RFI 190000000019 - prisoner integrated health care revised.doc

Request for Information

STATE OF MICHIGAN

Department of Corrections Procurement Request for Information (RFI)

RFI # 190000000019

Integrated Health Care for Prisoners

This Request for Information (RFI) seeks to obtain information from potential Bidders interested in providing integrated health care to prisoners under the jurisdiction of the Michigan Department of Corrections (MDOC). This information gathered is intended to assist the State of Michigan to better understand (a) industry best practices, (b) effective operating models, and (c) pricing models.

Anticipated Timeline

Issue Date

April 12, 2019 Deadline to Submit Questions

3:00 p.m. EST

April 26, 2019 Anticipated Date State will Post Answers to Questions

May 3, 2019 Deadline to Submit Response 3:00 p.m. EST May 17, 2019 The information in this document is subject to change. Check www.michigan.gov/SIGMAVSS for the current information.

STATE OF MICHIGAN

REQUEST FOR INFORMATION INSTRUCTIONS

1. CONTACT INFORMATION FOR THE STATE. The sole point of contact concerning this Request for Information (RFI) is:

Lisa Lehnert, Buyer

(517) 335-4904 LehnertL@michigan.gov

2. QUESTIONS. Questions concerning the RFI must be emailed to LehnertL@michigan.gov no later than the time and date specified on the cover page of this document. Answers to questions will be posted on www.michigan.gov/SIGMAVSS.

Questions should be submitted using the following format:

3. DELIVERY OF RESPONSE. Vendor responses should be submitted electronically on www.michigan.gov/SIGMAVSS and must be emailed to LehnertL@michigan.gov no later than the date and time located on the cover page of this document. All documents should be created using tools that are compatible with the Microsoft Office Suite 97 standard desktop tools, without need for conversion. System prompts for pricing attachments and information can be disregarded.

Questions on how to submit information or how to navigate in the SIGMA system can be answered by calling (517) 373-4111 or (888) 734-9749.

4. ORAL PRESENTATION. The State reserves the right to invite some vendors for oral presentations and/or system demonstrations.

5. GENERAL RESPONSE CONDITIONS. The State will not be liable for any costs incurred in preparation of vendor’s response, delivery of the response, and any follow-up discussions with the State. This RFI is not an offer to enter into a contract.

6. FREEDOM OF INFORMATION ACT. All portions of a response are subject to disclosure as required under the Michigan’s Freedom of Information Act, 1976 Public Act 422.

7. RIGHTS TO INFORMATION CONTAINED IN RESPONSES. All informational responses will be considered the property of the State.

STATE OF MICHIGAN

Request For Information # 190000000019 Integrated Health Care for Prisoners The purpose for this Request for Information (RFI) includes, but is not limited to, collecting market information to better understand best practices about integrated health care for prisoners. The information gathered may be used to assist the State in developing program strategy and possibly developing an RFP.

1. Program Overview

MDOC currently delivers general health care, behavioral health care, substance abuse and pharmacy services. MDOC integrates all aspects of heath care in a manner that organizes prisoners by their level of care, utilizes evidence-based approaches to maximize health outcomes, optimizes medication taken by each prisoner, and efficiently manages overall costs. MDOC intends for the reformed health care delivery system to focus on preventative measures, clinical outcomes, medication management, and innovative approaches to care, collaboration between all services, and to provide MDOC with greater predictability and efficient management of health care costs. There will also be enhanced focus on ensuring a connection to appropriate care in the community when a prisoner is paroled or discharged.

