Attachments 1-12.pdf

RFPP05021200001

ATTACHMENT #1

BLOCK 20 - PERFORMANCE WORK STATEMENT

A.I.1 INTRODUCTION

The Federal Bureau of Prisons (BOP) requests all interested parties to submit a proposal for the operation and management of four (4) Health Services Units (HSU) located at the Federal Correctional Complex (FCC) in Beaumont, Texas. The FCC consists of a high security penitentiary, a medium security facility, low security facility, and satellite minimum security prison camp. The contractor will be required to maintain appropriate levels of care for inmates at the camp facility; however the physical arrangements are limited. In order to deliver appropriate care to camp inmates, the contractor may be required to treat camp inmates within another designated HSU.

The BOP intends to award a single contract to a responsible contractor for the operation and management of the HSUs at the FCC as well as coordination and management of inmate inpatient/outpatient care in the community as necessary.

A.I.2 BACKGROUND

The FCC is located in Jefferson County, Texas, approximately six miles south of the City of Beaumont off Highway 69. The official mailing address of the FCC is the following:

Federal Correctional Complex P.O. Box 26015

Beaumont, Texas 77720-6015

The FCC currently houses male inmates. The FCC is presently identified as a Care Level II BOP facility. Care Level II is an intermediate classification on the four-level scale where Care Level I represents the healthiest inmates and Care Level IV represents inmates with serious health issues.

Criteria for categorizing an inmate in the Care Level II category is included as Attachment #5.

Despite this description of the general health of the inmate population, however, needs for inmate healthcare may arise at any time, in any specialty, and any level of complexity. Classification and designation of inmates is the sole responsibility of the BOP.

A.I.3 MISSION STATEMENT

The overall mission of the BOP is to protect society by confining offenders in a safe, humane, and appropriately secure facility that provides work and other self-improvement opportunities to assist offenders in becoming law-abiding citizens. As a part of this responsibility, the BOP must provide necessary medical, dental, and mental health services to inmates by professional staff, consistent with acceptable standards of correctional medical care.

A.1.4 OBJECTIVES

In support of this health care mission, it is BOP's objective to acquire the services of a contractor, who shall furnish all necessary equipment, supplies, personnel, and administration in order to provide health services to inmates designated to the FCC.

A summary of the contractor's responsibilities under this contractual agreement are as follows:

1. Deliver health services to the inmate population in such a way to promote quality health care while fulfilling the BOP's mission, goals, and objectives.

2. Provide urgent and routine care consistent with correctional standards, while continuing to maintain the level of quality dictated by the BOP policy, American Correctional Association (ACA), The Joint Commission, and clinical guidelines approved by national organizations such as Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and American Diabetes Association, etc.

3. Adhere to all applicable local, state, and Federal laws and regulations governing the delivery ofhealth services. Remain current on any revisions to established policy set forth by the BOP, ACA, The Joint Commission, and all Federal, state, and local regulations.

4. Establish an organizational improvement program and quality measurement system (administrative, clinical process and outcomes) which is subject to review by the Medical Director of the Bureau of Prisons to ensure all policies and procedures are designed and implemented in a manner to promote orderly and efficient delivery and management of the health services to the inmate population.

A.1.S EXPLANATION OF TERMS

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

2. Joint Commission Standards The standards for hospital and ambulatory care published by the Joint Commission.

3. Federal Bureau ofPrisons (BOP) - Federal government agency with whom the contractor will enter into the resulting contract.

4. Contracting Officer (CO) - BOP employee empowered to award, modify, administer, and cancel contracts on behalf of the United States Government.

5. Contracting Officer's Representative (COR) - On-site BOP staff person, named in the contract, who is authorized to perform certain functions on behalf of the CO. The COR is the point-of-contact for the Health Systems Specialists and the Managed Care Administrator for the issuance of technical direction under the contract. The primary function of the COR is to regulate, evaluate, and inspect contract work as it progresses, recommend final acceptance of completed work, and to provide the CO with information and recommendations on any problems arising in the day-to-day administration of the contract.

6. Health Systems Specialist (HSS) - On-Site BOP staff person, who is authorized to perform certain functions on behalf of the COR. The HSS under the direction of the COR is responsible for monitoring compliance with the Statement of Work in each facility and report problems to the COR. The HSS shall analyze indicator data related to the facility on a perpetual basis to identify programmatic and operational weaknesses and suggest, prepare and/or implement action plans of resolution. The HSS serves as liaison between the contract medical administrators and the COR and technical advisor to the medical contract staff.

7. Contractor - The firm, individual or entity, following award selection, with which the BOP enters into this contract; ensures performance of services described in this Performance Work Statement.

8. Managed Care Administrator - The contractor's designated representative, regardless of local title, who has ultimate responsibility for the overall performance of the contractual services described herein.

9. Inmate/Offender - An individual or prisoner confined under the auspices and the authority of the BOP (see also 28 Code of Federal Regulations (CFR) Ch. V 500.1).

10. Facility - The ground and physical plant owned by the Federal government, and used by the contractor to care for inmates as required in this PWS. Unless specifically noted, facility includes all correctional entities operating at the FCC.

