LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
1. PROJECT OVERVIEW
1.1.
The goal of this Request for Proposal (RFP) is to identify and contract with a qualified
Contractor who can provide cost effective medically necessary services and maintain a level
of quality in accordance with current standards established by the National Commission on
Correctional Health Care (NCCHC) including all updates throughout the Contract.
Vendor Response:
1.2.
It is the intent of the Larimer County Sheriff’s Office Jail to solicit proposals from qualified
Contractors to provide comprehensive medical and mental health services for the inmates
housed at the Larimer County Jail. The County requires the use of professionally licensed
or certified staff within their practice (i.e. QMHP, PA, RN, etc.) to perform the various
functions needed to provide quality healthcare to our inmates.
Vendor Response:
1.3.
The current program requirements include inmate medical screening, admissions
evaluation, triage, sick call, care of medically fragile inmates, pharmacy services, psychiatric
screening, suicide risk assessments, mental health services, medical clearances for intraagency and inter-agency transfers, work clearances, and the continuing care of identified
health problems, detoxification and emergency services.
Vendor Response:
1.4.
The responsibility for the provision of healthcare services to people confined in Jail
commences with the commitment of the person to the custody of the Jail, and ends with their
release from custody.
Vendor Response:
2. NEW PROGRAMATIC CHANGES REQUESTED FOR 2017 FROM CURRENT CONTRACT
2.1.
For 2017, the Larimer County Jail shall require Contractors to provide comprehensive
medical and mental health services inclusive of medical, mental health, and pharmacy.
Vendor Response:
2.2.
All Contractors shall give due consideration to a sub-contract with the local mental health
provider SummitStone Health Partners for mental health services to the inmates at the Jail.
Services include psychiatric care, suicide prevention, emergency evaluations and post
release case management services. SummitStone Health Partners is a private, non-profit
community behavioral health agency serving Larimer County residents of all ages. Services
include prevention, intervention, and treatment of mental health and substance use
disorders. SummitStone Health Partners endeavors to coordinate care with other service
agencies; to advocate and empower individuals with mental illness; to operate effectively
and efficiently with available resources; and to promote a countywide system of care.
SummitStone Health Partners became a private, non-profit corporation in 2000, when the
Larimer County Commissioners decided that behavioral health services should be organized
as a private organization. A five-member Board of Directors was appointed to serve as the
founding governing body of the new, private, non-profit corporation. By January 1, 2000,
SummitStone Health Partners fulfilled all requirements to become a fully operational 501 (c)
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
(3) corporation. Since then, SummitStone Health Partners has merged with several other
agencies in an effort to ensure that the highest quality of services are available to residents
of the county. This includes mergers with Namaqua Center and Island Grove Regional
Treatment Center. In 2014, SummitStone Health Partners expanded its reach to the criminal
justice population by collaborating with Larimer County. SummitStone Health Partners
comprehends the impact that untreated mental health and substance use disorders have on
our community. They recognize the critical need to reduce the cost that incarceration of
these individuals incurs. The potential for clients who have interactions with SummitStone
Health Partners staff within the jail, to be seamlessly connected to SummitStone Health
Partners services once they are released from the jail, will drastically increase the likelihood
of adherence to treatment.
Vendor Response:
3. BACKGROUND INFORMATION
3.1.
Larimer County is located in north-central Colorado. It is the seventh largest county in
Colorado, both in area and population. Quick facts according to the 2015 U.S. Census
Bureau are as follows:
Larimer County
Colorado
Quick Facts
(2015)
(2015)
Population
333,577
5,456,574
Persons under 5 years old, percent
5.3%
6.2%
Persons under 18 years old, percent
20.3%
23.0%
Persons 65 years old and over, percent
14.3%
13.0%
Female persons, percent
50.1%
49.7%
White persons, percent
93.0%
87.5%
Black or African American persons, percent
1.1%
4.5%
American Indian and Alaska Native persons,
percent
1.0%
1.6%
Asian persons, percent
2.3%
3.2%
Native Hawaiian and Other Pacific Islander,
percent
0.1%
0.2%
Persons of Hispanic or Latino origin, percent
11.2%
21.3%
White persons, not of Hispanic/Latino origin,
percent
83.2%
68.7%
Vendor Response:
3.2.
