RUSO Medical Services RFP.pdf

Request for Proposals

Jail Inmate Medical Services

All Proposals Shall be Marked Services

Return Proposals to:

George Murray, Jail Captain

Inmate Medical 311 Miner Ave E, Suite L100 Ladysmith, Wisconsin 54848

1. Introduction

The Rusk ng proposals from qualified service providers with specific experience in correctional facilities to provide medical services for inmates within the Rusk County Jail located at 311 Miner Ave E, Ladysmith Wisconsin. The health care services shall include on-site health care personnel, direct medical services for inmates, and coordination of off-site medical care, hospitalization, dental and other services that may be needed.

Request for Proposa Vendor successful vendor(s) in the context of providing services under a contract resulting from this RFP.

All responses received from this RFP will be evaluated on the criteria provided.

One original, plus three (3) copies must be delivered to the address below on or before 12:00 pm central standard time on March 22nd, 2024. The County will not be responsible for proposals delivered to a person or location other than that specified herein, and reliance on third party shipping methods will not excuse late proposals.

Rusk Office Attn: George Murray, Jail Captain

Any amendments or addendums to this RFP are valid only if in writing and issued by the Rusk

Office. Questions regarding specifications for this RFP must be submitted, in writing no later than March 15th, 2024 to Jail Captain George Murray at gm121@ruskcountywi.us or by

Postal Service to:

Rusk Office Attn: Captain George Murray the information cannot be obtained and shared with all potential vendors in a timely manner.

2 General Terms and Conditions

2.1 Primary Responsibility:

The selected vendor(s) will be required to assume full responsibility for all services and activities offered in the proposal. Further, the County will consider the selected vendor(s) to be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract.

2.2 Assurance:

Any contract awarded under this RFP must be carried out in full compliance with Title VI and VII of the Civil Rights Act of 1964, as amended, and Section 504 of the Rehabilitation Act of 1973, as amended. The Provider must guarantee that services provided will be performed in compliance with all applicable Federal, State and Local laws and regulations pertinent to this project. Prior to executing an agreement the Provider will be required to provide evidence substantiating the necessary skill to perform the duties through the submission of references.

2.3 Independent Contractor:

In performance of the work, duties and obligations assumed by the vendor, it is mutually understood and agreed that agents and employees, will at all times be acting and performing in an independent capacity and not as an officer, agent, servant, employee, joint venture, partner or associate of the County.

2.4 The County prohibits discrimination in employment or in the provision of services because of race, color, religion, religious creed, sex, age, marital status, ancestry, national origin, political affiliation, physical disability, or medical condition. This clause does not require the hiring of unqualified persons.

2.5 The County reserves the right to reject any and all proposals, to negotiate specific terms, conditions, compensation, and provisions on any contracts that may arise from this solicitation; to waive any informalities or irregularities in the proposals, and to accept the proposal(s) that appear(s) to be in the best interest of the County. In determining and evaluating the proposals, cost and commissions will not necessarily be controlling; the experience of those who will be providing services under the contract, quality, equality, efficiency, utility, suitability of the services offered, and the reputation of applicants will be considered, along with other relevant factors.

2.6 The County reserves the right to:

Request clarification of any submitted information;

Not enter into any agreement.

2.7 and incorporated in the contract.

3. Contract Terms

The contract period will be for five (5) years commencing on July 1, 2024 with an option for the County at its discretion to extend the contract for additional one-year term/s.

4. Background

This Request for Proposal (RFP) is to establish a contract for provision of medical services for inmates within the Rusk County Jail. The health care services shall include on-site health care personnel, direct medical services for inmates, and coordination of off-site medical care, hospitalization, dental and other services that may be needed.

Rusk County Office/ Jail:

The Rusk County Jail has the capacity to house 52 inmates. Average daily population over the last ten years is 40.

5. Qualifications of Bidder

To be considered for award of this contract, the vendor must meet the following minimum qualifications:

The vendor must have specific experience in correctional facilities to provide medical services for inmates and have had at least three (3) years previous correctional managed experience with proven effectiveness in providing medical services to inmates.

The vendor must have proven ability for contract start-up by July 1, 2024

The vendor must have qualified and trained staff with sufficient back-up personnel and background checks submitted for each employee that will be providing medical service at the Rusk Office/Jail.

