Medical Services - Sheriff

1 RFP #21-0065 Sedgwick County…Working for you REQUEST FOR PROPOSAL RFP #21-0065 MEDICAL SERVICES – SHERIFF’S OFFICE September 21, 2021 Sedgwick County, Kansas (hereinafter referred to as “county”) is seeking a firm or firms to provide medical services. If your firm is interested in submitting a response, please do so in accordance with the instructions contained within the attached Request for Proposal. Responses are due no later than 1:45 pm CST, December 13, 2021. All contact concerning this solicitation shall be made through the Purchasing Section. Bidders shall not contact county employees, department heads, using agencies, evaluation committee members or elected officials with questions or any other concerns about the solicitation. Questions, clarifications and concerns shall be submitted to the Purchasing Section in writing. Failure to comply with these guidelines may disqualify the Bidder’s response. Sincerely, Joe Thomas, CPSM, C.P.M. Director of Purchasing JT/lj SEDGWICK

COUNTY, KANSAS FINANCE DEPARTMENT Purchasing Section 525 N. Main, Suite 823 ~ Wichita, KS 67203 Phone: 316 660-7255 Fax: 316 383-7055 https://www.sedgwickcounty.org/finance/purchasing/ requests-for-bid-and-proposal/ https://www.sedgwickcounty.org/finance/purchasing/%20requests-for-bid-and-proposal/ https://www.sedgwickcounty.org/finance/purchasing/%20requests-for-bid-and-proposal/ 2 RFP #21-0065 Sedgwick County…Working for you TABLE OF CONTENTS 1.0 GENERAL INFORMATION 1.1 Introduction 1.2 Scope of the project 1.3 Exclusions 1.4 Reduction and expansion of services 1.5 Definitions 1.6 Calendar of events 1.7 Mandatory Pre-proposal meeting 1.8 Contract term and funding 1.9 Reasonable accommodations 2.0 PREPARING AND SUBMITTING A PROPOSAL 2.1 General instructions 2.2 Proprietary information 2.3 Incurring costs 2.4 Submittal instructions 2.5 Proposal organization and format 2.6 Multiple proposals 2.7 Oral presentations and site visits 3.0 PROPOSAL SELECTION AND AWARD PROCESS 3.1 Preliminary evaluation 3.2 Proposal scoring 3.3 Right to reject proposals 3.4 Evaluation criteria 3.5 Award and final offers 3.6 Notification of intent to Award 4.0 GENERAL PROPOSAL REQUIREMENTS 4.1 Introduction 4.2 Organization capabilities 4.3 Staff qualifications – governance and administration 4.4 Experience, client list and references 4.5 Litigation and claims history and experience 4.6 Mandatory requirements 5.0 SCOPE OF SERVICES 5.1 Inmate care and treatment 5.2 Staffing levels 5.3 Job descriptions 5.4 Orientation training for health services staff 5.5 Credentialing 5.6 Continuing education for qualified health services personnel 5.7 Subcontractor agreements 5.8 Health promotion and disease prevention 5.9 Special needs and services 5.10 Health records 3 RFP #21-0065 Sedgwick County…Working for you 5.11 Administrative meetings and reports 5.12 Policies and procedures 5.13 Comprehensive quality improvement (CQI) program 5.14 Emergency plan 5.15 Communication regarding special needs patients 5.16 Notification in emergencies 5.17 Procedure in the event of an inmate death 5.18 Complaints/grievance mechanism 5.19 Equipment specification requirements 5.20 Infection control program 5.21 Staff TB Screening 5.22 Environmental health and safety 5.23 Ectoparasite control 5.24 First-aid supplies 5.25 Training for Sheriff’s deputies 5.26 Inmate workers 5.27 Pharmaceuticals 5.28 Clinic space, equipment and supplies 5.29 Diagnostic services 5.30 Hospital and specialized ambulatory care 5.31 Translation/interpretation services 5.32 Drug free workplace 5.33 Other healthcare services 6.0 INSURANCE REQUIREMENTS 6.1 Indemnification 6.2 Evidence of insurance 7.0 COST PROPOSAL 7.1 General instructions on submitting cost proposals 7.2 Format for submitting cost proposals 7.3 Fixed Price Period 8.0 CONTRACT TERMS & CONDITIONS 8.1 Central contact person for implementation and operations 8.2 Restriction against non-compete provisions 8.3 Staff participation 8.4 Cooperation upon termination or non-renewal of contract 8.5 Assignment 8.6 Ownership of data 8.7 Audit and inspection of records 8.8 Media releases and contact 8.9 Medical restraints and therapeutic seclusion 8.10 Forced psychotropic medication 8.11 Forensic information 8.12 Informed consent 8.13 Right to refuse treatment 4 RFP #21-0065 Sedgwick County…Working for you 8.14 Medical research 9.0 PAYMENT REQUIREMENTS 9.1 Billing and payment process 9.2 Paybacks and credits 9.3 Holdbacks 10.0 SPECIAL CONTRACT TERMS AND CONDITIONS 10.1 Required Response Content 11.0 REQUIRED FORMS ATTACHMENTS A. Reference Data Sheet B. Designation of Confidential and Proprietary Information C Cost Summary Page Sheriff’s Office D Salary Ranges and Rates E1 Staffing Tables- SCALDF E2 Staffing Tables- Jail Annex 12.0 RESPONSE FORM 5 RFP #21-0065 Sedgwick County…Working for you 1.0 GENERAL INFORMATION 1.1 Introduction This document is a Request for Proposal. It differs from a Request for Bid or Quotation in that the county is seeking a solution, as described on the cover page and in the following Background Information section, not a bid or quotation meeting firm specifications for the lowest price. As such, the lowest price proposed will not guarantee an award recommendation. As defined in Charter Resolution No. 68, Competitive Sealed Proposals will be evaluated based upon criteria formulated around the most important features of the product(s) and/or service(s), of which quality, testing, references, service, availability or capability, may be overriding factors, and price may not be determinative in the issuance of a contract or award. The proposal evaluation criteria should be viewed as standards that measure how well a vendor’s approach meets the desired requirements and needs of the county. Criteria that will be used and considered in evaluation for award are set forth in this document. The county will thoroughly review all proposals received. The county will also utilize its best judgment when determining whether to schedule a pre-proposal conference, before proposals are accepted, or meetings with vendors, after receipt of all proposals. A Purchase Order/Contract will be awarded to a qualified vendor submitting the best proposal. Sedgwick County reserves the right to select, and subsequently recommend for award, the proposed service(s) and/or product(s) which best meets its required needs, quality levels and budget constraints. The nature of this work is for a public entity and will require the expenditure of public funds and/or use of public facilities, therefore the successful proposer will understand that portions (potentially all) of their proposal may become public record at any time after receipt of proposals. Proposal responses, purchase orders and final contracts are subject to public disclosure after award. All confidential or proprietary information should be clearly denoted in proposal responses and responders should understand this information will be considered prior to release, however no guarantee is made that information will be withheld from public view. Background Sedgwick County, located in south-central Kansas, is one of the most populous of Kansas’ 105 counties with a population estimated at more than 511,000 persons. It is the sixteenth largest in area, with 1,008 square miles, and reportedly has the second highest per capita wealth among Kansas’ counties. Organizationally, the county is a Commission/Manager entity, employs nearly 2,500 persons, and hosts or provides a full range of municipal services, e.g. – public safety, public works, criminal justice, recreation, entertainment, cultural, human/social, and education. The purpose of this document is to provide interested parties with information to enable them to prepare and submit a proposal for inmate medical service. The county intends to use the results of this process to award a contract(s) or issuance of a purchase order for the product(s) and or services(s) stated above. Sedgwick County will be the contracted party of the contract resulting from this RFP. The contract will be administered by the Sedgwick County Sheriff’s Office. 6 RFP #21-0065 Sedgwick County…Working for you The contract administrator for the Sedgwick County Sheriff’s Office will be an assigned administrative lieutenant in the Support Division of the Detention Bureau. This Request for Proposal (RFP) is issued on behalf of Sedgwick County by the Purchasing Department, which is the sole point of contact for the county during the procurement process. 1.2 Scope of the Project Sedgwick County Sheriff’s Office: The Sedgwick County Detention Bureau is comprised of two (2) facilities: The Sedgwick County Adult Local Detention Facility (SCALDF), located at 141 W. Elm, Wichita, Kansas was first built in 1990 with four (4) floors on the south side of the core services area of building. In 1998, the SCALDF was expanded when the six (6) story north tower was added, bringing the final capacity of the facility to 1,226 beds. During the 1998 addition the core services area to include booking, visitation, and the clinic was overhauled. In 2014, the SCALDF security and control system was updated to a digital system but this did not affect bed space. The SCALDF is our main detention facility and is separated into 22 housing units. It is a direct supervision facility having a combination of eight (8) dormitory housing units, seven (7) direct housing units, and seven (7) indirect housing units. Each housing unit has its own dayroom and gym area for the inmates to use. Housing units typically houses 52-64 inmates. The core area of the SCALDF houses the booking area, property/intake, professional visitation, medical area, classroom space, minister visitation, public lobby, and administration. The Sedgwick County Jail Annex, located at 701 W. Harry, Wichita, Kansas initially opened in the early 1980s as a work release facility. In 2018, it was remodeled and updated to become a 180-bed male minimum-security facility divided amongst five (5) dormitory housing units. These housing units are not direct supervision, but are regularly monitored by staff. In the front section of the building, there is an administrative area, control room, and office/exam space for medical staff. The Sedgwick County Sheriff’s Office, Average Daily Population (ADP), for all facilities to include out of county housing, due to crowding, is as follows: YEAR Average Daily Population 2018 1,421 2019 1,529 2020 1,503 The Sedgwick County Sheriff’s Office total bookings for the SCALDF: YEAR Total Bookings 2018 24,768 2019 25,107 2020 18,794 7 RFP #21-0065 Sedgwick County…Working for you 1.2.1 Project Description County is soliciting a competitive Request for Proposal (RFP) to retain the professional services of a contractor to provide comprehensive health and mental health services to the inmate population. These services shall consist of medical, nursing, mental health (social work, psychiatry), medical records, dental, lab, x-ray, ancillary services, pharmacy, as well as off-site emergency, outpatient specialty and inpatient hospitalization services. It is the goal of county that the vendor provides as many services as possible on-site, within the confines of the Sedgwick County Adult Detention Facilities to minimize community trips. In this RFP, this contractor may be referred to as vendor or provider, depending upon the context. The Sedgwick County Sheriff’s Office’s current health services program includes: management, medical services/physicians, nursing, mental health, dental, pharmacy, digital medical records, lab, x-ray, on-site routine and specialty services, and medical/dental/office supplies and services. The county would like to see Proposers submit alternative proposals from which the county may choose from to enhance the current level of program services by including on-site specialty and diagnostic services, dialysis, hospitalization, hospice, specialized detox services, medication assisted treatment programs, and other comprehensive services. The purpose of this total health system network is to provide quality healthcare including mental health services in order to help facilitate quality preventive care and education, early identification and intervention, and treatment. The goals and objectives of the contract resulting from this RFP are: • To provide comprehensive health and mental health services to the inmate population. • To ensure high quality comprehensive health and mental health services to the inmate population within the control of Sedgwick County Sheriff’s Office. • To deliver services in a manner consistent with community standards in the greater Sedgwick County area as well as with applicable State of Kansas statutes, federal laws and constitutional requirements. • To treat inmates with respect and dignity in all interactions and encounters. • To comply with professional standards and accreditation guidelines for the National Commission on Correctional Health Care (NCCHC). • To establish reports and other mechanisms to ensure accountability to county for services and staffing provided. • To maintain documentation of services provided that is accurate, complete, thorough and comprehensive. • To audit services and staffing through a system of quality improvement. • To maintain staffing levels within prescribed guidelines and patterns identified in this proposal. • To provide appropriately credentialed and licensed/certified/registered health and mental health professionals and staff. • To create an employee-focused work environment that fosters professional growth and development. • To initiate systems for recruitment and retention of qualified staff. 