic session. The dentist shall document on the dental clinic log:

1. the time in and out for the dentist;

2. the final diagnosis for each youth seen or reason why not seen, and

3. Any additional youth seen or added to the clinic log.

The Contractor shall maintain dental clinic logs which will list the youth to be seen at each dental clinic session.

A. Name and Social Security number;

B. Address C. Date of birth;

D. Race and sex;

E. Application and resume;

F. References and documentation of reference checks;

G. Starting date of employment;

H. Evidence that educational and experiential requirements of the position have been met;

I. Documentation of training received;

J. Evidence of a request for a current criminal background check and evidence the employee has passed the criminal background check within 60 days from onboarding; and K. Signed policy acknowledgment form for the DJS policy “Elimination and Reporting of Sexual Abuse and

Harassment-PREA Juvenile Facility Standards Compliance”; Signed PREA L. Mandated PREA Disclosure Form, required prior to provision of services and then yearly on July 1 (no later than July 10);

The Contractor shall submit the following reports to DJS by the 15th of the following month;

A. Invoice B. Summary of Services C. Patient Procedure List

Contractor Responsibilities and Tasks