The vendor must have the central office capability to supervise and monitor the program ensuring satisfactory provision of services.

6. Inmate Medical Services Base Service Plan

Vendor is to clearly define the services being provided and describe any minor changes the vendor feels are necessary. the Rusk County Jail shall commence immediately upon the commitment of such person to the control of the Sheriff at the Rusk County Jail.

6.1 Vendor Requirements

As a part of the ensuing contractual agreement, the vendor shall:

Deliver and maintain high quality, cost effective healthcare. Implement policies, procedures and protocols with clear objectives for the Rusk County Jail that meet the standards and requirements of Wisconsin Department of Corrections Administrative Code (Chapter 350), standards of the National Commission on Correction Health Care (NCCHC) and the American Correctional Association (ACA).

Comply with all requirements of HIPAA to the extent that HIPAA applies to the Jail.

It is mutually understood an independent vendor relationship will be established under the terms and conditions of the agreement; that employees of the selected provider are not, nor shall be, deemed employees of the Rusk County Jail and that employees of the Rusk County Jail are not, nor shall be, deemed employees of the selected provider.

Operate the inmate medical healthcare services program using Wisconsin licensed, certified and professionally trained personnel to perform all aspects of conventional health in a correctional setting, including physicians, registered nurses and licensed practical nurses as necessary.

Provide a licensed physician, or physician assistant, to consult with Rusk County Jail staff 24 hours/day, 7 days/week, 365 days/year, when healthcare staff is not present at the facility. A physician, or physician assistant, shall respond to requests within 15 minutes.

Maintain a quality assurance program and provide information on the same. Quarterly meetings shall be scheduled with vendor staff and jail administration to review issues, statistical information, suggested changes and provide feedback about the medical services being provided by the vendor.

Offer a comprehensive annual training program for medical healthcare education for the Rusk jail staff. Training topics to be reviewed with the Rusk County Jail Captain and will comply with the jail administration Standards of the Wisconsin Department of Corrections, and standards of the National Commission on Correctional Heath Care (NCCHC).

Maintain an open, collaborative relationship with the administration and staff of the Rusk County Jail and Rusk County Health & Human Services staff that provide services to Rusk County inmates.

Conduct an ongoing health education program for adult inmates. Topics shall include, but not be limited to: personal hygiene, nutrition, alcohol and drug abuse, sexually transmitted diseases, effect of smoking and anger management.

basic healthcare services.

Maintain confidential, complete and accurate records of care. Collect and analyze healthcare statistics on a daily basis for generation of monthly and annual reports. Analysis should include information that will assist all parties in justifying current services and identify any need for enhanced services. These and all records of care will be the property of the Rusk Department of Corrections standards.

Allow the Jail Captain or designee total access to the onsite medical files, reports, schedules, grievances, charts, etc.

6.2 Staff Schedule

Vendor must provide adequate healthcare personnel required for the services listed in this request for proposal. Vendor must provide the following staffing:

A Licensed Practical Nurse or Registered Nurse will be on-site Monday, Wednesday, Friday for a minimum of 5 hours each day; total of 15 hours per week.

Additional hours may be provided if mutually agreed upon by both parties in writing, with at least 24 hours advanced notice.

Provide or arrange for the provision of an on-call physician to be available by telephone 24 hours/day, 7 days/week, 365 days/year.

Said hours may be re-allocated and subject to change as determined by mutual agreement of the parties, but shall in all respects be consistent with the medical recommendations of a licensed physician.

The proposal must include a specific schedule for one (1) RN or LPN.

Staffing schedule and patterns must be maintained regardless of training needs, holidays, sick days, vacation or vacancies and shall be mutually agreed upon.

6.3 Personnel

Rusk County would request that the successful vendor consider employment of existing staff if appropriate.

procedures of the Rusk County Jail.

Continued assignment of staff shall be subject to the approval of the Rusk Office through the Jail Captain.

Only Wisconsin licensed, certified and professionally trained medical personnel shall provide professional coverage.

The successful provider shall provide appropriate in-service training and education programs as required by law and/or license regulations for their staff. Vendor must provide comprehensive training to their staff on how to work effectively, professionally and safely in a correctional facility.

All personnel shall comply with current and future state, federal and local laws, regulations, court orders, administrative regulations, administrative directive, and policies and procedures of the Rusk Office.

