STATE OF NEW HAMPSHIRE

NH DEPARTMENT OF CORRECTIONS

REQUEST FOR PROPOSAL

COMPREHENSIVE HEALTHCARE SERVICES

RFP NH DOC 2025-05

ISSUE DATE: March 3, 2025

CLOSING DATE: April 1, 2025

State of NH, Department of Corrections

Comprehensive Healthcare Services

Promoting Public Safety with Respect, Professionalism, Dedication and Courage as One Team

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

Vendor Initials: __________

Date: __________

Table of Contents

SECTION A: OVERVIEW AND SCHEDULE

1. Executive Summary

2. Current Population

3. Schedule of Events (Timetable)

4. Vendor Conference

5. Goals and Objectives

6. Minimum of Vendor Qualifications

7. Requested Contracted Services

SECTION B: DESCRIPTION OF AGENCY/DIVISION/PROGRAM

SECTION C: GENERAL SCOPE OF SERVICES

1. Description of Service

2. Required Mental Health Services

3. Administrative Services

4. Key Medical, Dental and Mental Health Performance Indicators

5. On-Site Clinical Laboratory and Phlebotomy Services

6. General Service Provisions

7. Other Contract Provisions

SECTION D: PROCESS FOR SUBMITTING A PROPOSAL

1. Proposal Submission Deadline, Labeling, Addressing Instructions

2. Hard CopySubmission Criteria

3. Contact Information – Sole Point of Contact

4. Proposal Inquiries

5. Addendum(s) or Withdrawal of RFP

6. Restriction of Contact with NHDOC Employees

7. Validity of Proposal

8. Alternations/Changes to RFP and Associated Documents

9. Sub-contractors

10. Rejection of Proposal

11. Remedies for “Minor Irregularities” of a Proposal

SECTION E: CONTENT AND REQUIREMENTS FOR A PROPOSAL

1. Proposal Organization

SECTION F: EVALUATION OF PROPOSALS

1. Evaluation Criteria and Scoring

2. Proposal Review

3. Planned Evaluations

4. Initial/Procedural Screening of Technical Proposals

5. Preliminary Technical Scoring of Proposals

6. Final Technical Scoring of Proposals

7. Cost Proposal Review

8. Best and Final Offer (BAFO)

9. Final Selections

10. Rights of the NH Department of Corrections

SECTION G: TERMS AND CONDITIONS RELATED TO THE RFP PROCESS

1. RFP Addendum

2. Non-Collusion

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

3. Property of the State

4. Confidentiality of a Proposal

5. Public Disclosure

6. Non-Commitment

7. Proposal Preparation Cost

8. Ethical Requirements

9. Challenges on Form or Process of the RFP

SECTION H: AGREEMENT TERMS AND AWARD

1. Non-Exclusive Agreement

2. Award

3. Standard Contract Terms

4. Special Terms (If Applicable)

SECTION I: APPENDIXES

Appendix A – Transmittal Letter

Appendix B – Exception to Terms and Conditions

Appendix C – Standard Terms and Conditions

FORM NUMBER P-37 (version 2/23/2023)

EXHIBIT A - SPECIAL PROVISIONS

SCOPE OF SERVICES - EXHIBIT B

1. Purpose

2. Term of Agreement

3. Location of Services

4. Current Population

5. Description of Service

6. Requestd Contract Services

7. Required Medial Dental and Mental Health Services

8. Administrative Services

9. Key Medical, Dental and Mental Health Performance Indicators

10. On-Site Clinical Laboratory and Phlebotomy Services

11. General Provisions

12. Other Contract Provisions

13. Minimum Required Services

14. General Service Provisions

15. Change of Ownership

16. Contractor Designated Liaison

17. Contractor Liaison’s Responsibilities

18. NH Department of Corrections Contract Liaison Responsibilities

19. Reporting Requirements

20. Performance Evaluation

21. Performance Measures

22. Bankruptcy or Insolvency Proceeding Notifications

23. Embodiment of the Agreement

24. Cancellation of Agreement

25. Contractor Transition

26. Audit Requirement

26. Notification to Contractor

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

27. Additional Information

28. Contractor Personnel

29. Non-Exclusive Contract

EXHIBIT C - ESTIMATED BUDGET/METHOD OF PAYMENT

PROPOSAL CHECK SHEET

GLOSSARY OF TERMS

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

SECTION A: OVERVIEW AND SCHEDULE

1. Executive Summary

1.1. Purpose: The purpose of this Request for Proposal (RFP) is to seek Comprehensive Healthcare

Services for NH Department of Corrections (herein known as the “NHDOC,” “State,” or

“Department”). All healthcare services shall be provided based on generally accepted standards of care, in accordance with federal and State of NH laws, NHDOC policies, initiatives and in the most cost effective and efficient manner possible in the following areas:

• Medical Services;

• Dental Services;

• Mental Health Services;

• On-Site Phlebotomy and Clinical Laboratory Services

1.2. Performance Period: Contract(s) awarded as a result of this RFP is anticipated to be effective upon

Governor and Executive Council (G&C) approval for the period beginning July 1, 2025 through

June 30, 2028. NHDOC shall have the option to extend the term of this for Agreement services for one (1) additional term not to exceed two (2) years, subject to the Parties’ prior written agreement on terms and applicable fees for the additional term, satisfactory vendor performance, continued funding, and Governor and Executive Council approval.

