inmate_medical_service_program-2025-01-30-14-06-23.pdf

REQUEST FOR PROPOSAL

RFP 26-006

INMATE MEDICAL SERVICE PROGRAM

Cecil County

200 Chesapeake Blvd

Elkton, MD 21921

RELEASE DATE: January 30, 2025

DEADLINE FOR QUESTIONS: March 4, 2025

RESPONSE DEADLINE: March 18, 2025, 12:00 pm

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://secure.procurenow.com/portal/cecil https://secure.procurenow.com/portal/%7bproject.government.code%7d

Cecil County

REQUEST FOR PROPOSAL

Inmate Medical Service Program

I. Introduction II. Notice of Communication

III. Legal Notice IV. Method of Source Selection V. Proposal Submittal Requirements

VI. Scope of Work VII. Constraints on the Successful Contractor

VIII. Responsibilities of the Organization IX. Insurance Provisions X. Evaluation of Proposals and Award

XI. Evaluation Phases XII. Proposal Response Questions

Attachments:

B - RFP 26-006 Cost Sheet

C - Qualifications Affidavit

Request For Proposal #RFP 26-006 Title: Inmate Medical Service Program

1. Introduction

1.1. Summary

Cecil County, Maryland (County) on behalf of the Cecil County Sheriff's Office, Cecil County Correctional

Facility (CCCF) requests proposals from qualified firms to provide (1) on-site medical services to meet the medical needs of inmates (initial physical assessments, ongoing evaluation and treatment of medical conditions, stabilization of urgent and emergency medical/psychiatric conditions, and medication management); (2) on-site dental services to meet the needs of inmates (initial assessment, extractions, examinations, and emergency treatment); (3) on-site mental health care delivery to meet the needs of the inmates; and (4) an off-site Network Preferred Provider of medical facilities, physicians, and other ancillary medical providers to provide medically necessary services to inmates which cannot be provided on-site at the County facility (CCCF).

The resulting contract (“Contract”) shall provide medically necessary services and maintain a level of quality in accordance with standards established by Cecil County, Cecil County Sheriff's Office, department of Corrections , the National Commission on Correctional Health Care (“NCCHC”), and the American

Correctional Association (“ACA”), as well as the standard of care expected of each practitioner in their field as established by their professional organizations and required by the laws of Maryland and any applicable constitutional standard of care.

The Contract shall cover services to all inmates that are housed in the CCCF and to all persons in the custody of the Cecil County Sheriff's Office. Offerors are encouraged to submit innovative and creative proposal responses based on the specifics of this RFP, provided that the level and quality of services are maintained in accordance with the standards of the DOC, NCCHC, ACA, and the Maryland Commission of

Correctional Standards (MCCS).

The Cecil County Correctional Facility (CCCF), is requesting proposals for professional medical services to the inmates at the Cecil County Detention Center and Community Corrections facility which is located at

500 Landing Lane, Elkton, MD 21921.

1.2. Background

The CCCF was established in 1674 and is a multi-operational Agency. The Sheriff’s Office provides law enforcement, correctional and court related services to a county population of approximately 100,000 citizens, situated along the I-95 corridor between Baltimore, Maryland and Wilmington, Delaware.

In 1982, construction of the CCCF began on a piece of property within the limits of Elkton. The new facility opened in January of 1984. The Cecil County Detention Center was designed to house male and female prisoners awaiting trial and those sentenced to incarceration for 18 months or less.

The CCDC is a 200 General Population Bed Facility. The CCCC is a 124-bed minimum custody facility.

1.3. Timeline

Release Project Date January 30, 2025

Pre-Proposal Meeting (Non-Mandatory) February 26, 2025, 10:00am

A guided tour to familiarize contractors with the environment in which services are to be provided is scheduled for this date.

Location:

Cecil County Correctional Facility

500 Landing Lane

Elkton, MD 21921

*Any Contractor who anticipates submitting a proposal is encouraged to participate in a guided walkthrough of the correctional facility, as this is the only opportunity to complete a walkthrough of the facility.

Bring photo ID.

The following conditions must be met:

-Each contractor will be allowed to send a maximum of two staff for the tour.

-No cell phones, briefcases, or handbags will be allowed in tour.

-You may bring a clipboard or note pad to take notes. No recording devices or photographic equipment are allowed.

Question Submission Deadline March 4, 2025, 3:00pm

Proposal Submission Deadline March 18, 2025, 12:00pm

2. Notice of Communication

All communications by a vendor to the county, its officials, and department heads regarding this procurement shall be done through the Cecil County Procurement Office.

No vendor, its’ representative, agent, or employee shall engage in private communication with a member of the Cecil County Council, Government, or county department heads regarding any procurement of goods or services by the County from the date that this procurement packet is released. No private communication regarding the purchase shall be permitted until the procurement process is complete and a purchase order is granted, or a contract is entered into. “Private Communication” means communication with any vendor outside of a posted meeting of the governing body, a regular meeting of a standing or appointed committee, or negotiation with a vendor which has been specifically authorized by the governing body.