8 RFP #21-0065 Sedgwick County…Working for you • To enhance staff skills and job satisfaction with continuing education and staff development activities. • To focus on client satisfaction with the “client” including the inmate population, the health and mental health professionals, and county. • To ensure communication is open and forthright regarding all issues relative to the contract and county. • To work both cooperatively and collaboratively with county toward the common goal of quality health care. 1.3 Exclusions 1.3.1 Inmate Exclusions The following inmates are not considered as covered under this RFP: • In-home restriction, house arrest, electronic surveillance/detention. • Escape status and not in the physical custody of county. • The vendor will not be responsible for direct care of Sedgwick County inmates boarded in other county jails due to Sedgwick County’s crowding, but will be responsible for outside facility medical care costs and prescriptions for these inmates in other counties and for assurance of continuity of care when processing these inmates in and out of the Sedgwick County Detention Facilities and consulting with the other jail’s healthcare providers. • Day-reporting or non-custody individuals. Inmates within the physical custody of county regardless of facility or out of county housing location are included in this RFP. This includes state inmates of the Kansas Department of Corrections, inmates housed from other city or county jails or other state prison systems, federal detainees or inmates, or probation/parole violators returned to custody under county. Any external reimbursement for off-site services for these individuals’ care, or for pharmaceuticals, shall revert to the county in payment or reduction of billing. Any third party reimbursement funds received by the vendor as a result of submission for off-site inmate healthcare must be provided to the county in payment or reduction of billing. 1.4 Reduction and expansion of services County reserves the right to expand services should additional funds become available during the contract term. Expansion of current services to provide enhanced programming or to meet the need of an increased population may be requested by county, based upon the availability of supplemental or expanded funding or grants. County reserves the right to reduce the scope of services during the contract term. Any information contained herein is provided as an estimate of volume based on past history. This data is provided for the general information of vendors and is not guaranteed to be relied upon for future volume levels. 9 RFP #21-0065 Sedgwick County…Working for you 1.5 Definitions The following definitions are used throughout the RFP. County means Sedgwick County County Agency means Department /Division utilizing the service or product Proposer/vendor means a firm submitting a proposal in response to this RFP. Contractor means proposer awarded the contract. 1.8 Calendar of Events Listed below are specific and estimated dates and times of actions related to this RFP. The actions with specific dates must be completed as indicated unless otherwise changed by the county. In the event the county finds it necessary to change any of the specific dates and times in the calendar of events listed below, it will do so by issuing a supplement to this RFP and posting such supplement on the Sedgwick County website. Distribution of Request for Proposal to interested parties September 21, 2021 Mandatory Pre-Proposal Meeting October 13, 2021 Questions and clarifications submitted in writing by 5:00 pm CDT October 25, 2021 Addendum Issued by 5:00 pm CST November 15, 2021 Sealed Proposal due before 1:45 pm CST December 13, 2021 Evaluation Period December-January, 2021 Oral presentation by invited vendors January-February, 2022 Board of Bids and Contracts Recommendation March 3, 2022 Board of County Commission Award March 9, 2022 Contract start date January 1, 2023 1.9 Mandatory Pre-Proposal Meeting A mandatory pre-proposal meeting will be held to respond to written questions and to provide any needed additional instruction to vendors on the submission of proposals. All vendors who intend to respond to the RFP shall be prepared to attend the pre-proposal meeting. If an invited vendor fails to attend the conference and submits a proposal, the proposal will be rejected. A tour of the facilities impacted in this RFP will also be conducted. Prior to touring the secure areas of the Sedgwick County Detention Facilities and Sedgwick County Department of Corrections Facilities, vendors who attend the conference will need to have a security clearance check performed. Vendors must submit a letter of registration listing all attendees by 4:00 pm on October 6, 2021 in order to participate in the pre-proposal meeting. This letter of registration will be used to perform criminal background checks on all participants, as required prior to admission in any jail facilities. 10 RFP #21-0065 Sedgwick County…Working for you Date: Wednesday, October 13, 2021 Time: 10:00 am Location for Start of Tours: Sedgwick County Adult Local Detention Facility: Kevin Easter Conference Room 141 W. Elm St., Wichita, KS 67203 Second location: Jail Annex 701 W. Harry St, Wichita Ks 67213 1.10 Contract Term and Funding The contract shall be effective on January 1, 2023 at 12:00 am and shall run for three (3) year(s) from that date, with an option by mutual agreement of the county and contractor, to renew for two (2) additional one (1) year periods. Alternatively, the county may elect for a five (5) year contract. Should the parties wish to renew the contract for the two (2) additional one (1) year periods, proposed rates for years four (4) and five (5) must be submitted to the Sheriff, by way of their contract administers, by June 1 of the year prior to the renewal. 1.11 Reasonable Accommodations The county will provide reasonable accommodations, including the provision of informational material in an alternative format, for qualified individuals with disabilities upon request. If you need accommodations at a proposal opening/pre-proposal meeting, contact the Purchasing Department at (316) 660-7255. 2.0 PREPARING AND SUBMITTING A PROPOSAL 2.1 General Instructions The evaluation and selection of a contractor and the contract will be based on the information submitted in the proposal plus references and any required on-site visits or oral interview presentations. Failure to respond to each of the requirements in the RFP may be the basis for rejecting a response. Carefully review this Request for Proposal. It provides specific technical information necessary to aid participating firms in formulating a thorough response. Should you elect to participate, submit one (1) original AND one (1) electronic copy (.PDF/Word supplied on a flash drive) of the entire document with any supplementary materials to: Joe Thomas Sedgwick County Purchasing 525 N. Main, Suite 823 Wichita, KS 67203 11 RFP #21-0065 Sedgwick County…Working for you Sedgwick County’s Responsibilities • Provide information, as legally allowed, in possession of the county, which relates to the county’s requirements or which is relevant to this project. • Designate a person to act as the County Contract Manager with respect to the work to be performed under this contract. County reserves the right to make inspections at various points of the project. Contractor agrees to openly participate in said inspections and provide information to the county on the progress, expected completion date and any unforeseen or unexpected complications in the project. 2.2 Proprietary Information All restrictions on the use of data contained within a proposal and all confidential information must be clearly stated on the attached “Designation of Confidential and Proprietary Information” form. At the conclusion of this process, all proposals will be available for review in accordance with the Kansas Open Records Law. 2.3 Incurring Costs Sedgwick County is not liable for any cost incurred by proposers in replying to this RFP. 2.4 Submittal Instructions SUBMITTALS are due NO LATER THAN 1:45 pm CST, MONDAY, December 13, 2021. Responses must be sealed and marked on the lower left-hand corner with the firm name and address, proposal number, and proposal due date. Late or incomplete responses will not be accepted and will not receive consideration for final award. Proposal responses will be acknowledged and read into record at Bid Opening, which will occur at 2:00 pm CST, on the due date. No information other than the respondent’s name will be disclosed at Bid Opening. Proposal Terms Questions and Contact Information Any questions regarding this document must be submitted in writing to Joe Thomas at Joseph.Thomas@sedgwick.gov by 5:00 pm CDT, October 25, 2021. Any questions of a substantive nature will be answered in written form as an addendum and posted on the purchasing website at https://www.sedgwickcounty.org/finance/purchasing/current-rfpsrfbs/previous-rfbsrfps/under the Documents column associated with this RFP number by 5:00 pm CST November 15, 2021. Firms are responsible for checking the website and acknowledging any addenda on their proposal response form. Minimum Firm 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 Request for Proposal. 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: 1. Have a minimum of five (5) years’ experience in providing services similar to those specified in this RFP. mailto:Joseph.Thomas@sedgwick.gov https://www.sedgwickcounty.org/finance/purchasing/current-rfpsrfbs/previous-rfbsrfps/ 12 RFP #21-0065 Sedgwick County…Working for you 2. Have an understanding of industry standards and best practices. 3. Have experience in managing projects of comparable size and complexity to that being proposed. 4. 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. All laws of the State of Kansas, whether substantive or procedural, shall apply to the contract, and all statutory, charter, and ordinance provisions that are applicable to public contracts in the county shall be followed with respect to the contract. 5. Municipal and county government experience is desired, however, the county will make the final determination based on responses received and the evaluation process. 6. Have the capacity to acquire all bonds, escrows or insurances as outlined in the terms of this RFP. 7. Provide project supervision (as required) and quality control procedures. 8. Have appropriate material, equipment and labor to perform specified services. 9. Park only in designated areas and display parking permit (if provided). 10. Wear company uniform or ID badge for identification purposes. 