Prince_George_s_County_Incarcerated_Individuals_Medical_Final_3-31-2026.pdf

Prince George’s County, Maryland - Department of Corrections

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 1

PRINCE GEORGE’S COUNTY, MARYLAND

DEPARTMENT OF CORRECTIONS

STATEMENT OF WORK

Comprehensive Incarcerated Individuals Medical Services

1. Background and Purpose Prince George’s County, Maryland, through the Department of Corrections (“Department”), is responsible for the care, custody, and control of all persons lawfully committed to its detention facilities. Individuals housed in the Correctional Center include pretrial detainees and sentenced persons. The Department is responsible for providing constitutionally adequate healthcare services, including medical, mental health, dental, pharmaceutical, infirmary, specialty care coordination, and related services, to all persons in its custody from the time of commitment until release, transfer, or other lawful disposition.

The County seeks a qualified Contractor to provide comprehensive correctional healthcare management services at the Department’s facilities. This contract is for full-service correctional healthcare management and is not limited to temporary staffing, physician placement, nursing placement, consulting services, or hospital-only services. The Contractor shall furnish all clinical, administrative, management, pharmaceutical, reporting, and operational components necessary to maintain a safe, lawful, efficient, and professionally accepted healthcare program in a secure correctional environment.

The Department currently operates a correctional facility with an average daily population of approximately 996 incarcerated individuals based on the most recent three-year period. The facility houses adult males, adult females, and juveniles, with an average length of stay in 2025 of approximately 76 days for non-mentally ill incarcerated persons and 100 days for mentally ill incarcerated persons. The facility’s housing units have a rated bed space capacity of 1,524, which may increase to 1,624 with the use of dayroom bunk space, exclusive of the medical unit. The Department’s expanded medical unit includes approximately 7,500 gross square feet of additional ground-floor space and a 5,600 gross square foot second-floor level. The infirmary contains a total of 44 beds, including 14 male ward beds, 6 female ward beds, and 24 single rooms, and the medical unit includes six (6) fully equipped examination rooms. The Department manages a medically complex population that includes, among others, incarcerated individuals with chronic conditions such as diabetes, hypertension, asthma, thyroid disorders, kidney and liver disorders, pregnancy-related needs, quadriplegia, and amputations. Incarcerated individuals requiring care beyond the capability of the facility are referred to local hospitals and, when medically necessary, tertiary care providers including Johns Hopkins Hospital and George Washington University Hospital.

2. Governing Laws, Regulations, and Standards The Contractor shall comply with all applicable federal, state, and local laws, regulations, licensing requirements, and correctional healthcare standards. This includes, but is not limited to:

• The Prison Rape Elimination Act (PREA) standards codified at 28 CFR Part 115

• The Health Insurance Portability and Accountability Act (HIPAA), including the Privacy Rule, Security Rule, and Breach Notification Rule (45 CFR Parts 160 and 164)

• Applicable requirements of the Maryland Department of Health (MDH)

• Standards and requirements of the Maryland Commission on Correctional Standards

(MCCS)

• Occupational Safety and Health Administration (OSHA) and Maryland Occupational Safety and Health (MOSH) requirements

• Biomedical waste handling and disposal regulations

• All applicable County and Department policies governing detention healthcare operations

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 2

Contractors who have contact with incarcerated individuals shall comply with all PREA training and reporting requirements. The Contractor shall also ensure full compliance with HIPAA requirements, including the implementation and maintenance of appropriate administrative, physical, and technical safeguards to protect protected health information (PHI) and electronic protected health information (ePHI). Professional Standards and Accreditation Alignment

The Contractor shall perform all services in a manner consistent with nationally recognized correctional healthcare standards, including:

• National Commission on Correctional Health Care (NCCHC) standards, or equivalent

• American Correctional Association (ACA) standards, where applicable or required by the

County

Regulatory Interpretation

Any references in prior documents, policies, or agreements to outdated agencies or incorrect nomenclature shall be interpreted to mean the current Maryland Department of Health (MDH).

Where behavioral health oversight is implicated, such references shall include the Behavioral Health Administration (BHA).

3. Minimum Qualifications and Experience To be considered for award, the Offeror must demonstrate that it possesses the experience, resources, organizational capability, and professional qualifications necessary to provide comprehensive correctional healthcare services of the type and scope required by this solicitation.

The County will evaluate the Offeror’s qualifications to determine responsibility in accordance with the Prince George’s County Code and applicable procurement regulations. Failure to meet the minimum qualifications set forth in this section may result in the Offeror being determined non-responsible or the proposal being rejected.

