RFP 2024-037 Inmate Medical Services - FInal - Post (PDF).pdf

REQUEST FOR PROPOSALS

FOR

ROWAN COUNTY

Inmate Medical Services # 2024-037

ROWAN COUNTY

130 West Innes Street Salisbury, NC 28144

704-216-8178 jody.farrow-bennett@rowancountync.gov

Date Issued: Tuesday, April 16, 2024

Date Due: Tuesday, May 21, 2024, at 3:00 PM ET

Administered By: Jody Farrow-Bennett, Purchasing Director mailto:jody.farrow-bennett@rowancountync.gov

Rowan County Request for Proposals Date Due: Tuesday, May 21, 2024, at 3:00 PM ET Inmate Medical Services

NOTICE TO CONTRACTORS

REQUEST FOR PROPOSALS

ROWAN COUNTY – INMATE MEDICAL SERVICES

Rowan County requests proposals to manage and deliver comprehensive inmate healthcare services at the Rowan County Detention Center, located at 115 W. Liberty St., Salisbury, NC, and the Rowan County Detention Center Annex, located at 400 Grace Church Road, Salisbury, NC. Hereinafter, the term “Detention Center” shall be understood to mean both facilities. This service would provide onsite nursing coverage a minimum of 24 hours per day, Monday through Friday; 24 hours per day on Saturday and Sunday and on-call services for non-staffed periods, in addition to physician and other medical services, to visit both facilities when scheduled, as described in the Requirements and Specifications Sections of this Request for Proposal (RFP). The terms “medical care” or “healthcare services” include both “psychiatric and psychological care” as well as “dental care.” The facility houses both adult male and female inmates.

Presently the medical services are provided through a contracted company, Wellpath. Emergency dental services are provided offsite, and emergency mental health evaluations and limited mental health services are provided either onsite or offsite under contracts with local service providers. Emergency room and hospital care are provided by the Novant Health Rowan Medical Center or other local hospital facility. The detention center medical section consists of one exam room, an office/records room, and a pharmaceutical supply area in each facility. There is no dental office space.

Additional information regarding medical cost experience, local providers and services is available upon written request (see General Requirements).

It is the desire of Rowan County to award an inmate healthcare services contract for an initial 36-month term beginning July 1, 2024. Please indicate in proposal the earliest date your firm may begin services. Rowan County intends to include in the contract a option to extend the term of the contract for two (2) additional one-year terms, up to a total of five years, provided such extensions are in the best interests of the parties. The County’s procurement policy extends the option to reassess contracts every five (5) years to determine if the contract is still advantageous for the County.

Proposals for the Rowan County Structured Cabling Services will be accepted until Tuesday, May 21, 2024, at 3:00 PM ET at the Rowan County Purchasing Department, 130 West Innes Street, Suite 31, Salisbury, North Carolina 28144.

Request documents may be obtained by contacting the Rowan County Purchasing Director or from the County website at:

Rowan County Purchasing Department Attn: Jody Farrow-Bennett, Purchasing Director

130 West Innes Street, Suite 31 Salisbury, NC 28144 704-216-8178 jody.farrow-bennett@rowancountync.gov https://www.rowancountync.gov/675/Purchasing

Submission of any proposal signifies the Contractor’s agreement that their proposal and the content thereof, are valid for ninety (90) calendar days following the submission deadline and will become part of the contract that is negotiated between Rowan County and the successful Contractor. All prices submitted with the proposal shall remain in effect for the ninety (90) day period.

Contracts funded with federal grant funds must be procured in a manner that conforms with all applicable Federal laws, policies, and standards.

mailto:jody.farrow-bennett@rowancountync.gov https://www.rowancountync.gov/675/Purchasing

Insurance requirements are listed in the document and will be required only from the awarded vendor before entering into contract with Rowan County.

Once the RFP is public all questions related to the RFP shall be directed to the Purchasing Director. Any contact related to the RFP with County Staff and/or Board of Commissioners will be prohibited and cause for rejection.

Rowan County reserves the right to award and/or reject any and/or all proposals and waive any technicalities or irregularities. For complete details, consult the consult the RFP.

This is the 16th day of April 2024.

Rowan County

By: Jody Farrow-Bennett Rowan County Director of Purchasing and Contract Administration

Table of Contents Instructions to Bidders

1. Section 1: Introduction & General Instructions

1.1. Intent of Request for Bids

1.2. Important Dates

1.2.1. Issue Date

1.2.2. Pre-Bid Meeting

1.2.3. Deadline for Written Questions

1.2.4. Deadline for Submitting Bids

1.3. Pre-Bid Meeting

2. Section 2: Bid Submission

2.1. Submission of Bids

2.2. Request for Clarification

2.3. Errors & Omissions

2.4. Signed Bid Considered an Offer

2.5. Insurance Coverage

2.5.1. Worker’s Compensation

2.5.2. Comprehensive General Liability

2.5.3. Comprehensive Automobile Liability

2.6. Conflict of Interest

3. Section 3: Evaluation of Bids

3.1. Evaluation Criteria

3.2. Pricing

3.3. Required Information

4. Section 4: Agreement & General Conditions

4.1. Timeline to Execute Contract

4.2. Availability of Funds

4.2.1. Federal Funds

4.3. Non-Discrimination

4.4. Collusive Bidding

4.5. General Indemnity

4.6. Warranty

4.7. Assignment

4.8. References

4.9. Termination

Scope of Work Bidder Information Sheet Bid Response Form

1. Section 1: Introduction & General Instructions

1.1. Intent of Request for Bids

The purpose and intent of this Request for Proposal (RFP) is to contract for Medical Services for the inmates at both Rowan County Detention Centers. The following documents make up this Request for Bids:

a. This Document

b. Scope of Work

c. Bidder Information Sheet

d. Proposal Response Form

1.2. Important Dates

1.2.1. Issue Date: Tuesday, April 16, 2024

1.2.2. Pre-Bid Meeting Date: Wednesday, April 24, 2024, at 10:30 AM ET

1.2.3. Deadline for written questions: Thursday, May 9, 2024, at 5:00 PM ET

1.2.4. Deadline for Submitting Bids: Tuesday, May 21, 2024, at 3:00 PM ET

1.2.5. Anticipated Award Date: Monday, June 3, 2024

1.2.6. Estimated Contract Start Date Monday, July 1, 2024,

1.3. Pre-Bid Meeting

There is an optional pre-bid meeting for this project. The meeting will be held at the Rowan County Sheriff’s Office located at 232 N. Main St, Salisbury, NC 28144. Questions about the specifications and or bid documents should be addressed to Jody Farrow-Bennett the Rowan County Purchasing Director. A company representative is highly encouraged to be present at this meeting to offer a bid on the project.

2. Section 2: Bid Submission

2.1. Submission of Bids

Bids must be presented on the Proposal Response Form attached to the specifications in a sealed envelope and mailed or delivered to:

Rowan County Purchasing Department Attn: Purchasing Department 130 West Innes Street, Suite 31 Salisbury, NC 28144

The package shall be sealed and plainly marked “RFP 2024-037 Inmate Medical Services”.

Bidders must submit one original sealed bid.

No responsibility shall be attached to Rowan County (the County) for the premature opening of any bid not properly addressed or identified.

This will be a public bid opening. Once bid is awarded all bidders will receive notification.

Sealed Bids are due on Tuesday, May 21, 2024, at 3:00 PM ET; opening will be held in the J. Newton Cohen, Sr.

Administration Building at 130 West Innes Street, Conference Room 101, Salisbury, North Carolina. Failure to submit a Bid by this deadline will disqualify the Bidder from consideration in this project.

2.2. Request for Clarification

The County will not be bound by or be responsible for any interpretations or conclusions drawn from this RFP. All questions or requests for clarification or additional information must be submitted in writing no later than 5:00 pm on Thursday, May 9, 2024, at 5:00 PM ET. These written questions or requests must be submitted to Jody Farrow-Bennett, Purchasing Director, by mail or e-mail. Any questions the County feels are pertinent to all interested bidders will be delivered to all participating bidders as an addendum to this RFP. All addendums will be posted on the County website https://www.rowancountync.gov/675/Purchasing and it is the responsibility of the Bidder to check for any addendums. The addenda for clarification will be posted by 5pm Friday, May 10, 2024.

In addition, the County assumes no responsibility for conclusions or interpretations derived from technical and background information presented in this RFP, or otherwise distributed or made available during this procurement process. The County will not be bound by or be responsible for any explanation, interpretation, or conclusions of this RFP or any documents provided by the County, other than those given in writing by the County, through the issuance of an addenda. It is the full responsibility of the Bidder to thoroughly investigate the needs/requirements of the County not necessarily assumed in this RFP.

2.3. Errors and Omissions

The Bidder shall not take advantage of any errors or omissions in this RFP and shall promptly notify the County of any omissions or errors found in this document.

2.4. Signed Bid Considered an Offer

Receipt of a signed bid shall be considered an offer on the part of the Bidder. The terms, conditions, and specifications of this RFP will become part of the contract if the bid shall be deemed approved and accepted by the County. In the event of a default on the part of the Bidder after acceptance by the County, the County may take such action as it deems appropriate, including legal action for damages or specific performance.

2.5. Insurance Coverage

The Bidder shall not commence work under this contract until all insurance required under this section has been obtained. The Bidder shall not allow any subcontractor to commence on work that has been subcontracted until similar insurance has been obtained by the subcontractor. Also, the Bidder agrees that once awarded and during the term of this contract, the Bidder, at their sole cost and expense, shall provide commercial insurance of such type and with such terms and limits as may be reasonably associated with the contract. At a minimum, the Bidder shall provide and maintain the following coverage and limits:

2.5.1. WORKER’S COMPENSATION

Worker’s compensation insurance as required by North Carolina law to cover all the Provider’s employees engaged in any work under the Agreement. Workers’ Compensation in the minimum amount of $500,000 employer’s liability. A Certificate of Insurance shall be issued confirming the above coverage. The Certificate must include a clause obligating the Insurer to give thirty (30) days prior notice in the event of cancellation of or major change in the insurance.