3. Legal Notice

These General Provisions are considered standard language for an Offeror (hereinafter referred to as

“Offeror”, “Vendor”, “Respondent”, or “Contractor”) submitting a response for a Request for Bids, Proposals, Qualifications or other solicitation (hereinafter referred to as “Procurement Packet”) made by the County of Cecil (hereinafter referred to as “Cecil County” and “County” or any other governing body/agency for which the Cecil County Procurement Office has been authorized to perform procurement services. The Cecil County Procurement (Purchasing) Office webpage may be found at https://www.ccgov.org/government/purchasing.

It is the Offeror’s sole responsibility to be in compliance of all federal, state, and local laws, requirements, rules, codes, ordinances, and regulations applicable to their proposed goods and/or services. In the event of any conflict between the terms and provisions of these requirements and the specifications, the specifications shall govern. In the event of any conflict of interpretation of any part of this overall procurement packet, Cecil County's interpretation shall govern. Referenced appendices may be subject to change.

https://www.ccgov.org/government/purchasing

4. Method of Source Selection

Cecil County, Maryland is required to adhere to the Cecil County Code, Section 92 Purchasing, concerning good public purchasing practices using a competitive process (RFP). All available information may be reviewed on the Cecil County, Maryland website (www.ccgov.org).

http://www.ccgov.org/

5. Proposal Submittal Requirements

5.1. Proposal Submission

All proposals shall be submitted electronically to OpenGov Procurement by 12:00 pm, Tuesday, March 18, 2025 in order to be considered responsive. To be considered, proposals shall be received by the RFP closing date and time, and failure to adhere to the submittal requirements shall result in proposal being deemed non-responsive. The electronic time and date stamp will serve as the verification of the submittal requirement. Submittals received at other electronic addresses shall not be opened.

Late proposals will not be considered. Vendors/Contractors are strongly encouraged not to wait until the last minute to submit proposals. The time stated on the OpenGov Procurement will be definitive of the time of receipt. Proposals received after the deadline will not be accepted.

NO HARD COPIES WILL BE ACCEPTED.

5.2. Examination of Site and Data

Before submitting proposals, prospective Contractors shall carefully examine the Proposed Contract

Documents, inspect the site of proposed installations, acquaint themselves with all governing laws, ordinances, etc. and otherwise thoroughly familiarize themselves with all matters which may affect the performance of the work. The act of submitting a proposal shall be considered as meaning that the

Contractor has so familiarized themselves and, therefore, no concession will be granted by the County because of any claim of misunderstanding or lack of information. Contractors are expected to read and study all specifications with special care and to observe all their requirements.

Discrepancies, ambiguities, errors, or omissions noted by Contractors should be reported promptly to the

County for correction or interpretation before the date of the opening of proposal.

5.3. Site Visit

A site visit will be immediately following and in conjunction with the pre-proposal meeting.

Location:

Cecil County Community Corrections

500 Landing Lane

Elkton, MD 21921.

5.4. Questions

All questions shall be asked using the question & answer feature via OpenGov Procurement by 3:00 pm on Tuesday, March 4, 2025.

5.5. Bid Opening

As per County policy, proposal openings are closed to the public.

https://procurement.opengov.com/portal/cecil/projects/112786

5.6. Bid Packages

Bid packages can be downloaded on Cecil County's OpenGov Procurement Portal

(https://procurement.opengov.com/portal/cecil/projects/112786 ) as a PDF document for all vendors to download at no charge.

Changes or addendums to this bid will be posted on the County's OpenGov Procurement Portal.

The County is not responsible for information obtained from sources outside the Cecil County Purchasing

Office, including downloads from the County website. Vendors are directly responsible for obtaining updates, changes, or addendums either from the updated webpage or by contacting the Purchasing

Office.

5.7. Pre-Proposal Meeting (Optional)

An OPTIONAL pre-proposal meeting will be held in-person on Wednesday, February 26, 2025 at 10:00 am.

Location or Video Conference Information: A guided tour to familiarize contractors with the environment in which services are to be provided is scheduled for this date. Location: Cecil County

Correctional Facility 500 Landing Lane Elkton, MD 21921 *Any Contractor who anticipates submitting a proposal is encouraged to participate in a guided walkthrough of the correctional facility, as this is the only opportunity to complete a walkthrough of the facility. Bring photo ID. The following conditions must be met: -Each contractor will be allowed to send a maximum of two staff for the tour. -No cell phones, briefcases, or handbags will be allowed in tour. -You may bring a clipboard or note pad to take notes. No recording devices or photographic equipment are allowed.

5.8. Rejection of Proposals

The Cecil County, Maryland or its agencies reserves the right to accept in part or in whole any or all proposals submitted or to waive any technicality or minor irregularity in a proposal. Additionally, the

County shall reject the proposal of any Contractor determined to be non-responsive in accordance with the Code of Cecil County, Section 92 and requirements set within this RFP. Unreasonable failure of a

Contractor to promptly supply the County with information with respect to responsibility may be grounds for a determination of non-responsibility.

All Proposals, RFPs, IFBs or RFQs are contingent upon budgetary constraints.

5.9. Compliance with the RFP

All proposals submitted shall be in strict compliance with the RFP and failure to comply with all provisions in the RFP may result in disqualification or rejection of the proposal.