The Offeror must have been continuously engaged in the business of providing comprehensive correctional healthcare services for a minimum of five (5) years prior to the proposal due date. For purposes of this solicitation, comprehensive correctional healthcare services means the provision of full-service medical, mental health, dental, pharmacy, and related healthcare services within secure detention or correctional facilities, including onsite clinical care, infirmary services, off-site care coordination, utilization management, and quality assurance.

The Offeror must demonstrate that correctional healthcare services constitute a primary component of its regular business operations. Firms whose experience is limited to temporary staffing services, consulting services, hospital services only, or non-correctional healthcare environments shall not be considered to meet this requirement.

In addition, the Offeror must demonstrate that at least ninety percent (90%) of its day-to-day business operations for the past five (5) years have consisted of incarcerated individual medical or correctional healthcare services. The County may require supporting documentation to verify this representation, including corporate background information, client lists, contract summaries, or other evidence deemed necessary by the County.

The Offeror must have provided comprehensive correctional healthcare services within the last five

(5) years for at least two (2) secure detention or correctional facilities of comparable size, complexity, and operational requirements to the Prince George’s County Department of Corrections. Comparable facilities shall include those with an average daily population of not less than five hundred (500) incarcerated individuals, or such other size as the County determines to be substantially similar based on scope of services, level of medical care required, and security environment.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 3

Qualifying experience must include responsibility for all of the following services within a correctional environment: onsite primary medical care, mental health and behavioral health services, dental services, pharmacy services and medication administration, infirmary or inpatient medical unit operations, coordination of off-site specialty care and hospital services, utilization management and cost control, quality assurance and performance improvement programs, and compliance with applicable correctional healthcare standards and regulations.

The Offeror must demonstrate experience providing services under contract with at least one (1) public sector correctional agency, including a county, state, or federal detention or correctional facility. The County may require references from such agencies and reserves the right to verify the Offeror’s performance, contract history, and ability to successfully perform the work required.

The Offeror shall demonstrate the ability to recruit, hire, credential, train, and retain qualified medical, mental health, dental, pharmacy, and administrative personnel sufficient to provide services on a continuous twenty-four (24) hour basis as required by the Department of Corrections.

The Offeror must also demonstrate the financial capacity, organizational structure, and management systems necessary to support a contract of this size and complexity.

The County reserves the right to request additional documentation, references, financial information, or other evidence of responsibility at any time during the evaluation process. Failure to provide requested information may result in the Offeror being determined non-responsible.

Only those Offerors determined by the County to meet the minimum qualifications and to possess the capability to successfully perform the contract shall be considered for further evaluation.

4. General Scope of Services The Contractor shall serve as the County’s designated healthcare authority for the correctional healthcare program and shall be responsible for the overall clinical administration, management, and operation of incarcerated individual healthcare services under the contract. In this role, the Contractor shall develop and maintain written clinical policies, procedures, protocols, standing orders, quality management processes, utilization management processes, infection control processes, and staffing plans, subject to County review and approval where required.

The Contractor shall provide, manage, coordinate, and be accountable for all services necessary for a complete correctional healthcare program, including but not limited to medical intake screening; health appraisals and physical examinations; sick call; urgent and emergent care;

chronic disease management; infirmary operations; communicable disease control; mental health services; psychiatric services; dental services; pharmaceutical services; medication administration;

specialty referrals; hospital and off-site care coordination; dialysis coordination; discharge and reentry healthcare planning; quality assurance; utilization management; clinical reporting;

accreditation support; and continuity of operations planning.

The Contractor shall provide all personnel, management, supervision, equipment, supplies, pharmaceuticals, and administrative support necessary to meet the requirements of this SOW unless this SOW expressly identifies a responsibility that remains with the County.

5. Clinical Services Requirements

5.1 Intake Screening and Initial Assessment

The Contractor shall provide an intake medical screening and mental health screening for each newly committed incarcerated individual within the timeframes required by Department policy and applicable correctional healthcare standards. The County requires screening within two (2) hours as an operational standard, and the Contractor shall meet that standard. At a minimum, the intake

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 4 process shall identify urgent and emergent medical conditions, suicidality, pregnancy status where clinically appropriate, chronic care needs, communicable disease concerns, current medications, substance withdrawal risks, disability or accommodation needs, and any immediate need for isolation or higher clinical monitoring.

The Contractor shall conduct tuberculosis screening and all other intake testing or screening required by County policy, public health guidance, correctional healthcare standards, and clinical judgment.

5.2 Health Appraisal and Physical Examination

The Contractor shall complete a comprehensive health appraisal, including history and physical examination, within fourteen (14) calendar days of admission unless a shorter period is required by County policy or clinical need. Annual and periodic examinations shall be conducted as clinically indicated and as required by County policy, chronic care protocols, age-based risk, and length of stay.