2.5.2. COMPREHENSIVE GENERAL LIABILITY

The Contractor shall maintain Comprehensive General Liability coverage in amounts not less than $1,500,000 per occurrence / $3,000,000 aggregate. This Certificate must also include a clause obligating the insurer to give thirty (30) days prior notice in the event of cancellation of or major change in the insurance and name the County as an additional insured.

This coverage must include:

https://www.rowancountync.gov/675/Purchasing

1. Blanket contractual coverage for the liability assumed by the Contractor under the indemnity provision of the contract involved. Such Certificate must specifically state that the contractor is insured, and it must be signed by the insurance company, not the agent or broker.

2. Contractor's protective coverage for his subcontractors.

2.5.3. COMPREHENSIVE AUTOMOBILE LIABILITY

The Contractor shall maintain Comprehensive Automobile Liability covering all owned, hired, and non-owned vehicles used in connection with this Agreement. The minimum combined single limit shall be $1,000,000 for bodily injury and property damage; and $1,000,000 uninsured/underinsured motorist coverage. A Certificate of Insurance shall be issued confirming this coverage. The Certificate must include a clause obligating the insurer to give thirty (30) days prior notice in the event of cancellation of or major change in the insurance.

2.5.4. CYBERSECURITY LIABILITY INSURANCE

Provide is required to carry cybersecurity liability in the amount of $1,000,000 aggregate with County listed as additional insured.

2.5.5. BLANKET EMPLOYEE DISHONESTY BOND

The Contractor shall maintain a bond to protect against dishonest acts committed by the Contractors employees. The minimum limit of this bond shall be $500,000 applicable to all loss caused by or involving one or more employees, whether the result of a single act or a series of acts. ROWAN COUNTY shall be added to the bond as an oblige.

2.5.6. THEFT, DISAPPEARANCE, AND DESTRUCTION CRIME INSURANCE

The Contractor shall maintain coverage applicable to loss or damage to food stamps within any vault, or while inside or outside the Contractor premises, and in the Contractor care, custody, and control. The minimum limit of this policy shall be $500,000 inside the premises and $50,000 outside the premises. ROWAN COUNTY shall be included as an additional insured/loss payee.

2.6. Conflict of Interest

All Bidders must disclose in writing with their bid the name of any owner, officer, director, or agent who is also an employee of the County. All Bidders must also disclose in writing with their bid the name of any employee of the County who owns, directly or indirectly, an interest of five percent (5%) or more in the Bidder’s firm or any of its branches or subsidiaries. By submitting a bid, the Bidder certifies that there is no relationship between the Bidder and any person or entity which is, or gives the appearance of, a conflict of interest related to this RFP or project.

3. Section 3: Evaluation of Bids

3.1. Evaluation Criteria

Price will be a major consideration in the County’s evaluation criteria, but it will not be the only determining factor in our evaluation. The proposals will be evaluated on a “best overall value” basis including, but not limited to, pricing, experience, references, quality, performance, and the Contractor’s ability to adhere to all conditions and requirements of the specifications outlined in this RFP. The Contractor’s ability to provide a team of skilled, trained employees, maintenance costs, and the Contractor’s experience with similar projects will also be considered in the County’s evaluation of the proposals submitted.

Evaluation criteria (1-5 scale)

a. 20% Cost

b. 15% Experience

c. 40% Service, Reliability, Qualification, & History

d. 15% Financial Stability

e. 10% References (Local/NC)

The contract term will be for a three (3) year term and be subject to renewal for two (2) additional one (1) year terms based on the County’s satisfaction of workmanship and responsiveness; up to five (5) consecutive year terms in total. The County’s procurement policy extends the option to reassess contracts every five (5) years to determine if the contract is still advantageous for the County.

3.2. Pricing

Submission of any bid signifies the Bidder’s agreement that its bid and the contents thereof are valid for ninety

(90) calendar days following the submission deadline and will become part of the contract that is negotiated between the County and the successful Bidder. All prices submitted with the bid shall remain in effect for the ninety (90) day period.

4. Section 4: Agreement & General Conditions

4.1. Timeline to Execute Contract

As time is of the essence, the Bidder is required to begin and/or commence the work to be performed under this contract within the time specified. Failure by the Bidder to begin and/or complete the work within the contract time shall be assessed a penalty for each day of overrun. The Bidder hereby agrees to execute this contract and that said charges are considered a just and reasonable compensation to the County and said charges shall be deducted from payment.

4.2. Availability of Funds

A contract for this project will be awarded and deemed binding only to the extent of appropriated funds for the purpose set forth in this RFP.

4.2.1. Federal funds: If the source of funds for this contract is federal funds, the following federal provisions apply pursuant to 2 C.F.R. § 200.326 and 2 C.F.R. Part 200, Appendix II (as applicable):

Equal Employment Opportunity (41 C.F.R. Part 60); Davis-Bacon Act (40 U.S.C. 3141-3148); Copeland “Anti- Kickback” Act (40 U.S.C. 3145); Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708); Rights to Inventions (37 C.F.R. § 401.2)Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387); Debarment and Suspension (Executive Orders 12549 and 12689); Byrd Anti-Lobbying Amendment (31 U.S.C. 1352); Procurement of Recovered Materials (2 C.F.R. § 200.323); Record Retention Requirements (2 CFR § 200.324); Prohibition on Certain Telecommunications (2 C.F.R. § 200.216); and Domestic Preferences for Procurements (2 C.F.R. § 200.322)

4.3. Non-Discrimination

The Bidder shall not discriminate against any individuals and will take proactive measures to assure compliance with all Federal and State requirements concerning fair employment, employment of people with disabilities, and concerning the treatment of all employees without regard to discrimination based upon age, race, color, religion, sex, national origin, or disability.

