The file's text, extracted by GovTribe without its formatting.
STATE OF MICHIGAN PROCUREMENT
| Department of Corrections |
| 206 E. Michigan Avenue, Lansing, MI 48933 |
| PO Box 30003, Lansing, MI 48909 |
Bidder Questions & Answers
RFI 190000000019
Integrated Health Care for Prisoners Questions below appear exactly as received from the vendors.
| Q # |
| Document and Section |
| Page # |
| Bidder Question |
| Answer (to be completed by the State) |
| Upon review of your recently published RFI, I did not see that it is a requirement to respond as a condition of eligibility for potentially submitting a proposal. Will you please clarify this for me as I want to be sure we do not disqualify our company in the event that you do release an RFP for the above mentioned services? |
| It is not a requirement for RFP eligibility. However, vendors are encouraged to share information. |
| What dispensing software is used at the DWH on-site pharmacy? |
| Currently the Contractor providing services provides the dispensing software. In the RFP process, potential bidders would be asked to provide their potential software in the response. What software does your company utilize? |
| 3 |
| General |
| NA |
| The RFI indicates that the Michigan DOC is seeking information to better understand industry best practices, effective operating models, and pricing models. Contracting your pharmacy independently presents numerous benefits over incorporating pharmacy into a comprehensive model. Using an independent pharmacy as a third party would provide many advantages to the DOC in terms of auditing, transparency, operations, clinical services, technology, and pricing. Would you permit an informational response to the RFI from vendors that specialize in correctional-based pharmacy services with experience servicing at least three Departments of Corrections with a census of 20,000 inmates or higher? |
| Yes. |
| 4 |
| Section 1 Program Overview |
| Page 3 |
| The pharmacy operation at DWH is highly unique and not commonplace within the industry. In the event that a RFP is published, will the DOC consider a tour of this specific facility during the pre-bid process so there is a clear understanding of the current operations and work flow? |
| Yes, please include details of what you would hope to see during the tour. |
| 5 |
| Section 2 Requirements |
| Page 5 - Requirement 12 |
| The RFI wishes information regarding the software that an Offeror's proposed pharmacy would utilize for pharmacy management. Is the RFI seeking information on the pharmacy's dispensing software that would be deployed at the DWH on-site pharmacy? Or is the RFI seeking information on the pharmacy's dispensing softwares ability to interface with the DOC's existing health record for electronic order entry and order transmittal? |
| The MDOC is seeking information on which software potential vendors are utilizing. |
| 6 |
| General |
| NA |
| What dispensing software is used at the DWH on-site pharmacy? |
| See response to question 2. |
| 7 |
| General |
| NA |
| Does the dispensing/pharmacy management software in use at DWH interface with the existing electronic health record? |
| Yes. |
| 8 |
| Section 2 Requirements |
| Page 8 - Requirement 35 |
| In the previous RFP for medical services, it was required for bidders to complete pharmacy pricing on a 20,000 line excel spread sheet that was very extensive and somewhat confusing in some areas regarding the metric quantities bidders were to price out for comparison purposes. Interpretations of such quantities were subjective and may have led to actual misrepresentations of actual AAC pricing that in turn were a factor in overall scoring and determination of the most advantageous proposal response. To overcome this challenge regarding accurate pricing of pharmaceuticals, would the DOC consider a smaller list of pharmaceutical such as a Top 100 list of medications by price and a Top 100 list of medications by prescriptions dispensed for pricing consideration? If not, would the DOC consider forming a committee prior to the release of the RFP in order to review the proposed pharmacy workbook so that any ambiguity regarding metric quantities and utilization can be addressed prior to the RFP being published since pharmacy costs are a very important scoring metric? |
| The format of the future RFP is not yet finalized. MDOC will take into consideration your proposed pharmacy exercise when developing the RFP. |
| 9 |
| General |
| NA |
| Are any medications currently being provided under a 340B program? If so, who is the covered entity eligible for 340B pricing access? |
| Currently the MDOC does not have medications provided under the 340B program; however, MDOC is in the process of researching more about the 340B program. |
| 10 |
| General |
| NA |
| Is NextGen the current EHR provider? If not, who is the current electronic health record provider for the DOC? |