5.10. Revisions Due to Ambiguity, Conflict, or Other Errors in RFP

Any ambiguity, conflict, discrepancy, omissions, or other error/s discovered in the RFP must be reported immediately to the Cecil County Purchasing Office, Connie S Kamit, 200 Chesapeake Blvd., Elkton, Maryland 21921 in writing and a request made for modifications or clarification. All changes to RFPs will be made in writing (addendum) and all parties who have received the RFP will receive the addendum.

Contractors are responsible for clarifying any ambiguity, conflict, discrepancy, omission, or error in the

RFP prior to submitting the proposal or it shall be deemed waived.

5.11. Implied Requirements

Any product or service that is not specifically addressed in the RFP, but which is necessary to provide functional capabilities proposed by the Contractor, must be included in the proposal.

5.12. Proposals and Presentation Costs

Cecil County, Maryland, or its agencies, is not liable in any way for any costs incurred by the Contractors in the preparation of their proposals in response to the RFP, nor for the presentation of their proposals and/or participation in any discussion or negotiations.

5.13. Exceptions to Format

The RFP describes the requirements and response format in sufficient detail to secure comparable proposals, recognizing that various proponent approaches may vary widely. Any proposal that differs from the described format may be considered non-responsive and rejected.

5.14. Validity of Proposals

All proposals shall be valid for one hundred eighty (180) days from the date of the RFP opening and become the property of the County. If negotiations result in modifications to the RFP, then one hundred eighty (180) days will commence from the date of the receipt of the new proposal. This period may be extended by mutual written agreement between the Contractor and Cecil County, Maryland.

5.15. Cooperative Purchase

The County reserves the right to extend all the terms, conditions, specifications, and unit or other prices of any contract resulting from this bid to any and all public bodies, subdivisions, school districts, community colleges, colleges, universities including non-public schools. This is conditioned upon mutual agreement of all parties pursuant to special requirements which may be appended thereto. The supplier/contractor agrees to notify the issuing body of those entities that wish to use any contract resulting from this bid and will also provide usage information, which may be requested.

The County assumes no authority, liability, or obligation, on behalf of any other public or non-public entity that may use any contract resulting from this bid. All purchases and payment transactions will be made directly between the contractor and the requesting entity. Any exceptions to this requirement must be specifically noted in the bid response.

5.16. Maryland Registration/Qualification Requirements

A. The Bidder must be in compliance with the laws regarding conducting business in the State of

Maryland.

All proposers must be registered to do business in the State of Maryland in accordance with the

Annotated Code of Maryland Corporations and Associations Sec. 2-102 Formation generally, Sec.

7-202 Registration to do interstate and foreign* business, and/or Sec. 7-203 Qualification to do intrastate. For Information on registering or qualifying a corporation, LLC, LLP or LP call the

Maryland Department of Assessments and Taxation (SDAT) at (410) 767-1340. Sole Proprietors and

General Partnerships may call (410) 767-4991 or you may download the SDAT forms at https://dat.maryland.gov/businesses/Pages/Internet-Certificate-of-Status.aspx – entity or by calling (410) 767-1340 or Toll Free (888) 246-5941.

*”a corporation, association, or joint-stock company organized under the laws of the United States, another state of the United States, a territory, possession, or district of the United States, or a foreign country.”

Sec. 1-101 Annotated Code of Maryland Corporations and Associations.

Bidders shall provide a copy Certificate of Status from the Maryland Department of Assessments and Taxation, evidence that the Bidder is in good standing with the State of Maryland.

See: https://dat.maryland.gov/businesses/Pages/Internet-Certificate-of-Status.aspx for information on obtaining the Certificate of Status. Certificates are not available for trade names, name reservations, government agencies, sole proprietorships, and some other accounts as these are not legal entities and thus are not required for these categories of bidders. For more information on the Certificate of Status please see https://dat.maryland.gov/Pages/sdatforms.aspx.

B. All bidders shall provide a copy of their current business license for the State of Maryland.

C. Cecil County reserves the right, at its sole discretion, to extend the date this documentation must be provided. The Bidder’s inability to provide this documentation could result in the bid being rejected.

D. All proposers must be in good standing with Cecil County, Maryland. Proposers must meet any outstanding taxes, fees, or accounts with Cecil County.

https://dat.maryland.gov/businesses/Pages/Internet-Certificate-of-Status.aspx https://dat.maryland.gov/businesses/Pages/Internet-Certificate-of-Status.aspx https://dat.maryland.gov/Pages/sdatforms.aspx

6. Scope of Work

6.1. Abbreviations/Acronyms

CCCF - Cecil County Correctional Facility

CCCC - Cecil County Community Corrections

CCDC - Cecil County Department of Corrections

MCCS - Maryland Commission on Correctional Standards

QHCP - Qualified Health Care Provider

MOUD - Medications for Opioid Use Disorder

MAT - Medication-Assisted Treatment

6.2. Responsibilities of CCCF

The CCCF will provide the Contractor with office space, facilities, utilities (including local phone service), janitorial supplies and the initial inventory of county owned medical equipment and supplies on hand at the CCDC/CCCC on the effective dates of the contract. Routine maintenance of the physical plant will be the responsibility of the CCCF.