1.3. Location of Services:

1.3.1. Services shall be performed at the following NHDOC locations.

Northern NH Department of Corrections Facility

Northern NH Correctional Facility (NNHCF) 138 East Milan Road, Berlin NH 03570

Southern NH Department of Corrections NH Facilities

NH State Prison for Men (NHSP-M) 281 North State Street, Concord NH

03301 Secure Psychiatric Unit (SPU)/Residential Treatment

Unit (RTU)

NH Correctional Facility for Women (NHCF-W) 42 Perimeter Road, Concord NH 03301

NH Department of Corrections Transitional Units

North End Transitional Housing Unit (NEH/THU) 1 Perimeter Road, Concord NH 03301

Concord Transitional Work Center (TWC)

275 North State Street, Concord NH

03301

Shea Farm, Transitional Housing Unit (THU) 60 Iron Works Road, Concord NH 03301

Calumet House, Transitional Housing Unit (THU) 126 Lowell Street, Manchester NH 03104

1.3.2. Locations may be added and/or deleted after the awarding of an Agreement at the discretion of the Department and upon mutual agreement of the Commissioner of

NHDOC and Contractor.

1.3.3. In the event that NHDOC wishes to add or remove facilities at which Contractor is to provide services, it shall:

• Give Contractor fourteen (14) days written notice of the proposed change; and

• Secure Contractor’s written agreement to the proposed changes.

1.3.4. Notwithstanding the foregoing, or any provision of this Agreement to the contrary, in no event shall changes to facilities be allowed that modify the “Completion Date” or “Price

Limitation” of the Agreement.

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

2. Current Population

3. Schedule of Events (Timetable)₁

The following table, provides a Schedule of Events for this RFP through contract finalization and approval by the Governor and Executive Council. NHDOC reserves the right to amend this schedule at its sole discretion and at any time through a published Addendum that will serve as a Public Notice.

Event # Description of Event Date of Event

1 RFP Issued 3/3/2025

2 Vendor Conference 3/13/2025 at 2:00 PM

3 Vendor Written Inquiries/Questions Due 3/20/2025 at 2:00 PM

4 NHDOC Posts Answers to Inquiries 3/26/2025

5 Proposals Due 4/1/2025 at 2:00PM

6 Evaluation of Proposals 4/18/2025

7 Best & Final Offer TBD, if applicable

8 Anticipated Contract Finalization May 2025 Year

9 Anticipated Approval by the Governor and Executive Council May 2025

10 Expected Services Start Date July 1, 2025

₁Note: NHDOC, with the exception of Event #5: “Proposals Due”, may alter the above Schedule of Events (Timetable) at any time. Vendor’s

“Proposals Due” date cannot be changed in order to maintain the integrity of the public contract procurement process of the State of New

Hampshire except for the reasons as stated in Section D: Process for Submitting a Proposal, Subpart 5.3., Addendum(s) or Withdrawal to/or this RFP and Section G: Terms and Conditions Related to the RFP Process, Notice of any such changes will be posted to the NHDOC and

Department of Administrative Services (DAS) websites and will be entitled Addendum and will serve as a Public Notice.

4. Vendor Conference

A pre-proposal meeting will be held to respond to written questions and provide any needed additional instruction to Vendors on the submission of the proposals. All Vendors who intend to respond to this RFP shall be prepared to attend the pre-proposal meeting. A tour of the facilities impacted in this RFP will also be conducted.

Date: March 13, 2025 Time: 2:00

Location for start of tours: 42 Perimeter Road, Concord NH 03301 (GPS 281 North State Street-

Concord NH 03301), as this is located in front of site or known as NH Correctional Men’s Prison.

For security clearance, Vendors interested in attending the Vendor Conference, MUST contact

Barbara Mitera at 603-271-7468 or Barbara.A.Mitera@doc.nh.gov BEFORE 12:00 NOON, MARCH 10, 2025 with the following information.

° Legal name of attendee

° Driver’s License Number and State

° Date of Birth

5. Goals and Objectives

The goals and objectives of a contract resulting from this RFP are:

Northern NH Correctional Facility (NNHCF) Berlin, NH 03570 547

NH State Prison for Men – (NHSP-M) Concord, NH 03301 1,056

Secure Psychiatric Unit (SPU)/Residential Treatment Unit (RTU) Concord, NH 03301 64

Division of Rehabilitative Services Concord, NH 03301 185

NH Correctional Facility for Women – (NHCF-W) Concord, NH 03301 112

*information obtained as of 6/24/2024

NH Department of Corrections Current Average Population

Current Average Patient Population:

mailto:Barbara.A.Mitera@doc.nh.gov

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

• To provide comprehensive health care services to the people incarcerated within the NHDOC facilities that is consistent across all NHDOC facilities and complies with departmental policy as well as in line with professionally sound research and science. This includes adequate professional staffing coverage plans when regularly assigned staff cannot be available.

• To ensure high quality and constitutionally appropriate comprehensive health services.

• To deliver services in a manner consistent with applicable State of NH statutes, rules as well as federal laws and constitutional requirements. In addition, adherence to standards promulgated by national recognized regulatory bodies such as Affordable Care Act (ACA), National Commission on Correctional Health Care (NCCHC), and Joint Commission as determined by the NHDOC.

• To treat people with respect and dignity in all interactions and encounters.