| Yes. |
| 11 |
| General |
| NA |
| Does each DOC facility have first dose or interim stock medications available in blister cards or stock bottles? Or, are all stock medications available only in physician emergency kits in limited quantities? Can a general overview of the current stock inventory and administrative process be provided? |
| We currently use a mail order pharmacy system. Medication orders are typically started when medications arrive, unless the provider has indicated stat or start now in the order. Currently we stock an approved list of medications with established inventory levels in the Physician Dispensing Box / Emergency Dispensing Box. Items are added and removed from this list through the Pharmacy and Therapeutics Committee. Local pharmacy can also be utilized for stat orders if needed. |
Our inventory starts with receipt and verification of medications. Our online pharmacy, Medroom keeps our internal inventory of meds on site. Medications are tracked via administration, either through restricted medication line or Keep On Person (KOP) distribution. Returns are reviewed and verified by our clinic management staff. Inventory of stock is done monthly on site by clinic management. Established inventory levels and utilization are reviewed at time of inventory, and adjusted as needed.
| 12 |
| General |
| NA |
| Regarding the on-site pharmacy operation at DWH, can you provide the current staffing matrix and identify how many staff positions are filled by current medical vendor and how many positions are currently filled by civil servant staff? |
| There is one full-time Civil Servant pharmacist, three full-time and one part-time contractual pharmacists. There are five full-time contractual pharmacy technicians. |
| 13 |
| General |
| NA |
| Does the MI DOC currently house inmates in county locations within Michigan? Are DOC inmates housed outside the state of Michigan? If so, can details be provided? |
| No, we do not currently house inmates in county locations or outside the state of Michigan. |
| 14 |
| Section 1 |
| Page 3 |
| Why is this RFI being issued? |
| 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. |
| 15 |
| Section 1 |
| Page 3 |
| Has the DOC ever thought to separate out the Pharmacy portion as a separate bid? |
| In the current health care model being utilized, MDOC intends to bid medical, behavioral health and pharmacy as one bid. Please include specifics on the benefits of pharmacy being a separate bid. |
| 16 |
| Section 1 |
| Page 3 |
| Who are the current incumbent vendors on the DOC contract? |
| The current vendor is Corizon Health Inc. |
| 17 |
| Section 1 |
| Page 3 |
| What are the current rates for services for each of the incumbent vendors? |
| The current base per prisoner per month rate is $246.54, which includes health care, pharmacy and behavioral health. |
| 18 |
| Section 1 |
| Page 3 |
| What was the annual spend on this contract for Prison Health Care 2018, 2017, and 2016? |
| Total contract costs including Pharmacy: |
FY2016 (Jun-Sep) $48,402,000
FY2017 $133,811,000
FY2018 $128,077,000
| 19 |
| Section 1 |
| Page 3 |
| What was the Annual Pharmacy Spend on this contract for 2018, 2017 & 2016? |
| FY2016 (June-Sep) $17,648,200 |
FY2017 $42,166,800
FY2018 $36,739,000
| 20 |
| Section 1 |
| Page 3 |
| Will this be a multiple source award? |
| No, that is not the intent. However, MDOC will finalize the RFP format after RFI responses are reviewed. |
| 21 |
| Section 1 |
| Page 3 |
| What is the current ratio of site managers to staff? |
| What do you propose for the ratio of site manager to staff? |
| 22 |
| Section 1 |
| Page 3 |
| What is the current ratio of staff to inmates? |
| What do you propose for the ratio of staff to inmates? |
| 23 |
| Section 1 |
| Page 3 |
| What is the number of staff currently in each prison facility? |
| This information is not needed to respond to the RFI. A staffing plan will be included as part of the RFP. |
| Page 1 |
| What is the anticipated award date? |
| The anticipated award is not known at this time. |
| Page 1 |
| What is the anticipated start date of the contract? |
| The anticipated start date is June 1, 2021. |
| 26 |
| Section 1 |
| Page 3 |
| What will be the expected contract term? |
| The anticipated contract term will be five years, with additional option years. |
| 27 |
| Section 1 |
| Page 3 |
| What is the estimated number of staffing hours per week for each of the following disciplines? |
· Physicians
· Registered Nurse
· Licensed Practical Nurse
· CNAs
· Dentists
· Oral Surgeons
· Dental Hygienists
· Dental Assistants
· Physical Therapists
· Medical Assistants The only positions noted that are in scope for this contract are the physicians (including behavioral health practitioners), and specialty providers, to include oral surgeons and physical therapists. The other positions listed are out of scope for this contract.
