Jail_Medical_Services_(Addendum_#1_Revision).pdf

REQUEST FOR PROPOSAL

2025-RFP-188

JAIL MEDICAL SERVICES

Pierce County

930 Tacoma Avenue S

Tacoma, WA 98402

RELEASE DATE: September 3, 2025

DEADLINE FOR QUESTIONS: September 17, 2025

RESPONSE DEADLINE: October 1, 2025, 4:00 pm

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://procurement.opengov.com/portal/piercecountywa https://procurement.opengov.com/portal/%7bproject.government.code%7d

Pierce County

REQUEST FOR PROPOSAL

Jail Medical Services

I. Introduction II. Procurement Information

III. Scope of Work IV. Submittal Criteria V. Evaluation Process

VI. Evaluation Criteria VII. Vendor Questionnaire

VIII. RFP General Terms & Conditions

Attachments:

A - Staffing Summary

B - Medical Clinic and Nurse Station Drawings

C - PSA EXHIBIT E- Insurance

Request For Proposal #2025-RFP-188 Title: Jail Medical Services

1. Introduction

1.1. Summary

Pierce County (hereafter referred to as “County”) is seeking proposals for a performance-based, shared medical treatment obligation contract to provide comprehensive, on-site medical services to individuals in custody at the Pierce County Jail (PC Jail) and Adult Status Youth (ASY) housed either at Remann Hall or the PC Jail.

The scope of services includes all legally required and medically necessary care, encompassing medical, dental, pharmacy, routine mental health screenings and prescribing, as well as both medical and mental health-related pharmaceutical services. Required care may include coordination of outpatient and inpatient services as appropriate. Full implemented Medical

Services need to be delivered in the Jail before or no later than February 16, 2026.

Jail medical services are currently provided in several locations within the jail facility, including the booking area, the jail medical clinic, and various housing units.

1.2. Background

The Pierce County Sheriff's Office (PCSO) operates the PC Jail to serve all of Pierce County. By statute, adult and remanded juvenile pre-trial inmates and inmates sentenced to one year or less are housed in the PC Jail. By contract, the County houses misdemeanant pre-trial and sentenced misdemeanants for incorporated parts of Pierce County through Municipal Courts as well as all unincorporated areas through District Courts.

The PC Jail has a capacity of 1296 (708 in the main high-security facility which runs at 100% capacity and 588 in the open dorm, minimum-security jail).

The PC Jail consists of two facilities inside one controlled perimeter. All movement within and between the facilities is controlled by the correctional staff.

Our Average Daily Population (ADP) is approximately 800.

A. The maximum-security facility houses maximum to medium security inmates and has a budgeted capacity of 708.

1. Indirect supervision (single cells) and open dorm units.

1. Also houses the majority of inmates requiring special medical attention.

B. The minimum-security facility houses minimum to medium security inmates and has a budgeted capacity of 588.

1. Direct supervision and an open-dorm housing.

1. A snapshot of May 2025 to August 2025 shows an average number of bookings per day of approximately 42, with averages of 13 during day shift with a range of 2 - 47, 17 during swing shift with a range from 6 to 31, and 12 during graveyard shift with a range from 5 go 28.

1.3. Contact Information

Stephanie Browning

Procurement and Contract Specialist 2

950 Fawcett Ave

Suite #300

Tacoma, WA 98402

Email: stephanie.browning@piercecountywa.gov

Phone: (253) 798-7796

Department:

Procurement and Contract Division

Department Head:

Jana Prince

Procurement & Contracts Manager

1.4. Timeline

Release Project Date September 3, 2025 mailto:stephanie.browning@piercecountywa.gov tel:(253)798-7796

Pre-Proposal Meeting (Non-Mandatory) September 11, 2025, 11:00am

Optional Pre-Bid Walkthrough.

LOCATION: Pierce County Jail: 930 Tacoma Ave

South -Meet in the Lobby

A guided tour to familiarize vendors with the environment in which services are to be provided is scheduled at:

11:00am, Check in time is 10:45.

• Each vendor will be allowed to send a maximum of two staff for the tour.

The walk through will last approximately 60 minutes.

• No cell phones, briefcases, or handbags will be allowed in the jail. Safe storage will be provided for use during the tour.

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

• Paid parking is available off of Yakima and

Nollmeyer Lane directly behind the County City building.

Bring picture ID.

This is the only opportunity vendors will have to walk through the facilities.

Question Submission Deadline September 17, 2025, 4:00pm

Proposal Submission Deadline October 1, 2025, 4:00pm

Proposal Evaluation Approximately three weeks after proposal submission deadline, proposals will be evaluated and interviews may be held if multiple Proposers are deemed capable of meeting the requirements.

2. Procurement Information

2.1. PROCUREMENT DOCUMENTS & RFP'S HOLDER LIST

PROPOSERS WHO REGISTER AND DOWNLOAD BID DOCUMENTS will be automatically added to the

FOLLOWER'S list in the County's eProcurement Portal. Notifications for bid updates, addendum and other bid information will be sent to all bidders who register on the Pierce County eProcurement Portal.