2.5 Proposal Organization and Format Proposals should be organized and presented in the order and by the number assigned in the RFP. Proposals must be organized with the following headings and subheadings. Each heading and subheading should be separated by tabs or otherwise clearly marked. The RFP sections which should be submitted or responded to are: • Introduction (See Section 4 of this RFP) • Response to general requirements (See Section 4 of this RFP) Organizational qualifications Staff qualifications and Facilities References • Response to technical requirements (See Section 5 of this RFP) • Cost proposal (See Section 7 of this RFP) • Required forms (See Section 11 of this RFP) • Appendices (Additional Information the proposer submits) Attachment A Reference Data Sheet Attachment B Designation of Confidential and Proprietary Information Attachment C Cost Summary Page Sheriff’s Office Attachment D Salary Ranges and Rates Attachment E1 Staffing Tables- SCALDF Attachment E2 Staffing Tables- Jail Annex 2.6 Multiple Proposals Multiple proposals from a vendor will be permissible; however, each proposal must conform fully to the requirements for proposal submission. Each such proposal must be separately submitted and labeled as Proposal #1, Proposal #2, etc. 13 RFP #21-0065 Sedgwick County…Working for you 2.7 Oral Presentations and Site Visits Top ranked selected proposers may be required to make oral interview presentations and/or site visits to supplement their proposals, if requested by the county. The county will make every reasonable attempt to schedule each presentation at a time and location that is agreeable to the proposer. Failure of a proposer to conduct a presentation to the county on the date scheduled may result in rejection of the vendor’s proposal. 3.0 PROPOSAL SELECTION AND AWARD PROCESS 3.1 Preliminary Evaluation The proposals will first be reviewed to determine if requirements in Section 2.0 are met, and if additional mandatory requirements are met. (See Section 4.0). Failure to meet mandatory requirements will result in the proposal being rejected. In the event all vendors do not meet one or more of the mandatory requirements, the county reserves the right to continue the evaluation of the proposals and to select the proposal, which most closely meets the requirements specified in this RFP. 3.2 Proposal Scoring Accepted proposals will be reviewed by an evaluation team and scored against the stated criteria. This scoring will determine the ranking of vendors based upon their written proposals. If the team determines it is in the best interest of the county to require oral presentations, the highest-ranking vendors will be invited to make such presentations. Those vendors that participate in the interview process will then be scored again, and the final ranking will be made based upon those scores. 3.3 Right to Reject Proposals and Negotiate Contract Terms The county reserves the right to reject any and all proposals and to negotiate the terms of the contract, including the award amount, with the selected proposer prior to entering into a contract. If contract negotiations cannot be concluded successfully with the highest scoring proposer, the county may negotiate a contract with the next highest scoring proposer. 14 RFP #21-0065 Sedgwick County…Working for you 3.4 Evaluation Criteria The proposals will be scored using the following criteria: Component Points General requirements a. Organization capabilities & Experience client list and references (Sections 4.2 & 4.4) 10 b. Staff qualifications – governance and administration (Section 4.3) 10 c. Litigation and claims history and experience (Section 4.5) 5 Technical requirements a. Inmate care and treatment (Section 5.1) 10 b. Staffing (Sections 5.2-5.7) 10 c. Health promotion and disease prevention (Section 5.8) 5 d. Special needs services (Section 5.9) 5 e. Health Records (Section 5.10) 5 f. Pharmaceuticals (Section 5.27) 5 g. Diagnostic services/ Hospital and specialized ambulatory care (Sections 5.29 & 5.30) 5 h. All other requirements (All other elements of section 5) 10 Cost 20 Total Points 100 3.5 Award and Final Offers The award will be granted in one of two (2) ways. The award may be granted to the highest scoring responsive and responsible proposer. Alternatively, the highest scoring proposer or proposers may be requested to submit final and best offers. If final and best offers are requested, they will be evaluated against the stated criteria, scored and ranked. The award will then be granted to the highest scoring proposer. Any final negotiations for services, terms and conditions will be based, in part, on the firm’s method of providing the service and the fee schedule achieved through discussions and agreement with the county’s review committee. The county is under no obligation to accept the lowest priced proposal and reserves the right to further negotiate services and costs that are proposed. The county also reserves the sole right to recommend for award the proposal and plan that it deems to be in its best interest. The county reserves the right to reject all proposals. All proposals, including supporting documentation shall become the property of Sedgwick County. All costs incurred in the preparation of this proposal shall be the responsibility of the firm making the proposals. Sedgwick County reserves the right to select, and subsequently recommend for award, the proposed service, which best meets its required needs, quality levels and budget constraints. 3.6 Notification of Intent to Award As a courtesy, the county may send a notification of award memo to responding vendors at the time of the award. 15 RFP #21-0065 Sedgwick County…Working for you 4.0 MANDATORY PROPOSAL REQUIREMENTS 4.1 Introduction Provide an overview of the company’s interest in and ability to provide comprehensive inmate medical and mental health services to Sedgwick County. 4.2 Organization Capabilities The company is required to provide an overview of the firm’s size, corporate staffing organizational structure and format, including a detailed explanation of services presently provided by the firm and related core competencies. The vendor must also indicate the specific firm strengths that are most compatible with Sedgwick County’s RFP objectives of the contractor. Provide narrative about the company’s ability to offer complete healthcare services to include: Physician Services, Nursing, Dental Services, Mental Health Services, Ancillary Services, and Pharmaceutical Services. Include details about services provided. Attach an organization chart including the corporate hierarchy to the level of owner/board of directors with position titles and names of each incumbent with the reporting structure clearly defined. The tables of organization should relate to the lowest level being the on-site format for reporting and lines of command. This may require the submission of multiple organizational charts. Document experience in obtaining accreditation through the NCCHC, ACA, or applicable state accreditation agencies. 4.3 Staff Qualifications – Governance and Administration Attach resumes for all senior management staff within the corporation. In addition, provide resumes of the key on-site management team potentially identified for the contract including the Medical Director, Health Service Administrator, Director of Nursing, Director of Mental Health and Psychiatrist. The Health Services Administrator shall hold a Baccalaureate degree in a health-related field such as public health, public administration, business administration, hospital administration, nursing, etc., or possess education and experience which demonstrates competence and success in administering a complex organization, managing numbers of personnel comparable to the Sedgwick County health services program, complying with accreditation standards, and displaying a commitment to continuous quality improvement, particularly in a healthcare related environment. A master’s degree and correctional experience are preferred. The Medical Director shall be licensed in the State of Kansas and that license shall be in good standing. DEA licensure shall be current and in good standing as well. The Medical Director shall be Board Certified or Board Eligible in one of the following specialty physician fields: family practice, internal medicine, emergency medicine, or preventive medicine. 16 RFP #21-0065 Sedgwick County…Working for you Final medical judgments shall reside with the responsible, designated Medical Director who is responsible for the clinical care provided throughout this contract. The contractor shall be responsible for all decisions relating to the delivery of healthcare services provided under this contract, for on-site services as well as off-site services. The Director of Nursing shall hold a Baccalaureate degree in Nursing. Have and maintain current licensure as a Registered Nurse within the State of Kansas. The Director of Nursing should have experience in the practice of nursing and possessing advanced studies and expertise in administration of Nursing Services. The Director of Nursing shall have the authority, responsibility and accountability for structuring, comprehensive planning, and implementing the Nursing Service Program. The Director of Mental Health shall have a Master’s degree in psychology, social work or behavioral science field. Have and maintain licensure to practice psychology or social work within the State of Kansas. The Director of Mental Health provides clinical and administration supervision and direction to mental health staff and oversight of mental health services with the Sedgwick County Adult Detention Facilities and Sedgwick County Department of Corrections Facilities. Psychiatrist shall have a Doctorate in psychiatry. Have and maintain licensure to practice medicine in the State of Kansas and be board-certified in psychiatry. The Psychiatrist provides a full range of psychiatric services to inmates. The Psychiatrist shall provide clinical consultation regarding identified cases to mental health and healthcare staff. Each candidate is subject to review and approval of county. The contractor shall submit updated resumes to the county for approval throughout the contract if at any time these personnel turn over. Acknowledge you understand that you are required to submit resumes to the county for approval throughout the contract if at any time the key on-site management team personnel turn over and will comply. 4.4 Experience, Client List and References Geographic Scope Identify the geographic scope of the firm, whether local, within Kansas, regional, national or international. If the company is not local, identify the location of the closest office designated to provide project support, supervision and oversight. Provide details regarding off-site (from SCALDF) resources dedicated to this contract and indicate percentage of time committed exclusively to this project. Client List List all clients for the last five (5) years. Include both current and former contracts and include appropriate contact person names and titles, agency (city, county, state, federal, etc.), location with address and telephone number as well as facsimile number and e-mail address (if in existence). Each contract must be identified as current or former and if a prior contract, why the contract was lost, when and to whom. Locations must be included where services were provided even if no executed agreement was ever reached. 17 RFP #21-0065 Sedgwick County…Working for you Disclose any contract terminations with jails and prisons (i.e. projects cancelled prior to contract completion) for any reason during the past five (5) years. Describe the circumstances and provide the customer’s name, e-mail or mailing address and telephone number. Failure to disclose such terminations may be grounds for county to reject the proposal and eliminate it from further consideration. If none, state “None”. 4.5 Litigation and Claims History and Experience Legal Claims Submit a listing of all legal claims closed and pending relating to inmate health services, problems or disputes over the firm’s performance on contracts or projects held during the last five (5) years, specifying the jurisdiction of the case, i.e. state tort, malpractice, civil rights – individual versus class action, etc. Cases should be separated by type of litigation, i.e. state tort malpractice, federal civil rights violation cases (identified as individual or class action), or related to contract terms, termination, breech or failure to perform. If none are known to exist, state “None”. Settlements Provide information on any legal settlements within this period as well with the dollar amount listed and terms of the agreement described. If none are known to exist, state “None”. Legal Actions Initiated by Proposer Specifically disclose any jails, prisons, counties or states operating a jail or prison the vendor has sued. Failure to disclose closed or pending claims, legal settlements, and/or jails, prisons, counties or states operating a jail or prison being sued may be grounds for county to reject the proposal and eliminate it from further consideration. If none are known to exist, state “None”. 