What are considerations or factors your company uses to determine this?
| 28 |
| RFI Instructions |
| P. 2 / Req. 4 |
| Does the State have an anticipated timeframe for oral presentations/system demonstrations, should this option be pursued? |
| It is anticipated that RFI demonstrations would be scheduled for July or August 2019. |
| Would the State provide an unlocked/unprotected version of the RFI so bidder can format responses within the designated sections for Detailed Responses? The current document does not allow for formatting within the response block. |
| The attachment was uploaded as a Word document and is not password protected. While in Word, select the “Review” tab, click “restrict editing” and select “stop protection.” |
| 30 |
| RFI/Pharmacy |
| Page 5, Requirement 11 |
| Does the DOC currently access 340b pricing? If so, for which disease states? Please provide the name of your current 340b covered entity? |
| See response to question 9. |
| 31 |
| RFI/Pharmacy |
| Page 5, Requirement 12 |
| Please confirm your current version of the NextGen operating system? |
| This information is not needed to respond to the RFI. |
| 32 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| How is Duane Water Hospital (DWH) licensed? (ie, a hospital, outpatient health care center, clinic. Etc…)? |
| DWH is not a hospital. It is a health center and is not licensed. |
| 33 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Which facilities/ patient care areas does the DWH pharmacy serve? |
| Currently DWH pharmacy provides services for DWH inpatient, DWH step down unit, Egeler Reception and Guidance Center, and some Jackson facilities on an urgent basis. |
| 34 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Is the DWH pharmacy responsible for the delivery of medications to all facilities served? |
| DWH pharmacy is responsible for the delivery of medications to the facilities it serves. |
| 35 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Are there any special pharmacy consulting services (ie.,SNF medication review/ consulting) provided by the DWH pharmacy staff? |
| No. |
| 36 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| What accreditation(s) does the DWH facility hold that may impact the practice of pharmacy in the institution (ie, Joint Commission, Special Compounding Pharmacy Accreditation/ Licensure) |
| None. |
| 37 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Please provide the equipment list with purchase dates specific to the pharmacy. |
| This information is not needed to respond to the RFI. |
| 38 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| What is the name of the current prescription processing system? Is it owned by the current pharmacy provider or the DOC? |
| See the response to question 2. |
| 39 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Is the current prescription processing system utilized by the pharmacy the same system utilized by other staff for prescription management, reports, credit processing, etc…) |
| No. |
| 40 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Does the DWH medication distribution system utilize any automation, (i.e. Pyxis, Omnicell, Automed, etc….)? |
| No. |
| 41 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| What is the current operating hours of your pharmacy at DWH? If the pharmacy is not open 24/7, how do you currently ensure the availability of medication(s) during non-operating hours? |
| The current operating hours of the DWH pharmacy are 7:00 a.m. to 7:00 p.m. There is current stock of medications available and the current Contractor has a local pharmacy purchasing process in place for emergencies. |
| 42 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Are all onsite pharmacy staff employees of the Department of Corrections? |
| No. |
| 43 |
| RFI/Pharmacy |
| Page 5, Requirement 15 |
| Is the Pharmacist-in-charge, as defined by Michigan Department of Licensing and Regulatory Affairs-Board of Pharmacy, currently an employee of the Department of Corrections or an employee of your current contractor? |
| The pharmacist-in-charge is an employee of the current Contractor. |
| 44 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: What are the programming expectations? |
| Please use the following link to view the Corrections Mental Health Services Levels of Care (LOC). |
https://www.michigan.gov/corrections/0,4551,7-119-68854_68856_9744---,00.html