2.2. PROCUREMENT QUESTIONS

All questions must be submitted within the County's eProcurement Portal, under the Questions and

Answer Section no later than 4:00 pm on Wednesday, September 17, 2025. Bidders must be registered in the eProcurement Portal software to submit questions, receive addenda, notifications and ultimately submit a proposal.

Proposals must be received by the Procurement & Contract Services and the Finance Department before

4:00 pm on Wednesday, October 1, 2025. Proposer is responsible for submission of proposal before the deadline. The County shall not be responsible for late submittals.

2.3. Expected Term of Resulting Agreement

The initial contract period is anticipated to be until December 31, 2031. The County has the option of renewing for two additional, two-year terms after initial contract is executed with notice from the

Contracted Proposer 9 months prior to end of each the initial and any opted additional term. The actual schedule will be negotiated with the selected organization(s) based on the finalized scope of work, funding, and services being purchased.

2.4. Definitions

• Adult Status Youth means 16–17-year-old individuals charged with crimes that by statute are prosecuted as an adults.

• Attachment means any item required as a part of the proposal

• Average Daily Population (ADP) means total number of inmates in custody at PC Jail, to include both minimum-security and maximum-security facilities

• County means Pierce County

• Days means calendar days unless otherwise specified

• EHR System means electronic health record

• Formulary means a list of prescription medications covered by a health insurance plan, organized into tiers based on costs.

https://procurement.opengov.com/portal/piercecountywa

• Grievance means escalated communication (written or electronic) initiated by the inmate to prompt a formal response by appropriate personnel for alleged complaint or protestation.

• Inmate means person detained or confined in the Pierce County Sheriff’s Office Jail or Remann

Hall.

• Key Personnel means Executive Management Team (CEO, CFO, etc.) and team who will be responsible for getting services up and running

• Kite means a written or electronic form provided by the jail to inmates so that they may submit questions or share information with jail personnel and/or jail medical services.

• Licensed means staff who hold and active and unrestricted license in a good standing, in the

State of Washington in the relevant professional discipline for the position in which the licensee will be providing services

• Medical Director is a physician employed by the County. The Medical Director is the clinical health authority for the PC Jail, responsible for clinical and medical decisions of the Health

Services Unit. This is highly responsible, professional medical work, including clinical, supervisory, and administrative responsibilities. This Director participates as a member of the

Health Services Unit Management Team. This is a civilian, non-commissioned position appointed by the Sheriff.

• Medical Services means all legally required, medically necessary services to include dental, pharmacy, routine mental health screening and prescribing, pharmacy (both medical and mental health), and necessary outpatient and inpatient services

• Medical Care Staff means qualified Washington licensed health care professionals as well as administrative and support staff

• NCCHC means the National Commission on Correctional Health Care Accreditation Standards for

Medical Services in Jails for medical and mental health services.

• Proposer means person or entity responding to this request for proposal

• Registered Nurse (RN) means a healthcare professional who has completed formal education, passed a licensing exam, and is authorized to provide a wide range of nursing services.

2.5. Disclaimer

This RFP is for informational purposes only and does not constitute a commitment, implied or otherwise, that Pierce County of Washington State will take any actions. Pierce County of Washington

State reserves the right to change or cancel this RFP at any time.

3. Scope of Work

3.1. Scope Details

Proposer will provide all medical services including medical, pharmacy, dental, radiology, laboratory.

The County is currently budgeted for current on-site mental health services consisting of eight (8) mental health professionals, one (1) Mental Health Manager, one (1) Office Assistant. The County will also maintain one full-time Physician to serve as the Medical Director for Medical Services in the Jail. The successful Proposer will be expected to integrate its services with the existing mental health providers including maintaining shared medical records, continuing current verified psychiatric medications for up to 30 days from booking, and initiating treatment with psychotropic medication for uncomplicated psychiatric conditions consistent with community standards for primary care practitioners.

With an ADP of 800, the contract negotiation should be centered on this number with built in escalators and de-escalators based on future ADP.

Description of Clinic

The main clinic is located in the maximum-security jail on the 3rd floor. Included are four (4) exam rooms, one (1) radiology room, pharmacy space, two (2) triage offices, one (1) dental exam room, a nurse' station, and an administrative wing with a conference area. There are two (2) holding cells that can house up to 20 inmates waiting for clinic services (these numbers vary based on security classification of the inmates called for sick call). In addition, there is a nurse exam room located in the jail adjacent to the booking area, as well as a confidential medical screening site at booking. Each housing unit in the jail has an adjacent room that may be used for nurse triage, and interview rooms are located just outside the security perimeter of each housing unit in the jail. The design of the jail encourages that medical services be brought to the inmate whenever clinically appropriate.

3.2. Outline of Medical Services

Proposer will provide on-site inmate Medical Services for the PC Jail using the following objectives:

Pierce County strives to aligns its medical services in accordance with the National Commission on

Correctional Health Care, NCCHC guidelines.