• To establish reports and other mechanisms to ensure accountability, track efficiency and effectiveness of services and staffing provided.

• To maintain documentation of services provided that is accurate, complete, thorough and comprehensive including but not limited to diagnosis for which treatment is being rendered and course of care and in keeping with the Department’s Electronic Health Record (EHR).

• To audit services, impact of services on costs and staffing fulfillment through a system of quality improvement and risk management principles.

• To maintain staffing levels within prescribed guidelines and patterns identified in this proposal.

• To provide appropriately credentialed and licensed/certified/registered staff.

• To initiate systems for recruitment and retention of qualified professional staff.

• To enhance staff skills through ensuring training and orientation to departmental policies and procedures, within keeping with national published standards for correctional healthcare, in-line with correctional healthcare case law resulting in job satisfaction and increased outcomes with patient care.

• To ensure communication is open and forthright regarding all issues relative to the contract and

State.

• To work both cooperatively and collaboratively with State toward the common goal of quality and affordable and appropriate health care.

6. Minimum of Vendor Qualifications

This section lists the criteria to be considered in evaluating the ability of firms interested in providing the service(s) and/or product(s) specified in this RFP. Firms must meet or exceed these qualifications to be considered for award. Any exceptions to the requirements listed should be clearly detailed in proposer’s response. Proposers shall:

• Have a minimum of five (5) years’ experience in providing services similar to those specified in this

RFP.

• Have an applied understanding of industry standards, certifications and best practices.

• Have successful experience in managing projects of comparable size and complexity to that being proposed.

• Have knowledge of and comply with all currently applicable, and as they become enacted during the contract term, federal, state and local laws, statutes, ordinances, rules and regulations.

• Provide project supervision (as required) and quality control procedures.

• Have appropriate material, equipment and labor to perform specified services.

7. Requested Contracted Services

Specific professionals are being sought to fulfill the range of services needed to ensure a responsive, clinically appropriate, and comprehensive healthcare services. These contracted services will work in collaboration with our state healthcare staff and other correctional team members to ensure an adequate and safe healthcare delivery system to meet the needs of our resident population. All contracted employees shall be qualified and licensed to perform the necessary duties in the State of NH related to their scope of service. All healthcare staff are located on site with some travel/movement among

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05 facilities required to meet staffing needs in the event of vacancies, changes in staffing due to illness or vacation, staffing efficiencies and possible emergencies. All contracted healthcare staff will be expected to participate in quality assurance activities as appropriate to their role. All healthcare staff will be expected to engage in initial resident assessment activities as appropriate to their role. At all times, services shall be provided in accordance with federal laws, state laws and administrative rules, NHDOC policy, and industry standards. Professionals to provide the following services are sought via this RFP.

7.1. Medical Staff - for the provision of routine, acute, chronic, and primary care evaluation, and treatment. Basic emergency response, development of treatment plans, and coordination of care with community healthcare partners and NHDOC staff is also expected. This includes medical assessment at the time of reception into our facilities. Those in this group must be able to perform the majority of their tasks independently including an understanding of various treatment modalities (including providing addiction treatment medications.) for a wide range of medical issues. The settings are both an outpatient setting and infirmary level of care within a correctional system. On-call services are part of the expectation to ensure continuity of care twenty-four (24) hours a day for three hundred, sixty-five (365) days a year.

T h i s does include facility visits after hours, weekends, and holidays for admissions and urgent/emergent care. A medical case manager, who shall assist in managing medically complex cases, those hospitalized, medical parole cases and resolving resident medical concerns, is also sought. Medical assistants to ensure coordination of care and support to provider staff, is also part of this RFP, a Chief Medical Officer (CMO) is sought.

The CMO, medical providers, and medical assistants shall be based at NHDOC facilities. The medical case manager shall have an off-site office provided by the vendor. The CMO, medical providers, and medical assistant positions are not remote positions.

7.2. Mental Health Staff - for the provision of mental health services that include but not limited to psychosocial, clinical, addiction services and pharmaceutical modalities, as well as providing routine, individual and group therapies, to residents who are acute and chronic as well as emergency services. Oversight and documentation of mental health treatment plans, including ongoing assessment and monitoring of residents on any level of mental health watch in accordance with policies, coordination of care with both contracted and state employees, and ability to provide appropriate services in a NHDOC inpatient facility, residential treatment settings, and general outpatient services to those who have a wide range of psychiatric disorders as diagnosed in the most current diagnostic and statistical manual of mental health disorders.

Psychiatric providers and are expected to provide sick call services and on call services to ensure continuity of care 24 hours a day. This includes facility visits after hours, weekends, and holidays for admissions, urgent and emergency care. Additionally, providing addiction treatment medication is expected. A psychologist position is being sought to provide assessment, evaluations, testing, management of special populations, and crisis intervention. A clinical coordinator (NGRI) to monitor, report and track those people civilly committed under the NH Not Guilty by Reason of Insanity statute (NGRI), who may be residing at varying levels of care across the NH Mental Health Delivery System, including living independently in the community. Licensed Alcohol and Drug Counselors (LADC) are part of the search for services to provide assessment and treatment for those with substance use disorders. Mental health clinicians are needed for management of a broad range of Mental health needs. A Chief

Psychiatric Officer (CPO) is sought to review, interpret and assist in development of policies and procedures in compliance with mental health laws, policies , and standards of care.