The MDOC currently contracts for medical health care, behavioral health care, and pharmaceutical services to an average of 39,500 prisoners annually at 29 correctional facilities/prisons (28 - male facilities and one – female facility) and reentry centers. This number includes prisoners from other jurisdictions (such as federal and county prisoners). The Contractor must provide services to all populations included on the MDOC Client Census

The MDOC operates a 152-bed inpatient facility in Jackson, MI (Duane L. Waters Health Center (DWH)), which houses prisoners whose medical needs cannot be met at an infirmary or ambulatory clinic. DWH provides acute, medical, long term care, and surgical procedures that are non-invasive or use conscious sedation for liver biopsies. Attached to DWH is C Unit, which houses prisoners that are not to the level of needing inpatient services nor can their needs be met in an ambulatory facility. C Unit has 94 medical beds. DWH currently has two procedure rooms utilized for liver biopsies, colonoscopies, EDG’s, and other biopsies. DWH also has an on-site emergency room staffed 24 hours, seven days per week. Staffing for the emergency room includes MDOC paramedics, nurses and a medical provider. DWH also provides specialty clinics for, prisoners housed within 90 miles of DWH. DWH operates the only onsite pharmacy in the department. The staffing is comprised of both contractors and civil servants. The current clinics include services for optometry, audiology, podiatry, physical therapy, urology, nephrology, oral surgery, rheumatology, and some tele-med clinics including infectious disease. The Contractor is responsible for providing the medical providers for both health care and behavioral health coverage along with the management of the pharmacy and pharmacy staff.

Through MDOC’s current contract, the vendor provides secure units at two local hospitals; 22 bed and 12 bed units. MDOC provides the custody staffing for these units. The Contractor is responsible for continuing and managing the arrangements for continued use of the secure units ensuring that prisoners are housed there instead of in the general hospital rooms.

In addition to the DWH infirmary, the MDOC currently has infirmaries located at Woodland Correctional Facility (WCC), Women’s Huron Valley (WHV) and Marquette Branch Prison (MBP).

Approximately 24% of the prisoner population is currently being treated at some level for mental health challenges. A larger percentage of prisoners may receive mental health treatment during their incarceration, but many prisoners move on and off the mental health caseload. The MDOC operates a 200-bed inpatient facility at WCC that houses prisoners with severe mental illness whose needs cannot be met in a general population facility. This facility also houses the Crisis Stabilization Program which stabilizes prisoners in need of emergency mental health care. In addition, the MDOC has three correctional facilities with Residential Treatment Units. Outpatient services comprise the majority of the caseload and those services are provided at multiple facilities. There are also two Adaptive Skills Residential Programs (ASRP) units that work with the developmentally disabled population who may have co-occurring disorders and provide skills training and therapy. Assist with ADLs and return a general population setting. The treatment team at each facility that provides mental health services consists of a psychiatrist and multiple qualified mental health professionals.

The Contractor must provide all physicians and mid-level providers serving MDOC inmate medical and psychiatric needs; maintain an off-site network of specialty services located in close proximity to the MDOC facilities to minimize transportation services; claims adjudication for off-site services; utilization management services; medical and psychiatric performance measurement; polypharmacy monitoring and management; quality improvement activities; and supports to re-entry and discharge planning. The Contractor will be responsible for the purchase and delivery of pharmaceuticals for prisoners utilizing a mail order process, that includes a mechanism that provides credit for medication returns, while utilizing generics when possible to reduce cost, management of an on-site pharmacy, analysis and support of prescribing patterns and a formulary with a goal of maximizing efficacy and efficiency while minimizing waste and cost. Currently the Contractor and MDOC share financial risk such that the Contractor has the incentive to manage inmate health care on-site where appropriate and minimize the use of off-site services except where medically necessary. In addition, the Contractor will manage and monitor pharmacy utilization that includes identifying issues with polypharmacy, appropriate use of medications, and identification of medication errors.

2. Requirements Recruitment and Staffing

1. How would you propose to staff all 29 MDOC prisons, to include the physician to midlevel staff ratio? Describe how these ratios will be monitored and reported.

Detailed Response:

2. What are your organization’s methods for maintaining qualified staffing levels to ensure the population’s health care needs are being met at all 29 MDOC prisons?