4.4. Collusive Bidding

The Bidder’s signature on the Bid Form is a guarantee the prices quoted have been arrived at without collusion with other eligible Bidder(s) and without effort to preclude the County from obtaining the lowest possible competitive price.

4.5. General Indemnity

The Bidder shall save and hold harmless, protect, defend and indemnify the County (including the County Manager, the Board of Commissioners, as well as Rowan County officers, agents and employees) from and against any demand, claim, suit, loss, expense or damage which may be asserted against any of them in their official or individual capacities by reason of any alleged damage to property, or injury to, or death of, any person arising out of, or in any way related to, any action or inaction of the Bidder (including its officers, agents and employees) in the performance or intended performance of this contract, or the maintenance of any facility, or the operation of any program, which is the subject of, or is related to, the performance of this contract. The obligations of the Bidder pursuant to this paragraph shall not be limited in any way by any limitation in the amount or type of proceeds, damages, compensation or benefits payable under any policy of insurance or self-insurance maintained by, or for the use and benefit of, the Bidder. As an integral part of this contract, the Bidder agrees to purchase and maintain, during the life of this contract, contractual liability insurance in the amount required in the general liability insurance requirements and to furnish proper evidence thereof with the County named as an additional insured.

4.6. Assignment

The successful Bidder shall be the prime Contractor and shall be solely responsible for all contractual performance. The Bidder shall not assign, transfer, convey, sublet, or otherwise dispose of its agreements with the County, or its rights, title, 9or interests herein, or its power to execute such agreement, to any other person, company or corporation without the previous written consent and approval of the County.

4.7. References

The Bidder shall provide references of “like” customers the date, product(s) and services provided each business reference. The Bidder shall include in the reference information name, address, contact person(s), telephone number(s), e-mail address and any other information that may be deemed important and that will assist the County personnel in contacting the Bidder’s references. The County may request additional evidence of the Bidder’s experience, qualifications, ability, products, service facilities and financial standing for which the Bidder shall be prepared to provide to the County, if required.

4.8. Termination

4.9.1 Termination For Cause

The County reserves the right to terminate this contract at any time for cause. The violation of any provision or condition contained in this contract, or the refusal, failure, or inability to carry out any provisions of this contract shall constitute sufficient cause to terminate this contract for cause. Should the County elect to terminate this contract for cause, the County will notify the Contractor in writing and shall specify the cause for termination and the date that such termination shall be effective. Immediate dismissals may be executed if deemed necessary by the County.

If the Contractor:

1. Fails to begin the work under the contract within the time specified.

2. Fails to perform the work with sufficient workers and equipment, or with sufficient materials to ensure the prompt completion of the work.

3. Performs the work unsuitably.

4. Discontinues the prosecution of the work.

5. Becomes insolvent, declares bankruptcy, commits any act of bankruptcy, allows any final judgment to stand against him unsatisfied for a period of forty-eight (48) hours, or shall make an assignment for the benefit of creditors.

6. Shall not carry on the work in an acceptable manner from any other cause whatsoever.

The County shall give notice in writing to the Contractor of such delay, neglect, or default, specifying the same.

If the Contractor, within a period of ten (10) days after such notice, shall not proceed in accordance therewith, then the County shall, upon written certification of the fact of such delay, neglect or default, and the Contractor’s failure to comply with such notice, have full power and authority, without violating the contract, to take the prosecution of the work out of the hands of the Contractor, to appropriate or use any or all materials and equipment on the grounds as may be suitable and acceptable, and may enter into an agreement for the completion of the contract according to the terms and provisions thereof, or use such other methods as, in its opinion, shall be required for the completion of this contract in an acceptable manner.

All costs and charges incurred by the County, together with the costs of completing the work under the contract, shall be deducted from any monies due or which may become due to the Contractor. In case the expense so incurred by the County shall be less than the sum which would have been payable under the contract, if the contract had been completed by the Contractor, then the Contractor shall be entitled to receive the difference, and in case such expense shall exceed the sum which would have been payable under the contract, then the Contractor shall be liable and shall pay to the County the amount of said excess.

4.9.2 Termination for Convenience

If the County shall determine that it is in the County’s best interest, the County shall notify the Bidder to terminate the work within seven (7) days. In such event, the Bidder shall be entitled to compensation for all work properly executed and any expenses incurred in terminating the contract and vacating the County work site.

No claim shall be made by the Bidder for any loss of anticipated profits because of any alteration, change or termination, or by reason of any variation between the approximate quantities and the quantity of work as done.

5. Section 5: Scope of Work

5.1. Locations

The County has two Detentions Centers:

• Main Detention Center (Site 1) is located at 115 West Liberty Street, Salisbury, NC 28144 and is a four-story facility that provides housing to male and female adult inmates within ROWAN COUNTY. The total capacity of the Main Detention Center (Site 1) is 210 inmate beds.