• Operate medical services in an ethical and humane manner with respect to the inmate’s right to basic health services. Services are to be delivered to any inmate within the area of the facility where access is controlled by Correctional Deputies (secure perimeter). Proposed services will meet all legal and community standards for correctional medical services and be consistent with

NCCHC guidelines.

• Operate the medical services program in a cost-effective manner with full reporting and accountability to the Pierce County Sheriff or his/her designee.

• Operate the medical services program at full staffing and use only Washington State licensed, certified, and professionally trained personnel who have passed a criminal history background check conducted by the County. The County will have final approval rights for all proposed hires https://www.ncchc.org/jails-and-prisons/ and reserves the right to bar any contractor employee from the facility at the sole discretion of the County.

• Operate the medical services program providing comprehensive services that are legally defensible and meet acceptable standards for health services in jail facilities.

• Provide indemnification to the County for any liability arising from the medical services practices provided as a result of this RFP.

• Provide indemnification to the County for any liability arising from the medical services practices provided as a result of this RFP.

3.3. Adult Status Youth

Proposer will provide all medical services including but not limited to medical, pharmacy, dental, laboratory, and radiology for Adult Status Youth (ASY) in custody at the Pierce County Jail or Remann

Hall (Juvenile Detention Facility). Care must be provided in a manner that prevents contact including sight and sound of the juvenile with adult inmates. Services also include coordination of any necessary treatment at a hospital or off-site provider.

3.4. Telehealth

Utilization of telehealth services for non-clinic hours may be allowed presuming it does not limit the use of on-site clinic services. Proposer shall source, install and maintain all onsite telehealth equipment.

Proposer shall provide training in all areas of telemedicine and shall ensure that back-up arrangements for urgent/emergent care beyond the scope of the telemedicine systems are established.

The County's expectation is the cost of telehealth services is the responsibility of the Proposer.

3.5. Policies and Procedures

Prior to beginning service delivery, the Proposer will provide the County with comprehensive written policies and procedures that meet legal and community standards for quality of care in a correctional setting. All policies of the Proposer that involve responsibility of county staff shall be negotiated and reviewed annually. The rights and ownership of policies, procedures, and printed materials produced specifically for the County under the Scope of Work for this contract, shall be vested in the County upon satisfactory completion of any contract awarded as a result of this RFP and payment in full of all fees for services.

Proposer and County shall have and follow an established Policies and Procedures Manual based on

NCCHC standards that incorporates all essential healthcare and administrative forms for use by onsite clinicians. In collaboration with PCSO, Proposer shall develop a site-specific policy and procedure manual based on PCSO’s existing policies. All policies and procedures must comply with federal and state laws, rules, regulations, and guidelines, as well as with correctional healthcare standards of the NCCHC.

Policies and procedures will serve as the framework for the delivery of healthcare services and ensure that all practices align with best practices and regulatory requirements in correctional healthcare settings.

The successful applicant will negotiate quality measures and monthly reports which must be met to receive full payment in the subsequent quarters.

3.6. Staffing

Proposer will submit a staffing proposal for approval by the County listing all staff by shift and by type of license held. The Proposer shall offer 24/7 on-call services to execute essential actions addressing patient care concerns in instances where the Medical Director and onsite Contract healthcare providers are unavailable.

Booking posts must be staffed 24/7 by Registered Nurse (RN) or higher-level medical staff. At no time will there be less than one RN in the facility. Once accepted this proposed staffing pattern will be used to determine compliance with minimum contract standards, should staffing fall below approved levels partial payment may be withheld.

Current list of FTEs is provided in attachment. County is open to discussion on proposed staffing plan from Proposer, to include suggested staffing level for nurses (RN/LPN) to meet obligations. County has identified specific positions to be covered with staffing plan.

• Health Services Administrator

• Director of Nursing

• Nurse Practitioner/ Physician Assistant

• Psychiatric ARNP

• Charge Nurse

• Dentist

• Dental Assistant/Hygienist

• Administrative Assistant

• Pharmacy Tech

• Medical Records

Preceptorships are encouraged and will be the responsibility of the Proposer. Proposer will hire and supervise qualified nursing/medical students from appropriate colleges to work within the Jail.

Preceptors will be employees of the Proposer and Proposer will be responsible for drafting standardized written agreements. The County shall have the opportunity to review and approve the student and the final written agreement.

3.7. Required Forms

Proposer will collaborate with County to ensure appropriate forms are included in the electronic health care record (EHR).

3.8. Screening at Booking and Access to Treatment

A standard form is used to record the information gathered during the booking process. This initial screening is performed by Proposer. If during the booking process, it is determined that if the inmate requires medical attention, the inmate is immediately referred to the medical person on site. This person shall at a minimum be a Registered Nurse and at least one RN shall be assigned to handle booking health care screenings at all times. The medical staff at booking is then responsible for completing a health care assessment that will determine the inmate’s immediate medical service needs and take appropriate steps to ensure these are addressed throughout the inmates stay. This can include:

verification of current medications and arranging for those to be continued, referral for routine care by medical staff at the jail, recommendations for special housing based on medical needs, special diet concerns, or placing the inmate on suicide precautions until further evaluation by jail mental health staff. This assessment should be initiated within 15 minutes of the request and completed within 30 minutes. Any recommendation to refuse a booking except in cases of imminent life-threatening condition and those medical concerns outlined in the booking medical clearance guidelines must be reviewed by a RN or higher. All diversions for medical reasons at booking will be tracked and reported to the County and reviewed through a quality improvement process jointly staffed by the County and the

Proposer.