Larimer County encompasses 2,640 square miles in north-central Colorado. Cities and
towns include Berthoud, Drake, Estes Park, Fort Collins, Laporte, Loveland, Red Feather
Lakes, Timnath, and Wellington.
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
3.3.
The Larimer County Jail is located in Fort Collins. It originally opened in 1983 with a design
capacity of one hundred fifty-two (152) inmates and was expanded in 1992, bringing the
design capacity to two hundred nine (209) inmates. Double bunking was required and
increased the capacity to three hundred eight (308) inmates. The most recent expansion
took place in 2014, resulting in a design capacity of six hundred five (605) inmates.
Vendor Response:
3.4.
The Larimer County Jail houses predominantly adult male and female inmates. The only
juveniles housed in the Jail are those that are being tried as adults. The Jail utilizes a direct
supervision philosophy to manage inmates which is a combination of direct supervision and
podular-remote surveillance housing areas. The Jail consists of one building with eleven
(11) housing areas and a total of twenty-two (22) separate living areas. A central area
contains the kitchen, laundry, library, gymnasium, six (6) multi-purpose program rooms and
a medical unit. There is no medical infirmary; however, one of the housing units contains a
two-cell housing area with day room designed for negative air flow, which can be used in the
case an inmate needs to be segregated from the rest of the population due to a medical
condition. Each housing area has at least one (1) conference room that may be utilized to
deliver services.
Vendor Response:
3.5.
Average Daily Population Statistics
Larimer County Jail Average Daily Population
500
450
400
350
300
ADP
2012
453
2013
447
2014
434
2015
483
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
4. MEDICAL UNIT OVERVIEW
4.1.
The Medical Unit work space is as follows:
4.1.1.
Health Services Administrator office
4.1.2.
Director of Nursing office
4.1.3.
Nursing work station with secure pharmacy
4.1.4.
Medical Conference room with workstation for clerical staff
4.1.5.
Supply Storage Room
4.1.6.
Clinician Exam Room with workstations for clinic staff
4.1.7.
Dental Exam Room
4.1.8.
Inmate Waiting Room
4.1.9.
Shower/tub bathroom with handicap accommodations for inmates
4.1.10.
Staff bathroom
4.1.11.
Mental Health Manager Office
4.1.12.
Mental Health Staff Office
Vendor Response:
4.2.
All Medical Services at the Jail are currently provided by Correct Care Solutions, formerly
dba Correctional Health Care Management; this Contract terminates December 31, 2016.
This current Contract does not include coverage for mental health, pharmacy and off-site
care.
Vendor Response:
5. STATISTICAL DATA
5.1.
The following is an overview of statistical data from Medical Services for the calendar years
of 2014 and 2015. This data is provided for informational purposes only and in no way is
intended to limit, project, or predict the intended upcoming Contract.
Description / Event
2014
2015
Average Daily Population
434
482
Total Number of Bookings
10,595
11,125
Number of Medical Intake Screenings Completed in Booking
7,996
8,413
Number of History and Physicals Completed within 14 days
1928
2207
Number of Inmates Seen by Physician
267
463
Number of Inmates Seen by Mid-Level Practitioner
2,705
4,665
Number of Inmates Seen by Dentist
301
350
Number of Prescriptions Filled (both Medical and Psychotropic)
14,946
16,100
Number of Inmate X-Rays Performed (excluding Chest X-Rays i.e. Positive test for
128
150
Purified Protein Derivative (+ PPD))
Number of Dental X-Rays Performed
280
232
Number of Emergency Codes Responded To
61
177
Number of Transports to ER (Emergency Room)
101
119
Number of Inmate Hospitalizations
75
84
Number of Off-Site Consults (i.e. Cardiology, Orthopedic, OB/GYN, etc.)