| 45 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: Please provide the number and size of group rooms and programming areas that would be available. |
| MDOC staff are currently providing the programming. |
| 46 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: Is the focus of the inpatient unit to be transitional back to general population or for long-term MH stays? |
| Both. |
| 47 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: In the Crisis stabilization unit, are forced meds, involuntary med orders, and therapeutic restraints used? How about in the other units? |
| Yes, forced meds and involuntary med orders are used in the Crisis stabilization unit. However, MDOC does not use therapeutic restraints outside of acute care mental health. |
| 48 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: For the ASRP, which discipline was providing assistance with ADLs? (MH Techs, CNAs?) Is this |
a long-term unit? How many beds?
ADL assistance is not provided in the ASRP unit.
Yes, ASRP is a long-term unit.
There is a total of 262 ASRP beds (144 located at an Ionia facility and 118 located at a St. Louis facility).
| 49 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: How many suicide watch cells? |
| All of the cells at the Mental Health inpatient unit can be used as suicide watch cells. |
| 50 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| For the Mental Health inpatient unit: How are patients with disciplinary concerns currently managed? |
| The treatment team, consisting of MDOC and contractual staff, determines appropriate sanctions for disciplinary concerns based upon the prisoner’s functioning. |
| 51 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| Please describe the current programming provided for the restrictive housing/segregation population (both MH and otherwise)? |
| This information is not needed to respond to the RFI. What information would your organization want included in an RFP? |
| 52 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| What are the expectations related to an integrated care system? |
| Please see RFI Section 1 “Program Overview.” |
| 53 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| The RFI defines an "Integrated Care Model" as the "systemic coordination of general and behavioral health care." As this statement can be interpreted in many ways, would the DOC please provide a more detailed explanation of what it believes integrated care means? |
| The Department sees integrated care as the following; |
1. Providing comprehensive care through the integration of primary care and behavioral health services.
1. Developing a systematic approach for identifying the level of health and mental health services needed by patient and matching the patient to the level.
1. Developing a model increases provider productivity and provides prisoners with integrated care.
| 54 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| Please include specific examples that typify the DOC's view of integrated care. |
| Currently, the MDOC is prioritizing those patients who are psychiatrically stable and then referring them to health care providers for medical management. |
| 55 |
| RFI/Integrated Care |
| Pages 6-8, Requirements 20-37 |
| What is the MH clinical leadership structure for the system's MH program to include the specialty hospital and all other facilities? |
| See response to question 23. |
| At which two local hospitals does the current vendor maintain the 12- and 22-bed secure units referenced in the RFI? |
| The two local hospitals are Henry Ford Allegiance in Jackson and McLaren Hospital in Lansing. |
| Please clarify which positions are currently staffed by the State and which are staffed by the Contractor. Will this remain the same under the new contract? |
| Please see RFI Section 1 “Program Overview.” |
Yes, this will remain the same.
| Are any health care positions—State-employed or Contractor-employed—covered by labor unions? If yes, please indicate which positions are covered by which labor union(s). |
| Yes, some of the State-employed positions are covered by labor unions. The Contractor-employed positions are not. This is out of scope of the contract. |
| Are any managed care organizations (e.g., Blue Cross Blue Shield, Aetna, United, Cigna, etc.) currently involved in the contract in any way? |
| Yes. |
| Are any universities or academic medical centers currently involved in the contract in any way? |
| Yes. |
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