3.9. Health Assessment

Within 14 days of an inmate’s arrival to the Jail, a practitioner shall perform a full Health Assessment reporting all notifiable conditions to the Tacoma-Pierce County Health Department. Referrals to mental health or dental will be provided as appropriate. An RN may perform this function if s/he has been appropriately trained and credentialed by Proposer to perform history and physical examinations. The content of the screening shall be in accordance with the most current NCCHC Standards. If performed by an RN, any significant findings will result in a follow-up visit with a Practitioner, Mental Health

Professional, or Dentist as appropriate in a clinically appropriate timeframe. Mental Health services will be provided by a County Licensed Mental Health Worker and or the Proposer’s licensed Psychiatric

ARNP.

3.10. Equipment

The County agrees to provide Proposer with office space, equipment (listed below) and utilities at the facility sufficient to enable Proposer to perform its obligations pursuant to the RFP.

Proposer will install, maintain, and support an information technology infrastructure within the Facility.

This infrastructure will be utilized only by Proposer' s staff and authorized County personnel to support the provision of healthcare services within the Facility.

The County will provide to Proposer, beginning on the date of commencement of services, the use of all supplies, medical equipment, and office equipment in place at the Facility health care unit which are the

County' s property or in the possession of the County.

County provided equipment includes dental chairs, dental radiology equipment, exam tables, transport wheelchairs, microscopes, autoclaves, refrigerators, and a variety of sterilizable medical instruments and devices.

3.11. Service Requirements

Proposals should address how the Proposer will provide service in the following categories, keeping in mind that all requested and provided medical services will be in accordance with legal and community standards for medical care in a correctional setting. Explanations are given for specific requirements the

County has regarding each service category below.

3.12. Clinic Sick Call

Inmates are identified for sick call using different methods including referral from booking nurse, referrals from medication passes, withdrawal monitoring, segregation monitoring, or scheduled follow-ups. Inmates can also directly request medical services through confidential kites to the medical staff.

These are collected, triaged daily, and responded to appropriately by licensed medical staff.

Clinic Sick Call Procedures

Clinic staff work closely with assigned clinic transport officers to maximize the efficiency of both clinic and custody operations. Proposer will specify the days and hours they propose operating clinic sick call.

Clinic Services

A. Radiology: The Proposer will be responsible for providing imaging and readings of radiology images. Additionally, maintenance and licensing fees will be the responsibility of the Proposer for existing radiology equipment as well as any new equipment brought on site. Proposer will need to provide mobile x-rays and ultrasounds outside of dental and be financially responsible for the cost of all x-ray and ultrasound services ordered.

B. Dental: The clinic has one dental suite. The Proposer will be expected to operate 40 hours of dental sick call per week. Dental referrals can be made by practitioners in the clinic or by direct requests of inmates through the kite process. It is expected that urgent dental issues will be addressed; cosmetic or elective dental procedures are the responsibility of the inmate to arrange when they are no longer in custody.

C. Pharmacy: Proposer will provide a total pharmaceutical system for the Facility, operated in accordance with all federal and state laws and regulations. The system will include the ability to process new prescriptions, fill orders for dispensing within the Facility, and keep necessary records. All medications will be prescribed by appropriately licensed staff and dispensed by a licensed nurse in accordance with the requirements of the Washington Board of Pharmacy.

Proposer will administer new medications within the timeframe ordered by the physician or, if none was specified, within a clinically appropriate timeframe not to exceed 24 hours. Proposer shall identify their safeguard plan for medication delivery disruption. Any anticipated substantial change in cost or process of acquiring and providing Rx, the County be notified and included in ultimate decision making.

Proposer will arrange and bear the costs of all prescription and non-prescription over-the-counter medications prescribed by a duly licensed physician or other appropriate health care provider. Proposer is to provide a detailed summary on the costing of over the counter and prescriptions pharmaceuticals.

Proposer will provide any information regarding the use of formulary generic medications and the decision process for this determination. Proposer shall identify their safeguard plan if a medication or delivery of the medication is disrupted.

The Proposer will acquire, authorize, and administer medications as clinically indicated for MAT, HIV, STIs, vaccinations, and psychiatric treatment if provided by the manufacturer or other source at no cost.

Sources include the Tacoma-Pierce County Health Department and Washington State Health

Department Adult Vaccine Program and Early Intervention Program. Such medications include but are not limited to Invega, Aristada, Vivitrol, and Bicillin.