• Jail Annex (Site 2) is located at 400 Grace Church Road, Salisbury, NC 28144 and is a one-story facility that provides housing to male adult inmates within ROWAN COUNTY. The total capacity of the Jail Annex (Site 2) is 160 inmate beds.

5.2. General Information

• Rowan County will provide utilities, phone service, internet access, copy machine and fax machine for the use of the chosen provider.

• Rowan County equipment that may be used by the chosen provider include an exam table, two stools, beam scale, dial scale, procedure light with magnifier, nebulizer, AED in booking and other areas in the facility, digital blood pressure monitor, blood glucose monitor and various other small medical and office equipment.

• The following are experience number estimates over the last 12 months:

o >4000 inmates seen for sick call.

o We have chronic care patients that the providers order labs for, but no chronic care clinic.

o Approx. 105 on-site x-rays.

o 100 – 150 on-site emergencies.

o 50-70 off-site emergencies.

o >200 inmates on medication.

o inmates with HIV.

o 40-50% of inmates on medication are psychotropic medications.

o >200 inmates sent to offsite providers.

o No immunizations given.

o All dentals are sent out to oral surgeon/provider.

o 150-200 inmates on suicide watch.

o Approx. 150 instances of Lab work include CBC, BMP, INR, Lipids, LFT.

o In-patient hospitalizations include seizure, cardiac, falls, psychotic episode, dehydration, various injuries occurring in detention center.

o Less than 5 psychiatric in-patient hospitalizations.

o Greater than 50% of inmates have a substance abuse problem.

• The proposer should offer a pricing option for TB testing for Sheriff’s Department employees.

• The Rowan County Detention Center utilizes a Jail Management System from CentralSquare, OneSolution

JMS on-premises.

• The Rowan County Detention Center currently utilizes an Electronic Medical Record (EMR) system under contract with WellPath. The EMR system proposed should be web-based and not require any on-premises software and should be operated, maintained and secured by the provider. It is expected that all access to this system is secured via individual user authentication with MFA. Any integrations with the Rowan County on-premises OneSolution JMS software should be coordinated with Rowan County IT and CentralSquare.

All costs should be included for any integrations required for daily operations.

• If there are any unique technologies that are used, the provider will be responsible for those costs including installation and cabling as needed. All equipment proposed will be reviewed with Rowan County IT for integration in as there is an expectation that only Internet access will be needed.

• The age bands for the jail population by percentage are:

o 18 – 25 32% o 25 – 40 41% o 40 – 55 23% o 55+ 4%

• The current health record management process is manual/paper files as well as utilizing the OSSI Jail Management System.

• The ALOS for inmates at the Rowan County Detention Center is about 90 days. This average does not include 36 inmates that have been housed for over 365 days. The longest tenured inmate has been housed for over 1,774 days.

• Current utilization management process for acute care hospital services is a recommendation by the nurse to the Physician. The Physician would then contact either ProMed (local multispecialty provider), Novant Rowan Hospital, or other local hospital facility.

• Current sick call procedures:

o Inmate uses kiosk/paper to request to see nurse.

o Kiosk system automatically reports to Nurse to schedule daily visits.

Officer contacts nurse for emergency only.

o Nurse sees inmate for examination.

• Mental health services are to be handled by the contractor.

• The contractor will choose the most appropriate and cost-effective pharmacy to provide optimal service and price.

• Detox takes place in the one Detox cell or one of the three padded cells.

• There have been numerous pregnant women in the Rowan County Detention Center over the last 17 years.

There is not a current OB/GYN provider under contract, but the pregnant inmate would be seen by an available hospital choice if necessary. There is not an expectation that every pregnant woman be seen regardless of length of stay.

• The current lab provider is Labcorp. Labcorp picks up blood drawn by the nurse at the Detention Center.

• Rowan County Detention Center is not currently NCCHC/ACA accredited.

• It is expected that the chosen provider will execute its own specialist contracts, hospital services contracts and claims payment services.

• Rowan County will not consider proposals that do not accept financial risk for outside medical services.

• Rowan County will use a scoring matrix for proposals that applies equal weighting to quality of response to services, capacity to manage and provide services proposed, experience in detention center healthcare, quality of references and price. The provider offering the proposal that is deemed the best overall proposal for Rowan County will be chosen. This will not necessarily be the proposal offering the best price.

5.3. Objectives

Each response will be evaluated as to its achievement and compliance with the following stated objectives.

Specific services desired are described under Specifications:

• To operate the healthcare program in a cost-effective manner with full reporting and accountability to the Rowan County Sheriff, the Rowan County Detention Center Administrator and Rowan County Management.

• To operate the healthcare program at sufficient staffing to attend to inmate medical needs and use only licensed, certified, and professionally trained personnel.

• To implement a written healthcare plan with clear objectives, policies, and procedures.

• To operate the healthcare program in a humane manner with respect to the inmate’s right to basic healthcare services.

• To deliver high quality basic healthcare services that can be audited against established standards and sufficient for accreditation by the National Commission of Correctional Health Care and the American Correctional Association.