206
245
Number of Employee and Visitors Treated
0
0
Number of Inmate Deaths
1
0
Number of Inmates on Diabetic Diets that Require Insulin
284
314
Number of Inmates Seen by Psychiatrist
533
652
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Number of Inmates on Medications
Number of Inmates on HIV Medications
Number of Inmates on Psychotropic Medications
Number of Inmate Hospital Days
7,331
82
845
17
7,938
58
1115
18
Vendor Response:
5.2.
Top 10 Medical Diagnoses (not necessarily in the order of most common to least common)
5.2.1.
Hypertension
5.2.2.
Diabetes
5.2.3.
Asthma
5.2.4.
Seizures
5.2.5.
Hyperlipidemia
5.2.6.
Hypothyroidism
5.2.7.
Constipation
5.2.8.
Pruritis/seasonal allergies
5.2.9.
Pain
5.2.10.
Infection
Vendor Response:
5.3.
Top 10 Mental Health Diagnoses (not necessarily in the order of most common to least
common)
5.3.1.
Schizo-affective disorder
5.3.2.
Depression
5.3.3.
Anxiety
5.3.4.
Tourettes
5.3.5.
Bipolar
5.3.6.
PTSD (Post Traumatic Stress Disorder)
5.3.7.
ADD/ADHD (Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder)
5.3.8.
Developmentally delayed
5.3.9.
Borderline personality disorder
5.3.10.
Anti-social personality disorder
Vendor Response:
6. SCOPE OF WORK
6.1.
The Medical Services Contractor shall be the coordinator of the healthcare delivery system
for inmates at the Larimer County Jail. Healthcare delivery is defined as medical, mental
health, and dental care. Contractor shall provide medication management to all inmates for
both medical and mental health conditions. The Medical Services Contractor shall provide
healthcare in line with community standards for Larimer County, Colorado.
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
6.2.
Larimer County strongly encourages all Contractors work inclusively with SummitStone
Health Partners in a concentrated effort to secure a community-wide connection considering
the scope and breadth of Contract.
Vendor Response:
6.3.
Larimer County will not be directly involved in the negotiation process with SummitStone
Health Partners, although the Jail agrees with the merits of acquiring a community partner
versus a sole source provider for mental healthcare.
Vendor Response:
6.4.
All parties agree that the specifications and other Contract documents do not purport to
control the method of performing the work, but only the requirements as to the nature of the
completed work. Contractor assumes the entire responsibility for the method of performing
the work. Suggestions as to the method included in the RFP shall be deemed advisory only
and the feasibility of such methods, or the lack thereof, shall not affect Contractor’s liability,
or status as an independent Contractor.
Vendor Response:
6.5.
All parties agree that the contents of this RFP and any clarifications thereto submitted by the
successful proposer shall become a part of the Contractual obligation and incorporated by
reference into the ensuing Contract. All parties agree that all terms and conditions printed
in this request for proposal will also become part of the Contractual obligation and
incorporated by reference into the ensuing Contract.
Vendor Response:
7. ADMINISTRATIVE REQUIREMENTS
7.1.
A written manual of standardized policies and defined procedures approved by the
Contractor’s Medical Director and the Contract Administrator must be reviewed at least
annually and revised as necessary. All parties agree that all medical and other records,
policies and procedures, manuals, instructional books, orientation, and continuing education
records and materials, and documentation of every sort, developed for or used in the
operation of healthcare services during the Contract period shall be the property of the
County and, at the termination of the Contract, remain the property of the County without
further obligation.
Vendor Response:
7.2.
All parties agree that upon receiving a notice of termination issued by County, Contractor
shall continue to provide services and wind down operations pursuant to this Contract,
unless expressly directed otherwise by County in the notice of termination. Contractor shall
provide a wind down plan in their proposal.
Vendor Response:
7.3.