11. Hospital - The term "hospital" as used here is a community-based hospital providing a full range of diagnostic and therapeutic services, including, at a minimum: inpatient and outpatient urgent and routine specialty care, radiology, psychiatry, and laboratory services.

COR

12. Health Services Unit (HSU) - The organizational unit providing urgent and routine health care. In addition, the HSU is the designated part of an institution that delivers care to inmates on an ambulatory or observation basis.

13. Professional Staff - Contractor's licensed and credentialed staff employed as health care providers under the contract.

14. Medical Services - Sometimes referred to as health services, includes any medical treatment delivered to a patient. This will include, but not limited to: inpatient/outpatient services, routine sick call care, chronic care clinics, intake screenings, physical examinations, and medical observation services. These do not include services which are considered for "inmate convenience. "

15. Mental Health Services - For purposes of this solicitation, these services are defined as inpatient/outpatient psychiatric evaluation/treatment. The BOP is responsible for psychology servIces.

16. Dental Services - For purposes of this solicitation, these services include, but are not limited to, routine and urgent care rendered to the inmate popUlation, under the direction of a licensed dentist, in order to maintain oral health.

17. Manday Rate - The contractor's per unit cost to be utilized for reimbursement under this contract. This rate equates to the proposed cost per inmate, per day, based on the actual count at (approx.) 12:00 AM of each day. The actual count is inclusive of all inmates located in community hospital(s).

18. Fiscal Year - The one-year periods beginning on October 1 and ending on September 30.

19. Proposal- The written offer, including technical, business and past performance, submitted by the contractor for consideration by the BOP in response to the Request for Proposal (RFP).

A.l.6 REGULATORY REQUIREMENTS

Notwithstanding the standards of The Joint Commission and ACA, the BOP will provide information regarding its policies and procedures to assist the contractor in implementing and administering health care services. This will ensure consistency between the level and quality of care provided by the contractor, as compared to the BOP's current health care delivery system.

The following is a list of the applicable BOP Program Statements (P.S.), Complex Supplements (CS), Program Review Guidelines and Technical Reference Manuals (TRM) which the contractor may use as guidelines, or benchmarks, in the provision of health services. Current versions of policy have been cited in this solicitation/contract. As updates and revisions to BOP policies become effective, those updates and revisions shall automatically be incorporated into the contract. The BOP shall be responsible for providing all updates and revisions to policy statements.

The following list ofP.S.s and BOP Forms are hereby incorporated into the solicitation/contract.

Due to their volume, the following documents can be viewed on the BOP web site at www.bop.gov.

P.S. 1210.23 Management Control and Program Review Manual http:www.bop.gov

P.S. 1330.16 Administrative Remedy Program P.S. 5311.01 Inmate DNA Sample Collection Procedures P.S.5325.07 Release Preparation Program P.S.5538.05 Escorted Trips P.S.5562.05 Hunger Strikes P.S. 5566.06 Use of Force and Application of Restraints P.S.6010.02 Health Services Administration P.S.601O.03 Psychiatric Evaluation and Treatment P.S.6013.01 Health Services Quality Improvement P.S.6027.01 Health Care Provider Credential Verification, Privileges and Practice Agreement

Program P.S.6031.01 Patient Care P.S. 6031.02 Inmate Copayment Program P.S.6080.01 Autopsies P.S.6090.02 Health Information Management P.S.6190.03 Infectious Disease Management P.S. 6270.01 Medical Designations and Referral Services for Federal Prisoners P.S. 6311.04 Plastic Surgery and Identification Records P.s.6340.04 Psychiatric Services P.S.6360.01 Pharmacy Services P.S.6370.01 Laboratory Services P.S.6400.02 Dental Services P.S.6541.02 Over-the-Counter Medication BP-A0630 Medical History Report (Employees/Applicants) BP-A0631 Post Conditional Offer of Employment & Employee Physical Exam BP-A0658 Inmate Claim for Compensation Resulting From Work Injury

The following policy statements and memorandums are incorporated into this solicitation/contract as attachments:

BMX 1330.I6B, Administrative Remedy Program BMX 6031.01.9B Urgent Medical and Dental Services BMX 6031.01.24D, Inmate Serious Illness and Death; Advanced Directives; Do Not Resuscitate Orders BMX 6541.02E, Over-the-Counter Medications TRM 6001-03 - Sentry Medical SMDIMDS Technical Reference Manual G6000I.06 - Program Review Guidelines - Health Services - Institutions Medical Hold Status Procedure and Implementation Memorandum (January 24, 2011) Risk Management List Memorandum (April 7, 2011) OSHA Respirator Medical Evaluation Questionnaire

In order to maintain consistency and continuity in critical areas of the BOP health care delivery system, certain BOP policy requirements are mandated to be followed by the Contractor. These http:G6000I.06 http:6031.01.9B mandatory policy citations are indicated, where applicable, within this solicitation.

A.1.7 SCOPE OF SERVICES

The contractor shall provide comprehensive management, oversight, planning, equipment maintenance and repair programs, which assure maximum efficiency of the HSUs of the FCC.