The CPO, psychiatric providers, LADCS, and mental health clinicians are not remote positions and shall have offices in facilities as determined by NHDOC. The NGRI coordinator and psychologist shall have office space located in Concord, NH at the expense of Vendor.

7.3. Dental Staff - to provide dental evaluation and treatment (including, but not limited to, partials

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05 and dentures, oral surgery, and dental hygiene services). Care provided can be routine, acute, or emergent. Dental sick call is expected, and a Chief Dental Office (CDO) is sought. Dental staff procured under this proposal shall be on site at NHDOC facilities.

7.4. Program Manager (PM) who shall serve as the Chief Administrator for Vendor and primary contact person to who is accountable to the NHDOC Director of Medical & Forensic Services.

This position must provide: Program Implementation, Contracted Staff oversight to compliance with general acceptable principles of respect and civility and compliance to their roles. Oversee the day-to-day operations of the program, ensuring activities are carried out efficiently and effectively. Monitor program timelines, deadlines, and deliverables to ensure program goals are met on schedule. Risk Management: Identify potential risks and challenges that may impact program success and develop mitigation strategies. Monitor and address issues as they arise to minimize disruptions to program operations.

7.5. Quality Improvement Analyst - who shall provide a wide range of duties to include Mental health training, suicide prevention and help develop monthly staff trainings. , conducting incident reviews, and organizing follow up strategies as a result of incident reviews, assisting in developing and executing a cohesive patient education program, and gathering and analyzing data to identify trends, establish a quarterly reporting mechanism to the Medical & Forensic

Services leadership, and to provide data to various stakeholders as determined by the NH

Department of Corrections to include utilization management strategies.

7.6. Administrative Assistant - one assistant to provide support to the Program Manager in fulfilling obligations incurred under this service request. This position will ensure that staff schedules, on call schedules and coverage schedules are distributed in a timely manner. Assist new hires under this contract complete orientation and all other correctional requirements.

7.7. Addictionologist - highly-educated physician who is board certified in addiction medicine from entities such as the American Board of Medical Specialties, the American Board of Preventive

Medicine, and the American Board of Psychiatry and Neurology. Seeking a skilled physician in addiction prevention as well as evaluation, diagnosis, and treatment. They will work to prevent, diagnose, and treat substance abuse-related health problems. Provide services for people struggling with problematic use of various substances including alcohol, nicotine, and prescription drugs.

Help to ensure that addiction treatment programs are designed to manage all rehabilitation-related challenges.

This position will play a key role in treating the symptoms of detox, prescribe medications to minimize withdrawal symptoms and reduce cravings. Lead the team to best practices and work closely with the LADC team, nursing, clinicians and other providers on the units and facilities.

This position is located at the NHSP-M.

SECTION B: DESCRIPTION OF AGENCY/DIVISION/PROGRAM

NHDOC is an executive agency of the State of New Hampshire charged with overseeing the State’s correctional facilities providing care and custody to residents, patients at the SPU and probation and parolees by providing safe, secure, humane supervision and evidence-based rehabilitation to enhance public safety in New Hampshire.

https://www.health.harvard.edu/topics/addiction https://www.health.harvard.edu/topics/addiction

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

SECTION C: GENERAL SCOPE OF SERVICES

1. Description of Services

Vendor shall provide services for Comprehensive Healthcare Services contract through a single provider to cover the needs to the residents of NHDOC at all sites listed above unless otherwise specified by NHDOC. Infirmary level of care and dental services are provided at NHSP-M, NNHCF, and NHCF-W. Residents in Division of Rehabilitative Services will be seen for infirmary and dental care at the appropriate facility. All residents will receive and intake screening per NHDOC policy and national standards of correctional practices. Transitional housing services are provided with medical and dental services via the same gender NHDOC facility closest to their address. The NHDOC reserves the right to change staffing assignments by site to ensure appropriate and adequate coverage for all practice areas.

1.1. Required Contracted Medical Staff by Position, Site and Full-Time Equivalent (FTE)1:

Facilities/Locations Position2 #FTE

ALL SITES

Chief Medical Officer (CMO) 1.0 Staff Physician(s) 2.3

Advanced Practice Registered Nurse (APRNs)3 5.5 Medical Case Manager 1.0

Podiatrist 0.25 NHSP/M Medical Assistant 1.0

NCF Medical Assistant 1.0

Required Contracted Medical Staff by Position, Site and FTE 12.05

1.2. Current NH Department of Corrections State Medical Staff by Position, Site and FTE:

Facilities/Locations Position #FTE

Director of Rehab Services 1.0 Registered Dietician 1.0

Medical Record Supervisor 1.0 Director of Nursing (DON) 1.0

Assistant Director of Nursing 1.0 Chief Pharmacist 1.0

Pharmacist 4.0 Pharmacy Techn1cian 5.0

NHSP-M, SPU and

RTU

Nurse Coordinators 2.0 Staff Nurses 28.0

Medical Record Technicians 3.5 Ward Clerk 1.0

Secretary 1.0

NHSP-W

Nurse Coordinator 1.0

Staff Nurses 9.0

NCF

Nurse Coordinator 1.0 Staff Nurses 11

Medical Record Technician 1.0 Ward Clerk .5

Current NHDOC State Medical Staff by Position, Site and FTE 74 1 One(1) FTE = forty (40) hours