Contractor shall defend, indemnify and hold harmless the County, its agents, officers,
elected officials and employees from and against all claims, demands and judgments
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
(including attorney fees) made or recovered against them including, but not limited to,
damages to real or tangible property or for bodily injury or death to any person, arising out
of, or in connection with this Contract, to the extent such damage, injury or death is caused
or sustained in connection with the negligent performance or willful misconduct of
Contractor, or its employee, agents or Sub-Contractors. The County agrees to promptly
notify Contractor in writing of any such claim or demand to defend and indemnify and agrees
to cooperate with Contractor in a reasonable manner to facilitate the defense of such claim.
Contractor’s obligation to defend and indemnify extends to any claim or action which arises
from medical services provided by Contractor, or arising from allegations that appropriate
medical care was not provided by Contractor, or arising from allegations that medical care
provided by Contractor was in any manner negligent, inappropriate, or deliberately
indifferent. For purposes of illustration, if an inmate or former inmate brings an action alleging
improper medical care by Contractor, and also naming the Sheriff and Jail Administrator for
failing to supervise Contractor and negligently retaining Contractor, Contractor will have the
obligation to defend the entire claim, including all claims against the Sheriff and Jail
Administrator as they are directly related to allegations of improper medical care.
Vendor Response:
7.4.
All parties agree that the County shall have the unfettered right to monitor Contractor’s work
in every respect. In this regard, Contractor shall provide its full cooperation, and ensure the
cooperation of its employees, agents, and Sub-Contractors. Further, Contractor shall make
available for inspection, and/or copying when requested, original timesheets, invoices,
charge slips, credentialing statements, continuing education and training records, and any
other data, records and accounts relating to Contractor’s work and performance during the
Contract period. In the event Contractor does not hold such material in its original form, a
true copy shall be provided. All parties agree that the Contractor is subject to accuracy
checks from a third-party auditor for purposes of programmatic, performance and financial
audits.
Vendor Response:
7.5.
Contractor shall retain adequate support staff in its central office capable of competently
supervising and monitoring its operations in Larimer County.
Vendor Response:
7.6.
All parties agree that issues may arise that are highly time sensitive, such as those
involving security, requiring detailed information inclusive of written reports or other various
pieces of information. Contractor agrees to make communication a fluid and proper
exchange in the most expedient manner possible and shall provide such required levels of
communication utilizing the highest level of cooperation.
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
7.7.
Contractor must provide to the Contract Administrator proof of licenses and certificates for
all professional staff. Contractor shall obtain, secure, and maintain, at their cost, any and all
permits, licenses, and continuing education required by federal, state, and local laws and
applicable rules and regulations necessary for the implementation of work undertaken by
Contractor.
Vendor Response:
7.8.
Contractor must provide proof that all on-site staff are cardiopulmonary resuscitation (CPR)
certified, and this certification must be maintained throughout the Contract.
Vendor Response:
7.9.
Contractor must provide proof of malpractice insurance to Larimer County Risk Management
and the Contract Administrator for all Physicians, Mid-Level Practitioners, and all other
employees.
Vendor Response:
7.10.
Contractor must maintain NCCHC Accreditation throughout the Contract. Contractor must
pay for all fees required to maintain this certification. Contractor must provide all NCCHC
Accreditation reports to the Contract Administrator during and after accreditation process.
Vendor Response:
8. BILLING
8.1.
Contractor shall provide for monthly billings that include a detailed breakdown of all costs
actually incurred. The invoice shall detail actual time worked in the same format as it was
estimated in the approved staffing plan. The monthly billing shall be provided to Contract
Administrator by the fifth (5th) of each month.
Vendor Response:
8.2.
Contractor shall promptly pay all bills related to services at the Larimer County Jail. Any bill
outstanding more than sixty (60) days must be reported to the Contract Administrator.
Vendor Response:
Contractor is responsible for assessing fees to an inmate’s account. Monies collected are
returned to the County general fund. No inmate is denied medical care based on an inability
to pay. Fees are as follows:
8.3.1.
Appointment with a medical practitioner $15
8.3.2.