6.4 Required Services and Supplies

Correctional staff currently completes the medical screening during the booking process.

Those medical plan will be documented by the vendor for each inmate as deemed necessary.

professional for each inmate within fourteen (14) days of an initial confinement.

Examinations must be completed within the guidelines of the Wisconsin Department of Corrections Administrative Code standards of the National Commission on Correctional Health Care (NCCHC).

The vendor shall obtain all prescription and non-prescription medications, medical supplies and other supplies. The jail physician shall order all medications and must maintain all administration records. Prescribing, dispensing and administering of medications shall comply with all State and Federal laws and regulations. All costs will be the responsibility of the successful vendor.

istrative Record (MAR). When staff is not on duty, jail personnel may set up the MAR for the inmate. Medical review will be completed by the vendor staff on their next working day.

-site shall respond to inmate sick calls.

-site shall make daily segregation and receiving cell visits.

In addition, the vendor is required to provide the following medical services and supplies:

- Pharmacy services to include the cost of all prescription and non-prescription over-the-counter medications prescribed by a duly licensed prescriber. Prescribing, dispensing and administering of medications shall comply with all State and Federal laws and regulations

- Assisting with scheduling pathology/radiology services

- Medical staff when on-site shall be available for crisis intervention services.

- Removal and proper disposal of medical waste

- Other general healthcare services such as oral screening and evaluation for emergency dental

- Medical supplies

- TB testing and/or assessment of all inmates that are in the jail for 14 days or longer

- All medical services to inmates housed from other counties or government agencies

- On-site emergency medical treatment to inmates

- Healthcare services to pregnant inmates. Healthcare services for infants following birth

- Conduct an ongoing health education program for adult inmates and detainees; health education includes patient education in self-care skill, posters and pamphlets

- Provide annual training for Rusk County Sheriff jail staff that meets WI DOC 350.15

(6). Training to include, but not be limited to: First Aid, Blood Borne pathogens, Communicable diseases, Diabetes, Illicit Drugs & Effects, and similar topics

- Vendor must provide procedures for handling inmate medical grievances

- Stock first aid kits/emergency response kits, sharps disposal boxes, spill kits, protective gowns, booties, facemasks and other similar supplies to be used by the provider. These items are not provided by Rusk County

6.5 Vendor Responsibilities

Vendor is responsible for all of the following services and shall:

Submit schedules and staffing patterns for all medical services that reflect coverage as per the agreement.

Manage and maintain inmate medical records.

Provide statistical and management reporting systems as required by Rusk County and

Department of Corrections.

Implement a Medical Grievance Procedure program.

Educate/train corrections staff and inmates.

Complete an independent annual compliance evaluation and submit any certification(s).

Adhere to jail security procedures and codes of conduct.

Maintain a collaborative working relationship with Rusk County jail staff and with Rusk Rusk County Jail.

Vendor is not responsible to provide the following services:

Elective medical care for Rusk County Jail inmates. For purposes of the Agreement, Healthcare services for infants following birth and delivery.

7 Mandatory Proposal Requirements

7.1 Proposal Requirements

Minimum submission requirements include (listed in this order):

1. Table of contents.

2. Certification of Vendor vendor name, address, telephone number, facsimile number and primary contact person.

3. Copy of current certificate of insurance.

4. Brief history of the vendor.

5. Proposal for the cost of base services.

6. Comprehensive transition implementation plan.

7. Certification that the submitted proposal will remain valid from the proposal submission date for a period of 90 days.

8. Certifications for all key personnel to be assigned and actually provide services under contract with Rusk County.

9. Job descriptions of all staffing positions providing services under contract with Rusk

County. All project personnel assigned by the vendor are subject to a criminal history background check to be performed by the Rusk Office and must be approved by the Sheriff.

10. A detailed list of correctional projects and clients for the last three (3) years. The client list must include both current and former contracts and include appropriate contact person names and title, agency (city, county, state, and federal), location with address and telephone number as well as facsimile number and e-mail address. Each contract must be identified as current or former. Locations must be included where services were provided even if no executed agreement was ever reached.

11. Minimum of three (3) references identified by the company with the information listed immediately above. This information must be provided or the submission may be disqualified.

12. Full disclosure of all lawsuits and claims filed against the vendor, or its predecessors, in the past 48 calendar months.

13. for insurance including liability and malpractice.