5.3 Sick Call and Routine Medical Care

The Contractor shall establish, operate, and maintain a sick call system that provides incarcerated individuals with timely access to routine and urgent medical care without unreasonable delay. Sick call services shall be available at a minimum of five (5) days per week, Monday through Friday, and shall be supported by daily triage, follow-up, and nursing assessment functions as necessary to meet incarcerated individual healthcare needs.

The Contractor shall ensure that all incarcerated individual requests for medical attention are received, logged, reviewed, triaged, scheduled, and resolved in accordance with written clinical procedures approved by the County. Medical care shall not be denied, delayed, or withheld because of an incarcerated individual’s inability to pay any applicable co-payment.

If the County continues its incarcerated individual medical co-payment process, the Contractor shall document sick call encounters and forward appropriate records of billable sick call visits to the Department’s designated inmate finance function in accordance with County procedures. The County shall remain responsible for charging incarcerated individual’s accounts and administering any such co-payment process.

Sick call services may be rendered by qualified licensed healthcare personnel acting within the scope of their licensure under Maryland law, including but not limited to a Licensed Practical Nurse (LPN), Registered Nurse (RN), Nurse Practitioner, Physician Assistant, or physician, as clinically appropriate. Nursing coverage shall be provided twenty-four (24) hours per day, seven (7) days per week.

The Contractor shall provide physician coverage sufficient to meet the routine and urgent medical needs of the incarcerated population. At a minimum, a physician shall provide regular onsite coverage Monday through Friday and shall remain available on a twenty-four (24) hour on-call basis at all other times. The Contractor shall ensure continuity of physician coverage during periods of vacation, illness, leave, vacancy, or other absence of the regularly assigned physician, so that incarcerated individual access to medically necessary physician services is not interrupted.

The Contractor shall maintain complete and accurate documentation of all sick call encounters, assessments, treatment provided, referrals made, and follow-up actions taken, in the County’s approved medical record system.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 5

5.4 Emergency Medical Services

The Contractor shall provide immediate medical response to emergencies twenty-four (24) hours per day, seven (7) days per week. The Contractor shall maintain emergency response procedures, equipment, medication access, after-hours physician support, and staff competencies for emergency response. The Contractor shall stabilize, treat, and coordinate transfer of incarcerated individuals requiring emergency or hospital-level services.

5.5 Chronic Disease Management

The Contractor shall establish and maintain chronic care clinics and treatment protocols for incarcerated individuals with chronic illnesses and ongoing medical needs, including but not limited to cardiovascular disease, hypertension, diabetes, asthma, seizure disorders, endocrine conditions, infectious diseases, renal disease, hepatic disease, mobility limitations, pregnancy-related conditions, and medically complex disabilities. The Contractor shall maintain accurate treatment plans, medication management, follow-up scheduling, education, and monitoring.

5.6 Specialty Care, Diagnostics, and Hospital Coordination

The Contractor shall coordinate all medically necessary off-site and specialty services, including specialty consultations, diagnostics, emergency room visits, surgeries, hospital admissions, post-discharge follow-up, and other medically indicated outside care. The Contractor shall conduct medical necessity review, utilization management, scheduling coordination, discharge review, and continuity of treatment following return to the facility.

5.7 Communicable Diseases and Infection Control

The Contractor shall operate a comprehensive infection control and communicable disease program and shall coordinate with the Prince George’s County Health Department and Maryland public health authorities as required. The Contractor shall report communicable diseases and outbreaks as required by law and shall treat and manage cases consistent with public health guidance, correctional health standards, and clinical judgment.

5.8 Mental Health and Behavioral Health Services

The Contractor shall provide comprehensive mental health and behavioral health services for incarcerated individuals housed within the Department’s facilities. Mental health services shall include, at a minimum, screening, assessment, diagnosis, treatment planning, counseling, crisis intervention, suicide prevention, psychiatric evaluation, medication management, discharge planning, and referral to appropriate community-based providers upon release, where clinically indicated.

The Contractor shall establish and maintain written policies, procedures, and clinical protocols governing the identification, referral, evaluation, treatment, monitoring, and follow-up of incarcerated individuals with mental health needs. Services shall be delivered in a manner that supports continuity of care, timely access to clinically appropriate treatment, coordination with custody staff, and compliance with applicable correctional healthcare standards and Department requirements.