Appointment with a Psychiatrist $15
8.3.3.
Appointment with the dentist $15
8.3.4.
Prescription medications $8
8.3.5.
Keep on person over the counter medications $5
8.3.6.
Multi-vitamins $5
8.3.
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
8.4.
Included in the inmate population are inmates incarcerated on behalf of the Colorado
Department of Corrections. Contractor shall promptly notify the Colorado Department of
Corrections of treatment for such inmates using provided procedures and forms and shall
submit all such related bills to the Contract Administrator to ensure reimbursement to the
County of all medical expenses and cost of pharmaceuticals incurred on behalf of such
inmates. All such reimbursements are returned to the County general fund.
Vendor Response:
8.5.
Contractor shall be responsible for ensuring inmates are signed up for the Affordable Care
Act by collaborating with Larimer County Health and Human Services. Contractor shall
assist with sign up, make sure any inmate hospitalized or about to be hospitalized is
signed up and costs are processed by the hospital to the appropriate insurance coverage
before accepting responsibility for the costs or passing the costs onto the County for offsite care.
Vendor Response:
9. TRANSITION PLAN
9.1.
Contractor shall detail their preferred transition planning process, costs involved with the
transition and the estimated time it would take to transition from the current vendor. The
County intends to have a Contract in place a minimum of eight weeks (8) prior to the
expiration of current Contract. Provide a detailed implementation plan which includes a
timeline and completion dates. Part of the implementation shall include providing
completed background check information on employees and vendors who deliver services
to the Jail within one week of receiving the Notice of Award. This shall allow the Sheriff’s
Office to complete background checks prior to employees coming on site. Costs for
background checks shall be borne by Contractor. The Contract Administrator will invoice
the Contractor for all costs associated with background checks and these costs shall be
paid as a credit to the following month’s bill.
Vendor Response:
9.2.
Contractor shall submit a comprehensive transition implementation plan to describe
activities during the transition period prior to the initiation of on-site services to assure
uninterrupted service delivery and continuity of care.
Vendor Response:
10. ACCESSIBILITY TO SERVICES
10.1.
Non-English speaking inmates will receive verbal and/or written instruction, in a language
they understand, on how to access healthcare services in the Jail. Contractor shall utilize
a translation service.
Vendor Response:
10.2.
Contractor shall have written provisions and procedures in place for working with inmates
covered in the American’s with Disabilities Act (ADA).
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
11. ELECTRONIC MEDICAL RECORDS
11.1.
The electronic medical records management system utilized at the Jail is CorEMR. All
Contractor staff must be trained on and use this system. The Health Services Administrator
maintains the utilization of the medical records management system.
Vendor Response:
11.2.
The Larimer County Jail is not interested in incorporating a different electronic medical
records management system other than CorEMR into the Medical Contract.
Vendor Response:
11.3.
All health records are the property of Larimer County. Contractor acts as custodian for the
health records, and such records are kept confidential, subject to the rights of access thereto
at all times on the part of Larimer County. Contractor shall ensure access to inmate
healthcare records as controlled by the health authority consistent with the applicable local,
state and federal confidentiality laws. The confidential relationship of doctor and patient
extends to inmate patients and their clinicians. Contractor shall maintain a current record of
the rules and regulations covering the confidentiality of healthcare records and the types of
information that may and may not be shared.
Vendor Response:
11.4.
The release of any information regarding inmate healthcare shall be obtained only through
Larimer County Sheriff’s Office Records. This policy ensures appropriate legal measures are
taken when anyone is requesting an inmate's healthcare record. All healthcare records are
maintained in accordance with the laws of the State of Colorado, including those of
discharged inmates. Inactive medical records are maintained according to Colorado State
Statutes and the American Medical Association.
Vendor Response:
12. OFF-SITE PROVISION OF MEDICAL OR OTHER HEALTH CARE SERVICES
12.1.