4.6 Mandatory Requirements The following general requirements are mandatory and must be complied with. 4.6.1 Accreditation At the time of the issuance of this RFP, the Sedgwick County Adult Detention system is NOT accredited by NCCHC or ACA. The contractor shall comply with the professional standards of NCCHC. Acknowledge that you understand and will comply with this requirement. 18 RFP #21-0065 Sedgwick County…Working for you List any instances or years where accreditation was lost or the healthcare program was placed on probation by the NCCHC, at sites where the vendor was providing healthcare services. In such cases, also provide details of the corrective action plan that was initiated, if any, in response to accreditation loss/probation. 4.6.2 Annual independent contract compliance evaluation The contractor must obtain the services of an independent consultant to conduct an annual review of contract compliance, quality improvement programs, and the assessing of Holdbacks as addressed in 9.3 of this document. This professional must be experienced in the field of correctional healthcare, familiar with NCCHC and ACA standards. Additionally the county must be included in the selection process and has final approval of the consultant. The independent assessment shall be performed in the second (2) year of the contract and provide a basis for county to initiate extension of the initial agreement by one (1) to two (2) years. All expenses related to the independent correctional health consultant shall be the responsibility of the vendor. The report of the independent evaluator shall be delivered to the Jail Administrator prior to December 3st of the second (2) year of the contract. Describe your experience in obtaining the services of an independent consultant to conduct an annual review of contract compliance and quality improvement programs. If your firm does not have experience in this area, please indicate that here. 5.0 Scope of Services The successful vendor will be expected to meet no less than the following specifications and program requirements unless stated otherwise. This scope of services is a guideline for company response format and a proposed structure for the contract. It is not necessarily all-inclusive. 5.1 Inmate Care and Treatment for Sheriff’s Office Facilities 5.1.1 Receiving Screening : The contractor shall ensure at least one (1) licensed medical professional (EMT, LPN, or RN) to provide 24-hour per day, 7-day per week coverage in the intake/booking area. Vendors’ staffing proposals should detail what type of medical licensed professional will be working in booking and address potential needs for a second licensed medical professional for increased intake screening(s) during times of peak workload in the booking area. Vendors should also provide justification on why the recommend certain licensed medical professionals work in the booking area. The intake person shall complete an initial health assessment and medical screening in the booking area within four hours of inmate’s arrival at the facility. “District Court Appearance Bonds” intakes (inmates who are booked solely for the purpose of identification, and are immediately released from the jail) may be exempted from screening by the nurse. The person providing intake screenings in the booking area may request an arresting police agency to obtain an evaluation of an arrestee’s medical condition at a hospital emergency department if the arrestee is in need of medical intervention beyond the capability of on-site jail medical services. Any inmate returning to booking after having been referred to an off-site medical setting must have written documentation, such as discharge documents indicating the inmate’s medical condition and needs. Readmission Assessment Criteria - Regardless of the number of admissions, the intake screening shall be completed by a qualified medical professional as approved by the county upon each admission. 19 RFP #21-0065 Sedgwick County…Working for you Contents – The intake or receiving screening carried out at booking shall consist of the following components of inquiry or observation at a minimum (and a new receiving screening completed upon each admission despite frequency of admission to the jail setting): • Signs or symptoms of infectious disease including TB • Inmate’s medical history • Signs or symptoms of acute mental illness • Suicide ideation • Acute dental problems, swelling, infection • Known allergies to medications or other agents • Medication and therapeutic diet history and current use • Signs and symptoms of drug or alcohol withdrawal • Last ingestion of drugs or alcohol and type/quantity, method and related problems • Current pregnancy, date of last menstrual period, any gynecological problems • Behavior, appearance • Body deformities or difficulties with ambulation or movement • Persistent cough, lethargy, complaints of unexplained weight loss • Condition of skin including scars, tattoos, bruises, lacerations, lesions, jaundice, rashes, ectoparasite infestations and needle tracks or other indications of drug use • Oxygen Use • Any recent injury including surgery or motor vehicle accidents • Deaf or hard of hearing • Vision impairment • Paralysis (partial included) • DME • Other conditions or questions as deemed appropriate by the Medical Director. • Baseline blood pressure Describe how you will comply with this requirement and provide a sample of your medical intake screening tool, and detox screening tool. Intake Emergency Needs – Intake staff shall be oriented to the process for accessing immediate urgent intervention on-site with the jail physician or off-site to a local emergency department, if necessary. The intake staff shall have the ability to determine whether a situation is emergent (off-site) or urgent (on- site). Describe your process for contacting the jail physician after hours for urgent/emergent needs. Disposition – The intake staff shall also note patient disposition – whether the inmate is held in booking, returned to a housing unit, referral for urgent Physician/NP/PA intervention, or referral off-site for emergency treatment. Documentation on the intake receiving screening shall be thorough, comprehensive, legible, and include signature and date. 20 RFP #21-0065 Sedgwick County…Working for you Describe your process for referring inmates to the jail physician or off-site provide for urgent/emergent needs. Isolation Option – The intake staff, in consultation with the jail physician, may immediately place the inmate in isolation if the receiving screening indicates potential symptoms for tuberculosis such as fatigue, weight loss, night sweats, coughing, etc. An inmate who is identified as symptomatic upon intake and not sent to the hospital shall be placed in existing onsite isolation (Negative Pressure Room) cells in the Detention Facility clinic while a PPD is planted and read and sputum and smears obtained. The inmate may only be released from isolation when s/he is medically cleared by a physician as non-infectious. If the inmate is released from custody while in isolation pending outcome of the tuberculosis testing, the inmate shall be referred to an appropriate local hospital as determined through communication with the county health department. Describe how you will address isolation of inmates suspected of having tuberculosis. Mental Health Presence at Intake – The contractor shall submit an optional line item for a psychiatric social worker (PSW) in the intake area 16 hours per day, seven days per week. This PSW shall screen all intake forms and conduct a full mental health evaluation at the time of booking. During hours when the PSW is not present, the licensed medical professional in booking will conduct mental health evaluations as needed. This mental health professional then may help determine inmate disposition in consultation with the jail security supervisor, and as necessary, medical services. Describe how you could comply with this requirement and provide a sample of your mental health intake screening tool. Provide a line item cost for this option. Wellness Rounds – Licensed medical staff shall make rounds every four hours within the booking and intake area. It is imperative the area be monitored closely for any crisis situations. Describe how you handle wellness rounds. Transferring Inmates – Inmates who are transferred between Sedgwick County Detention Facility, the Annex Facility, and Out of County Housing shall have a health transfer summary completed to ensure any current needs are identified, medications, diet, etc., and that any pending treatments or appointments are identified for follow-up. Inmates received from other institutions outside of the SCDF system must have an accompanying health transfer form, which shall be reviewed by the jail nursing staff in conjunction with the inmate’s medical intake assessment. Sufficient hours will be provided to accomplish these tasks. Inmates being moved between SCDF, Annex, and Out of County Housing shall have all pertinent medical information conveyed to the health services staff in the receiving facility. Describe how you will address transferring inmates. 21 RFP #21-0065 Sedgwick County…Working for you 5.1.2 Information on Health Services The contractor shall establish written information to be given out to incoming inmates during the medical screening. This information shall be available both in English and in Spanish. All inmates who receive a medical screening are to receive instructions on how to access health services within the facilities. In addition to written instruction, inmates shall be informed verbally by nursing personnel of how to access health services. This verbal instruction shall occur during intake and during professional contacts between health services staff and inmates. The contractor shall ensure this information is readily available to the inmate population despite any potential physical disabilities or language barriers. Describe how you will comply with this requirement. 5.1.3 Oral Screening The contractor shall maintain a system for the oral screening of inmates prior to or in conjunction with the health assessment/physical exam, within 14 days of receiving screening. This oral screening may be conducted by nursing staff or other health staff who are trained by the dentist to visually identify gross abnormalities of the teeth and gums, to identify swelling and infection, and to respond to an inmate’s complaint of acute dental pain. Antibiotic and analgesic orders may be initiated by nursing based upon a verbal or telephone order by the dentist or physician. Nursing may not initiate legend medications from a generic standing order. The dentist shall also participate in the development of the formulary to ensure dental is represented in the areas of antibiotics, analgesic, and other items such as rinses that may be by prescription only. Describe how you will address oral screenings of inmates. Dental Program - Dental services shall be scheduled for full days and be carried out at least one day per week. However, the Sheriff’s Office would like a line item cost option for two days per week. Dental services shall include a licensed dentist and a dental assistant who has experience. A qualified healthcare professional, trained by the dentist, may be used for screening dental sick calls. Toothbrushes and toothpaste along with all other personal hygiene items are available in the SCDF through commissary or via the indigent procedures. Describe how you will provide dental services. Show cost of two days per week of dental services compared to one day. Priority of Dental Treatment - Dental services shall be focused on emergency treatment for acute pain, swelling and infection. Restorative care such as routine fillings and extractions will be available on a limited basis depending upon availability of the dentist. Prophylactic care such as routine cleaning is unavailable in the detention setting due to the short length of stay. However, inmates in custody longer than a year will receive a routine cleaning once a year. Individuals with prolonged lengths of stay that may be up to a year, or rarely more, shall be given priority for restorative care. Dental lab services shall be available through the contractor but utilization will be minimal with focus on those individuals without teeth or with an insufficient number of teeth in opposition to masticate properly. 