• To maintain an open and cooperative relationship with the administration and staff of the Detention Center and be sufficiently flexible to respond to unforeseen mandates and inmate population needs.

• To maintain complete and accurate records of care and to collect and analyze health statistics on a regular basis.

• To establish a comprehensive medication assisted treatment (MAT program) to include but not limited to:

o A program that would manage up to 100 individuals in the induction or maintenance stage.

o Manage an OTP Program o Induction – Upon request of individuals, or identification of condition by the contracted LCAS.

o Maintenance – sustainment of community providers, as well as continuity of care during confinement.

o Discharge planning – contracted LCAS coordination with community resources.

5.4. Qualifications & Requirements

Rowan County requires that any contractor meet the following minimum qualifications and must contain all requirement. Failure to meet each of these qualifications may result in the contractor’s disqualification.

5.4.1 Minimum Qualifications

• The contractor must be organized for the purpose of providing correctional healthcare services and must have at least five (5) continuous years of experience with proven effectiveness in administering healthcare programs, with preference to experience in inmate healthcare services.

• The contractor must demonstrate its ability to provide a healthcare system specifically for the Rowan County Detention Center. It must be able to demonstrate that it can complete the startup process in 90 days from the contract award date.

• The contractor must carry professional liability insurance in the amount of $1,500,000 per occurrence and $3,000,000 in the aggregate.

• The contractor must be able to provide qualified and licensed staff with sufficient back-up personnel (including provisions for inclement weather).

5.4.2 Mandatory Requirements

• All proposals must contain sufficient information concerning the Inmate Healthcare Program for the Detention Center to evaluate whether or not the contractor meets “Minimum Qualifications for All Contractors.”

• All proposals must list by name, address and administrator of healthcare systems, programs, and correctional institutions where contractor has prior experience or is currently providing medical care and the length of time in effect. This list will be used as a source of references for the contractor.

• All proposals must contain a full and complete staffing plan to provide minimally desired or recommended level of coverage and explain how medical, mental health and dental care for inmates at both Detention Centers will be delivered and at what levels of service.

• All proposals must contain a specific annualized price for a base population of up to 300 inmates for all medical care rendered under this contract (See also 4(b) below).

o If the Provider wishes to state one price for the first 12-month term of the contract and another for subsequent years, that is acceptable. Any other exceptions to the specific price shall be stated, such as per diem charge for an increase in average daily population above the base level.

o The cost of services must be stated with detail for the following options. A price must be provided which includes:

Contract cost per year for all services as outlined in this RFP as proposed to include Mental

Health Services.

Cost per year for any additional, optional services as described under Specifications.

Additionally, the contractor shall structure pricing options for different levels of services other than that minimally required (e.g., 12 hour / 7 day per week, and 24 hour / 7 day per week nursing coverage).

Rowan County is willing to share responsibility for the costs of medical care in excess of certain limits in order to assist the proposer in predicting its costs and potential liabilities.

All proposals must specifically state the limits of responsibility so proposed, and how Rowan County would share in these costs once those limits have been reached. County is suggesting a 50/50 split of the cost overages between the county and the company.

• The contractor must provide a yes/no response to the following with comments only as deemed necessary to indicate how resolved. Indicate the contractor’s experience in the past five years:

o Were grievances or formal complaints filed against the organization?

o Were lawsuits or judgments filed?

o Was there a default or breach of contract?

o Were there investigations of fraud, abuse, conflict of interest, or criminal activities?

o Where there any security breaches involving inmate medical records maintained by the organization’s EMR?

o Did this organization or parent organization declare bankruptcy or go into receivership?

o Were there any inmate fatalities or serious injuries that could in any way be proximately linked to the standard of care provided by the proposer organization at any of its contract facilities (include facility name, incident details and specific allegations, along with current status/disposition.)

• The contractor must include with the proposal the completed Authorized Signature Form included with this RFP.

5.5. Specifications

Contractor shall be the sole supplier and/or coordinator of the healthcare delivery system at the Detention Center and Detention Center Annex. Contractor shall be responsible for all medical care for all inmates at the Detention Center and the Detention Center Annex. The term “medical care” includes both “psychiatric and psychological care” as well as “dental care.” This responsibility of the Provider for the medical care of any inmate commences with the commitment of the inmate to the custody of the administration of the Detention Center (after pre-booking injuries and illnesses have been treated) and ends with the discharge of the inmate from the custody of the Rowan County Detention Center.

Healthcare services must be provided using National Commission of Correctional Health Care Standards and the North Carolina Jail Standards governing the health care of detainees (10A NCAC 14J – Section .1000.)

Provider must recruit, interview, hire, train, schedule and supervise all healthcare staff to meet all conditions and specifications as set forth in the solicitation, the proposal selected, and the resulting contract. Stationed at each detention center, and at minimum, nursing staff shall be scheduled to provide onsite nursing coverage 24 hours per day, Monday through Friday; 24 hours per day on Saturday and Sunday and on-call services for non-staffed periods, in addition to physician and other medical services providers described below. Provider shall specify levels of nursing care (PA/RN/LPN) for all coverage periods. Nurses will manage the distribution of all inmate prescriptions in order to eliminate the need for detention officers to perform this task. All medical staff providing services under this contract must be licensed to practice in the State of North Carolina. The provider agrees to interview and give first priority to existing medical staff. If provider does not maintain these minimum staffing levels, the County may impose a penalty of up to $250 daily for staffing shortfalls.