A.1.7.1 HSU Responsibilities

The contractor shall provide all necessary health services within each individual HSU. Where health services are not available within an HSU (i.e., urgent care and specialty services), the contractor shall be responsible for providing these services either at their designated outside facility or via an established supplemental subcontracting agreement(s) with a local health care provider(s). This will ensure adequate access to outside medical facilities and necessary medical expertise within the local community which are not readily available within the HSU.

At present, the vast majority of inmates requiring medical specialty evaluation are transported outside the FCC at great expense to the contractor and the BOP. Offerors are strongly encouraged to bring medical specialists into the facilities and/or utilize a telemedicine system to reduce the number of inmates transported to the community for evaluation.

For the purposes ofthis solicitation and resulting contract, any outside medical facilities to be utilized by the contractor must be located within a 100-mile driving distance of the FCC.

A.1.7.2 Accreditation, Credentialing, and Privileging Requirements

It is understood that an essential component of successful performance under this contract be the provision of health services commensurate with the level of care available in current BOP institutions. To satisfy this requirement, the contractor must provide adequate health care while meeting the appropriate levels of quality established by the American Correctional Association (ACA) and The Joint Commission.

The contractor shall obtain full ambulatory accreditation of each HSU within the FCC within 12 months from the Effective Date of Award. Once full accreditation has been obtained, the contractor shall maintain this accreditation throughout the life of the contract, inclusive of any option year exercised. The contractor shall be responsible for all costs associated with obtaining and maintaining full accreditation by The Joint Commission. The contractor shall provide, upon request, a status update of the accreditation process and a copy of the accreditation certificates once received.

For community-based medical care, it is the FCC's preference to obtain services of facilities that are accredited by the Joint Commission. Offerors utilizing a facility(s) which maintain accreditation by The Joint Commission shall submit a copy of the current aucreditation certificate as part of the offeror's technical proposal. If an offeror intends to utilize a facility(s) which is accredited or certified by any other recognized professional accrediting body, the offeror shall submit documentation validating this accreditation or certification as a part of its proposaL

A.1.7.3 Clinical Privileging and Credentialing

Pursuant to Joint Commission standards, the contractor shall ensure all applicable professional staff have been appropriately privileged and credentialed (i.e., primary source verified, National Practitioner Data Bank queried). All privileging and credentialing files shall be maintained on site at the FCC and made available to the COR upon request. Applicable health care professionals who will be involved in providing direct patient care under the resulting contract will be required to maintain current professional licensure in the State of Texas. Contractor will follow Program Statement 6027.01 Health Care Provider Credential Verification, Privileges, and Practice Agreement Program, except the contract providers will not have clinical privileges granted from the BOP. Clinical Privileges will be granted through the contractor's clinical staff.

A report will be sent to the COR the first week of each quarter listing the status of each required element in each credentialing file.

A.1.7.4 Patient Care

The general standard for the delivery of health care at the FCC by the contractor will be the provision of ambulatory care with limited observation services at each facility. Determinations regarding what care is routine, medically mandatory, or presently medically necessary shall be made using the clinical judgment by the contractor's health care professionals. The contractor shall follow the BOP clinical practice guidelines as a guide to disease management and comply with the memo dated April 7, 2011, from the BOP Medical Director covering the Risk Management List (Attachment #20). The only instances in which care shall not be provided will be for specific categories or levels of care excluded by BOP policy.

The contractor must coordinate the delivery of health services with BOP staff in order to ensure the safe and orderly operation of the FCC while observing, at all times, BOP regulations regarding the custody of inmates.

Each time a clinical decision is made to send an inmate to a local hospital or place an inmate in observation an e-mail message will be sent within one hour to all Wardens, Associate Wardens and Health Systems Specialists with the inmate's name, reg. number, institution, name of hospital, and reason for clinical decision to send to hospital or place in observation.

A.1.7.S Special Health Care Compliance Issues

The following is a listing of specific BOP policy requirements which require contractor compliance. Each requirement refers the Contractor to a specific BOP regulatory citation. The BOP will provide current regulations and the contractor is obligated to perform under these tenns:

A. Serious Illness and Death Procedures - In the event of an inmate serious illness or death, the contractor shall immediately notify the on-site BOP medical representative and comply with the procedures defined in the P.S. 6031.01, Patient Care, Section 24 and Complex Supplement BMX 6031.01.24D.

B. Infectious Disease - refer to P.S. 6190.03, Infectious Disease Management.

C. Organ Donation/Transplantation - refer to P.S. 6031.01, Patient Care, Sections 38 and 39.

D. Sick Call Procedures - refer to P.S. 6031.01, Patient Care, Section 17.

E. Intake Screening - refer to P.S. 6031.01, Patient Care Section 18 and P.S. 6340.04, Psychiatric Services, Section 9(a).

Physical Examinations - refer to P.S. 6031.01, Patient Care, Section 19.

G. Chronic Care Clinics - refer to P.S. 6031.01, Patient Care, Section 15 and Section 16 (a) and (b).

H. Mortality Reviews - refer to P.S. 6013.01, Health Services Quality Improvement, Section 11 and P.S. 6090.02, Health Infonnation Management, Section 13.