3.13. Mental Health

County mental health staff are located in the jail clinic and are considered part of the medical service team. Mental health staff are currently comprised of one (1) Mental Health Program Manager, eight (8)

Licensed Mental Health Professionals, and one (1) Office Assistant. The mental health manager will participate in all administrative meetings related to clinic operation. The Proposer is required to have at least one Psychiatric ARNP who is on the National Clozapine Registry and collaborate with the contracted mental health professional with prescriptive authority. Psychiatric medications verified at booking or clinic intake will be continued for 30 days by Proposer medical staff and referred to the mental health staff for follow up evaluation.

Medical and mental health are expected to have established routine collaborative methods of case staffing and cross referencing that work in the best interests of the inmate and the safety and security of the facility. Occasionally, it is necessary to seek court orders to administer treatment to inmates against their will. The Medical Director and/or Proposer provider will work with the mental health manager to produce the affidavits and testimony necessary for the court to review these requests.

3.14. Medication Delivery

The Proposer shall assure there is adequate licensed staff to conduct medication delivery frequently enough that inmates receive their medications in a timely fashion as prescribed. Upon admission all medically necessary medication shall continue without interruption whenever possible. The Proposer will produce regular reports for quality assurance indicating time between prescription and first delivery of prescribed medications. Newly prescribed medications will be started within 24 hours. Refused medications will be tracked and reported back to the clinician for appropriate action. No medically necessary prescriptions will be discontinued due to non- compliance without a documented counseling session by the Clinician or pharmacist.

3.15. Sexual Assault Nurse Examiner (SANE)

The Proposer will provide a qualified Sexual Assault Nurse Examiner who shall provide 24/7/365 on-call coverage, with a two-hour response time, for sexual assault forensic examinations in accordance with nationally recognized and accepted standards and protocols. The Proposer is responsible for providing medical treatment following the exam as outlined by the Sexual Assault Nurse Examiner including emergency contraception, STI, and HIV post-exposure prophylaxis. The Proposer shall store the sexual assault records and associated photos as medical records in accordance with protected health information practices and recommended guidelines for Sexual Assault Emergency Medical Evaluation for

Washington State.

https://www.newclozapinerems.com/home

3.16. Management of Withdrawal Patients

Determined at booking, inmates that are at risk for withdrawal will be housed appropriately. Inmates presenting with a risk of alcohol withdrawal will be monitored three times daily until a member of the medical staff determines they are no longer at risk. If inmates are to be removed from withdrawal protocol in less than 48 hours, only licensed practitioners are permitted to do so.

Inmates presenting with a risk of Opiate or Fentanyl withdrawal will be tested and assessed for suicide risk by a booking nurse, using a County-provided standard screening form. These inmates will be monitored twice daily for a period of three days or longer if clinically indicated. If Methadone withdrawal is suspected, inmates will be monitored for 10 days or longer if clinically indicated. Opiate and Fentanyl withdrawal status monitoring will be tracked on a provided log. Proposer shall partner with a community behavioral health agency to provide MAT/MOUD treatment for those inmates with Opioid

Use Disorder (OUD). The Proposer shall support the County in locating free doses of injectable MAT medications and Methadone from the manufacturer or through grand funding. The Proposer shall coordinate with community agencies to secure follow-up care at release when appropriate.

Proposer shall supply Naloxone for all suspected inmate opioid related incidents.

3.17. Outside Medical Services-Scheduled and Emergent

Proposer shall arrange for provisions of on-site specialty services whenever possible (e.g. OB/GYN services, dialysis services, physical therapy, etc.). The Proposer will be responsible for scheduling appointments or emergency visits, coordinate inmate transport with custody staff, and payment (rates to be negotiated between the proposer and provider) for all medically necessary outside appointments

(both scheduled and emergent). The Sheriff will provide custody staff to transport inmates to scheduled outside appointments and the provider will work with designated custody staff to assure these appointments are kept in a manner that respects both the needs of the inmate and the security concerns of the custody staff. Proposer's medical staff will be responsible for informing the outside provider that they will be serving a person in custody who will arrive in handcuffs with uniformed officer. Medical Staff shall not share with anyone other than the Sheriff or designee the date, time, or location of appointment. It will be the responsibility of the Proposer to inform the outside Provider of the same restrictions. If an interpreter is required for the inmate, the proposer is responsible for making arrangements and payments. If custody staff receives any follow up instructions from the outside provider, custody staff will deliver them to medical staff on their return to the facility.

For emergency medical services the Proposer will ensure that the receiving facility is contacted immediately and given available medical information to assist the emergency provider. Proposer medical staff will respond immediately to any internal call of medical emergency and provide assistance as needed until the emergency is cleared or handed off to an outside provider.

3.18. Transfer to Other Facilities

Proposer's medical staff will be notified by custody staff as soon as possible of any planned transfers to other correctional facilities. Prior to transfer, medical staff will prepare an individual health record transfer summary for any inmate being sent to another correctional facility. If transfer occurs without notification to medical staff, the transfer summary will be completed upon notification and sent to the appropriate medical authority at the receiving facility.