The Contractor shall provide psychiatric services through a licensed psychiatrist with prior correctional healthcare experience, or substantially similar secure institutional experience, for a minimum of forty (40) hours per week during a seven (7) day work week, in accordance with a schedule approved by the Department. The Contractor shall also provide a minimum of four (4) full-time equivalent licensed clinical social workers, licensed clinical professional counselors, or other licensed clinical therapists to deliver assessment, counseling, case management, crisis intervention, discharge planning, and related behavioral health services. In addition, the Contractor shall provide a psychiatric physician assistant, psychiatric nurse practitioner, or qualified mental

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 6 health nurse for a minimum of twenty (20) hours per week to support psychiatric evaluation, medication monitoring, continuity of care, and related clinical services.

The Contractor shall ensure that mental health staffing is sufficient to meet the acuity, volume, and complexity of the incarcerated population and to provide timely services for routine, urgent, and emergent behavioral health needs. The Contractor shall maintain procedures for prompt evaluation and intervention for incarcerated individuals presenting with suicidal ideation, self-harm behavior, psychosis, acute decompensation, withdrawal-related behavioral health needs, or other mental health crises.

The Contractor shall provide appropriate coordination between mental health, medical, and custody staff to support safe housing, treatment planning, medication continuity, crisis response, and reentry preparation. Where the County requires or authorizes substance use disorder treatment or medication-assisted treatment services as part of the correctional healthcare program, the Contractor shall provide such services in accordance with applicable law, professional standards, and County requirements.

All mental health encounters, treatment plans, medication decisions, referrals, crisis interventions, discharge activities, and follow-up services shall be documented completely and accurately in the County’s approved medical record system.

5.9 Infirmary Operations

The Contractor shall manage and operate the infirmary and all medical housing beds designated by the Department, including male ward, female ward, and single-room or isolation capacity. The Contractor shall provide clinical oversight, treatment, daily rounds, documentation, medication administration, and treatment planning for incarcerated individuals housed in medical beds. The Contractor shall coordinate with custody staff to ensure safe operation of the infirmary.

5.10 Dental Services

The Contractor shall provide onsite dental services and off-site oral surgery coordination as medically necessary. Dental services shall include routine dental evaluations, treatment, urgent dental care, infection management, and medically necessary follow-up. All dental providers shall be licensed to practice in Maryland.

5.11 Obstetric and Pregnancy-Related Care

The Contractor shall provide prenatal care coordination and pregnancy-related clinical services for pregnant incarcerated individuals, including referral to appropriate prenatal providers, medically necessary monitoring, access to indicated specialty care, and postpartum planning. The Contractor shall comply with applicable Maryland and County policies regarding pregnancy and postpartum care. If the County requires lactation-related accommodation or equipment for postpartum incarcerated individuals, the Contractor shall provide such support consistent with policy and operational feasibility.

5.12 Dialysis Services

The Contractor shall manage dialysis care for incarcerated individuals who require dialysis, including any approved on-site mobile dialysis arrangement, backup plans for equipment failure or service interruption, and coordination of off-site dialysis when necessary.

5.13 Discharge and Reentry Healthcare Planning

The Contractor shall provide release-related medical and mental health review, continuity planning, and referrals for incarcerated individuals needing continuing care. Discharge planning shall include medication continuity where required by County policy or clinical need, referral to community providers as indicated, and coordination with County release processes.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 7

6. Pharmaceutical Services The Contractor shall provide and manage all pharmaceuticals, both prescribed and non-prescribed, required for incarcerated individuals’ healthcare under this contract. The Contractor shall be responsible for formulary management, procurement, dispensing, medication administration controls, medication storage, controlled substance controls, medication reconciliation, medication error reporting, and pharmacy policy compliance.

Under no circumstances shall incarcerated individuals carry medications to their cells. The Contractor shall support any required discharge supply of medications, including psychotropic medications if required by County policy or clinically appropriate for continuity of care.

7. Medical Supplies, Equipment, Sterilization, and Maintenance The Contractor shall procure, supply, maintain, and replace all medical supplies and equipment necessary to deliver services under this contract, including prosthetic and ambulatory devices where medically necessary and contractually required. The Contractor shall maintain, calibrate, clean, sterilize, and secure medical instruments and equipment in accordance with manufacturer standards, applicable law, infection control requirements, and professional standards.

8. Electronic Medical Records, Technology, and Data Security The Contractor shall maintain complete, accurate, confidential, and contemporaneous medical and mental health records using the County’s designated electronic medical record platform, currently CorrecTek, unless and until the County directs otherwise. All records shall remain the property of the County. The County reserves the right to change EMR systems during the contract term, and the Contractor shall cooperate in any transition at no additional cost unless the contract expressly provides otherwise.

County data, databases, and derived data products created, collected, manipulated, or acquired under the contract shall remain the sole and exclusive property of the County. The Contractor shall not use County data, including metadata, analytics, or derivative information, for training, developing, or operating artificial intelligence or machine learning tools without the County’s prior written consent.