2 Submitted proposals shall include job descriptions for each required contracted medical staff matrix.

3 3.0 FTE's: NHSP-M, 1.0 ITE NCF, .5 FTE NHCF-W, .5 FTE SPU/RTU. 5 FTE Concord Campus

Medical-Dental-Mental Health and Phlebotomy Services

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensics RFP NHDOC 2025-05

Initials: __________

.Date: __________

1.3. Medical Services Program (Vendor shall be responsible for the following):

1.3.1. Medical Intake History and Physical Exam that includes ordering a Purified Protein Derivative or Tuberculosis (TB) planting and/or chest x-ray; identification of acute and chronic medical, mental health and dental conditions requiring treatment, dynamic and personalized care planning, medication reconciliation, appropriate and thorough clinical documentation and to classify residents/patients as to medical risk and appropriateness for special programs and housing assignment in a time frame designated by the Department's policy and procedure directives. All services will be provided in a gender responsive and gender-affirming manner.

1.3.2. Vendor shall provide referrals for mental health services to any residents/patients identified as having a current mental illness or possibility of mental illness, suicide, or homicidal ideation and/or unstable mental health condition. Medication shall be continued for chronic disease maintenance and infectious disease care and medications related to other conditions identified, such as intoxication and withdrawal.

1.3.3. Vendor shall document appropriate dispositions and follow-up care needed in the Department's

Division of Medical & Forensic Services healthcare records as indicated through departmental policies and procedures.

1.3.4. Vendor shall provide periodic medical evaluations (routine physical examinations) to those residents/patients identified by the Department's Division of Medical & Forensic Services for the purpose of providing preventative health care and identifying new health problems.

1.3.5. Vendor shall assist to identify and to treat terminally ill residents/patients and shall participate in the Department's Division of Medical & Forensic Services multi disciplinary end of life care program.

1.3.6. Vendor shall provide treatment to residents/patients with acute and sub-acute medical problems or other medical or health problems that are unmanageable in the general population in infirmaries designated by the Department's Division of Medical & Forensic Services unless hospitalization is medically indicated.

1.3.7. Vendor shall provide treatment to residents/patients whose medical conditions require that they be housed in respiratory isolation cells designated by the Department's Division of Medical &

Forensic Services, as part of the infirmary care program, unless hospitalization is medically indicated.

1.3.8. Vendor shall refer residents/patients for specialty, subspecialty and hospital services when medically indicated according to Vendor/Department's Division of Medical & Forensic

Services mutually agreed upon Utilization Management Program.

1.3.9. Vendor shall follow the guidelines of Vendor/Department's Division of Medical & Forensic Services Utilization Management (UM) Program for the delivery of secondary medical services.

1.3.10. Vendor shall utilize on-site specialty clinics at the Department's facilities whenever possible, prior to sending residents/patients to outside care providers. On-site specialty clinics include, but are not limited to: ZioPatch, Electrocardiogram (EKG), ultrasound, x-ray, orthotics and prosthetic, phlebotomy, orthopedics, and optometry. At any time, the Department may add additional on-site specialty clinics, which are to be utilized by Vendor in the same manner as described above. In addition to on-site specialty clinics, the Vendor shall ensure that Vendor medical provider staff will be trained and qualified to provide basic suturing interventions.

1.3.11. Vendor shall follow the Department's Division of Medical & Forensic Services policy and procedure directives for ordering and dispensing prosthetics, braces, special shoes, glasses, hearing aids, orthopedic devices, wheelchairs, et cetera and shall not provide any equipment, food, or property unless specified in policy or as authorized by the Division of Medical &

Forensic Services.

State of NH- Department of Corrections

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

1.3.12. Vendor shall treat and stabilize persons requiring emergent or urgent care and coordinate all emergency transfers to designated community provider hospitals with the

Department's security staff.

1.3.13. Vendor shall participate in the Department's Division of Medical & Forensic Services Infection

Control (IC) Program and shall be responsible for on-site clinical management of infectious disease residents/patients with HIV/AIDS, hepatitis virus, SARS-CoV-2, tuberculosis, and any other infectious diseases and patient in need of medical management. In addition, Vendor shall support on-site clinical management of medication assisted treatment for substance use disorder and medication for the treatment of opioid use disorder, and endocrinology.

1.3.14. Vendor shall provide clinical management of conditions consistent with the Department's

Division of Medical & Forensic Services specific programs, procedures and protocols. It is anticipated that new clinics may need to be developed due to changing population needs and/or new industry standards/procedures for management of conditions and/or illnesses.

1.3.15. Vendor shall operate and manage a comprehensive chronic care clinic program that ensures conditions requiring chronic care are appropriately diagnosed, treated, and controlled to prevent and minimize de-compensation. Chronic care conditions shall include, but not limited to residents/patients with chronic medical problems such as asthma, diabetes, seizures, hypertension, infectious diseases, cardiac disease, conditions related to aging, terminal illness, et cetera. National guidelines developed by recognized organizations shall be followed in the management of chronic disease. The Department's Division of Medical & Forensic Services will decide which organizational guidelines shall be utilized.

1.3.16. Vendor shall provide chronic care residents/patients a review of their chronic condition by a physician minimally every six (6) months and at more frequent intervals where clinically indicated as described in the chronic care clinic treatment guidelines approved by the

Department.

1.3.17. Vendor shall prescribe medications as medically necessary and appropriate and shall utilize the Department's Division of Medical & Forensic Services Pharmacy formulary. Vendor shall follow and adhere to the Department's Division of Medical & Forensic Services non-formulary medication prescribing guidelines, policies, and procedures.