3.19. Monthly Reports and Invoices

The Proposer will provide monthly reports detailing specific statistical data as requested by the Sheriff or his/her designee. These reports will include:

• Number of inmates seen by nurses for sick call

• Number of inmates seen by physician/practitioner for sick call

• Number of referrals for outside treatment

• Number of inmates seen by dentist

• Number of inmates sent to emergency room

• Number of inmates admitted to community hospital

• Number of inmates receiving medication

• Number on inmates screened for Tuberculosis

• Number of inmates receiving a trustee physical

• Number of grievances received by clinic

• Number of inmate kite requests for services

• Number of inmates seen in response to kite requests

• Number of inmate kite requests for services

• Number of inmates seen in response to kite requests

• Number of inmates started by clinic on psychiatric meds

• Any other reports requested by the County with proper notification

3.20. Equality Assurance

Proposer will provide care in accordance with standard quality of care for each profession and for the operation in general. The Proposer shall describe the system for ensuring this that quality is continuously monitored, and appropriate corrective actions are taken as indicated. The County retains the right to audit medical service issues either via County staff or its agent(s). Any deficiencies noted via audit will result in a written plan of correction by the Proposer.

3.21. Coordination with the Sheriff

Proposer agrees to work in coordination with the Medical Director, Mental Health Team, and the

Corrections Administrative – PREA Coordinator Lieutenant who reports directly to the Jail Chief. This

Lieutenant is the Jail’s liaison to medical services and is the direct contact for the Proposer. This position works closely with the Medical Director, Proposer, and Mental Health to facilitate communication, problem solve, and to ensure the Proposer’s policies and procedures are in line with the Jail’s needs for safety and security. The proposer agrees to provide full access to the Proposer's policies and records related to the Jail.

The Proposer agrees to participate in cross training with corrections staff. In addition to medical staff receiving orientation to custody rules and standards, medical staff will provide training in basic first aid and effective use of clinic services to custody staff. The Proposer will respond to inmate grievances in accordance with internal grievance policy standards. The frequency of cross training will be coordinated by the Parties.

3.22. Health Care Records

Proposer will be required to provide an electronic health care record, work to assure continuity of care and assist in a smooth transition from one proposer to another. The Proposer will provide a dedicated project manager(s) to coordinate all aspects of this transition. Proposer must describe one or more hosting options, their business continuity plan in case of system failure, and all of the Electronic Health

Record (EHR) functionality to include examples. No proposer equipment, including network switches or

PCs, will be connected to the County network. The County requires a copy of the Proposer’s Standards of Attestations Engagement No. 16, System and Organizations Controls Report 2, Type 2 (SSAE 16 SOC 2) audit report if a Software as a Service (SaaS) option is proposed. The Proposer must describe their employee authentication and authorization approach for access to the EHR system.

Proposer’s system must be able to send and receive information with the County’s custom jail management system and other systems using web services and/or transfer files. The Proposer’s

Electronic Health Record (EHR) system should comply with Health Level Seven (HL7) standards version 2 or 3 for data exchange between the County’s jail management system and local pharmacies. The

Proposer’s system should comply with American National Standards Institute X12 (ANSI X12) specification for finance and insurance transactions. The Proposer’s EHR system and transactions must comply with the HITECH Act, and HIPAA Privacy and Security Rules for electronic Personal Health

Information (PHI), as well as applicable Washington State and Federal laws. Provider personnel shall be familiar with and comply with all WA law relevant to jail care management, to include: Public Records

Act RCW 42.56 and Jail Records RCW 70.48.100

3.23. Start-up and Service Implementation

Proposer will have the capability to commence services on a date agreed upon by the parties. Proposer shall provide a start-up and implementation plan that includes a schedule with timelines for the initial delivery of equipment and supplies, the hiring and training of staff, and the transition of Medical

Services. Proposer must demonstrate how they will be fully implemented full Medical Service delivery in the Jail before or no later than February 16,2026.

3.24. Continuity of Service

Continuity of Medical Services is a must. The County expects complete coordination between the incoming Proposer and the current contractors to facilitate a smooth transition.

3.25. Expenses

Proposers Responsibility https://ssae-16.com/ssae-18/the-ssae16-auditing-standard/ https://ssae-16.com/ssae-18/the-ssae16-auditing-standard/

• All employee wages, taxes and benefits

• Policy and Procedure development

• Any IT expenses required to set up, configure, integrate, and support the Proposer EHR

(including but not limited to, County staff time, hardware, software, and internet connectivity)

• Subscriptions to Office 365 if access to Microsoft products is required on a Pierce County provisioned computer.

• Travel and Training expenses

• Licensing of employees

• All pharmacy costs* (Proposer shall provide two models, one that includes and one that does not include costs)

• Outside medical care*(Proposer shall provide two models, one that includes and one that does not include costs)

• In-person or certified medical interpreter services

• Publications and subscriptions

• Pharmacy waste and disposal

• All insurance required in this RFP

• Medical Supplies

• Maintenance and repair of any Proposer supplied equipment

• Ensure all medical equipment undergoes regulatory inspections

• Dental supplies other than what is currently on-site

• Radiology supplies

• Telehealth services (if applicable)

County Responsibility

• Repairs on existing equipment

• Office supplies (i.e. county forms, copy paper, etc.)