The Contractor shall maintain an information security program reasonably designed to ensure the confidentiality, integrity, and availability of County data and Protected Health Information.

9. Cost Sharing, Inpatient and Specialty Care Cap, and Medicaid Inpatient Rule The annual aggregate cap established under this Contract applies solely to the categories of medically necessary off-site inpatient and specialty care costs expressly identified in this Section and approved in accordance with the Contract. Except as specifically stated herein, all routine onsite healthcare services, staffing, administration, management, routine infirmary operations, onsite sick call, chronic care, mental health services, dental services, routine pharmaceuticals, routine medical supplies, and other services otherwise required under this Contract shall be deemed included in the Contractor’s fixed compensation and shall not be charged to or counted toward the annual aggregate cap.

The Contractor shall be responsible for the first Four Hundred Thousand Dollars ($400,000.00) in annual aggregate costs for covered inpatient and specialty care services incurred during each contract year. Annual covered costs in excess of the $400,000.00 aggregate cap shall be shared on a pro rata basis, with the County responsible for forty-five percent (45%) and the Contractor responsible for fifty-five percent (55%), subject to the documentation, review, audit, and reconciliation requirements set forth herein.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 8

Covered costs that may be counted toward the annual aggregate cap are limited to medically necessary off-site and inpatient services, including, where properly documented and approved, emergency room visits, inpatient hospitalizations, outpatient hospital procedures, surgery, specialty physician services, advanced diagnostics, contracted off-site laboratory services, contracted off-site radiology services, dialysis, oral surgery, air ambulance, and other off-site specialty services approved by the County. Inclusion of a category of service in this paragraph does not by itself make the claimed cost reimbursable or cap-eligible; all claimed costs must be supported by complete documentation and must satisfy the requirements of this Section.

The following costs are excluded from the annual aggregate cap unless expressly approved in writing by the County through a contract modification or written contract administration determination: routine onsite staffing costs; routine onsite pharmaceuticals; routine onsite lab work;

routine primary care services; routine mental health services; routine dental services; routine infirmary care; Contractor administrative expenses; overhead; profit; subcontractor administrative markups not expressly authorized by the County; County-provided transportation and custody staffing costs; services that are not medically necessary; services lacking sufficient supporting documentation; duplicate billings; denied or non-payable claims; costs attributable solely to Contractor error or delay; and any costs otherwise included in the Contractor’s base compensation.

The Contractor shall not exclude or offset any claimed amount from the annual aggregate cap without express written County approval. No credit, refund, offset, carryforward, or reallocation of cap-related amounts shall be effective unless reviewed and approved in writing by the County.

The Contractor shall provide DOC Leadership and/or the appointed DOC Contract Program Manager with a quarterly aggregate cap report in a format approved by the DOC. At a minimum, each quarterly report shall include the incarcerated individual identifier, date of service, provider name, category of service, date billed, date adjudicated, amount billed, amount paid or payable, payer source if any, claim status, and whether the Contractor contends the claim is included or excluded from the cap. The Contractor shall separately identify all excluded costs and state the contractual basis for each exclusion.

The Contractor shall also provide a quarterly cost-containment report describing trends, utilization drivers, case mix, corrective measures, and recommendations to reduce avoidable off-site and inpatient costs while maintaining constitutionally adequate care and medically necessary treatment.

At the close of each contract year, and within 60 days, the Contractor shall submit a year-end reconciliation of all cap-eligible and excluded costs. The County shall have the right to audit, verify, question, and adjust the reconciliation. Any refund, credit, or payment due as a result of reconciliation shall not be final until approved in writing by the DOC and the County Purchasing Agent or designee.

With respect to Medicaid-covered inpatient hospital services, the Contractor shall cooperate with the County and hospitals to identify services that qualify under applicable federal and State law for Medicaid reimbursement. Only those inpatient hospital costs actually approved and payable by Medicaid may be excluded from the annual aggregate cap, and such exclusion must be supported by documentation acceptable to the County. The Contractor shall not exclude any claimed Medicaid-related amount from the cap based solely on anticipated eligibility, pending application, or unresolved billing status.

Nothing in this Section shall be construed as limiting the County’s right to challenge, audit, disallow, or recover improper charges, nor shall this Section be construed as resolving any disputed financial matter except through a written reconciliation approved by the County. The County shall have the

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 9 right, upon request, to inspect and audit all invoices, encounter records, utilization review documentation, billing support, and related records supporting any claimed cap-eligible cost.

10. Accreditation, Regulatory Support, Quality Assurance, and Infection Control The Contractor shall support the Department’s compliance with all applicable Maryland Commission on Correctional Standards (MCCS) requirements, as well as any accreditation or certification programs in which the Department participates that impact incarcerated individuals' healthcare services. This includes actively participating in internal/mock audits and providing necessary assistance, documentation, and operational support to maintain compliance and readiness for audits or inspections.