Detailed Response:

3. Describe how your organization recruits and retains qualified staff, ie. Retention bonuses, other incentives offered to employees, etc.

Detailed Response:

4. Describe how your organization builds staff resilience and minimizes staff burnout.

Detailed Response:

5. How do you ensure that your physicians and midlevel staff have the appropriate competencies/skills to deliver services?

Detailed Response:

6. How will your organization deliver training to address those skills?

Detailed Response:

7. What partnerships do you have, such as relationships with universities, community stakeholders, locum tenens affiliations, etc. to aid in your recruitment strategies?

Detailed Response:

8. If your organization has training programs or if the MDOC offered these programs, how would you ensure that medical providers deliver effective supervision and educational experiences to these trainees?

Detailed Response:

9. What staffing resources do you have available for telehealth, including technology support services?

Detailed Response:

10. Telehealth presents physical plant challenges in the prison setting. What ideas, resources and/or experience would you bring to address these difficulties?

Detailed Response:

Pharmacy

11.

What relationship(s) and/or partnership(s) does your organization have to provide prescription drugs and medication management to all 29 MDOC prisons, including access to 340B pharmacy pricing, relationships with wholesalers and manufacturers, etc.?

Detailed Response:

12.

What software does your organization use for pharmacy management? The MDOC may request a software demo as part of the RFI process.

Detailed Response:

13. Describe what level of access MDOC would have to the pharmacy management software.

Detailed Response:

14.

Describe the capability of the pharmacy management software, such as electronic reporting, check-ins, refills and returns, etc.

Detailed Response:

15.

Do you have any suggestions to make pharmacy services more cost effective and efficient for the MDOC?

Detailed Response:

16.

The Contractor must provide a method for return and credit for all medications returned. Describe your organization’s policy/practice for medication returns, including which medications are eligible for credit.

Detailed Response:

17.

Currently the MDOC requires its Contractor to provide all medications at its acquisition cost. Describe your current pricing structure that your organization utilizes or that you would propose.

Detailed Response:

18.

Describe how your organization would pass on any rebates and/or discounts to the MDOC for pharmaceutical purchases.

Detailed Response:

19.

Describe your organization’s experience in managing an onsite pharmacy, including pharmacy staff.

Detailed Response:

Integrated Care (Health Care and Behavioral Health)

20. Describe in detail your experience with an integrated care model (systemic coordination of general and behavioral health care), including the integrated care model that you currently use.

Detailed Response:

21. How do you determine level of care, and program placement? Please include the tools and methods used to make these determinations.

Detailed Response:

22. How do you determine medical necessity and treatment outcome? Please include the tools and methods used to make these determinations.

Detailed Response:

23. What trends does your organization track to ensure that your organization is aligned with community standards and/or best practices?

Detailed Response:

24. Does your organization set any productivity standards for providers across all disciplines? If so, how are those productivity standards set? How will those be tracked and reported?

Detailed Response:

25. How does your organization ensure that productivity standards are met?

Detailed Response:

26. What expertise does your organization have in behavioral health specialty areas, ie. suicide prevention, behavior modification, effective therapies for corrections population, co-occurring disorders, etc.

Detailed Response:

27.

Describe any innovative or best practices your organization has utilized in treating mentally ill prisoners.

Detailed Response:

28. What structure does your organization have in place for health wellness and health promotion?

Detailed Response:

29. Describe your experience with medication assisted treatment (MAT).

Detailed Response:

30. How would you advance the use of MAT in the prison setting?

Detailed Response:

31. What experience does your organization have working with community service practitioners, insurance carriers, and health and human service agencies to ensure prisoners continuity of care upon release/discharge?

Detailed Response:

32. Describe your organization’s process for clinical reviews.

Detailed Response:

33. What is your organization’s procedure for providing training, including working with a criminal justice population, overfamiliarity, ethics and mandatory MDOC training of deployed contracted staff at MDOC facilities prior to their first work day?