I. Eye Care refer to P.S. 6031.01, Patient Care, Section 27.

J. Federal Prisoners in Transit - refer to P.S. 6270.01, Medical Designations and Referral Services for Federal Prisoners.

K. Living Will/Advance Directives - refer to P.S. 6031.01, Patient Care, Section 24 (c) and (d).

L. Hearing Conservation Program - refer to P.S. 6031.01, Patient Care, Section 28.

M. Medical Evaluation for Transfer to Halfway House or Non-Federal Prison System - refer to P.S. 6360.01, Phannacy Services, Section 12 and P.S. 6270.01, Medical Designations and Referral Services for Federal Prisoners, Sections 10 and 13.

N. Hunger Strikes - refer to P.S. 5562.05, "Hunger Strikes."

O. Use of Force and Application of Restraints on Inmates - refer to P.S. 5566.06, "Use of Force and Application of Restraints on Inmates."

P. Dental Services, Records, and Treatment Procedures - refer to P.S. 6400.02, Dental Services, Section 6 (b,c,d,g,h), 8, 10, 13, 14, and 15.

Q. Administrative Remedy Procedures - The contractor shall provide an appropriate report along with all information, documentation, and technical support in a prescribed format to the BOP as necessary for the BOP to resolve issues through administrative remedy procedures, in accordance with P.S. 1330.16, Administrative Remedy Program and Complex Supplement BMX 1330.l6B.

R. Release Preparation Program, Institution, refer to P.S. 5325.07, Release Preparation Program, Institution.

S. Special Diets, refer to P.S. 6031.01, Patient Care, Section 26.

T. Deafness and Hearing Aids - refer to P.S. 6031.01, Patient Care, Section 29.

U. Inmate Copayment Program - refer to P.S. 6031.02, Inmate Copayment Program.

V. Over-the-Counter Medication - refer to P.S. 6541.02, Over-the-Counter Medication

W. Program Review refer to P.S. 1210.23, Management Control and Program Review Manual and G6000I.06 - Program Review Guidelines - Health Services - Institutions

X. DNA Collection - refer to P.S. 5311.01, Inmate DNA Sample Collection Procedures

Y. Utilization Review refer to P.S.6031.01 Patient Care, Section 8, through (a) &( b).

A.1.7.6 Ancillary Services

All ancillary services shall be provided by the contractor, or subcontractor, as an adjunct to the medical, mental health, and dental services. These services include, but are not limited to, the following:

A. Pharmacy Services

The Contractor shall provide pharmaceutical services as an integral part of their health care delivery system. The contractor shall ensure sufficient supplies of pharmaceuticals, in compliance with the BOP National Drug Formulary, are available on-site to meet the needs of the HSUs at the FCC. The BOP formulary may be amended only with the approval of the BOP Health Services Division, Central Office. A pharmacist shall be on-site at all times during which a pharmacy is open for the dispensing of pharmaceuticals to the inmate popUlation. The contractor shall provide appropriate patient education regarding medications by a qualified pharmacist.

http:P.S.6031.01 http:G6000I.06

The Contractor shall comply with the following BOP and Federal regulations/policies:

1. Procedures and Operational Practices - The contractor's phalTI1acist will develop and maintain written procedures and operational practices pertaining to phalTI1aceutical services, in concert with the medical staff and, as appropriate, with other representatives of other disciplines that comply with Program Review Steps - refer to G6000L06, Program Review Guidelines - Health Services - Institutions.

2. National FOlTI1ulary - refer to P.S. 6360.01, Pharmacy Services, Section 7(b).

3. P.S. 6360.01, Pharmacy Services, Sections (1-8)

4. P.S. 6360.01, Pharmacy Services, Section 9, (a) and (b) also d through m.

5. P.S. 6360.01, Pharmacy Services, Sections (10-12)

6. P.S. 6360.01, Pharmacy Services, Section (14-18)

B. Laboratory Services

The contractor shall provide comprehensive clinical laboratory services to meet the needs of the inmate population at the FCC. Each HSU shall have necessary means on-site to perform, at a minimum, laboratory tests which comply with the "Waived Classification Category" of the Clinical Laboratory Improvement Act of 1988 (CLIA). The Contractor shall obtain CLIA certification for each HSU laboratory within 90 calendar days of the date of contract award. The contractor shall maintain CLIA certification for each HSU throughout the remainder of the contract. The contractor shall provide a copy of the CLIA certificate to the COR upon request.

These services shall include, but are not limited to, the following: finger stick blood glucose tests, urine dipstick tests, and hematocrits.

Offerors may propose an alternative method ofproviding these laboratory services as long as the requirements of CLIA are met. Any alternative approach shall be well documented and provide a clear understanding of the proposed provision of laboratory services.

C. Radiology Services

The contractor shall provide radiological services designed to meet the needs of patients in accordance with professional practices and legal requirements.

The contractor shall be responsible for the calibration and preventive maintenance of all radiological equipment provided by the BOP. In addition, a Federal Drug Administration (FDA) survey of radiographic equipment at each HSU shall be conducted on a biennial basis.