If the County requires participation in Commission on Accreditation of Rehabilitation Facilities (CARF) standards related to substance use disorder programming, the Contractor shall support such participation to the extent that healthcare services fall within the Contractor’s scope of responsibility.

Quality Assurance and Performance Improvement (QAPI)

The Contractor shall establish, implement, and maintain a formal Quality Assurance and Performance Improvement (QAPI) Program. At a minimum, the program shall include:

• Routine medical chart reviews

• Mortality and morbidity reviews, as appropriate

• Infection control surveillance and review

• Utilization review of services, including off-site care

• Incident and sentinel event reviews

• Development and monitoring of corrective action plans

• Ongoing performance monitoring and data analysis

The Contractor shall establish and actively participate in Quality Assurance and Infection Control Committee meetings at intervals approved by the County, and shall maintain documentation of all meetings, findings, and action items.

Reporting Requirements

The Contractor shall submit quarterly reports to the County that include, at a minimum:

• Service volume metrics (e.g., sick call, chronic care, mental health encounters)

• Identification and analysis of cost drivers

• Summary of significant incidents and trends

• Off-site care utilization and associated costs

• Quality assurance findings and outcomes

• Status of corrective actions

• Recommendations for service delivery improvements and cost-containment strategies

Key Expectation

The Contractor is expected to maintain a proactive, data-driven approach to healthcare delivery that ensures:

• Continuous compliance with regulatory and accreditation standards

• Improvement in clinical outcomes and operational efficiency

• Effective infection prevention and control practices

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 10

11. Continuity of Operations Plan and Emergency Preparedness The Contractor shall develop, maintain, and periodically test a Continuity of Operations Plan (“COOP”) for the incarcerated individual healthcare program. The COOP shall address service continuity during emergencies, disasters, utility failures, disease outbreaks, cybersecurity incidents affecting clinical systems, staff shortages, facility disruption, and temporary provision of services at alternate locations if required. The Contractor shall coordinate drills and documentation with the Department.

12. Health Education and Training The Contractor shall provide health education and training to correctional staff and incarcerated individuals as required by the County. Training shall include recognition of common correctional health issues, suicide prevention, mental health emergencies, communicable disease control, and PREA-related medical and mental health responsibilities applicable to clinical personnel and contractors.

13. Staffing and Personnel Requirements

The Contractor shall provide qualified healthcare personnel in numbers, classifications, schedules, and assignments sufficient to deliver all services required under this Contract on a continuous basis and in a manner that ensures timely access to care, continuity of treatment, compliance with applicable laws and standards, and protection of the health and safety of incarcerated individuals and staff.

At a minimum, the Contractor shall provide staffing no less than the levels and position classifications set forth in the Minimum Staffing Requirements Exhibit (to be added) attached to and incorporated into this Contract. The staffing levels identified in that exhibit are minimum mandatory requirements and shall not be construed as relieving the Contractor of its obligation to provide additional staffing if necessary to meet actual workload, acuity, census, operational needs, emergency conditions, or other Contract requirements. If the Contractor proposes staffing levels above the minimum requirements and such staffing is accepted by the County as part of award, the Contractor shall maintain those higher accepted staffing levels unless otherwise approved in writing by the County.

The Contractor shall ensure that all persons performing services under this Contract are appropriately licensed, certified, registered, trained, and legally authorized under the laws of the State of Maryland to perform the duties assigned. The Contractor shall maintain current documentation of all required licenses, certifications, registrations, training records, and credentials and shall provide copies to the County at contract start, upon renewal, and upon request.

The Contractor shall provide staffing coverage twenty-four (24) hours per day, seven (7) days per week, to the extent required by this Contract, the Minimum Staffing Requirements Exhibit, and the operational needs of the Department. The Contractor shall ensure that physician, nursing, mental health, dental, pharmaceutical, and administrative leadership coverage is maintained in accordance with the Contract and that incarcerated individual access to medically necessary services is not interrupted by leave, illness, vacancy, turnover, or other staffing disruptions.

The Contractor shall designate and maintain key personnel, including but not limited to the Medical Director, Health Services Administrator, and other positions identified by the County as key personnel or critical positions. The Contractor shall not permanently remove or replace any key personnel without prior written notice to and approval by the County, except in emergencies or circumstances beyond the Contractor’s control, in which case the Contractor shall notify the County as soon as practicable and provide qualified interim coverage acceptable to the County.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 11

The Contractor shall be responsible for recruiting, hiring, onboarding, credentialing, training, scheduling, supervising, and retaining all personnel necessary to perform the Contract. The Contractor shall maintain staffing contingency plans sufficient to address vacancies, turnover, extended leave, census fluctuations, emergency conditions, and unexpected increases in service demand.