• Long distance phone calls

• Language Line Services

• Medical Hazardous Waste disposal

• Provision of computers at each workstation, copy and fax machine for use by clinic

3.26. Affordable Care Act, Private Insurance, and Inmate Billing

Pierce County does not bill inmates for medical services, recognizing that this may inadvertently dissuade inmates from seeking timely and necessary medical care. The County is aware that the

Affordable Care Act envisions providing insurance coverage to jail inmates who are held on pre-trial status. If the Proposer wishes to develop a system for billing third-party payers for their service, any payments that result from such billing (as long as no inmate financial participation is required) will be discussed between County and Proposer.

3.27. Segregation

There are approximately 100 cells where inmates are held on 23-hour lockdown. The Proposer will be responsible for nursing rounds three (3) times per week including visual and verbal interaction and provision of any indicated follow up care of all inmates in segregation and is encouraged to deliver routine medical services to inmates in the segregation area whenever possible consistent with medical standards of care.

4. Submittal Criteria

2025-RFP-188, Jail Medical Services

4.1. Submittal Requirements

Each Proposal shall be submitted as outlined in this section. Please include a cover and/or first page, containing the name of the project Jail Medical Services, name of the respondent, contact information, and submittal date. In addition, provide an opening letter indicating interest in this project, and briefly describe what makes the Proposer a suitable candidate to be selected for this type of services, no more than two pages. A table of contents should be next. Please provide the following information in the sequence and format prescribed below. Supplemental materials providing additional information may be attached, but the information requested below is to be provided in this format.

4.2. Submittal Format

Please use the following as a guideline to format your qualifications:

• Font Size: Please fonts no smaller than 11 points

• Format: In order for Pierce County to adequately compare and evaluate qualification objectively, each response to specific requests and criteria should be clearly labeled.

• Page Count: Maximum qualifications length should not excess 20 pages - NOT including title page, letter of interest (cover letter), table of contents, resumes and required forms.)

These requirements are in addition to any other requirements identified herein.

4.3. Submittal Information for each Criteria

Criteria 1: The proposed plan to have services fully in place by February 16, 2026, including all elements of the scope of services.

• Include a detailed plan to have services in place, to include a timeline for contract development and execution, hiring of staff, and assuring all equipment and supplies are in place

Criteria 2: The experience of the proposing organization and their key personnel in providing Jail medical, dental, and pharmaceutical services and in a correctional setting.

• Proposer name, local address, email address, and phone number.

• The name and title of the person authorized to execute a contract on behalf of the firm.

• Primary Individual to contact

• Number of years the firm has been in business (include and identify entity name change and dba)

• An organizational chart that explains team member responsibilities.

• The name and resume of key individuals who would be assigned to these services and each individual assigned to backup each primary person in his/her absence, together with similar information for each individual to be provided under any subcontract.

• Resumes and experience of key individuals, including all licenses, certifications, etc

• Briefly describe the rationale for the key team members for these services, and what qualities and attributes they possess that will ensure the success of this project.

• References listing client contracts of similar services.

• Names and titles of anticipated subcontractors who may be involved in this project.

Criteria 3: The proposed approach to provide the services requested, including daily work plan for all scope items, compliance with requirements, innovative offerings, and services delivery options.

• Describe ability to meet the requirements and provide the requested services listed in this RFP

• Clearly describe the approaches and methods that will be used to accomplish the necessary services.

• Address each point in the RFP in which you are to describe your approach or solution.

• Address Provider's ability to obtain the County's requested insurance per Attached C of this RFP.

• Description of your approach in working with the County and their staff members.

• Describe in detail your approach to meeting EHR system/data security and compliance regulatory requirements.

• Include a summary of innovative ideas and suggestions for implementing or enhancing the scope of services.

• The Proposer’s policies and procedures related to quality assurance, continuous improvement, and patient protection and safety.

• Areas not in this RFP, but which the Proposer believes are essential to the effective performance and completion of these services should also be addressed in the Proposal.

Criteria 4: The proposed staffing plan for the services outlined in this RFP.

• Including the information outlined in RFP Section 3.6, provide your staffing plan to cover all services included in this RFP.

• The proposals’ prioritization of in-person care over telehealth, compliance with the telehealth requirements of this RFP, and the proposed telehealth utilization’s overall benefit to the

County.

• Specify hours of Telehealth use and after-hours triage in your proposal submission.

• Methods (or plan) for recruitment and retention to ensure adequate staffing and continuity of care, to ensure compliance with minimum contract standards

Criteria 5: The proposer’s proposed firm pricing, including appropriateness of total cost and inclusion of performance-based payment structure.

• Complete pricing for all services in the proposal, including information about the total annual cost to the County, the payment structure. Your budget should include a description of the costs borne by your organization broken down by category (employee wages, medical supplies, interpreter services, etc.).

o Items to include, but not limited to, staffing, equipment and supplies, pharmaceuticals, IT equipment, IT systems, technical equipment, insurance costs, any applicable taxes, and any other miscellaneous items necessary to accomplish the scope of services.