22 RFP #21-0065 Sedgwick County…Working for you Describe how you will address prioritization of dental treatment comply with this requirement and the type of dental services you will typically provide (i.e. routine fillings, extractions, etc.). Provide a line item cost for conducting an oral examination by a dentist for inmates in custody over 12 months from date of admission. 5.1.4 Health Assessment The contractor shall complete a full health assessment/history and physical examination within the first 14 calendar days of an inmate’s arrival at the SCDF. The history and physical need not occur immediately following admission, except for those detainees referred for chronic illness, but must be completed by the end of a two-week period. Priority for health assessment shall be given to those identified during the intake booking process to have chronic or infectious illness or other more urgent medical needs, and those with medications continued upon admission. Describe your process for conducting and documenting health assessments within 14 days of inmates’ arrival. Health Assessment Components - Licensed and credentialed medical professionals or physicians shall conduct health assessments. Any inmate with medication continued during the intake process shall be evaluated fully by the provider as to the need for the medication on a continuing basis and the exact medication to utilize, i.e. continue the prior medication if non-formulary or convert to a formulary medication if therapeutic efficacy is demonstrable. The provider shall order laboratory tests for diagnostic purposes as indicated and the provider must sign off on all labs ordered. Detail who you would have conduct the health assessments. If a nurse performs the assessment, describe how you would address medication needs and laboratory tests. Physician Review of Lab Findings - All lab results, in general, must be signed and dated by a physician to indicate review of the findings. This sign-off shall occur within a reasonable time to ensure documents are available to be filed in the medical record promptly. Abnormal results that are of concern to the physician shall receive appropriate follow-up and the patient shall be informed with a written copy of lab results. Minor abnormalities in lab findings remain the discretion of the physician regarding the need for further diagnostic work-up. Describe how you will comply with this requirement and the typical timeframe for physician review and sign-off. 23 RFP #21-0065 Sedgwick County…Working for you STD Testing - Routine diagnostic testing for sexually transmitted diseases is not generally available within the jail setting unless the individual exhibits signs and symptoms of a communicable disease. This information may be uncovered during the receiving or transfer screening, during medical examination or through the sick call process. Any individual identified with a sexually transmitted disease such as syphilis, gonorrhea, or chlamydia, shall be treated immediately to ensure treatment prior to release. Screening for HIV, Hepatitis B or Hepatitis C shall be based on symptom description rather than routine lab testing for these illnesses. Individuals who seek testing shall be tested. All HIV testing is on a volunteer basis unless court ordered. Vendor will comply with State of Kansas reporting requirements. Describe how you will address STD testing of inmates. Forensic Testing - Health services staff who have a patient provider relationship shall not carry out forensic testing or specimen collection. On site or on-call individuals with no treatment responsibility, such as a medical assistant or phlebotomist, may be utilized; however, the preference is no on-site healthcare staff participate in the process of forensic specimen collection, including HIV, DNA, blood for paternity determination, etc. Rather, outside providers shall obtain such specimens. The contractor is not responsible for the cost of forensic testing; however, if a physician orders a toxicology screen for an inmate suspected of overdose for diagnostic or treatment reasons, the vendor is responsible. Describe how you will address forensic testing of inmates. List line item cost for forensic specimen collection through on site phlebotomist and/or on-call lab services. Inmate Immunizations - Immunizations, as indicated by provider order, shall be carried out in conjunction with ongoing inmate healthcare. It is the responsibility of the provider to determine need for immunizations. However, during flu season, based on availability of a sufficient quantity of the vaccine the contractor shall purchase from an outside company, flu vaccination shall be carried out for the inmate population according to clinical priority, i.e. chronically ill, immune compromised, frail elderly, etc. Pneumovax vaccination during this time is preferable as well according to physician order and protocol. Staff Immunizations – Staff members of SCDF have options to access to the flu vaccination. Describe how you will address inmate immunizations and how you will handle flu vaccinations for the inmate population and staff population. Periodic Health Appraisal - Although most inmates’ length of stay is of a short duration, some individuals may remain in the facilities a year or more. In such cases, the Medical Director shall establish a policy and procedure for routine periodic physical exams for health maintenance consistent with professional standards. Age, gender and physical condition may dictate the increased frequency of the periodic examination. Inmates with chronic or long-term communicable illnesses shall receive a complete physical on an annual basis regardless of age or gender. In addition, inmates on psychotropic medication shall receive a complete physical examination on an annual basis to include blood level testing as appropriate. Describe how you will address periodic health appraisals. 24 RFP #21-0065 Sedgwick County…Working for you 5.1.5 Daily Handling of Non-Emergency Medical Requests The county has an existing system for inmates to make electronic requests for medical, dental, or mental health attention on a routine basis through the current commissary vendor. Inmates currently use the clinic request function on the housing unit kiosk. Inmates shall be seen by the appropriate level of healthcare team member for medical complaints within two days. Dental complaints will be screened by nursing staff, if the dentist trains the staff appropriately. A qualified mental health staff member or nurse with psychiatric experience shall screen all mental health requests including those requesting to be seen by the psychiatrist. The level of provider seen shall be established through the triage process by nursing staff. The contractor will cooperate with the county in the administration of the county’s policy regarding the collection of medical co-pays from inmates. Inmates in restrictive housing (Disciplinary Detention/Restrictive Housing) shall have access to sick call on a routine basis with the same frequency as the general population. Nursing staff shall conduct rounds daily in restrictive housing areas and take note of any inmate complaints or medical issues. A log system may be utilized to document completion of this function, with inmate name, identification number, complaint, disposition and staff member name and date. Rounds shall be conducted daily in these areas with the medication administration process. Describe how your process for daily handling of non-emergency medical requests. Include how you will handle inmates in restrictive housing areas and the documentation of rounds. 5.1.6 Sick Call Actual sick call encounters shall be conducted by nursing and physician staffing for medical complaints, nursing or dental staff for dental complaints and a PSW for mental health issues. Sick call shall be available on-site five days per week. The county would like to see cost option of Sick call on site daily, including weekends. Physician sick call shall be conducted not less than five days per week at the SCDF. For the Jail Annex the vendor will provide a telemedicine option to aid the onsite nurse at the Jail Annex. With the desire for the contractor to use a telemedicine option for sick call when a PA and/or physician needs to see an inmate in order to limit inmate movement between facilities. Medical exams and procedures shall be carried out in the appropriate clinical environment already provided and not in open areas, hallways, or corridors where privacy is lacking and confidentiality is at risk. Exam and treatment rooms shall be properly equipped by the contractor with an exam table, mayo stand, gooseneck lamp, oto/ophthalmoscope, thermometer, blood pressure cuff and stethoscope and scale. If hand-washing facilities are not available in each room, then appropriate antibiotic/antiseptic cleansing gel shall be utilized. Sick call requests shall be reviewed daily. These requests shall be triaged by medical staff. The triage disposition shall be documented on the sick call request indicating disposition and name, date and time of the person carrying out triage. Inmate sick call request shall be triaged within 24 hours of receipt of the request; however, the actual clinical visit may not occur for an additional 24 hours including weekends as sick call shall be available at all Sheriff’s Office sites seven days per week. 25 RFP #21-0065 Sedgwick County…Working for you If the inmate is seen by medical staff at a sick call visit and medical staff determines the individual needs to see a higher level of medical professional, the inmate shall be scheduled for a physician visit. Non- emergent physician appointments shall be scheduled for the physician’s next available appointment time, normally within two business days. Describe how you will manage sick call. Include your process for triaging requests. Provide the cost difference between sick call five days a week and daily including weekends. 5.1.7 Emergency Services Emergency services are a critical element of a comprehensive jail health program. The contractor shall establish policy, procedure and systems for 24-hour emergency care at all facilities. Emergency Transportation – Emergency ambulance services for Sedgwick County is provided by government-operated EMS providers. The contractor shall establish and maintain a liaison role with local hospital emergency departments in order to facilitate communication for continuity of care and coordinate mutually acceptable procedures. The contractor shall work cooperatively with the county in enforcing security guidelines for escorts during emergency transportation. Describe your plan for establishing and maintaining a liaison role with local hospital emergency departments and EMS in order to facilitate communication for continuity of care and coordinate mutually acceptable procedures. Emergency Access/Response - Routine orientation for security and health staff shall include the process for inmate access to emergency treatment during all hours of the day or night. Inmates shall be informed by the intake licensed medical professional of the process for routine and emergency access to care during the medical intake. Licensed medical professionals are expected to respond to the housing units or other locations within the facility, however sometimes the inmate may be brought to the clinic, depending upon the nature of the emergency complaint. If the inmate is brought to the clinic area, s/he should be transported by wheelchair or gurney rather than directed to the clinic on foot. Licensed medical staff may also provide phone triage. Detention staff should provide an escort during an emergency. Describe your response to emergency care. 5.1.8 Written and Verbal Clinicians’ Orders Written, verbal or telephone orders may be initiated by a mid-level provider, physician, dentist or psychiatrist within the jail health services. LPN or RN staff may only respond to a verbal or telephone order and shall not initiate orders. A LPN or RN shall note provider orders within six to eight hours. Orders shall be carried out according to instruction. A physician shall cosign verbal or telephone orders within 72 hours. Describe your on-call process for accessing mid and upper level providers after hours and how you manage written and verbal orders. 