The Contractor shall conduct pre-employment screening and background checks for all personnel assigned to the facility, including any criminal history or other checks required by the County or Department policy. The County reserves the right to deny facility access to, or require removal of, any Contractor employee, subcontractor, consultant, or agent deemed unsuitable for work within the detention environment. The Contractor shall not assign any individual to provide services at the facility until all County-required approvals, screening requirements, and security clearance requirements have been satisfied.

The Contractor shall ensure that all clinical personnel maintain current certifications required by law, professional standards, or the Contract, including but not limited to Basic Life Support (BLS), CPR, Advanced Cardiac Life Support (ACLS), AED, or other certifications as applicable to the individual’s scope of practice and assigned duties.

The Contractor shall submit staffing reports in the format and frequency required by the County. At a minimum, staffing reports shall identify filled positions, vacant positions, turnover, use of temporary or agency staff, overtime utilization, and any staffing issues affecting performance.

Persistent vacancies, chronic understaffing, or failure to maintain minimum staffing levels may constitute non-performance and may subject the Contractor to corrective action, enhanced monitoring, financial remedies if applicable, or other contractual remedies.

Nothing in this Section shall be construed to permit staffing below the minimum levels set forth in the Minimum Staffing Requirements Exhibit or to limit the Contractor’s obligation to provide sufficient staff to meet all requirements of this Contract.

14. Medical Advisory Committee and County Coordination The Contractor shall participate in regular medical advisory or contract operations meetings with the Department. At minimum, the Healthcare Services Administrator, Medical Director, and other appropriate clinical leadership personnel shall attend meetings requested by the County to discuss incarcerated individuals’ healthcare operations, staffing, quality findings, utilization trends, incidents, and corrective actions.

15. County Responsibilities The County shall provide or arrange for custody, security escort, and routine non-emergency transportation for incarcerated individuals requiring approved off-site consultations, specialty care, diagnostics, procedures, and hospital treatment, unless otherwise expressly stated in the Contract.

The Contractor shall remain responsible for the clinical coordination of such services, including medical necessity review, referral preparation, scheduling coordination, clinical communication with outside providers, and continuity of care upon the incarcerated individual’s return to the facility.

Emergency ambulance transport initiated through Prince George’s County Fire/EMS or other emergency responders shall be handled in accordance with applicable emergency response protocols. If a non-emergency transport service other than County-provided custody transport is medically necessary and approved in accordance with Contract procedures, responsibility for payment shall be determined in accordance with the final Contract allocation of costs for off-site services and transport.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 12

If the County elects to maintain an incarcerated individual medical co-payment process for sick call or other billable encounters, the Contractor shall document qualifying encounters and transmit the information necessary for billing to the Department’s designated inmate finance function in accordance with County procedures. The County shall remain solely responsible for assessing, posting, collecting, adjusting, waiving, or otherwise administering the individual’s account charges.

Medical care shall not be denied, delayed, or withheld because of an individual’s inability to pay or account balance status.

16. Performance Standards, Monitoring, Reporting, and Remedies

16.1 General Performance Requirement

The Contractor shall perform all services required under this Contract in a timely, professional, safe, lawful, and clinically appropriate manner consistent with this Statement of Work, all applicable laws and regulations, generally accepted standards of correctional healthcare, and all written policies, procedures, and directives approved by the County.

The Contractor acknowledges that incarcerated individual healthcare services under this Contract are essential public safety and constitutional services. Accordingly, the Contractor shall maintain staffing, supervision, documentation, scheduling, reporting, and quality assurance processes sufficient to ensure continuous compliance with all service delivery requirements and timelines established in this Contract.

Failure to satisfy any required standard of service, response time, documentation requirement, staffing obligation, or reporting obligation may constitute non-performance, breach, or default, depending on the nature, severity, frequency, and duration of the deficiency.

16.2 County Monitoring and Oversight

The County, through the Department of Corrections, the Contract Administrator, the Office of Procurement, or other authorized County representatives, shall have the right to monitor, inspect, audit, review, and evaluate the Contractor’s performance at any time during the term of the Contract.

County monitoring may include observation of Contractor operations; review of staffing schedules, vacancy reports, medication administration records, referral logs, transport coordination records, and incident documentation; interviews with Contractor personnel; verification of licenses and certifications; and review of any other documentation necessary to assess compliance.

The Contractor shall cooperate fully with all County oversight activities and shall provide timely access to records, personnel, reports, and information reasonably requested by the County.