14.

standard contract if available.

7.2 Proposal Format

utilizing a table of contents following the proposal requirements listed above. Any documentation the vendor feels should be included to support their response should be added after the required documentation.

7.3 Compliance with the Request for Proposal

Proposals submitted must be in strict compliance with the terms of the RFP. Failure to comply with all provisions of the RFP may result in disqualification. Rusk County reserves the right to reject any and all submittals or to waive minor defects or irregularities in any submittal. By submitting a proposal, the vendor agrees that Rusk final, binding, and conclusive upon it for all purposes, and acknowledges that Rusk County in its sole and unqualified discretion may waive or deviate from the procedures and/or timetable described in the RFP. All materials submitted become the property of Rusk County and may be available to the public.

7.4 Implied Requirements

Products and services that are not specifically addressed in this RFP but which are necessary to provide functional capabilities proposed by the respondent must be included in the proposal.

8. Award Procedures

8.1 Conditions of Award

Rusk County, through its duly authorized agents reserves the right to reject any or all proposals, to waive all technicalities and to accept the proposal deemed most advantageous to Rusk County.

All vendors, by submissions of their respective proposals, agree to abide by the rules, regulations, and procedures of Rusk County. An intent to award will not be made and an agreement will not be executed until Rusk County, at its sole discretion, accepts a proposal.

8.2 Disqualification

Award will not be made to any person, vendor or company in default of a contract with Rusk County, or to any vendor having as its sales agent, representative or any member of the vendor, any individual previously in default or guilty of misrepresentation.

8.3 Notice of Acceptance

Rusk County will notify the selected vendor as soon as practical of the selection. Email notice of award to the vendor will be considered sufficient notice of acceptance of proposal.

8.4 Proposal Results

Vendors may secure information pertaining to results of the proposals by request in writing to Rusk County Jail Captain George Murray, Monday through Thursday, between 8:00 a.m. and 4:30 p.m, and Friday 8:00 am to 12:30 pm.

8.5 Selection Criteria

Award shall be made to the vendor whose proposal is determined to be in the best interest of Rusk County, taking into consideration cost and other evaluation factors listed in the RFP. Proposals submitted will be evaluated based on criteria including, but not limited to the following:

1. General quality and adequacy of response

a. Completeness and thoroughness

b. Understanding of the project

c. Responsiveness to terms and conditions

d. The listing of any exceptions or conditions detailed by the vendor to the specifications as written

2. Experience & qualifications of firm and assigned staff

a. Experience of firm

b. Qualifications of personnel

c. Experience of personnel

3. Reasonableness of cost estimates

a. Annual lump sum cost

b. Unit cost for any other services as may be proposed by the vendor

c. Evidence of efficient use of resources

d. Total cost of each service option

4. Services

a. Ability to commence July 1, 2024

b. Detail and responsiveness of the Transition Implementation Plan

5. References/Client Lists nistrative Team and respective oversight committees. Vendors, who are deemed on a basis of selection criteria, fully qualified and best suited among those submitting proposals, may be requested to participate in discussions regarding their proposals. Discussion will cover cost, methods and all other relevant factors. Rusk County reserves the right to select a bidder based on the quality of the proposal not necessarily the lowest bidder.

At the conclusion of the discussions, the vendors will be ranked on the basis of selection criteria and final negotiations will be conducted with the vendor ranked first. If a satisfactory agreement can be reached, the contract shall be awarded to the vendor; otherwise, negotiations will be conducted with each subsequent vendor until a satisfactory contract can be established or until the determination is made that the rejection of all proposals is in the best interest of Rusk County.

8.6 Method of Award

The award will be made to the vendor whose proposal is determined to be professionally and technically complete. The selection process may however, include a request for additional information or an oral presentation to support the written proposal. The price proposal will be considered firm and cannot be altered after receipt per the terms of this proposal.

Rusk County reserves the right to award this contract not necessarily to the vendor with the lowest price, but to the bidder that demonstrates the best ability to fulfill the requirements of the RFP.

The successful vendor will be chosen based on the qualifications and selection criteria discussed in this proposal.

The successful vendor shall commence work only after the transmittal of a fully executed contract and after receiving written notification to proceed from Rusk County. The successful bidder will perform all services indicated in the proposal in compliance with the negotiated contract. All bids will be reviewed and recommendations for a selection will be made by the Rusk Administrative Team to the County Board.