CCDC/CCCC will provide existing equipment, supplies and office furniture to the Contractor. Any additional or replacement equipment, supplies, instruments and office furniture required by the Contractor to provide health care services shall be the responsibility of the Contractor. The Contractor and Contract

Manager shall inventory the existing CCDC/CCCC office furniture, equipment and instruments.

Upon contract expiration, the existing inventoried office furniture, equipment and instruments shall be returned to CCDC/CCCC in at least as good a condition as when provided, considering normal wear and depreciation.

6.3. Responsibilities of the Contractor

All equipment and instruments purchased by the Contractor shall be returned to the Contractor at the expiration of this contract. The Contractor shall be responsible for the maintenance, repair and the operations of all equipment and instruments following all federal and state laws and any other applicable regulation. CCDC/CCCC, on the expiration of the contract, may request to purchase Contractor’s owned equipment, instruments and furniture at a mutually agreed upon price.

The Contractor shall purchase and maintain on-site two (2) Automated External Defibrillator (AED). A

QHCP trained in the use of the AED shall be present at the CCDC/CCCC 24 hours per day, seven days per week.

The Contractor shall provide all medical, mental health and dental care CCDC/CCCC inmates. The

Contractor’s responsibility to each inmate commences at the time of commitment and acceptance to the

CCDC/CCCC Facility. The Contractor shall be responsible for treating pre-existing conditions that require continuing medical treatment. The Contractor is responsible for inmates receiving treatment within or outside the CCDC/CCCC when this agreement goes into effect.

The Contractor shall comply with the MCCS, CCDC/CCCC and CCCF policies and procedures related to medical services at the CCDC/CCCC. The Contractor shall assist the Standards Office with compliance and the annual review for compliance with related policies and procedures; final approval shall rest with the

Director and Sheriff.

CCCF must approve, in advance, all sub-contracts entered into by the Contractor for the purpose of completing the provisions of this contract. The Contractor will not sell assign, transfer, nor convey any of its rights except with the written consent of the Sheriff or his designee.

The Contractor shall appear as requested before any court to provide medical information regarding inmates, or to provide a copy of medical records upon receipt of a summons or subpoena.

The Contractor shall be responsible for the maintenance and repair of existing equipment and instruments, which shall be inventoried by the Contractor and Contract Manager at the onset of this contract. Copy of the inventory shall be provided to the Contract Manager.

The Contractor shall provide all medical, dental and mental health supplies, and office equipment (to include computer, fax, copier, etc. required to support the scope of work). The Contractor shall ensure that all equipment and instruments are maintained and operated following all federal and state laws and any regulatory agency where applicable. Contractor shall be responsible for the maintenance of all existing equipment and equipment that is provided by the Contractor.

The Contractor will be responsible for preserving and supervising medical records for the inmate population. Such medical records are the property of the CCCF. The Contractor will ensure compliance of the federally mandated electronic medical records no later than the mandated date.

The Director, Contract Manager and the Contractor shall agree upon the scheduled hours for the physician and mental health professionals. These hours shall remain constant, to the extent possible, within each week. A Mental Health professional must be on site seven days per week and a minimum of 12 hours per day, hours are to be coordinated with the Director of CCDC and CCCC.

The Contractor shall provide the Contract Manager with job descriptions, a copy of the license/certification and CPR certification of each staff member on the date of employment. In addition, staff will undergo a criminal records check by the CCCF and be bound by CCCF policies and procedures on dress and security.

The services rendered under this contract are critical to the mandated responsibilities of the

Sheriff. Therefore, the Contractor shall reimburse the CCCF for all expenses incurred by the Sheriff in providing services, which are the responsibility of the Contractor.

In the event the agreement is terminated prior to its expiration, all completed or incomplete documents, studies, reports, correspondence and other products prepared by or for the Contractor under this agreement shall become the exclusive property of the CCCF. Notwithstanding the above, the offeror shall not be relieved of liability to the CCCF for damage sustained by virtue of any breach of the agreement by the Contractor.

6.4. Legal Responsibilities

Legal Responsibilities of the County:

Cecil County and the CCCF have no obligations to provide legal counsel or legal defense to the Contractor or its sub-contractors in the event that a suit, claim or action of any character is brought by its sub-contractors as a result of or relating to Contractor’s obligations under the contract.

Cecil County and the CCCF have no obligation for the payment of any judgments or the settlement of any claims made against the Contractor or its Sub-contractors as a result of or relating to the Contractor’s obligations under the contract.

Legal Responsibilities of the Contractor:

The Contractor shall bring all legal actions necessary to enforce the treatment and medication orders necessary to maintain the safety of the inmate and inmate population. The Contractor is responsible for all aspects of the medical needs of the inmates at this institution; as such, even in the event that a court shall determine that the Sheriff and/or County has a non-delegable duty with regard to claims or financial obligations relating to medical issues, the Contractor shall nevertheless indemnify and defend the County and the Sheriff’s Office in any investigation, suit, action, claim, or allegation of any kind.

The Contractor will immediately give notice to the Director and the Contract Manager of any claim or suit made or filed against the Contractor or is Sub-contractors regarding any matter resulting from or relating to the Contractor’s obligations under this contract.