16.3 Monthly Performance Audit

Authorized Department staff shall have the right to conduct a monthly performance audit of the Contractor’s services. The monthly audit may include chart review, staffing review, report review, inspection of medication administration records, review of referral tracking, and verification of compliance with contractual timeframes and service requirements.

At a minimum, the County may review the following:

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 13

1. whether intake medical and mental health screenings were completed within the required timeframe;

2. whether history and physical examinations were completed within fourteen (14) days of commitment;

3. whether annual or periodic examinations were completed where required;

4. whether sick call requests were triaged and addressed within required timeframes;

5. whether chronic care clinics were conducted as scheduled;

6. whether urgent dental needs were addressed timely and routine dental care was provided where required;

7. whether medications were ordered, received, administered, and documented as prescribed;

8. whether specialty referrals, off-site appointments, and follow-up care were coordinated and completed as clinically required;

9. whether mental health assessments, crisis interventions, and psychiatric follow-up occurred within required or clinically appropriate timeframes;

10. whether infirmary documentation and monitoring were complete and current;

11. whether pre-release or discharge healthcare planning was completed where required;

12. whether staffing levels and qualifications were maintained in accordance with the Contract and the Minimum Staffing Requirements Exhibit; and

13. whether required reports were submitted timely and accurately.

16.4 Required Service Standards

The following are minimum required service standards. The Contractor shall comply with all service delivery timelines and operational requirements stated in this Contract, Department policy, and any County-approved clinical procedures.

16.4.1 Intake Medical and Mental Health Screening

The Contractor shall complete and document intake medical and mental health screenings for all newly committed incarcerated individuals within the timeframe required by this Contract and Department policy. Where the Contract requires intake screening within two (2) hours of commitment, the Contractor shall meet that requirement unless a delay is documented and accepted by the County as resulting from circumstances beyond the Contractor’s control.

All urgent or emergent conditions identified during intake shall be immediately referred for appropriate treatment and documented in the medical record.

16.4.2 Health Appraisal and Physical Examination

The Contractor shall complete and document a comprehensive health appraisal, including history and physical examination, within fourteen (14) calendar days of commitment, or within such other period as may be required by the final Contract.

Annual and periodic examinations shall be completed where required by the Contract, Department policy, or clinical protocols.

16.4.3 Sick Call Response

The Contractor shall maintain a sick call system that allows incarcerated individuals to request medical care without unreasonable delay. Sick call requests shall be reviewed and triaged promptly, and routine sick call encounters shall be provided within the timeframe established by the Contract and approved procedures.

Statement of Work - Comprehensive Incarcerated Individuals Medical Services | Page 14

Where the County requires that sick call requests be seen within forty-eight (48) hours, or seventy-two (72) hours on weekends, the Contractor shall comply with that requirement unless a delay is clinically justified and documented or otherwise accepted by the County.

16.4.4 Emergency Medical Response

The Contractor shall maintain staffing, equipment, training, and procedures necessary to respond to medical emergencies twenty-four (24) hours per day, seven (7) days per week. All emergency responses shall be documented. Failure to respond appropriately to emergencies may constitute a material performance deficiency.

16.4.5 Chronic Care Clinics

The Contractor shall maintain and document chronic care clinics in accordance with the schedules and treatment protocols approved by the County and required by clinical standards. Incarcerated individuals enrolled in chronic care shall be seen and monitored in accordance with the approved schedule.

16.4.6 Mental Health and Psychiatric Services

The Contractor shall provide timely access to mental health evaluation, crisis intervention, and psychiatric care for incarcerated individuals identified as needing such services. All urgent mental health referrals, crisis situations, suicide-related concerns, and psychiatric follow-up needs shall be addressed within the timeframes established by County policy, approved clinical protocols, and accepted standards of care.

16.4.7 Dental Services

The Contractor shall provide urgent dental triage and treatment within the timeframe established by the Contract and approved procedures. Routine dental evaluations and follow-up care shall be provided within the timeframes required by the Contract for incarcerated individuals who meet the applicable custody-duration threshold.

16.4.8 Pharmaceutical Services and Medication Administration

The Contractor shall ensure that prescribed medications are ordered, received, and administered as prescribed and documented in the medical record and medication administration record.

Medication omissions, delays, and errors shall be tracked, investigated, and reported in accordance with County requirements.

16.4.9 Specialty Care and Off-Site Referrals

The Contractor shall maintain a tracking system for all off-site referrals, specialty consultations, hospital admissions, diagnostic testing, and follow-up care. The Contractor shall coordinate all referrals and follow-up in a timely manner consistent with medical necessity and the requirements of this Contract.

16.4.10 Infirmary Operations

The Contractor shall maintain complete clinical…