Rusk County reserves the right to reject any and all proposals for any reason in whole or in part received in response to this RFP. Rusk County will not pay for any information herein requested, nor is it liable for any cost incurred by the proposer.

Vendors whose proposals do not meet the mandatory requirements will be considered non-compliant. After the evaluation of the proposals and selection of the successful vendor, all vendors will be notified of the selected vendor.

9. Accounting Procedures

The accounting procedures and internal financial controls of the Vendor shall conform to generally accepted accounting practices (GAAP) in order for the costs allowed by this request can be readily ascertained and expenditures verified.

10. Reports, Records and Inspection of Records

Vendor shall keep full and accurate records of the medical services provided. A copy of the records shall be supplied to the Sheriff and/or designee with the monthly invoices. In addition, the successful Vendor shall retain all records related to the services provided for seven (7) years after the termination of an agreement. All records related to the service provided under this request shall be available for auditing by the County at any time during regular working hours.

11. Reporting of Accidents or Incidents at the Rusk County Jail

Vendor shall ensure that its employees immediately report any accidents or incidents of any unusual nature in writing to the Sheriff and/or Jail Captain.

12. Staffing Requirement

a. The Sheriff reserves the right to refuse admittance to any person(s) who may constitute a security risk to the Rusk County Jail.

b. The Vendor shall medical complaints with the Jail Captain or jail staff. All complaints from inmates about medical services provided shall be resolved as soon as practicable.

13. Reservation of Rights

The Rusk Office reserves the right to reject any and all proposals, to award the agreement to other than the low proposal, to negotiate the terms and conditions of all and any part of the proposals, to waive irregularities and or formalities, and in general to make award in the manner as determined to be in the best interest and at the sole discretion of the County.

14. Responsive Proposals

Companies are expected to examine the RFP requirements and all instructions. Failure to do so ny shall furnish all information requested herein. The person signing the proposal must initial all erasures or other changes. If any person contemplating submitting a proposal is in doubt of the true meaning of any part of the specifications of other conditions with the RFP, they are advised to have the portions in question clarified.

15. Changes to RFP Documents

Each change or addendum issued in relation to the RFP will be ruskcounty.org. In addition, to the extent possible, copies will be posted on the website. It shall be the vendor check the website as to the changes or addenda issued. All such changed or addenda issued, shall become part of the contract and all bidders shall be bound by such changes or addenda.

16. Withdrawal of Proposal

Proposals may be withdrawn in person by a provider, or authorized representative, provided their identity is made known and a receipt is signed for the response to the RFP, but only if the withdrawal is made prior to the stated RFP deadline.

17. Termination by County for Cause

If the vendor fails to fulfill its obligations under the contract resulting from this RFP in a timely and proper manner, or violates any of its provisions, the County may thereupon have the right to terminate the agreement by giving ninety (90) days written notice of termination, return receipt required, specifying the alleged violations and effective date of termination. The contract may not be terminated if, upon receipt of the notice, the vendor cures the alleged violation within 30 days.

In the event of termination, Rusk County will only be liable for services rendered and expenses incurred through the date of termination and not for the uncompleted portion and for any materials services purchased or paid for by the vendor for use in completing the contract.

18. Unrestricted Right of Termination by County without Cause

Rusk County further reserves the right to terminate this contract at any time for any reason by giving the vendor a minimum of sixty (60) days written notice by return receipt mail of such termination. In the event of said termination, vendor shall not reduce its activities hereunder unless agreed in advance by Rusk County. The vendor will be paid according to the contract for services rendered through the date of termination.

19. Indemnification and Hold Harmless

The vendor whose proposal is accepted must agree to the following indemnification and hold harmless responsibilities:

The vendor shall, at its own expense, protect, defend, indemnify and hold harmless its own employees. Rusk County will at its own expense, protect, defend, indemnify and hold harmless elected and appointed officers, employees and agents from all claims, damages, costs, lawsuits and expenses including but not limited to, all costs from administrative proceedings, court costs, and attorney fees, that may incur as a result of any acts, omissions or negligence of the selected firm, its employee or agents or its subcontractors or sub-subcontractors or any of their officers, employees or agents which may arise out of the contract.