Provider shall identify the need, schedule, coordinate and pay for all physician services rendered to inmates inside or outside the Detention Center. At a minimum, Contractor shall identify a “responsible physician” who shall conduct sick call and generally provide such care as is available in the community.

The “responsible physician” or another covering physician shall be on call to the nurse seven (7) days per week, twenty-four (24) hours per day for emergencies.

Provider shall review the Receiving Screening Form that is completed by officers on all new commitments to the Detention Center within twenty-four (24) hours of arrival at the detention facility. Such review shall be conducted by a licensed medical professional.

Provider shall provide a special medical program for inmates requiring close medical supervision, including chronic and convalescent care needs. The Proposer must include specific guidelines for housing standards of these inmates. Requirements to be included are:

o Each inmate assigned this classification must have a written individualized treatment plan developed by a physician:

o Inmates committed under the influence of alcohol or drugs must monitored must be kept under close observation for a reasonable time period utilizing the COW and CIWAA protocols;

o Inmates with suicidal tendencies and those with a history of seizures, as determined by a medical authority, must be assigned to quarters that have close observation; and o A physician must determine pharmacological or non-pharmacological support care.

A standard form will be used for purposes of recording the information of the Receiving Screening and will be included in the health record of the inmate.

Provider shall identify the need, schedule, coordinate and pay for preventative care for inmates to prevent unnecessary offsite visits to ER.

Provider shall identify the need, schedule, coordinate and pay for all non-emergency and emergency medical care rendered to inmates inside or outside the Detention Center.

Provider shall identify the need, schedule, coordinate and pay for any inpatient hospitalization of any inmate of the Detention Center, subject to any proposed limits of liability. This shall include all institutional charges, physician charges and any and all additional charges for medical care. This also includes responsibility for making emergency arrangements for ambulance service to the inpatient facility and reimbursement to the local ambulance organization for the services provided as well as establishing response protocols with the Rowan County EMS for emergency medical responses where ambulance transportation is necessary.

Provider shall identify the need, schedule, coordinate and pay for all supporting diagnostic examinations, both inside and outside the Detention Center. Provider shall also provide and pay for all laboratory services, as indicated.

Provider shall provide the necessary follow-up for health problems identified by any of the screening tests or laboratory tests.

Provider shall identify the need, schedule, coordinate and pay for mental health services rendered to inmates inside the Detention Center. The cost of court-ordered evaluations and any inpatient hospital commitments at a state facility will not be a part of the Provider’s responsibility.

Provider shall provide Emergency dental services which shall be available on a 24-hour a day basis.

Provider shall provide a total pharmaceutical system for the Detention Center beginning with the physician’s prescribing of medication, the filling of the prescription, the dispensing of medication, and the necessary record keeping. The Provider shall be responsible for the costs of all drugs administered.

The pharmaceutical system shall include prescription medications and over-the-counter medications. All prescription medications shall be prescribed by the responsible physician. All controlled substances, syringes, needles and surgical instruments will be stored under security conditions acceptable to the Detention Center and in accordance with DEA regulations and acceptable NCCHC & ACA standards.

Provider shall provide and pay for additional equipment deemed necessary beyond that presently at the facilities and for supplies used in the healthcare delivery system administered under this contract at the current facilities.

Provider shall maintain complete and accurate medical and dental records separate from the Detention Center confinement records of the inmate. In any criminal or civil litigation where the physical or mental condition of any inmate is at issue, Provider shall provide the Sheriff or County Official with access to such records and, upon request, provide copies.

Provider will provide quality assurance, to include a systematic investigation of inmate grievances and complaints, and evaluation of cost containment, service provision, and concurrence with standards referenced in Objectives Section.

Provider shall provide a consultation service to the Sheriff (or Detention Center) or County Official on any and all aspects of the healthcare delivery system at the Detention Center, including evaluations and recommendations concerning new programs, architectural plans, staffing patterns for new facilities, alternate pharmaceutical and other systems, and on any other matter relating to this contract upon which Rowan County seeks the advice and counsel of the Provider.

Provider shall inform Rowan County of any security or network breaches reported as it relates to the EMR system housing Rowan County Detention Center inmate records.