Contractor shall not be responsible for costs associated with off-site provision of medical or
other healthcare services. Any expense incurred or to be incurred for medical and other
healthcare services provided off-site must be approved by the Contract Administrator and
shall be the responsibility of the County. Contractor is responsible for review and
verification that all invoices are appropriate and accurate prior to payment by the County of
off-site services using County funds. This includes verification of services provided and
accuracy of all co-pays and deductibles. Contractor is expected to exercise sound medical
judgment when referring inmates for off-site care. The County’s total costs associated with
off-site provision of medical or other healthcare services has averaged forty thousand
dollars ($40,000) per year. Any off-site costs incurred by Contractor shall be invoiced
separately to the County.
Vendor Response:
12.2.
The County follows Colorado Revised Statute § 17-26-104.5 and has additionally
negotiated pricing for off-site medical care. Colorado Revised Statutes § 17-26-104.5
states, “[w]hen a person is held in custody in a county Jail, the person shall be primarily
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
responsible for the payment of the cost of medical care provided to the person for a selfinflicted injury or a condition that was preexisting prior to the person's arrest and shall be
charged for the medical care by the provider of care. Based on this statute, Contractor
shall establish policies and procedures to identify self-inflicted and preexisting inmate
injuries and conditions and to notify off-site health services providers or hospital providers
of the obligation to bill inmates directly for such injuries or conditions. Contractor shall also
establish policies and procedures to notify off-site health services providers and/or hospital
service providers of any third party insurance or Medicaid eligibility available to inmates for
such injuries. To the extent an off-site health services provider or hospital provider requires
a guarantee of payment that an inmate cannot provide, Contractor shall be responsible for
providing such guarantee of payment and Contractor shall be responsible for paying any
off-site costs not billed directly to the inmate under Colorado Revised Statutes § 17-26104.5.
Vendor Response:
12.3.
All parties agree that Contractor will enforce minimum staffing requirements to avoid
increasing other County costs for off-site care. For example, if a Medical Director’s hours
are less than the specified minimum requirements, there exists the potential for referrals to
external physicians to be more frequent. This results in a higher requirement for deputy
transports for medical care. To further emphasize, if hours for all staffing (Health Service
Administrator, Medical Director, Physician Assistant, Registered Nurse and Nurse
Practitioner) were to fall short of minimum staffing requirements, the potential for emergency
room visits, hospital admissions, and inmates on non-formulary drugs along with deputy
transports would potentially rise resulting in significant additional charges to the County.
Contractor shall reimburse the actual cost of deputy transports when staff positions remain
unfilled or uncovered. Prior to invoking any penalties, the Contract Administrator shall meet
with the Health Services Administrator to discuss and validate non-performance. Notice of
non-performance will then be provided in writing to Contractor. Should any of the penalties
be invoked, they shall be paid as a credit against monthly billing for Contract services.
Vendor Response:
12.4.
Contractor shall prepare a detailed plan for the implementation and operation of a cost
containment program to include controlled healthcare costs and areas for cost savings using
tried and proven methods evidenced by successful programs at other contract sites.
Vendor Response:
12.5.
Contractor shall ensure that the healthcare status of inmates admitted to outside hospitals
is reviewed to ensure that the duration of the hospitalization is no longer than medically
indicated. Contractor shall provide in their proposal a detailed plan and procedure for
inmates receiving care in an off-site medical care facility. Contractor shall provide daily email
updates on healthcare status of inmates admitted to outside hospitals to the Contract
Administrator.
Vendor Response:
13. ELECTIVE MEDICAL CARE
13.1.
No elective care shall be approved without the consent of the Contract Administrator. In the
event an inmate requires elective care, the inmate shall be responsible for all costs. Elective
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
medical care shall be defined as care which if not provided, would not, in the sole opinion of
the Medical Director or designee, cause the inmate’s health to deteriorate or cause harm to
the inmate’s wellbeing. Decisions concerning elective medical care shall be consistent with
the applicable American Medical Association (AMA) Standards. The Contractor shall ensure
that bills are accurate and procedures are followed for elective care as they would for any
off-site non-elective medical care.