Due to the age and condition of the BOP's current radiographic equipment, the successful contractor, will be required to install digital x-ray equipment as a means to ensure an effective and efficient method of solution ofproviding these services. Within 180 days of the Effective Date of Award, the contractor will install digital x-ray equipment, which will remain the property of the contractor, for the use at the FCC.

D. Rehabilitative Services

The contractor shall provide rehabilitative services such as physical therapy, respiratory therapy, occupational therapy, etc., on site as needed for proper management and recovery of the patients.

The contractor shall provide all necessary post-operative treatment.

Offerors may propose an alternate method of providing rehabilitative therapy services as long as the services are provided by a qualified health care professional.

A report will be provided to the COR on the first working day of each month listing each inmate referred for rehabilitative services during the past 12 months. The report will include: Inmate's name, number, date referred, date first seen, date finished.

E. Optometry Services

Optometry services shall be provided to any inmate requiring such services within 90 calendar days from the date the need for service is established. The contractor shall also provide corrective lenses based on an optometrist prescription. These lenses shall be provided within 30 calendar days from the time a prescription is obtained. The contractor shall adhere to P.S.

6031.01, Patient Care, Section 27.

A report will be provided to the COR on the first working day of each month listing each inmate referred for optometry services during the past 12 months. The report will include: Inmate's name, number, date referred, date of VA, date seen by optometrist, if glasses prescribed, and date glasses delivered to inmate

F. Autopsy Services

The Warden may order an autopsy on the body of a deceased inmate based on criteria set forth in P.S. 6080.01, Autopsies, and established local FCC Beaumont policy. The contractor shall provide these services in accordance with BOP policy.

G. Institution Emergencies

The contractor shall be required to respond to any and all institution emergencies requiring the delivery ofhealth care at any location within the Complex. While the contractor's response to an emergency shall be immediate, the contractor shall respond only to emergency medical issues and only after the BOP has determined that the emergency area has been secured.

H. DNA Sample Collection

The contractor shall be required to provide DNA sample collection services for qualifying inmates confined at the FCC in accordance with Program Statement 5311.01, Inmate DNA Sample Collection Procedures and Public Law 106-546, "The DNA Analysis Backlog Elimination ACT of 2000." Under this law the contractor will be responsible for the following requirements:

1. The contractor will be responsible for generating weekly SENTRY rosters to determine which inmates require DNA sampling, then place these inmates on "call-out" to the respective Health Services Unit.

2. The contractor will be responsible for immediately notifying the appropriate Unit Team staff and Health System Specialist of all "no shows" or "refusals".

3. The contractor will be responsible for collecting the DNA sample in accordance with the instructions contained in the Federal Bureau of Investigation'S (FBI) collection kits.

4. Upon completion of the collection, the contractor will be responsible for obtaining the inmate's fingerprints, completing the FBI collection form, packaging the sample and FBI form in the package provided by the FBI, and taking the prepared package to the designated department for mailing.

5. The contractor will be responsible for updating the inmate's DNA status in SENTRY via the

PP79.

6. The contractor will be responsible for maintaining a Laboratory Accession Log in which the inmate's DNA number generated by the PP79 will be recorded, along with the inmate's name, register number, and date of the blood draw.

L BOP Employee Healthcare

Each applicant for BOP employment shall have a physical examination as part of the application process. The contractor shall conduct the physical exam at the mutual convenience of the HSU and Human Resource staff. The BP-A0630, Medical History Report and BP-A0631, Post Conditional Offer of Employment & Employee Physical Exam forms shall document the examination. The completed forms shall be given to the Human Resource Department.

Components of the examination shall include: a complete medical and mental health history, a physical examination including audiometric testing, PA & LAT Chest x-ray, routine urinalysis (microscopic, ifindicated), and appropriate TB screening (TB screening may be completed during Introduction to Correctional Techniques phase one (lCT) training.

BOP employees shall meet the physical standards established between the Bureau and OPM, and shall be able to perform their duties without hazard to themselves or others. Minimum basic standards are published in the announcement of examinations for various positions, available through the institution human resource office. In general, the examiner shall be guided by the mission and duties of the employee in the Bureau and the requirement for high standards of physical and mental health. In questionable situations, the approving physician may refer a case to an OPM Examining Board. If an examination is completed by other than a physician, it shall be reviewed and countersigned by a physician. Candidates with remedial defects or temporary illness at the time of examination shall be reexamined in 30 days.

The contractor shall conduct training physicals prior to BOP staff being authorized to attend certain training assignments. BOP employees shall meet the physical standards established by the Bureau and shall be able to perform their duties without hazard to themselves or others. The contractor shall conduct the physical exam at the mutual convenience of the HSU and Human Resource staff. The forms shall be provided by the Human Resource Depar:tment and the completed forms shall be given to the BOP staff member.

BOP employees shall be offered an annual PPD screening for tuberculosis. The Hepatitis B vaccine shall be offered during ICT phase one (within at least 10 days) for new employees, upon request ofother employees not previously vaccinated, and contract employees who are at risk.

No other immunizations/vaccines are authorized (refer to the current Program Statement on Infectious Disease Management).

Should the BOP purchase flu vaccine, the contractor will be responsible for administering the flu vaccine to BOP staff. Note: Flu vaccine and supplies will be purchased by the Government.