1.3.18. Vendor shall provide comprehensive resident/patient health education to all residents/patients.

1.3.19. Vendor shall treat and stabilize, as medically appropriate, residents/patients requiring emergent dental care when the Dental Services provider is not on site.

1.3.20. Vendor shall provide timely and appropriate care of the pregnant patient in accordance with the Department's policies and guidelines.

1.3.21. Vendor shall produce reports addressing the work being performed under the Contract in a form, format and time frame delineated by the Department's Division of Medical & Forensic

Services.

1.3.22. Medical Case Management services are required to assist in medical parole management, management of medically complex cases, assisting in ensuring Medicaid eligibility, and assisting in educating and assisting in advance directive completion.

1.3.23. Chief Medical Officer (CMO) shall travel to all prison sites to provide clinical supervision to

Vendor and non-Vendor medical staff including all Advanced Practice Registered Nurses

(APRNs), participates in required medical staff committees, reviews formulary requests for medications, manages complicated medical cases, completes record reviews to ensure compliant clinical practices, recommends changes to policy or develops new policies for review for improvement of service delivery, participates in the creation and revision of clinical protocols and algorithms, clinically supervises all licensed health staff when the Department implements any new health delivery initiatives such as point of care

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05 ultrasound, or telehealth and completes clinical performance evaluations annually.

Participates with the Department's Division of Medical & Forensic Services and other appropriate agencies in reviewing potential medical risk management issues or tort actions and makes court appearances to testify on clinical decisions. Other duties include responsibility for on-call schedule and recommendations for medical parole pursuant to RSA 651. The CMO is ultimately responsible for ensuring that all medical vendor employees are trained to Department policies and procedures as well as practices related to the provision of correctional health care.

1.3.24. CMO shall be an integral part of the Department's Division of Medical & Forensic Services

Continuous Quality Improvement (CQI) program by participating and/or facilitating the following:

• Continuous Quality Improvement initiatives and routine professional peer review;

• Participate in periodic Continuous Quality Improvement meetings on its Monthly Facility

Service Schedule (MFSS) to review measures of performance and to develop and monitor and measure quality improvement outcomes;

• Conduct reviews in the Medical Service Areas to monitor the health services provided, collect, trend, and disseminate data, develop, and monitor corrective action plans and facilitate communication between all health care disciplines;

• Provide an appropriate, clinically equivalent clinician, designated by Vendor to review the work of all practicing physicians and midlevel providers on an annual basis;

• Provide reports to the Department's Division of Medical & Forensic Services in a form, format and time frame mutually agreed upon between the Department's Division of

Medical & Forensic Services and Vendor;

• Upon the Department's Division of Medical & Forensic Services request, the Chief

Medical Officer shall investigate complaints made by residents/patients or other persons in interest regarding any aspect of the Medical Services health care delivery system and respond to the Department within ten (10) days of receipt of the request. The Department, in its sole discretion, may direct Vendor to take specified action(s) regarding a complaint;

• Participate in the Department's Division of Medical & Forensic Services mortality and morbidity review process;

• Participate in the Pharmacy & Therapeutics and Infection Control Committees; and Chief

Medical Officer has a current and shall maintain an on-going Drug Enforcement

Administration (DEA) certification.

1.3.25. CMO shall be an integral part of Vendor/Department's Division of Medical & Forensic

Services Utilization Management program by participating and/or facilitating the following:

• Participating in Utilization Management practices for all Medical clinical services;

• Assure resident/patients receive timely, appropriate, and coordinated medical services to optimize patient outcome;

• Ensure necessary care is provided in a cost-effective manner consistent with appropriate standards of care;

• Participate in a Utilization Management Program which shall include but not be limited to review of:·

a. All inpatient admissions (hospital and infirmary);

b. Outside specialty outpatient procedures and consultations;

c. Specialty diagnostic and imaging services to include on-site x-rays and EKG;

d. Surgeries;

e. On-site specialty clinics (Orthopedics, Optometry and Podiatry);

f. Laboratory testing; and

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

g. Medication prescribing.

1.3.26. CMO shall participate in a concurrent review program that includes daily examination of inpatient admissions to monitor length of stay and frequent communication with hospital staff to facilitate discharge of residents/patients to minimize length of stay.

1.3.27. Chief Medical Officer shall participate in discharge planning activities and make recommendations for the most appropriated Department setting.

1.3.28. CMO shall provide primary care services for residents/patients at designated Department sites.

Works jointly with other providers and Department nursing staff to facilitate proper health services for residents/patients of the Department, participates in appropriate operational initiatives on behalf of the Department's Division of Medical & Forensic Services, assists in the review of potential risk management issues or tort actions, consults with community providers to ensure medically appropriate and necessary care.

1.3.29. CMO shall provide reports to the Department in a form, format and time frame mutually agreed upon between NHDOC and Vendor.

1.3.30. CMO will publish clinical practice guidelines to include but not limited to management of foreign body ingestion, withdrawal management, palliative care, standards by sex and age for physicals and laboratory services, and others based on correctional healthcare and other informed national healthcare standards.

1.4. Medical On-Call Services (Vendor shall be responsible for the following):

1.4.1. Vendor shall provide on-call medical coverage for all facilities/locations identified in Scope of

Services, Exhibit B, Service Locations of this document, Monday through Friday from 4PM to

8AM, twenty-four (24) hours a day and on weekends as well as all State and Federal holidays.