26 RFP #21-0065 Sedgwick County…Working for you 5.1.9 Patient Transport Patient transport is the responsibility of the county for routine medical appointments off-site. It is the responsibility of the contractor to coordinate with the county for emergency services as well as for routine medical or other clinical appointments off-site necessitating the use of a chair car or other handicapped accessible vehicle. Medical staff or the physician shall determine the appropriate mode of transportation for both appointments and emergencies. The mode of transport may include a squad car, van, chair car or other handicapped accessible vehicle, transport ambulance or Sedgwick County ambulance. Scheduling - Medical staff shall notify clinic liaison clerical staff member on a daily basis of pending medical off-site appointments as much in advance as possible so security staff may be scheduled to carry out the transport. The contractor shall work cooperatively with the county in the scheduling of off-site appointments and attempt to accommodate scheduling to minimize security supervision overtime. Appointments shall be clustered if possible for ease of transport. The clinic liaison shall identify, track and monitor appointments that are missed for lack of security escort, as this should be a rare occurrence. These cases should be reviewed with the county on a routine basis and reviewed during quality improvement meetings. Other reasons for missed appointments shall be monitored as well such as absence from the facility for court, a visit, refusal, etc. These factors should be monitored and reported on as well to minimize missed appointments. Describe how you will work with the county’s staff to minimize and schedule transport for medical appointment. On-Site Services - The goal of the county is to have services delivered on-site to the extent feasible including physician specialty and subspecialty clinics. These on-site clinics shall include orthopedics, optometry, obstetrics and gynecology, and others as determined necessary by the county. If three or more inmates are scheduled within a two-week time for a particular specialty, the contractor shall make every effort to bring this specialty service on-site whether for a one-time or recurring basis, or use a telemedicine option. Please describe any specialty or subspecialty clinics that you have established at other facilities. Propose a plan for such clinics at Sheriff’s Office facilities. Medication or Diet during Transport - Although jail transport is generally not lengthy travel or overnight stays, inmates may need medications during a day off-site for clinic appointments. If the inmate needs to have medication during his/her absence from the facility and the medication is not KOP, the doctor run deputy shall be given the pre-packaged dose for distribution to the inmate at the time identified on the envelope. If the medication is KOP, the inmate may carry the medication in an envelope on his/her person for the visit. If the inmate being transported is a diabetic inmate or other inmate with a special medical diet, the health services staff will direct the kitchen to prepare a package lunch for the transport to meet the dietary requirements. Describe your plan for providing medication and diet to inmates during transport. 27 RFP #21-0065 Sedgwick County…Working for you Documentation with Off-Site Encounters - Both routine and emergency transportation shall include at least minimal medical documentation. If the transport is for an off-site medical or dental appointment, a consult request shall be included and a copy of the latest lab, x-ray or other diagnostic information may be attached. If the transport is for an emergency, a transfer summary shall be completed. In either case, the medical record document shall be sealed in an envelope and medical staff shall provide the envelope to the escorting doctor run deputy for delivery to the off-site or emergency provider. Return documentation should be included as well with a consult follow-up or other progress note and plan from a specialty visit and a disposition form from the emergency room. Return documentation should be handled by the doctor run deputy and returned to the medical staff member designated at the sites. Describe how you will document off site encounters. Indicate whether you rely on a discharge or after visit summary of utilize your own form. If you have a form, include a sample. 5.1.10 Mental Health Evaluation Mental Health Program - The mental health evaluation shall be one key component of the comprehensive jail mental health program established by the contractor. The clinical services provided shall be consistent with the community while emphasizing prevention, identification, early intervention and aggressive treatment of mental disorders with the goal of reducing the frequency and duration of episodes of serious mental illness. The goal shall be to provide services to the inmate such that s/he is able to function to the best of their potential ability. All inmates shall be considered as eligible for mental health services with the priority given to those individuals identified as most severely impaired by serious mental disorder, the most dangerous to themselves or others, and those who exhibit an inability to function within the general population setting of the detention facilities. The existence of a mental disease or disorder as categorized within the American Psychiatric Association’s Diagnostic and Statistical Manual (4) of Mental Disorders shall be the basis for service consideration. Axis II disorders including antisocial and borderline personality disorders shall be evaluated for group intervention based on individual need. The mental health team shall also work with preventive or promotive programs including psycho-educational or cognitive behavior programs focusing on topics such as anger management, impulse control, or substance abuse, as examples. The Sedgwick County Detention Facility already has a 49 bed Mental Health Management Unit (MHMU) inside of the facility. This unit is for the mental health management of both male and female inmates and is divided into four different sections. The current vendor helped create this unit and works closely with the county in the running of it. The MHMU allows detention staff and mental health to work collaboratively to meet the needs of these inmates. Services provided in the unit include: medication management, groups, therapy to assist with coping skills, psychoeducation and discharge planning. The current services offered allow for comprehensive treatment. The vendor is expected to provide a discharge planner for the mental health population to connect inmates to community resources i.e. COMCARE prior to release. A tour of this unit will be included in the pre-proposal meeting. It is the expectation of the county the winning vendor will continue to operate this type of mental health unit inside of the Detention Facility at least at the current level, but the county would also like see proposals for improvement. 28 RFP #21-0065 Sedgwick County…Working for you Describe how you will administer the mental health program at the jail to ensure all inmates have access to care. Describe your experience in managing and running a MHMU. Also, provide examples of MHMU policies, group therapy, and discharging planning for this population. Evaluation Priority – The contractor shall establish a process for the systematic mental health evaluation of inmates. Describe your process for prioritizing mental health evaluations. Documentation Guidelines – Documentation of the mental health evaluation shall be consistent and standardized and placed within the confidential medical record. All mental health records and dental documentation shall be placed in one comprehensive medical record. The one medical record, identified by the inmate’s Name Number, shall be the single repository for all documentation related to health or mental health care regardless of the profession of the individual staff member completing the form or note. Describe how you will ensure all records, medical, dental, and mental health, are maintained in one comprehensive medical record. Crisis Intervention and Disposition - Any individual inmate found to be in need of urgent follow-up is identified by the mental health professional/PSW at the time of the booking screening or mental health evaluation unless previously referred by members of the security or healthcare staff or other jail staff person. If the inmate is in need of immediate intervention, the PSW shall determine the appropriate disposition placement in designated cells (where heightened watch occurs) or placement in mental health housing for the more chronic mentally ill. Written criteria and protocol shall be implemented for each potential mental health placement option and a referral process delineated in detail. Intervention and diversion of inmates in crisis may occur at all times during an inmate’s incarceration. Describe your process for crisis intervention and disposition. Evaluation Components - This mental health evaluation shall minimally consist of a structured patient interview with a mental health professional (mental health professional defined primarily as independently licensed clinical social worker, PSW, but may also include psychiatry or licensed doctoral level psychology staff, or advanced practice registered nurse with a psychiatric clinical specialty) prior to the 14th day of inmate custody within the jail, and shall minimally include: • History of psychiatric inpatient hospitalization, public or private. • History of outpatient mental health treatment, public or private. • Current psychotropic use – medication, dosage, and prescriber. • Current drugs of abuse or alcohol use – type of drug, method of use, frequency, last use. • Current suicidal thoughts, ideation or plans. • Prior suicide attempts – ideation, gesture, attempt. • History of sexual offenses. 29 RFP #21-0065 Sedgwick County…Working for you • History of sexual abuse. • History of violent interpersonal behavior or property damage. • History of child abuse. • History of victimization within detention by predators, on the street. • Special education background/level of education. • History of serious head trauma with even momentary loss of consciousness. • History of seizure activity and cause if identified – alcohol, withdrawal, head trauma, etc. • Gross assessment of intellectual functioning. • Adjustment to incarceration. Describe your evaluation process. If a standardized evaluation form is utilized, provide a copy. Describe your experience with developing behavioral plans for challenging inmates and provide an example. Intellectual Functioning - If an inmate is identified as potentially mentally retarded/developmentally disabled during the booking process, receiving screening, mental health evaluation, or otherwise, the inmate shall be referred to a mental health professional for assessment. If the inmate has difficulty in functioning within general population due to his/her limited intelligence or may be victimized, this inmate shall be considered by the mental health staff for placement into the mental health housing unit which provides a more sheltered and protected environment. Describe how you will work collaboratively with Sheriff’s Office staff and education staff to assist with placement and care. 5.1.11 Dental Treatment Only a Kansas-licensed and credentialed dentist shall perform dental treatment with the assistance of an experienced Dental Assistant. Dental services shall not be limited to extractions only but shall focus on emergency intervention to eliminate pain, swelling and infection and to restore function regarding ability to masticate sufficiently to eat without a special ground or pureed diet. Dental priorities shall be established by the dentist according to level of severity of the complaint and objective need. Oral surgery resources, likely off-site, shall be available within the community for use by referral from the dentist should this need be identified. In general, prophylactic dental care such as scaling and cleaning is not available unless a serious and urgent periodontal problem exists that requires immediate intervention and it is ordered and carried out by a licensed dentist. Describe how you address dental treatment of inmates. 