6.5. Fee - for - Service

The Contractor shall assist the CCDC/CCCC with developing and implementing a fee-for-service program that will entail a reasonable fee being deducted from the inmate’s account for each medical visit within

60 days after the Contract date.

The fee–for–service program must comply with standards established by the MCCS and must comply with

Annotated Code of MD Correctional Services Manual Sect. 11-203.

6.6. Specialty Services

Contractor will provide on-site, to the extent possible, specialty services as deemed appropriate by the responsible physician. To the extent specialty care is required and cannot be rendered on-site, the responsible physician will initiate the referral and the Contractor will be responsible for off-site rendering of such care. The Transport Unit of the CCDC/CCCC will provide routine transport of the inmates to the off-site location. Off-site locations shall be, to the extent feasible, within the jurisdiction of Cecil

County. The Contractor and the Contract Manager will mutually agree on Out of County services in advance.

For inmates with special medical conditions requiring close medical supervision, including chronic and convalescent care, the responsible physician shall develop a written individualized treatment plan. The plan should include medical instructions to health care providers and other personnel regarding their roles in the care and supervision of the patient.

6.7. Third Party Compensation

The Contractor shall pursue third party compensation. When third party compensation is received for covered inmates, the Contractor shall deduct the amount of this compensation from the annual aggregate cap. The Contractor shall provide the County, Sheriff, Director and Contract Manager, on a monthly basis, an itemized report for such reimbursements for services rendered during the life of the contract. Under no circumstances shall the Contractor be paid twice, once by the third party reimbursement and a second time by the County. The Contractor may deduct any legal expense incurred as a result of the collection from the net payment imposed on the County, with appropriate justification, up to the amount of the reimbursement.

6.8. Emergency Services

The Contractor will provide off-site emergency medical care for inmates, as required, through arrangements made with local hospitals.

The hospitals must be:

(a) approved by the Sheriff, Director and Contract Manager and;

(b) have an appropriately staffed medical unit.

The QHCP shall determine whether an inmate requires transport to the nearest hospital.

The Contractor shall make provision for on-call 24-hour emergency medical, psychological and dental care. When called, the physician, psychologist/psychiatrist or dentist must telephone back within 30 minutes and, if required, shall return to the CCDC/CCCC upon request.

The Contractor shall provide on-site emergency treatment for Detention Center employees and visitors who are injured or become ill while on the premises.

6.9. Out of Facility Medical Services

The Contractor shall arrange for the admission of inmates at a facility approved by the Sheriff, Director and Contract Manager and shall be responsible for payment for same in accordance with the schedule submitted with the Proposal defining hospital caps and/or limits of coverage.

6.10. Medical Services

Health Trained CCDC/CCCC personnel shall complete receiving forms, which will include: Communicable

Disease Questionnaire, Mental Health Questionnaire, (to include suicide assessment) Medical

Questionnaire, and other medical forms as necessary. These forms shall be reviewed and evaluated by a

QHCP no later than the next medical shift. The Medical History Screening will be completed by the QHCP.

In instances where the inmate presents a medical problem, the QHCP shall report to the booking area immediately and make a determination as to whether the inmate should be accepted into the facility or referred to another appropriate health care service provider.

The qualified health care professional shall assist security and classification in determining a housing assignment, if required.

QHCP shall, at the time of booking or after review and evaluation of the appropriate screening forms, make recommendations including, but not limited to:

• Referral to an emergency health care facility

• Referral to the health care services at the CCDC/CCCC

• Referral to medical housing

• Placement in isolation

• Placement in observation area (awaiting psychiatric evaluation)

Physical exams of newly arrived inmates shall be completed within 14 days or sooner if requested by the

Director after arrival at CCDC/CCCC. This exam shall comply with the MCCS and CCDC/CCCC standards including, but not limited to:

• Review of the Screening/intake forms

• Complete history and physical exam

• Mental Health Evaluation

• Dental Screening

• PPD and RPR

• Pregnancy tests for females

• Initiation of therapeutic measures when appropriate

• Other tests and exams as needed/required

An annual examination, to include PPD, shall be conducted for all inmates remaining at the CCDC for more than one year. This examination shall occur as close as possible to the 365th day of incarceration.

Each inmate working in the kitchen or handling food products shall be given a physical examination, to include PPD and RPR, by the Contractor prior to that inmate beginning work.

Physical exams shall be conducted by a physician, physician’s assistant or nurse practitioner and documented on appropriate forms.

Daily triaging of medical complaints, made known to the medical unit via an inmate sick slip, shall be accomplished by a QHCP at least once daily.

• Triaging shall occur, to the extent possible, during medical tours of each housing area.

• The Contractor shall provide nursing protocols, as approved by the responsible physician, as a resource to accomplish the triage.

• All inmates requesting care shall be seen by a QHCP as soon as possible, and if found to require treatment by a physician or physician’s assistant shall be referred and seen at the next sick call.

Sick call shall be maintained at the scheduled time, three days a week with a minimum of two hours per day by a physician or physician’s assistant. Sick call will last as long as necessary, until all inmates are seen.

• Inmates precluded from attending sick call in the clinic will receive sick call services at the place of confinement.