On-call coverage is required three hundred sixty-five (365) days a year. Vendor's on call providers shall assess emergent needs of residents/patients as reported by Department's Division of Medical & Forensic Services medical staff or correctional staff in the absence of on-site medical professionals. Vendor shall provide an appropriate rotation of providers to meet the needs of on-call medical services to manage the facilities/locations listed in paragraph 3., Service Locations. The on-call provider shall respond by telephone to institution-based calls within fifteen (15) minutes of the telephone call for service and shall provide direction to the caller. If requested to do so or the situation warrants direct assessment, the on-call provider shall report to the institution within one (1) hour after notification. As part of this call, medical providers will triage off-hour dental emergencies within the scope of their practice and make recommendations for emergent dental care as appropriate.

1.4.2. The on-call schedule shall be part of the MFSS requirements as specified in Scope of Services, Exhibit B, 11. General Provisions, 11.8. Staffing Plans for Comprehensive Healthcare Services.

1.4.3. Medical On-Call Schedule:

• Monday-Friday: sixteen ( 16) hours/day for two hundred fifty-one (251) weekdays

(non-holiday).

• Weekends/Holidays: twenty-four (24) hours/day for one hundred four (104) weekend days and ten (10) holidays.

• Call Backs: Historically one (1) call back/month.

1.5. Required Contracted Dental Staff by Position. Site and FTE4:

Facilities/Locations Position5 #FTE

Chief Dental Officer (COO) 1.0

Oral Surgeon 0.25

NHSP-M, SPU, RTU

and NHCF/W

Staff Dentist(s) 1.6 Dental Assistant(s) 1.6 Dental Hygienist(s) 1.75

NCF

Staff Dentist(s) 1.0

Dental Hygienist(s) .25

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

Required Contracted Dental Staff by Position, Site and FTE 7.45 4 One (1) FTE = forty (40) hours 5 Submitted proposals shall include job descriptions for each required contracted dental staff matrix.

1.6. Current NH Department of Corrections Dental Staff by Position, Site and FTE:

All SITES Prison Dental Office Supervisor 1.0

NHSP-M, SPU, RTU

and NHCF/W

Dental Assistant(s)

2.0

NNHCF Dental Assistant 1.0

Current NHDOC Dental Staff by Position, Site and FTE 4.0

1.7. Dental Services Program (Vendor shall be responsible for the following):

1.7.1. Provide dental sick call clinics for each facility based on each facilities' requirements by population. .

1.7.2. Use of the Department's Division of Medical & Forensic Services electronic dental record that identifies the resident's/patient's oral health condition and specifies the priorities of treatment by category consistent with the Department's policy.

1.7.3. Ensure residents/patients referred to Dental Services by the Medical staff with an urgent or emergent need are seen within twenty-four (24) hours (Monday-Friday).

1.7.4. Provide dental services equivalent to those available in the general population to higher level custody/restricted residents/patients.

1.7.5. The Chief Dental Officer (CDO) will provide a coverage plan for all NHDOC's sites in the event of a dental staffing deficit.

1.7.6. Vendor shall at all facilities operated by the Department and designated identified in paragraph to ensure the following services are provided:

• All residents/patients are eligible for emergency or urgent needs.

• Restorations (fillings):

a. Amalgam (silver) restorations: primary or permanent (1, 2, 3 or more surfaces);

and

b. Composite resin (white) restorations on anterior and posterior teeth (1, 2, 3 or more surfaces).

• Referrals for evaluation and treatment by specialists shall be subject to

Vendor/Department's Division of Medical & Forensic Services agreed upon Utilization

Management process and require pre-authorization; and

• Deviations from dental treatment guidelines shall be subject to the Utilization

Management process.

1.7.7. Diagnostic/Preventative Dentistry by Primary Dentist:

• Initial periodic oral examination;

• Development of treatment plan;

• Intra-Oral cancer examination;

• Visual aids; and

• Consultations.

1.7.8. Dental X-Rays (Department-owned equipment):

• Bitewing;

• Single; and

• Other: X-Rays

a. Full Mouth

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

b. Panoramic

1.7.9. Prophylaxis by Dental Hygienist:

• Oral hygiene instruction;

• Oral scaling by resident/patient request per Dental PPDs, treatment guidelines and procedures; and

• Oral examination and referral to primary dentist when indicated.

1.7.10. Oral Surgery by Primary Dentist and Oral Surgery:

• Single tooth extraction;

• Surgical extraction-erupted tooth;

• Surgical extraction-soft tissue impaction;

• Surgical extraction-partial bony impaction; and

• Surgical extraction-full bony impaction.

1.7.11. Oral surgery by Oral Surgeon:

• Simple extractions;

• Surgical extractions;

• Tori removal;

• Trauma related issues; and

• Biopsies.

1.7.12. Periodontics (Gum Treatment) by Primary Dentist:

• Occlusal adjustment limited.

1.7.13. Major Restorative Dentistry by Primary Dentist:

• Re-cement existing fixed prosthetics; and

• Re-cement existing post, core, and crown.