• Proposer must submit a tiered pricing model based on the Monthly Average Daily Population

(ADP) of the facility. The proposed pricing should include:

o A fixed monthly rate for each ADP range, at minimum:

▪ 750–949 inmates

▪ 950–1,149 inmates

▪ 1,150+ inmates o The method for calculating the Monthly ADP o Any pricing adjustments or thresholds if ADP falls below 750 or significantly exceeds 1,150 o Identification of services included in the base rate and any excluded or billable services o Clear assumptions underlying pricing, such as staffing levels or service scope for each tier

• Provide a breakdown on how the County will be invoiced – to include lump sum, direct costs, or other planned methods of invoices for services.

• Proposer should be prepared to provide a (almost) six-year annual pricing structure to include a detailed price breakdown for year 1 and provide the anticipated increases for each subsequent year (such as cost-of-living increases).

4.4. Additional Information

• A statement outlining any proposal exceptions to the County’s requirements or requested clarifications to the requirements. (if applicable)

• The caption, cause number, Court, Counsel, and general summary of any litigation pending, or judgment rendered within the past three (3) years involving the proposer. (if applicable)

• Professional references.

• Proposals shall include complete manufacturer’s descriptive literature regarding the equipment and goods to be furnished and contain sufficient detail to provide a full and fair evaluation of the equipment and goods to be provided.

By submitting a proposal, Proposer agrees that all documents, reports, proposals, submittals, working papers, or other materials prepared by the Proposer pursuant to this proposal shall become the sole and exclusive property of the County, and the public domain, and not property of the Proposer. The

Proposer shall not copyright, or cause to be copyrighted, any portion of said items submitted to the

County because of this solicitation.

Only electronic submittal via the County's eProcurement Portal shall be accepted. No hard copies, emails or fax submittals are acceptable.

5. Evaluation Process

5.1. Evaluation & Award Process

An evaluation team will review the bidding documents and evaluate all responses received based upon the criteria listed herein. The County may request clarifications or additional information, if needed. The

Proposer determined to be most qualified through the initial evaluation phase may be interviewed and the final determination will also consider reference checks and interviews.

The County intends to select the most qualified for this pursuit/solicitation.

Selected Proposer will be invited to enter into contract negotiations with the County. Should the County and the selected proposer not reach a mutual agreement, the County will terminate negotiations and move to the next ranked proposer and proceed with negotiations. A Proposer’s inability to agree to the terms of the County’s standard contract may be a basis for the County to terminate negotiations and begin negotiating with one or more other Contractors.

The County reserves the right to accept or reject any or all submitted bids, to waive as informalities any irregularities, and to contract as the best interest of the County may require. The County may reject bids that are non-responsive or that are submitted by non-responsible proposers.

6. Evaluation Criteria

No. Evaluation Criteria Scoring Method Weight (Points)

1. The proposed plan to have services fully in place by February 16, 2027, including all elements of the scope of services.

Points Based 100 (50% of Total)

2. Qualifications and Experience

The experience of the proposing organization and their key personnel in providing Jail medical, dental, and pharmaceutical services and in a correctional setting.

Points Based 20 (10% of Total)

3. Approach to Work

The proposed approach to provide the services requested, including daily work plan for all scope items, compliance with requirements, innovative offerings, services delivery options.

Points Based 20 (10% of Total)

4. Staffing Plan for services

The proposed staffing plan for the services outlined in this RFP.

Points Based 25 (12.5% of Total)

5. Pricing

The Proposer’s proposed firm pricing, including appropriateness of total cost and inclusion of performance-based payment structure.

Points Based 30 (15% of Total)

6. Accuracy and Completeness of the Proposal

Proposals will be evaluated on the following criteria:

• The proposal has been formatted in accordance with the submittal requirements.

• Spelling and grammatical accuracy

• Coherent and logical flow of written responses

Points Based 5 (2.5% of Total)

7. Vendor Questionnaire

1. Proposer Confirmation* As an authorized representative of the Proposer, having carefully examined the Request for Proposals, propose to furnish services in accordance therewith as set forth in the attached proposal.

I further agree that this proposal will remain in effect for not less than sixty (60) calendar days from the date that proposals are due, and that this proposal may not be withdrawn or modified during that time.

I hereby certify that this proposal is genuine and not a sham or collusive proposal, or made in the interests or on behalf of any person not therein named; and I have not directly or indirectly induced or solicited any Contractor or supplier on the above work to put in a sham proposal or any person or corporation to refrain from submitting a proposal; and that I have not in any manner sought by collusion to secure to myself an advantage over any other contractor(s) or person(s).

In order to induce the County to consider this proposal, the Proposer irrevocably waives any existing rights which it may have, by contract or otherwise, to require another person or corporation to refrain from submitting a proposal to or performing work or providing supplies to Pierce County, and proposer further promises that it will not in the future directly or indirectly induce or solicit any person or corporation to refrain from submitting a bid or proposal…