• Daily services may not be arbitrarily canceled by a health professional without obtaining prior permission of the Medical Administrator, Contract Manager or Director.

• In the event that sick call is not held in accordance with the agreed upon schedule, an alternate date during that week will be arranged between the Contract Manager and the contract representative.

All inventories and inspections shall be conducted according to MCCS and the CCDC/CCCC policy and procedures and documentation of said inventories and inspections shall be completed on CCDC/CCCC forms and provided to the Contract Manager at their completion.

A monthly statistical report shall be provided to the Director, Deputy Director, and Contract Manager covering the number of inmates receiving services to include, but not limited to:

• Sick Call

• Hospitalizations

• Referrals

• Dental Exams

• Dental Screening

• Physical

• Mental Health Contacts

• Commitments to State Facilities

• Deaths

An annual statistical report shall be provided at the end of each calendar year to the Director, Deputy

Director, and Contract Manager.

The Contractor shall not, under any circumstances, perform medical testing on any inmate for the purpose of medical, pharmaceutical or cosmetic experimentation. Inmates shall not be used to perform any function or duties of the medical staff.

All physical examinations, screening and sick calls will be coordinated with the CCDC’s Security Staff.

First Aid Kits, contents and locations, as approved by the Health Care Provider, will be maintained and a monthly inventory conducted to determine supply by the Contractor.

6.11. Pre-Release Screening

The Contractor shall review all medical records of inmates at least twenty-four hours prior to their transfer to the Division of Correction. The Contractor must provide a copy of the inmate’s record to the

CCDC/CCCC Transportation Unit for transportation with the inmate.

In addition, the Contractor must provide a 72-hour supply of meds for the inmate’s use, if applicable.

For inmates released to the community, the medical record review shall be conducted prior to the release or within seven days after release. Following the medical review, the QHCP shall make appropriate follow-up referrals to community resources.

Records review for all methods of release will be documented on the Pre-Release Screening Form.

6.12. Laboratory Services

Laboratory tests shall be the responsibility of the Contractor. An RPR shall be conducted within 14 days of admission of each inmate at the time of the physical exam. Testing is done for routine screening and to rule out or confirm medical illness or conditions as clinically indicated. Positive screening for communicable disease shall be referred to the appropriate health care agency for follow-up. Positive pregnancy shall be referred to the appropriate Health Care Provider for pre-natal care and to the Healthy

Start Program provided by the Health Department. HIV testing shall be conducted by the Health

Department, as symptoms indicate, not routinely.

6.13. Dental Services

The Contractor shall be responsible to make dental referrals and to schedule appointments as needed.

6.14. Detoxification/Methadone Maintenance Program

These programs shall be undertaken when deemed appropriate by the responsible physician for inmates under his/her supervision. Methadone maintenance shall be determined on a case by case basis, with careful consideration to be taken with pregnant females, with final approval resting with the Director of

CCDC/CCCC based on recommendations from the Contractor’s representative. If the Contractor chooses, the Cecil County Mental Health and Addictions Department will provide methadone for detoxification and maintenance. Otherwise, the Contractor shall be responsible for procuring and paying for these services.

6.15. MOUD/MAT Program

The CCDC/CCCC operates a state mandated MOUD/MAT program. The Contractor shall work cooperatively with Security Staff, Cecil County Health Department, and a Cecil County contracted

Methadone provider to ensure proper implementation of the program and for the safety of the inmate population.

The Medical Contractor will be responsible for:

• Completing Intake Forms for MOUD/MAT

• Induction for Subutex

• Provider meeting with inmates inducted by the Methadone Contractor.

• Urine-Drug Screening for MOUD/MAT

• Conducting Lab work for MOUD/MAT

• Conducting EKG for MOUD/MAT

• Dosing inmates currently on the MOUD/MAT program

• Ordering of Subutex

• Destruction of Narcotics

• Communication and information sharing with Cecil County Health Department and Methadone

Contractor

• Continuity of care

• Secured storage of weekly delivered Methadone

• Conducting Inventory each shift

• Mental Health meeting with Diversion Inmates

• Collecting Statistical Data and Data sharing with Security and Cecil County Health Department

• Monitoring Treatment Response

• Electronic Data entry of Distributed Medications

6.16. Medical Records

The Contractor shall initiate a medical record on each individual arrested and accepted on the premises of the CCDC/CCCC beginning with the intake screening and ending with the pre-release screening. The medical records shall be confidential, accurate and complete including all requests, complaints and services rendered in accordance with MCCS and CCDC/CCCC policy and procedures and all federal and state laws regarding medical records.

All existing medical records of the CCDC/CCCC shall be made available to the Contractor at the commencement of the agreement. All medical records, as well as initiated records shall be in the custody and control of the Contractor. The Contractor shall provide the medical records to any agency, organization or person requesting such information for examination or photocopying according to HIPPA the CCDC/CCCC policy and procedure.

At the expiration of the agreement, all medical records shall become the sole and exclusive property of the CCCF/CCDC/CCCC. The problem oriented records format shall be used in the Medical Record System.

The inmate medical record shall include, but not limited to:

• Intake screening forms

• Health appraisal form

• Physician order/treatment plan

• Prescribed medications administered or not administered, date time and by whom.