All BOP employees shall be afforded first-aid treatment and/or emergency treatment for job related injuries and/or emergency situations. Contractor will have a provider evaluate each employee with a possible exposure to determine ifit matches the CDC definition for an exposure. The contractor will provide medications, laboratory testing and follow up as determined by CDC guidelines for each exposure.

Upon request, and with documentation from the BOP employee's private physician, the Clinical Director may, based upon available resources, administer prescribed medications to BOP employees on a case-by-case basis. HSUs may not dispense medications from institution stock for an employee's personal use, except in emergencies.

J. Dental

Dental A & 0 exams will be completed within 14 days. The inmate will be informed of clinical findings and instructed how to access care. Once an inmate has requested care, he will be placed on the dental list. When an inmate is removed off the routine list, at the first appointment, a comprehensive treatment planning exam will be completed. After a comprehensive treatment planning exam is completed, inmates will have consecutive appointments until their treatment plan is completed. Each inmate will have his treatment plan completed no longer than one year after arriving at the FCC.

Inmates who are placed in the Special Housing Unit will not lose their place on the dental list.

Inmates transferring to FCC Beaumont from another BOP facility, who request dental care, will be placed on the dental list as of the date of their initial request for care. When the inmate is removed from the dental list, a periodic exam will be completed to reassess the oral health of the inmate.

Due to the length of time it may take for the fabrication of full or partial dentures, the dentist should consider alternative diets for those inmates who may experience a prolonged amount of time prior to receiving dental prostheses.

Dental ACA Outcome Measures will be forwarded to the COR on a quarterly basis. A weekly report will be provided to the COR documenting the status of the wait list, the number of inmates seen at sick call for each institution, the number of inmates added to the wait list for each institution and a copy of the dental call-outs for the week at each institution.

If an inmate misses his dental call out, he will not be taken off the waiting list. The first time he misses a call out that is the inmate's fault; he will be scheduled for the next working day. The second and subsequent times the inmate misses a dental call out that is the inmate's fault he will be placed at the end of the waiting list. If the inmate misses a dental appointment and it is not his fault, he will be scheduled for an appointment the next working day.

When requested by BOP Executive staff or the COR, an inmate will be triaged for dental care on the day requested and a diagnosis and treatment plan will be documented in the medical record.

The treatment plan will be initiated that working day and completed in consecutive appointments.

K. Training Instructors

The contractor will be required to provide instructors to teach medical classes in Introduction to Correctional Techniques, BOP Annual Refresher Training, and Basic Prisoner Transportation.

Instructors will be provided to teach inmate admission and orientation, orderly job orientation, hazardous waste cleanup for hospital and unit orderlies for work assignments and other inmates for hurricane preparation. Contract instructors will also be required to teach assigned medical classes during contractor institution familiarization and contractor annual refresher training.

L. Sick Call

On days when there is sick call, it will stay open at least 30 minutes after the last housing unit is called to report to food service.

A.I.7.7 HSU Staffing Plan and Operational Procednres

As part of the technical proposal, each offeror shall provide a Comprehensive Staffing Plan, including subcontractors, and Operational Procedures for providing urgent and routine medical, mental health and dental services. In order to provide such services, the Contractor shall utilize the HSU to the fullest extent possible. Where services cannot be provided within the HSU (i.e., outpatient/inpatient surgery and inpatient services), the Contractor must have agreements with outside health service providers as a supplement.

The Comprehensive Staffing Plan must include a detailed description of the health care professionals, including subcontractors, and corresponding levels of expertise, certification and licensure, which will be utilized to perform the necessary health services.

The Operational Procedures shall document the methodologies to be used by the contractor, and subcontractors, in the delivery of necessary health services to the FCC. The contractor is encouraged to propose start-of-the-art technology and methodologies (i.e., telemedicine) as part of their operational procedures and technical approach to completing the requirements of this solicitation.

Both plans and procedures shall include, but are not limited to, provision for the following: (1) 24 hours a day, 7 days a week urgent medical, mental health and dental care; (2) initial health screening; (3) medical examinations; (4) daily triaging ofcomplaints; (5) sick call procedures;

(6) special medical programs and services for, but not limited to, inmates with chronic needs or requiring convalescent care; (7) mental health and substance abuse services; (8) ancillary services

- radiology, laboratory, pharmaceuticals services and supplies, physical therapy services, optometry services and supplies, and autopsy services; (9) dental services - urgent and routine;

(10) audiometric services and supplies; (11) health education; (12) medical diets; (13) infectious diseases; and (14) organization performance improvement program along with a quality measurement system.

A.1.7.8 Inmate Accident Compensation

To comply with the provisions of28 CFR Part 301, and to ensure continuity of medical services for inmates who file for compensation through the Inmate Accident Compensation (IAC) procedures for work related injuries, the contractor shall conduct physical impairment examinations prior to the claimant's release/transfer from institution custody. This must be completed no less than 15 days prior to date of release. The physician conducting the impainnent examination is required to complete page 2 ofBP-A0658, Inmate Claim for Compensation Resulting From Work Injury (section entitled, "To Be Completed by Examining Physician) and forward the completed fonn to the Safety Manager for final processing.