Vendor Response:
13.2.
Contractor shall not be responsible for the provision or cost of any elective care.
Vendor Response:
14. QUALITY ASSURANCE
14.1.
In order to establish and maintain quality assurance, a quarterly Medical Audit Committee
(MAC) shall be facilitated by Contractor to discuss the current issues, discuss third-party
programmatic, performance or financial audit reports, self-audit reports, identify problems or
report on potential high-cost inmate medical procedures and shall be attended by the
Contract Administrator, Health Service Administrator, Charge Nurse, Medical Director,
medical and psychiatric clinicians, and appropriate Contractor staff. Contractor shall staff
and provide administrative support to the committee and document all meeting notes.
Meeting notes shall be prepared by Contractor within three (3) days of the meeting and
distributed to all parties. Contractor shall provide consultation to the Contract Administrator
on any and all aspects of the healthcare delivery system for the Jail. This includes evaluation
and recommendations concerning new programs, alternate pharmaceutical, healthcare
delivery procedures that impact Jail deputies and other systems, and other matters relating
to this Contract upon which the Contract Administrator seeks the advice and counsel of
Contractor.
Vendor Response:
14.2.
The purpose of the MAC shall be to review significant issues and discuss changes to policy
or procedures. Problems shall be documented, best solutions determined, impact to
Contractor or Jail staff analyzed, and a change management strategy may be developed
with the approval of the Contract Administrator. All issues that impact staff or costs must be
documented and approved by Contract Administrator before any resolution may be
implemented.
Vendor Response:
14.3.
Contractor shall ensure the Jail is staffed with the appropriate number and types of
healthcare staff at all times. During the MAC meeting, Contract Administrator requires
Contractor to report staffing in sufficient detail to determine whether the staffing actually
provided was adequate enough to ensure quality of care. Contractor agrees to provide
appropriate examples of doing this by providing a monthly summary of hours worked by
each staff member by day and by shift. This particular report must reveal the days and shifts
on which staffing was less than specified.
Vendor Response:
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LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
15. REPORTING REQUIREMENTS
15.1.
Contractor shall determine and prepare the appropriate annual quality improvement studies
for process of inmate care and healthcare outcome studies. These include:
15.1.1.
Problem identification
15.1.2.
Study
15.1.3.
Plan development and implementation
15.1.4.
Result monitoring and tracking
15.1.5.
Demonstration of improvement or re-study the problem
Vendor Response:
15.2.
Contractor shall conduct quarterly self-audits inclusive of, but not limited to, intake
procedures, medication distribution, and pharmaceutical formulary costs or any other topics
addressing concerns of the Contract Administrator such as:
15.2.1.
Review quality assurance reports
15.2.2.
Review monthly actual staff reports with hourly billing rates
15.2.3.
Review statistical reporting
15.2.4.
Review statistics and savings realized from Affordable Care Act
15.2.5.
Review prescription utilization and annual formulary
Vendor Response:
15.3.
Quarterly statistical reporting to be provided to the Contract Administrator includes the
following statistical findings:
15.3.1.
Total # of intake screenings completed by Contractor staff
15.3.2.
Total # of sick call encounters completed by Contractor nursing personnel
15.3.3.
Total # of sick call encounters completed by the Health Care Providers (Physician or
Mid-Level. Does not include Chronic Care, Psychiatrist or Dentist)
15.3.4.
Total # of on-site emergencies called and responded to by staff
15.3.5.
Total # of nursing contacts, including blood pressure checks, segregation checks,
fasting blood sugar, dressing changes, etc. (Does not include sick call or emergency
room)
15.3.6.
Total # of initial health assessments completed during the month (fourteen (14) day
for Jails)
15.3.7.
Total # of annual health assessments (inmates who have been in Jail for twelve (12)
months or more)
15.3.8.
Total # of inmates that have been kept on-site for twelve (12) months or more
15.3.9.
Total # of non-tuberculosis (Non-TB) related X-Rays (TB related X-Rays are under
Infectious Disease Control)
15.3.10.