A comprehensive monthly and annual statistical report forwarded to the Contract Administrator and the Sheriff of Rowan County in accordance with the American Medical Association Standards and requests of the Contract Administrator and Jail Administration. Monthly narrative reports shall be submitted on the tenth (10) calendar day of each month to the Contract Administrator and the Sheriff, with data reflecting the previous month’s workload, to include:

o Deaths o Suicide data (i.e. attempts and precautions taken);

o Safekeeping admissions;

o Ambulance transports In and Out;

o Transfers to off-site hospital emergency departments;

o Off-site hospital admissions;

o Off-site ambulatory procedures;

o Report of status of inmates in local hospitals and medical observation area/infirmary;

o Inmates/residents seen by the physician;

o Medical observation area/Infirmary admissions, patient days, average length of stay;

o Medical specialty consultation referrals o Inmates/residents seen at sick call;

o Inmates/residents requests for various services (screened);

o Fourteen (14) day history and physical assessments;

o Intake medical screening;

o Inmates/residents seen by mental health professionals;

o Inmates/residents seen by the dentist;

o Diagnostic studies;

o Communicable disease reporting;

o Staffing;

o Report of third-party reimbursement, pursuit and recovery;

o Summary of completed medical incident report. (As part of quarterly QI meeting);

o Summary of completed medical grievance report. (Number presented monthly, discussion at quarterly Medical Audit Committee meeting);

o Monthly report of required ACA measurement outcomes.

Required Staffing Pattern (Total for both detention centers, one employee is to be onsite at all times):

o Health Service Administrator/RN (1 FTE) o Medical Director/DO o Nurse practitioner o Registered Nurses (2 FTE) o Licensed Practical Nurses (4 FTE) o PRN Registered Nurse o Part time Registered Nurse o Psychiatrist o Mental Health Nurse Practitioner o Mental Health Clinician (FTE) o Administrative Assistant

5.6. General Conditions

• The duration of this contract shall be from July 1, 2024, until June 30, 2027. Thereafter, this contract may be extended, upon agreement of the parties, for two (2) subsequent one-year terms. Contract renewal quotations shall be submitted no later than March 1 of each subsequent year. Renewal Quotations shall be valid for 120 days. Please indicate in the bid response when your company may begin services. It is understood that this service takes time to set up and get going. Time is of the essence in this bid process.

• The healthcare delivery system must conform to State standards for medical services provided in correctional institutions as established by the Department of Corrections or other appropriate State authority, or by statute.

The system must be in conformance with standards developed by the National Commission on Correctional Health Care (NCCHC) and North Carolina Minimum Standards for Jails (10NCAC 14J – Section .1000).

• Provider shall be required to examine and treat any inmate in segregation or otherwise unable to attend sick call in the cell of said inmate. Provider shall be required to render emergency care at any location on Detention Center property.

• Provider shall have no responsibility for security at the Detention Center or for the custody of any inmate at any time, such responsibility being solely that of the Detention Center. Provider shall have sole responsibility in all matters of medical, mental health and dental judgment. Provider shall have primary, but not exclusive, responsibility for the identification, care and treatment of inmates requiring medical care and who are “security risks” or who present a danger to themselves and others. On these matters of mutual concern, the Provider shall support, assist, and cooperate with the Sheriff and his staff whose decision in any non-medical matter shall be final. All decisions involving the exercise of medical, mental health or dental judgment are still the responsibility of the Provider.

• Provider shall indemnify and hold harmless Rowan County and its agents, servants and/or employees from all claims, actions, lawsuits, damages, judgments, or liabilities arising out of the healthcare delivery system at the Detention Center. Conversely, Rowan County shall indemnify and hold harmless Provider, its agents, servants and/or employees and /or medical and/or healthcare staff from any and all claims, actions, lawsuits, damages, judgments or liabilities arising out of the operation and maintenance of the Detention Center, including maintaining security.

• Provider shall have professional liability insurance coverage with limits of at least $1,500,000 per occurrence and $3,000,000 in the aggregate under such coverage. This insurance shall specifically cover provider and the services provided under this contract. Evidence of such insurance shall be presented to the County prior to the execution of the contract. Failure to maintain such insurance shall be grounds for immediate termination of this contract.

• Policies and Procedures of the Provider relating to medical care are generally to be established and implemented solely by the Provider. In areas that impact upon the security and general administration of the Detention Center, the Policies and Procedures of the Provider are subject to review and approval of the Sheriff. The Sheriff retains the right to review and approve Policies and Procedures of the Provider in an area affecting the performance of his responsibilities under law.

• Neither the obligations nor the rights of the Provider under any resulting contract may be assigned by the Provider without the express written consent of The Sheriff and Rowan County, whose consent shall not be unreasonably withheld.

• The contractor should provide, along with the response to this RFP, a sample contract for consideration, in case the contractor should be awarded the contract.

• The contractor shall permit the Sheriff of Rowan County to conduct any necessary background investigations of all personnel assigned to the facility and shall permit the Sheriff (or his designee) to disqualify any employee he reasonably believes to be a safety or security risk to the facility. All employees assigned to the facility shall abide by the facility’s operational policies and procedures. The Sheriff reserves the right to require the provider to replace any provider-assigned staff member at any time without cause. These requirements will remain in effect throughout the duration of the contract period(s).

6. Section 6: Definitions:

ACA STANDARDS - The standards for Adult Correctional Institutions published by the American Correctional Association.

ACUTE CARE - This level of care requires 24-hour physician and nursing care with 24-hour ancillary on-call hospital departments available. Examples of acute care patients are post-trauma, surgical patients with post-operative complications, unstable cardiac conditions, patients on ventilators, etc. The ALOS is 3-5 days and may extend up to 30 days in unusual circumstances.

ALOS - Average Length of Stay.

CHRONIC AMBULATORY CARE - This level of care does not require inpatient…