1.7.14. Prosthodontics (dentures) by Primary Dentist: Services shall include, but are not limited to, and shall be subject to the Department's Division of Medical & Forensic Services Dental Policy, Procedure and Directives (PPDs), treatment guidelines and procedures of the following:

• Complete dentures (upper or lower);

• Partial dentures; and

• Night

1.7.15. Dental Trauma:

• Immediate consult if applicable, patient should be medically stable;

• Follow up with either provider onsite or surgeon off site; and

• Follow up with patient going forward.

1.7.16. CDO shall travel to all prison sites to provide clinical supervision to Vendor dental staff, including staff dentists, dental assistants, and hygienists.

1.7.17. CDO shall participate in all required medical/dental staff committees, reviews formulary requests for dental medications, manages and provides oversight to dental services provided, completes dental record reviews to ensure compliance to PPDs, treatment guidelines and procedures, recommends changes to policy for improvement of service delivery, participates in the creation and revision of policies, treatment guidelines and procedures and completes clinical performance evaluations annually. Participates with the Department's Division of Medical &

Forensic Services and other appropriate agencies in reviewing potential medical risk management issues or tot1actions and makes court appearances to testify on dental clinical decisions.

1.7.18. CDO shall perform all aspects of general dentistry including but not limited to examination and triage, fillings (composite and amalgams), oral surgery (limited to simple and surgical extractions, prosthetics, complete and partial dentures, primarily removable) and hygiene (prophylaxis and root planing). Other duties include responsibility for assuring the dental staff schedule is adequate for clinical coverage at all facilities/locations.

1.7.19. CDO shall be an integral part of Vendor/Department's Division of Medical & Forensic Services

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

Continuous Quality Improvement program by participating and/or facilitating the following:

• Continuous Quality Improvement initiatives and routine professional peer review;

• Participates in periodic Continuous Quality Improvement meetings on its MFSS to review measures of performance and to develop, monitor and measure quality improvement outcomes;

• Conduct reviews in the dental service areas to monitor the dental services provided, collect, trend, and disseminate data, develop, and monitor corrective action plans and facilitate communication between all dental care disciplines;

• Provide an appropriate, clinically equivalent clinician, designated by Vendor, to review the work of all practicing dentists, oral surgeons, and hygienists on an annual basis;

• Provide reports to the Department's Division of Medical & Forensic Services in a font, format and time frame mutually agreed upon between the Department's Division of

Medical & Forensic Services and Vendor.

• Upon the Department's Division of Medical & Forensic Services request, the CDO shall investigate complaints made by residents/patients or other persons in interest regarding any aspect of the Dental Services health care delivery system ·and respond to the

Department within ten (10) days of receipt of the request. The Division of Medical &

Forensic Services, in its sole discretion, may direct Vendor to take specified action(s) with regard to the complaint;

• If appropriate, participate in the Department's Division of Medical & Forensic Services mortality and morbidity review process;

• Participate in the Pharmacy & Therapeutics and Infection Control Committees and;

• Reviews records and advises on requests for treatment and procedures for residents.

• The CDO is ultimately responsible for ensuring that all dental vendor employees are trained to Department policies and procedures as well as to best practices related to the provisions of correctional health care.

1.7.20. CDO shall be an integral part of Vendor/Department's Division of Medical & Forensic Services

Utilization Management program by participating and/or facilitating the following:

• Participating in utilization management practices for all dental clinical services;

• Assure resident/patients receive timely, appropriate, and coordinated dental services to optimize resident/patient outcomes;

• Ensure necessary care is provided in a cost-effective manner consistent with appropriate standards of care;

• Provide reports to the Department's Division of Medical & Forensic Services in a form, format and time frame mutually agreed upon between the Department and Vendor.

2. Required Mental Health Services

All sites have a broad range of outpatient mental health services offered to include crisis response, individual therapy, group therapy, psychoeducational groups, and medication management. Inpatient services are offered at the Secure Psychiatric Unit (SPU) and modified therapeutic communities within our correctional facilities is currently offered at the Residential Treatment Unit (RTU) ,Wellness Units (mental health), Focus (substance use disorder) Units, and the Intensive Sexual Offender Treatment (ISOT) unit.

Current NHDOC state mental health staff includes disciplines such as Social Workers, Clinical Mental Health

Counselors, Licensed Alcohol and Drug Counselors and Recreational Therapists.

In response to this section, indicate the treatment modalities that will be implemented to meet the needs of this population e.g., individual and group treatment recommendations, assessment tools, documentation expectations, experience managing a forensic population and your effectiveness.

2.1. Required Contracted Mental Health Staff by Position, Site* and FTE6:

State of NH, Department of Corrections Comprehensive Healthcare Services

Division of Medical and Forensic Services RFP NHDOC 2025-05

Facilities/Locations Position7 #FTE

Chief Psychiatric Officer (CPO) Office in SPU 1.0

Staff Psychologist HQ of Vendor 1.0

Addictionologist 1.0

NHSP-M

Psychiatric Nurse Practitioner 2.0 Mental Health Clinician 1.0

Licensed Alcohol and Drug Counselor 1.0

SPU/RTU

Staff Psychiatrist 1.0

Psychiatric Nurse Practitioner 2.0

NHCF-W

Psychiatric Nurse Practitioner 1.0

Mental Health Clinician 2.0 Licensed Alcohol and Drug Counselor 1.0

NHSP-M/

Concord Campus (CC) Staff Psychiatrist 2.0

Concord Campus Mental Health Clinician 1.0

NCF

Psychiatric Nurse…