30 RFP #21-0065 Sedgwick County…Working for you 5.1.12 Assessment Protocols The contractor shall establish and implement assessment protocols to be utilized by licensed medical staff within the jail setting. These protocols shall be reviewed and approved initially by the Director of Nursing and the Medical Director and shall be reviewed and updated or revised as needed on at least an annual basis. New protocols may be added at any time as the need is identified. Nursing Protocol Procedures - These nursing assessment protocols are not restricted to the use of routine OTC products. Protocols utilized by RN staff need to be individually cosigned; however, the Medical Director reviews and approves each protocol. Treatment with legend drugs may be initiated by nursing staff with a valid provider order (written, verbal or telephone). If the order is verbal or by telephone, it shall be cosigned by a physician accepting responsibility for the order within 72 hours. Describe your nursing protocols Clinical Pathways - Clinical guidelines or clinical pathways that are evidence and criteria-based that are utilized by mid-level providers, physicians or psychiatrists may be utilized and are not considered assessment protocols (designed for nursing staff use). These pathways or guidelines, usually disease- specific, should be customized to the jail setting and to the individual patient. Guidelines such as these are encouraged, but are not mandatory. Describe the Pathways that you propose to implement. Include sample pathways for alcohol withdrawal and opiate withdrawal. Chronic Disease Monitoring - Inmates identified during the intake medical screening or subsequent examination as chronically ill and in need of ongoing treatment shall receive a treatment plan. The treatment plan may be initiated by a mid-level provider or physician and shall dictate the frequency of evaluation and monitoring. The contractor shall ensure the frequency identified in the treatment plan is met and the related diagnostic blood work, or other monitoring instruments such as therapeutic diet compliance, etc., is completed in advance of the periodic chronic disease visit. These encounters may be performed by a mid-level provider, physician or psychiatrist in the event of a chronic mental illness. Describe how you will manage chronic conditions within the Sedgwick County Detention Facility. 5.1.13 Continuity of Care The intake receiving screening is the initiation of continuity of care for the inmate patient upon admission to the detention facility. If the individual is on medications, attempts shall be made to obtain prior records or at least prior prescription history, verbal if not written. The transfer summary upon movement among the facilities ensures there is no interruption in the health service delivery through the sharing of relevant health information. 31 RFP #21-0065 Sedgwick County…Working for you Aftercare is a significant challenge for a large urban jail setting given the extremely rapid turnaround of most of the individuals. Linkage with community clinics, health departments, indigent care facilities, shelters and mental health facilities shall be established for release planning. The contractor will work collaboratively with the Sedgwick County Health Department, COMCARE, free community clinics, and its designated contract agencies on release planning. The contractor shall establish a referral network and consolidate this information into a concise folder for staff use when coordinating linkage for care upon release. This manual shall include local resources available, primarily for indigent or Medicaid care, sexually transmitted diseases, infectious diseases such as HIV or Hepatitis, chronic illnesses and the mentally ill. When the healthcare staff is aware in advance of the inmate’s pending departure, a designee shall make every attempt to schedule follow-up in the community after release. Every attempt should be made by the jail staff to inform health services of pending releases or transfers with as much notice as possible to ensure continuity of care. Regardless of advance notice of pending release, health services staff shall inform and educate inmates about local resources available through such means as a community resource manual and discussion of these resources during incarceration. Describe how you will collaborate with community providers to ensure continuity of care. 5.1.14 Health Evaluation of Inmates in Restrictive Housing Medical Rounds – Any inmate being placed in a disciplinary or restrictive housing environment will have a full medical and mental health assessment by the contractor regardless of the time of day in order to establish a baseline. Medical staff shall conduct routine rounds within disciplinary detention and restrictive housing areas at a minimum of three times per week and may be done in conjunction with medication administration. These screening rounds may be documented on a log or other group format, listing individuals and dispositions or they may be documented individually on progress notes. If an inmate is removed from his/her cell to an examination room or interview room to see a nurse or other healthcare or mental health care professional, a progress note shall correspond with the staff name, title and date. Inmates within any type of restrictive housing shall have the same access to healthcare as the general population and sick call shall be available on the same frequency. Describe how you will document medical rounds for inmates in restrictive housing. Documentation should include documenting in the jail’s records management system as well as in the inmate’s confidential medical record. Mental Health Rounds - In addition, a designated mental health professional shall conduct rounds in the disciplinary and restrictive housing areas on a weekly basis, however, these rounds may increase depending on the special treatment plans provided by the contractor. These rounds are intended for mental health staff to make contact with inmates in this setting and to determine if any individuals are decompensating within the restrictive environment due to mental illness. Furthermore, inmates with serious mental illness who receive disciplinary action resulting in punitive segregation shall be assessed by a mental health professional as to the appropriateness of the placement timing given the mental condition of the inmate. Describe your process for documenting mental health rounds for inmates in restrictive housing. 32 RFP #21-0065 Sedgwick County…Working for you Documentation should include documenting in the jail’s records management system as well as in the inmate’s confidential medical record. 5.2 Staffing The contractor shall submit a detailed staffing plan/table that includes titles, hours scheduled (full-time or part-time), shifts, days of the week, etc. to demonstrate appropriate clinical coverage throughout the facilities. Full-time is considered 40 hours of work per week excluding the lunch period unless otherwise specified in the proposal with a rationale acceptable to the county. Staffing levels shall adequately reflect the size of the various institutions, intake screenings conducted annually, transfer summaries completed, and the comprehensive scope of services available on-site. Full-time work shall consist of a 40-hour work period with a 5-day workweek. Any schedule for full-time to be scheduled fewer than five (5) days per week will require the advance approval of the county, e.g. a 4-day workweek of 10 hours per day. The staffing may reflect a mix of physician and physician extender staff including mid-level providers/physician assistants for medical hours exceeding 40 per week. Physician staffing shall be in accordance with guidelines and recommendations of the NCCHC, Standards for Health Services in Jails. Submit the staffing table that you are proposing to serve the county at implementation in Attachments E1, E2, and E3. The onsite Health Services Administrator, Director of Nursing, Behavioral Health Coordinator, and Mental Health Practitioners for the Sheriff’s Office will only be responsible for Sheriff’s Office facilities. It is expected each shift at the Adult Detention Facility will have shift supervisor/charge nurse. There will also be one supervisor/charge nurse in charge of the Jail Annex. All of these supervising nurses will report to the Director of Nursing. What is your process for correcting deficiencies in your ability to meet staffing levels stated in your staffing plan (Staffing Table)? Are employee benefits provided? If so please provide details such as vacation, sick leave, hospitalization, life insurance, EAP, dental, etc. If employee benefits are provided, how long must an employee work before benefits start? Detail how your company recruits and retains qualified workers to fill county positions as referenced in the Staffing table. What is your retention rate? Would your company provide employment for the people who may be displaced by this contract? Provide the estimated start-up time required, (i.e., transition time anticipated between proposal acceptance and contract implementation) List any additional special services, which would be furnished by your company to Sedgwick County. Include any unique business features or special services your company offers, which are not considered common to your competition. If there are any changes, which have not been described in previous questions, list such changes here. 33 RFP #21-0065 Sedgwick County…Working for you Describe how you would handle in-house dialysis. Explain the staffing and the necessary requirements to handle dialysis. Please provide pricing under Ancillary Services. Describe how you would use the current Sedgwick County medical facilities floor plan/configuration/design to meet your staffing needs. Explain in detail all the necessary changes and the justification for each change. Describe your documented discipline program for staff in detail. Describe how you plan to manage multiple jail facilities (SCDF, Annex and Juvenile Detention) between multiple county agencies (Sheriff’s Office and Department of Corrections). Describe your plan and methodology for staffing for all services at each facility by type of position, hours of operation, and shift/hours coverage to correlate to your pricing response (Pricing Information Table, Benefits Summary Table, Salary Ranges Table and Staffing Table). Explain how you calculate and manage your staffing levels. Detail how staffing coverage is handled regarding vacation days, holidays, sickness, maternity leave, etc. (scheduled and non- scheduled). Do you use any tools or guides to ensure the staffing is sufficient to provide safe care to each patient at all times? If so, state what tool and/or guide and who has endorsed it. If a staffing tool or guide is used, will you be able to provide the Sedgwick County Sheriff’s Office with the formulas and plans regarding monitoring and the statistics showing compliance? Explain how your staffing rosters are developed and managed. The contracted physician must have privileges at a local hospital in order to schedule testing, consultations, procedures, etc. Explain how the contracted physician will assist in the care of inmates at the hospital. Describe the process for performing dental services. Describe your policies and procedures for the various outpatient professional services and surgeries. List any and all outpatient professional services and surgeries that will not be performed at the Sedgwick County Detention Facility. 