• Health services reports

• Consent and refusal forms

• Release of information forms

• Sick Slips

• Medical grievance forms

• Signature and title of each documenter

• Laboratory, radiology and diagnostic studies

• Consultation, emergency room and hospital summaries

• Pre-release form

• Dental screening, exams and treatment reports

• Mental Health screening and documentation

Dental and Mental Health records are considered a part of the Medical Record. The Mental Health

Professionals will be responsible for ensuring that confidential documents that should not be released or discussed in accordance with the Annotated Code of Maryland and HIPPA.

6.17. Mental Health

The Contractor shall provide on-site Mental Health services with Mental Health specialists in accordance with CCDC/CCCC policy and procedures.

The Contractor shall provide mental health including, but not limited to:

• Mental Health evaluation as needed.

• Suicide risk identification.

• Medication management.

• Crisis intervention.

• Commitment to State facilities when warranted.

• Routine and ongoing counseling as deemed appropriate.

The Contractor shall adhere to all requirements of the CCDC/CCCC policy and procedure governing suicide precaution. The Contractor shall ensure that each inmate placed on suicide precautions is evaluated by a Mental Health professional once per medical shift unless the inmate’s condition warrants additional attention.

The Contractor will provide at least eight (8) hours per week of a psychiatric service by a psychiatrist.

A member of the Contractor’s mental health program staff shall act as a liaison between the courts, attorneys, family, county agencies, other mental health providers and mental health institutions.

The Director, Deputy Director and Contract Administrator may require the psychiatrist to re-evaluate problematic mental health inmates at the expense of the Contractor.

6.18. Pharmaceuticals and Supplies

All prescription and non-prescription medication prescribed by the Contractor shall be the responsibility of the Contractor. All medical supplies, books and periodicals shall be the responsibility of the

Contractor. Prescription medication is to include all infectious disease and AIDS related medications currently available or that should become available during the contract period.

All prescription and non-prescription medications prescribed by the Contractor shall be blister pack format. Bulk medication is prohibited and will not be used in the CCDC/CCCC. A pharmacist shall formulate all medications. Only the QHCP is permitted to dispense medications. Records of administration, showing date, time, location and by who with signature and initial shall be kept on the appropriate forms.

The only “Personal Maintenance” medication allowed should be inhalers and creams contained in plastic tubes as ordered by a physician.

An appropriately licensed or certified person according to federal and state laws, and MCCS standards and the policies and procedures of the CCDC/CCCC shall administer medications. Medication shall be taken to each living area four times a day during routine medical tours via a medicine cart designed for blister pack storage. All medications shall be taken in full view of the QHCP and if there is any doubt, the

QHCP will order the inmate to open his/her mouth to confirm that medication has been ingested.

All medications shall be ordered by a responsible physician, dentist or psychiatrist.

The Contractor shall administer medication to the inmates within 24 hours after they have been prescribed by the physician, dentist or psychiatrist. Provision shall be made with the pharmaceutical supplier for the delivery of medication to ensure prompt administration to the inmates.

The Contractor shall be responsible for all inventories currently used or those instituted in the policy and procedure review. These inventories shall be documented on the appropriate forms and provided to the

Contract Manager on a monthly basis.

All outdated or unused medication shall be returned to the issuing pharmacy for credit and/or disposal, and accurate record keeping maintained on appropriate forms..

The Contractor shall cooperate with the Contract Manager in developing and updating a formulary as approved by the responsible physician.

The Contractor shall provide a three (3) day supply of chronic care medications to the inmate upon release.

6.19. Work Release and Home Detention Programs

The Contractor shall conduct a physical exam within 14 days of arrival on Work Release Inmates. The physical exam shall be conducted, to the extent possible without interruption of the work release inmate’s work schedule. In the event that scheduled sick calls do not comply with a work release inmate’s schedule, the inmate may be held in from work to accomplish the physical exam within the 14 day time period.

Work-related injuries or illnesses shall be the responsibility of the inmate or inmate’s employer. The

Contractor shall examine any inmate complaining of a work-related injury and document such occurrence, and also confirm any appointments with the worker’s compensation provider.

Minimum-security inmates on controlled medication (i.e.: Tylenol No.3) shall have the choice of remaining in from work to receive this medication from a trained person or not taking the medication and continuing their work schedules.

6.20. Hazardous Waste

The Contractor shall provide for the disposal of all medical hazardous waste. The service shall be provided by an appropriately certified carrier and shall follow all applicable federal and state laws.

The Contractor shall require all manufacturers, suppliers and distributors to furnish Material Safety Data

Sheets (MSDS) as required by 29 CER.1910.1200 with the first shipment of any hazardous material to the

Medical Department. Whenever the content of an MSDS is revised, the contractor shall ensure that the vendor provides new information relevant to the specific material. The Contractor shall maintain a MSDS

Book in the Medical room.

6.21. Infection Control

Infection and communicable disease prevention, monitoring and control services shall be provided either through an individual certified in infection control on-site or through the Contractor’s administrative services.

In the event it is deemed medically advisable to quarantine an inmate suspected of having a communicable disease, the inmate will be housed in medical isolation. The Contractor shall utilize appropriate isolation measures and will supervise the use of those isolation measures in this area. All inmates with a communicable disease shall be reported to the Cecil County Health Department.