Detailed Response:

34. What is your organization’s procedure for providing clinical supervision of staff?

Detailed Response:

35. What challenges does your organization foresee in bidding all services (general health care, behavioral health care and pharmacy)?

Detailed Response:

36. The MDOC is working to become a trauma informed department. Tell us your expertise and experience in trauma informed care. Are you a trauma informed organization?

Detailed Response:

37. How do you incorporate the treatment of trauma into care plans?

Detailed Response:

Claims

38. Does your organization have the ability to receive and extract data from an 837 claims file?

Detailed Response:

39. Describe your process for receiving and extracting 837 claims data.

Detailed Response:

40. Describe your mechanism to ensure that claims are not paid for prisoners who are no longer under the jurisdiction of the MDOC.

Detailed Response:

41. What upfront audits, standard and customized claim edits, and other industry standards and customized processes, are used to ensure that claims are correctly billed before being paid?

Detailed Response:

42. What experience does your organization have coordinating Medicaid benefits for inpatient hospital stays for prisoners?

Detailed Response:

43. Does your organization have any affiliation with any major insurance carriers?

Detailed Response:

44. Describe your organization’s authorization process on claims level data.

Detailed Response:

45. How does your organization calculate incurred but not reported (IBNR) claims and what documentation is provided at the claims level to support the IBNR?

Detailed Response:

Contractually

46. Describe how your organization would provide oversight and management to ensure contract compliance, including subcontractors.

Detailed Response:

47. Describe how your organization would ensure contract requirements and expectations are met across all areas (health care, mental health and pharmacy).

Detailed Response:

48. What quality checks and audits would you perform on the data and reports that you complete?

Detailed Response:

49. Are there quality assurance practices that you would recommend for a contract of this scope?

Detailed Response:

Miscellaneous

50. What process does your organization utilize for arranging service provisions, including the use of subcontractors?

Detailed Response:

51. Does your organization have any suggestions which align with best practices, to make integrated health care treatment more efficient?

Detailed Response:

52. Do you have any suggestions to make integrated health care treatment more cost efficient for the MDOC?

Detailed Response:

STATE OF MICHIGAN

Request for Information

Integrated Health Care for Prisoners

RESPONSE PREPARATION

Please respond to the following topics and questions in a “Question and Answer” format, providing thorough information for each, when possible.

1. Company full name and address.

2. Name, telephone number, and email address of the individual(s) who will serve as your company’s authorized contact.

3. Please identify who was involved in developing the response to this RFI?

4. Please include, as an attachment, the following:

· Mission Statement

· Organizational Chart

· Accreditation or other relevant credential

FORMCHECKBOX

The Contractor has provided the above attachments with its response.

5. Please provide a comprehensive overview of your prior experience providing, operating, programming and managing this type of project.

6. Provide contact information including names, telephone numbers and email addresses for your customer(s) for the work mentioned in #5 above.

7. Please provide the transition time that was needed for the experiences noted above in #5.

8. Provide your organizational structure.

9. What would be your preferred compensation structure?

10. Provide examples of other common pricing models, with an explanation of why they are not preferred.

11. What additional assets, tools, or expertise would your organization request from the State?

12. If a Request for Proposal is issued for provision of this service, is it likely that your company will bid on it?

a. If no, why not?

�Dr. McIntyre: See above comment.

�What is the definition of “sufficient”?

�Ask MK to review

�MK to rewrite

From Dr. McIntyre: Maybe, “How do you determine level of care, and program placement?”

I would also ask a question about tools used to determine medical necessity, treatment outcome.

Another question to ask is how they track trends, and what they do to ensure they are in-line with community standards, best practices, etc. (RFP QUESTION)

�I think the question should be What trends do you track to ensure that you are aligned with community standards and/or best practices?

This question will give us an idea of what metrics we might want to include. I think you should keep 14 and 15 as written.

�Ask Dave