34 RFP #21-0065 Sedgwick County…Working for you Use of Students – Although the county encourages the development of students, interns, fellows, etc., these individuals must meet security clearance requirements and receive one day of orientation prior to initiating services. Health services staff shall provide supervision of such trainees and the contractor may not include these individuals as an offset to staffing absences, hours lost or vacancies. Supervision of trainees may vary upon the profession and may require direct observation and sign-off of all work performed, if any. These categories of personnel must have liability protection equivalent to that of the contractor or they may not participate in programming on-site. Do you intend to utilize students? If so, describe how you will supervise and document their progress. Background Screening – All contractor staff shall meet the county background screening requirements. The county will complete all background requests within a reasonable time period. Vendor’s personnel shall be subject to the same security guidelines, rules and regulations as the county staff. State the procedure(s) you use to check work history and criminal backgrounds of your labor force, including all subcontractors, as well as procedures you will use to notify Sedgwick County when future civil or criminal action is taken against an employee. Sedgwick County reserves the right to review all work history and criminal background checks at any time and refuse the right to have a person work in Sedgwick County Detention Facility and Annex. Restriction of Access – Although the contractor has authority for all hiring and termination, the county may restrict an individual’s access to the sites on the basis of security violations validated through Sedgwick County Sheriff’s Office investigations and intelligence gathering operations. The county will communicate promptly with the contractor regarding any such situations. Acknowledge that you understand and will comply with this requirement. All contractor employees, independent contractors and subcontractors shall cooperate with the county in any investigation involving inmate and/or staff conduct. Acknowledge that you understand and will comply with this requirement. All contract employees shall be required to wear Sheriff’s Office issued ID’s at all times. Acknowledge that you understand and will comply with this requirement. 35 RFP #21-0065 Sedgwick County…Working for you Compensation and Benefits - Compensation and benefits of the contractor’s personnel shall be established solely by the contractor. However, the contractor shall provide the county a summary of salary target hourly/salary rates by position title, salary range for each position with anticipated high and low salary identified, with the proposal and shall also include a thorough summary of benefits offered. It is the goal of the county to minimize the disruption to and increase retention of current employees who may be retained by the contractor. The contractor shall obtain the county approval of each individual initially offered employment during the start-up transition. The rate range and schedule shall be updated not less than annually and submitted to the Jail Administrator and internal Sheriff’s Office contract monitor. This target rate shall be established as the payback base rate for each employee, independent contractor and subcontractor. Complete and Submit Attachment D (page 140). Dress Code – The contractor shall establish and enforce a dress code for all health and mental health staff, uniformed and those in civilian clothing that is consistent with the requirements of the county and appropriate to a correctional environment with regard to safety issues as well as appearance. Please acknowledge that you understand and will comply with this requirement. Staff Parking, Security Passes, and Keys – The contractor’s staff will be able to park in the Sedgwick County Parking Garage, for a monthly fee, which will be between the contractor and the current parking garage management vendor. If the contractor chooses to utilize this means of staff parking. If contractor terminates an employee, contractor will make every attempt to do so at the jail location so any parking passes, keys, or electronic security cards in the possession of the employee are returned to Sedgwick County. Contractor shall pay Sedgwick County the appropriate fee for any electronic security passes or keys which contractor’s employees, former employees, or subcontracted employees fail to return to Sedgwick County. Acknowledge that you understand and will comply with this requirement. 5.3 Job descriptions The contractor shall establish written job descriptions that are specific and unique to all facilities within 90 days of start-up. Initial start-up may include more generic job descriptions; however, these job descriptions shall be modified as appropriate to be specific to the county facilities. These job descriptions shall be approved by the Health Service Administrator and Medical Director as well as the county. Review of these job descriptions shall be at least annual and documentation of this review maintained. Provide job descriptions for any anticipated positions that you anticipate implementing at start-up. Also, describe your process for tailoring these descriptions to the county and how you anticipate the annual process for reviewing and maintaining site specific job descriptions. 36 RFP #21-0065 Sedgwick County…Working for you Staff Signatures – Each staff member shall review his/her respective job description and sign the form indicating both familiarity with the job description and with the expectations of the position. This form shall be maintained in all staff’s personnel records and training records. The job description shall be signed annually with the employee’s annual performance evaluation. Performance evaluations shall be conducted at least annually for all staff whether full-time or part-time and shall be maintained in the employee’s personnel file. The performance evaluation shall be signed by the employee per occurrence annually to demonstrate that the evaluation was conducted and understood. Describe your process for evaluating employees and communicating expectations. Post Orders – In addition to job descriptions, the contractor shall establish post orders for nursing staff and mental health professionals to adequately document detailed assignment expectations per shift per task(s) assigned. These post orders shall be in place within the first 90 days of the Contract. Provide a sample post order. If none currently exist, indicate “None” and describe how you will meet this requirement. 5.4 Orientation training for health services staff The county, for security issues, requires orientation training for all of contractor’s, subcontracted and agency staff. The county plans to offer this security training on an as-needed basis. Health Unit Specific Orientation - It is the responsibility of the contractor to ensure all health and mental health staff, whether PRN, part-time or full-time, independent contractors and subcontractors receive orientation by the contractor to the healthcare operation within the facilities. Orientation for agency personnel as well as PRN staff is mandatory as well; however, the program may be modified to one day of training. PREA training through the Sedgwick County Sheriff’s Office must be completed prior to entering the facility. Staff must also attend the Sedgwick County Sheriff’s Office orientation over Inmate Con Games within one month of being hired. The contractor shall design an orientation program for all staff at the SCDF and Annex. The orientation shall include the curricula, hours devoted per topic and the name of the instructor. This orientation is required in addition to on-the-job training by shadowing an existing staff member. While the length of orientation in total is within the discretion of the contractor based on the needs of the individual, the initial formal orientation shall be established as a firm number of hours/days and the curricula shall be approved by the county in advance of the training. Describe your process for orienting all staff to the healthcare operation within the facilities. Orientation Documentation - The contractor shall maintain all orientation training documentation and shall ensure the employee-training database is current and accurate. It is the duty of the contractor to be able to produce current training hours on each staff member upon request and not less than on a monthly basis in a report to the county. Describe your process for documenting orientation training. 37 RFP #21-0065 Sedgwick County…Working for you 5.5 Credentialing Requirements - The contractor shall ensure all health and mental health professionals are fully credentialed and appropriately licensed/certified/registered according to state and federal laws and regulations. The credentialing process shall include physicians, dentists, psychiatrists, mid-level providers/physician assistants, psychologists, nurses, EMTs, and social workers if applicable. Primary source verification shall be completed and the credentials file shall include documentation regarding employment history, state licensure/renewal, DEA registration, ACLS certification (or BCLS/CPR/AED), evidence of malpractice coverage, medical school training, internship, residency, foreign medical graduate verification, and board eligibility/certification through the American Board of Medical Specialties (ABMS). Contractor shall ensure the National Practitioner Data Bank is checked for each physician candidate and the Kansas-licensing agency has no findings or censure against the individual. Credentials files shall be complete within 90 days of hire or contract on-site and temporary credentials prior to that time shall minimally include licensure and DEA information as well as evidence of current malpractice insurance. These files are subject to review and inspection by the county upon request and become the property of the county upon contract termination. What type of qualifications and testing to assure qualification does your company employ when hiring personnel? Does your company perform customized recruiting or testing? Please attach sample test. Detail your company’s process for verifying credentials and licenses of employees upon hire and thereafter. Formal Complaints - Any complaints against an individual license shall be reported immediately to the county. Only individuals whose license is in good standing shall be considered. Individuals, whose license is under disciplinary action of any kind, probation or suspension, shall not be acceptable. Physician admitting privileges at local hospitals shall also be investigated to ensure good standing. It is preferable the Medical Director has staff privileges in at least one local hospital in Wichita. Detail how you will address complaints from Sedgwick County and/or the Sedgwick County Sheriff’s Office about the services you will provide during the course of this contract. Do you have a formalized project? Please provide details. Proficiency Testing and Competencies - While nurses and psychiatric social workers will not complete a full credentialing process, licenses shall be verified and any disciplinary action delineated. Nurses shall complete a proficiency inventory and be able to demonstrate appropriate techniques in phlebotomy, IV management, and other appropriate practices. Describe your proficiency testing and competency process and documentation. 38 RFP #21-0065 Sedgwick County…Working for you 5.6 Continuing education for qualified health services personnel Continuing Education Units – The contractor shall provide continuing education activities, on-site to the extent feasible. These activities shall be recognized with Continuing Education Units by the appropriate state licensure agency. Part-time staff shall also receive the same continuing education hours per year. The county will recognize training hours required by the contract and appropriate to the work environment as time worked. Describe how you will handle and document continuing education. CPR Certification and AED – All health and mental health direct care providers shall be certified in CPR to include use of the AED equipment. Certification shall be annual or may be biannual depending upon the agency utilized to provide formal certification. The Medical Director should be currently certified in ACLS while other staff shall be current in BCLS. Does your company provide in-service training programs for your staff? If so, provide details. Detail how you will meet the minimal requirements and what on-going training would you provide your personnel that would be ...