A.1.7.9 Respiratory Protection Requirements

To comply with the provisions of29 CFR Part 1910.134, and to ensure compliance with respiratory protection requirements by ensuring all employees and inmates who utilize respirators are appropriately medically cleared and fit tested, the contractor will conduct medical evaluations (and follow-up examinations when necessary), using OSHA's medical questionnaire, for employeeslinmates and provide a written recommendation regarding their ability to use a respirator and any limitations on respirator use related to the medical or work place condition of the employeelinmate. The BOP also needs to know whether or not there is a need for follow-up medical evaluations. (See Attachment # 21)

A.1.8 HSU ADMINISTRATION

A.1.8.1 Point of Contact

The Contractor shall designate the Managed Care Administrator to serve as the health services point of contact (POC) who shall be responsible for the delivery of health services under this contract. The POC shall have the full authority to act on behalf of the contractor on all matters relating to the daily operation of the contract. An alternate may be designated; however, the contractor must identify those times when the alternate shall be the primary POCo

A.1.8.2 Medical Records

Consistency in content and fonnat ofmedical records of inmates transferring between the FCC and other BOP facilities is a critical component of care for inmates. Therefore, the contractor shall adhere to P.S. 6090.01, Health Infonnation Management, regarding the preparation, fonnat, documentation, maintenance, and release and all medico legal aspects of an inmate's medical record. The contractor is responsible for supplying medical record folders, consistent with the specification provided by the BOP, only for those inmates who are new designations into the institution or in cases where transferred medical records cannot be located. The BOP shall provide to the contractor all applicable BOP fonns necessary to document an inmate's medical record.

All inmate medical records are the property of the BOP and shall be released to the BOP upon request. The Contractor shall adhere to BOP P.S. 6090.01, Section 18, Health Infonnation Management, regarding release and copy of inmate's medical records. All documents shall be filed in the medical record within five business days after the document is received. Local procedures will be developed to ensure all inpatient records, consult reports, and another documents generated outside the FCC are received as soon as possible.

A copy of the monthly medical record audit with corrective actions will be provided to the COR on the first working day of each month.

The contractor will use the BOP Eectronic Medical Record (BEMR) if and when made available to the contractor. The program is web-based and will be supplied to the contractor via the BOP secure WAN. Initial training will be provided to the contractor and their health services staff at the initiation. Ongoing training of new staff will be done by the contractor's health services staff.

Training regarding changes or upgrades to the program will be done via CENTRA web meeting by the BOP. If the contractor is not offered BEMR, the contractor shall document all health care utilizing a web-based electronic health record that is certified by an organization approved by the U.S. Department ofHealth and Human Services (HHS) / Office of the National Coordinator for Health Infonnation Technology (ONC). The contractor's EMR shall meet all current and future standards fonnally adopted by the ONe. The BOP Health Services Division shall be provided user accounts to utilize the contractor's EMR to read all inmate health records and utilize all reporting functions in real time. The contractor shall provide the BOP with regularly scheduled copiesoftheir EMR data (including inmate personally identifiable infonnation) in XML fonnat.

A.1.8.3 Sensitive Medical Data (SMD)/Medical Duty Status (MDS) Reporting Requirements

As required by the BOP policy, the contractor shall be responsible for inputting applicable sensitive medical data/medical duty status reporting data into the BOP's SMDIMDS system. The contractor shall also adhere to the requirements ofTRM 6001.03, Sentry Medical SMDIMDS and BP-S504.063, Outpatient Morbidity Classification fonn.

Sentry SMD will be used for the following:

A. Assigning inmates with chronic illness into chronic care clinics as appropriate and replacing with future appointments as needed.

B. Selection and entry of applicable diagnoses for chronically ill inmates at the conclusion of their intake physical exam and updated as appropriate.

e. Maintenance of significant chronic diagnoses for inmates already in the system by updating as appropriate.

D. Infectious disease monitoring (Human Immunodeficiency Virus (HIV) classification, testing, risk factors, Tuberculosis (TB) testing, TB prophylaxis, and TB disease) and data entry as currently perfonned.

E. Entering ofcommunity hospitalizations and medical referral center hospitalizations.

A.I.8,4 Inmate Skills Development System (ISDS)

The Contractor will enter medical data into ISDS system via Sallyport Home Page. Information will include Health Promotion / Disease Prevention, Disease/Illness Management, as well as a Transitional Plan. Inmates designated to FCC Beaumont will have the information placed into ISDS within seven days of arrival and updates are required every six months. The contractor will be required to develop their own local policy for the ISDS. Areport will be generated monthly and e-mailed to the COR to show which inmates at FCC Beaumont do not have the medical information in ISDS.

A.1.8.S Medical Transfers and Designations

Medical designations to BOP Medical Referral Centers or other BOP facilities will be at the sole discretion of the BOP. In order to transport an inmate, the patient must be in stable condition and be cleared for transport by the attending physician. Should an inmate be re-designated to another BOP facility for medical reasons, and a medical escort is required, the contractor shall provide this escort and all medical personnel costs associated with this escort.

Medical designation requests must be completed in writing in accordance with P.S. 6270.01 and approved by the COR and the Warden prior to submission to the BOP Health Services Division.