6.22. Health Education

As a part of the primary health care, the Contractor shall provide patient education, staff in-service training, first aid and CPR training for the health care staff.

The Contractor shall provide annual training to include lesson plans for the CCDC/CCCC security and support staff addressing medical and mental health issues relevant to correctional medical care and as dictated by the MPCTC, and MCCS.

The Contractor shall provide all training records to the Contract Manager.

6.23. Quality Assurance Program

The Contractor shall provide a quality assurance program consistent with MCCS designed in concert with the Standards Office and Contract Manager subject to approval by the Warden. This program shall include, but is not be limited to, audit and medical chart review procedures. The Sheriff or his designee shall have complete and unlimited right to access any and all information maintained by the Contractor that is needed to ensure compliance with the contract terms and conditions, and to have in place a

Contract Manager to monitor contractual compliance and to act as a liaison between the Program

Administrator and the Warden of the CCDC/CCCC. The Contract Manager shall be responsible for orientation and CPR training for the CCDC/CCCC staff personnel. The Contractor shall make available all records or data requested.

This may include, but is not limited to:

• Monthly Timesheets of all Staff

• Inventories/Inspections

• Licensure/Certificates

• CPR Certification

• Inmate Medical Records

• Monthly Billing for Review and Evaluation

• Statistical Reports

The CCDC/CCCC’s Contract Manager will be responsible for the overall monitoring of contract performance including, but not limited to, monthly monitoring of contractor timesheets, handling of patient complaints related to the Contractor and participating in monthly record audits for quality assurance.

The Contractor shall establish a program for assuring quality healthcare services to CCDC/CCCC inmates. The quality assurance program will evaluate the health care provided on-site for quality, appropriateness, and continuity of care. The quality assurance program will also monitor facilities, equipment and supplies, inmate complaints about services, gather information concerning levels of inmate and staff satisfaction with the health services, and provide regular infection control reports. Such plan should be implemented on the start date of the Contract.

A documented monthly meeting shall be held between CCDC/CCCC officials, Contract Manager and appropriate contractual personnel to review the issues, suggested changes, as well as to provide feedback relative to the program. At this time deficiencies or recommendations may be acted upon as deemed advisable by mutual agreement. The Contractor shall provide the documentation of this meeting, in minutes form, to the Contract Manager within 10 working days after the meeting. The meetings will held in the month of March, June, September and December.

The Contractor shall ensure that a performance evaluation on all health care staff under its supervision is completed at intervals no less frequent than semi-annually.

The Contractor shall designate a person to monitor evaluation on all health care staff under its supervision is completed at intervals no less frequent than semi-annually.

6.24. Limitation on Hiring Employees

Each prospective job candidate must be 18 years of age and will be interviewed by the Contractor’s with special focus on technical expertise, emotional stability, and motivation. The final selection shall be subject to approval by the Sheriff or his designee.

All of the Contractor’s employees shall have background investigations in accordance with the Sheriff’s

Office policies and procedures prior to placement at the CCDC/CCCC.

The CCDC/CCCC reserves the right to request timely replacement of any Contractor personnel who violates the rules/or regulations of the CCDC/CCCC, or poses a risk or unacceptable threat to the security of the institution. The Warden/Director will immediately notify the Contractor of the request and will submit written explanations to the Contractor for the basis for such request for replacement within (2) working days. The Warden/Director shall have the power to prohibit the employee from working at the facility.

Temporary medical personnel shall not be routinely used. Permanent Contractor staff shall be the only authorized personnel permitted to work in the CCDC/CCCC. Emergency exemptions must have prior approval by the Contract Manager or Warden/Director.

6.25. Staffing

The Contractor must provide an on-site Program Administrator who will have day-to-day responsibility for coordinating and controlling the activities of the health care professionals and shall manage the entire health care delivery system within the CCDC/CCCC. This will ensure that health care professionals interact as may be necessary and appropriate, that health services are delivered most efficiently and that costs and quality of services are centrally monitored and controlled. This person will be responsible to the

Contract Manager with the CCDC/CCCC.

The Contactor shall provide a single point of accountability in all matters relating to inmate health care services. This person will be directly responsible to the Sheriff and Warden and have the authority and responsibility to resolve all problems and satisfy all the needs and expectations of the CCDC/CCCC.

The Contractor’s staffing shall include a Health Authority who shall spend sufficient time on-site to provide the required medical administrative duties, quality assurance, utilization review monitoring and clinical/administrative coordination with all QHCP.

Adequate Qualified Health Care Personnel, with current license/certification from the State of Maryland, shall be provided 24 hours per day, 7 days per week, to provide the service as required by the MCCS and the CCDC/CCCC. An R.N. shall be designated as the Charge Nurse/Health Services Administrator.

The Contractor shall provide a schedule of staff assignments and service providers. This schedule shall be updated monthly or as conditions dictate. All positions shall be filled and provided by the scheduled staff or authorized relief personnel. A weekly report of compliance and/or exceptions shall be submitted to the Contract Manager with a report of the steps taken to prevent future exceptions.

The Contractor and the…