20. Taxes, Terms and Conditions

Section 258 of the law amends Sec. 77.54 (9a) of the Statutes which exempts the state and local units of government from payment of the state sales tax on goods and services purchased. We are informed by the Department of Revenue that no exemption certificates are required from governmental units and no exempt status numbers are issued to governmental units. All local units of government should notify vendors that they are exempt from payment of the tax by statute, and that notes to that effect on vendor invoices will satisfy Department of Revenue auditors should the vendor be audited.

Rusk County is exempt from Fede numbers are:

Fed ID #39-6005738. Payment terms are Net 30 upon receipt and acceptance.

21. Equal Employment Opportunity

The vendor and its subcontractors, as required by law, shall not discriminate against the employee or applicant for employment with the respect to hire, tenure, terms, conditions or privileges of employment, or a matter that directly relates to employment, because of race, color, religion, of a particular job or position, height, weight, or marital status. Breach of this covenant may be regarded as a material breach of the contract.

The vendor agrees to post notices containing this policy against discrimination in conspicuous places available to applicants for employment and employees. All solicitation or advertisements for employees, place by or on the behalf of the contract, will state that all qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, disability, age, height, weight, marital status and religion.

22. Insurance Requirements

The vendor whose proposal is accepted must meet and agree to maintain during the term of the companies licensed and admitted to do business in the State of Wisconsin. All coverag with insurance carriers acceptable to the County.

The vendor required by law. In the event that the vendor uses subcontractors and subcontractors for the performance of services required under this proposal, the vendor shall ensure that said subcontractors and sub- Insurance coverage, as required by law.

The vendor shall be responsible for insuring all its tools and equipment and all material which it may use and/or leave at the work site. The County shall not be responsible for any loss or damage to the vendor

The vendor shall procure and maintain during the term of the contract the following coverages:

Medical Malpractice/Professional Liability insurance in the amount not less than $1,000,000.00;

Comprehensive General Liability Insurance in an amount not less than $1,000,000.00 per occurrence and aggregate in an amount of not less than $3,000,000.00.

The Comprehensive General Liability policy shall contain additional endorsements naming Rusk County as an additional insured with respect to liabilities arising out of the performance of services under any agreement entered into by the selected vendor. The successful vendor shall provide to the County proof of professional liability or medical malpractice coverage. If any of the above expires during the term of the Agreement, the ven s insurer shall deliver renewal certification and/or policies to Rusk County at least thirty (30) days prior to expiration.

23. Transition on Commencement of Contract

The successful vendor shall assume full operations on July 1, 2024. A preliminary transition plan must be submitted with each proposal. The Vendor shall coordinate and cooperate with the existing medical service and employees to assure a smooth and orderly transition with uninterrupted medical services. Upon award of contract, the Vendor shall name a Transition Manager, who shall have responsibility for transition activities. Within thirty (30) days of award of contract, the Vendor shall submit a final Transition Plan to the Sheriff for approval.

24. Term of Contract

Contract/Agreement shall be in effective from July 1, 2024 for a minimum of five (5) years, terminating on June 30, 2029. During the first year of the contract/agreement either party may terminate the contract/agreement with or without cause by written notice to the other party given not less than ninety (90) days prior to the effective date of termination.

25. Selection Schedule

Issue RFP: February 29, 2024

Questions Due: March 15, 2024

Proposals Due: March 22, 2024

Potential Interviews with Project Team(s): April 2024

Selection: April or May 2024

Selection of a Vendor is dependent upon approval from the Rusk County Board of Supervisors.

RUSK COUNTY, WISCONSIN

Medical Service Proposal

Signature Sheet

Name of Agency:

Address:

Telephone Number: Fax Number:

Email Address: Federal Tax ID Number:

CHECK ONE OF THE FOLLOWING:

_______ Partnership _______ Non Profit Corporation _______ Profit Corporation _______ Other, Specify: _______________________________________________________

If awarded a contract in response to this proposal, our company:

__________ Will _______ Will Not Be able to meet the specifications as required in Insurance Requirements

Signature of Authorized Signatory:

Title:

Name of Authorized Signatory: (Print)

Date:

The above individual is authorized to sign on behalf of the company submitting this proposal.

Proposals must be signed by an official authorized to bind the provider to its provisions for at least a period of 90 days.

RUSK COUNTY, WISCONSIN

Inmate Medical Service