Documentation will be provided with the BP-S770 to justify everything on the form. The documentation must match the CARE level criteria for CARE 3 or 4 and the form will clearly state how the inmate's medical condition matches the CARE 3 or 4 criteria. The contractor will comply with the memo dated January 24,2011 (Attachment #19), from the BOP Medical Director concerning Medical Hold Status. Once the contractor has determined an inmate's CARE level is 3 or 4, the BP-S770 MEDICAL/SURGICAL AND PSYCHIATRIC REFERRAL REQUEST will be completed and ready for the Warden's signature within 7 days.

A.I.8.6 Catastrophic Limitation

An offeror may include in the technical proposal a catastrophic limitation which would place a cap on the contractor's liability for costs associated with the community-based treatment of inmates.

A.I.8.7 Prisoner Transportation/Security

When it has been determined that an inmate must be transported outside the secure perimeter of the facility, the contractor must adhere to all regulations prescribed by the BOP to ensure the safekeeping of the inmate, BOP and contract staff members, and the genera; public. The contractor must coordinate all emergency transportation with FCC staff. After normal business hours, the Clinical Director will report to the institution and examine each inmate who may need to be sent to the local hospital emergency room for non-emergency evaluation for treatment.

Non-emergency transportation shall normally be the responsibility of the BOP; however, the contractor shall be responsible for all emergency transportation (i.e., ambulance services) to an outside medical facility, and all costs associated therewith.

Once it is determined that an inmate must obtain treatment at an outside medical facility, the contractor shall be responsible for preparation, routing, and distribution of the escorted trip authorization and related documentation.

Any subcontracting arrangements with a community care provider shall accommodate either BOP or contracted guard services for the transferred inmate. These guard services will be provided by the BOP at no cost to the contractor. Although not responsible for the provision of guard services, the contractor shall be familiar with the requirements of BOP P.S. 5538.04, Escorted Trips, and its impact on the provision of medical services.

A.1.8.8 Submission of Various Medica) Reports

The contractor shall provide a daily report by 1400 hours on the status of each patient admitted to the hospital or in medical observation in a form requested by the COR. The status of each inmate in the hospital will be filed daily in the medical record.

Reports from SENTRY, BEMR, or other sources will be provided weekly to the COR in a format requested by the COR to show compliance with:

BP-770 completed for each inmate who is CARE 3 or 4;

Inmates in Chronic Care Clinics are seen by a physician at least every six months;

DNA collection is completed during the first 30 days after arrival;

Intake physicals are completed during the first 14 days after arrival;

All administrative remedies, letters, tort claims, congressionals, and other responses are completed according to the terms of the contract and local policy;

Co-Pays are properly charged and entered per policy;

Town Trip forms completed timely and correctly

A separate report for each institution will be provided to the COR weekly documenting if inmates were seen for scheduled appointments to include all call outs and SHU appointments. It will be provided in a format designated by the COR. It must include at least: inmate name and number, date of appointment, reason not seen for appointment, if documented in medical record, and was the appointment rescheduled.

ACA outcome measures will be reported monthly to the COR in the requested format.

The contractor will collect and report data for National Performance Measures as directed by the

FBOP Central Office and the COR. A hunger strike report will be sent daily by 1300 hours to all

HSSs for each inmate who is on hunger strike.

On a non-routine basis, the contractor shall submit various medical reports to the BOP. These reports may include, but will not be limited to, pharmaceutical utilization reports and pharmaceutical evaluation reports. Such reports shall be submitted within 14 calendar days of the BOP's request.

A.1.8.9 Mainline Responsibilities

As part of the BOP philosophy to be responsive to the needs of inmates, the contractor shall assign at least one medical staff member, nurse level or above to the dining hall at each of the four institutions for the lunch meaL At the Low, Medium, and High Security Facilities, the institution health service administrator or the institution nurse manager will cover mainline four days a week and dental staff will cover one day per week. The schedule will be from the time mainline starts until it ends but not to exceed 90 minutes in duration, Monday through Friday.

This person(s) will be responsible for addressing inmate questions about medical issues at the FCC. The contractor will keep a written record of the questions and requests as well as the resulting answers which should normally be available at the next mainline. The contractor will provide a copy of these written records to the COR weekly.

As part of the same BOP philosophy to be responsive to the needs of inmates, the contractor shall assign the institution nurse manager to do SHU rounds weekly according to local policy. A copy of the questions and answers from SHU inmates at each institution will also be provided to the COR weekly.

A.1.9 GOVERNMENT PROVIDED EQUIPMENT

A. Equipment

All HSUs at the FCC have the necessary medical equipment and are in operation at present.

However, for radiographic equipment, please refer to page 11 of this PWS.

The contractor shall be responsible for performing, and assuming all costs associated with performing all preventive maintenance and repairs of all Government equipment. Any repairs of equipment shall be coordinated with the COR. Replacement equipment shall be provided by the contractor at the contractor's expense and shall remain the property of the contractor. Any damages due to the negligence or misuse ofany Government provided equipment by the contractor, or subcontractor, shall be the financial responsibility of the contractor.