Total # of electrocardiograms (EKGs) performed on-site
15.3.11.
Total # of new patients seen by psychiatric provider (Psychiatrist or Mid-Level)
15.3.12.
Total # of Follow up visits by psychiatric provider (Psychiatrist or Mid-Level)
15.3.13.
Total # Positive Mental Health Screens from intake
15.3.14.
Total # of visits provided by mental health (not already counted under special needs,
individual/group therapy, segregation visits or discharge planning contact)
15.3.15.
Total # of visits provided to inmates on special needs list during the month
15.3.16.
Total # of segregation visits performed by mental health during the month
15.3.17.
Total # of inmates who received individual therapy during the month
13
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
15.3.18.
15.3.19.
15.3.20.
15.3.21.
15.3.22.
15.3.23.
15.3.24.
15.3.25.
15.3.26.
15.3.27.
15.3.28.
15.3.29.
15.3.30.
15.3.31.
15.3.32.
15.3.33.
15.3.34.
15.3.35.
15.3.36.
15.3.37.
15.3.38.
15.3.39.
15.3.40.
15.3.41.
15.3.42.
15.3.43.
15.3.44.
15.3.45.
15.3.46.
15.3.47.
15.3.48.
15.3.49.
15.3.50.
15.3.51.
Total # of inmates will a “severe and persistent mental illness” (psychosis, major
affective, severe recurrent depression, bipolar)
Total # of events of communicated threats or thoughts of self-harm (suicide) verbally
or written
Total # events where inmate engaged in some form of self-harming behavior that
does not result in lethality or intent to achieve death (suicidal gestures)
Total # events where inmate engaged in behavior that was of lethal nature, requiring
extensive off-site medical care (suicide attempts)
Total # of inmates who completed suicide during the month
Total # events where inmate was placed on suicide watch (may include same inmate
placed on watch more than once during month)
Total # of days that inmates were on suicide watch
Total # of inmates who have been committed, but awaiting bed or assessment in
community facility (State Hospital)
Total # of inmates whose petitions for civil commitment have been accepted and
transferred out to mental health treatment facilities
Total # of inmates placed in therapeutic restraints (not security-ordered)
Total # of inmates on court ordered/involuntary medication programs
Total # of inmates being followed for special mental health needs
Total # of mental health sick call encounters completed by Contractor personnel
Total # of requests for mental health services received during the month
Total # of dental screens/exams completed by the Dentist (either initial or annual)
Total # of dental sick call/screens by the Dentist
Total # of dental extractions
Total # of inmates refusing dental care and treatment
Total # of temporary fillings
Total # of inmates sent off-site for dental treatment or services
Total # of encounters not listed in categories listed above
Total # of ER visits that were taken via ambulance (to include County, Federal & ICE,
etc.)
Total # of ER visits that were taken via Jail transport/custody car (to include County,
Federal & ICE, etc.)
Total # of inmates admitted to hospital (to include County, Federal and ICE by
summing up the following two items, 15.3.42 & 15.3.43)
Total # of inmate hospital days
Total # of hospital days divided by the total # of Admissions. Example: five (5)
inmates divided by twenty (20) total hospital days equals an average of four (4) days
Total # of inmates seen for on-site specialty consultations such as obstetrics,
orthopedics, renal, etc.
Total # of inmates transferred off-site by security for appointments
Total # of inmates who received a one (1) day surgery and returned to the site within
twenty-three (23) hours
Total # of inmates transported off-site for radiology procedures such as computerized
tomography scan (CT SCAN), magnetic resonance imaging (MRI), X-Rays and
Ultrasounds
Total # of inmate deaths that occurred on-site
Total # of in-custody inmate deaths
Total # of inmate dialysis off-site
Total # of inmates prescribed medications to include formulary, non-formulary,
psychotropic & over the counter
14
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
15.3.52.
15.3.53.
15.3.54.
15.3.55.
15.3.56.
15.3.57.
15.3.58.
15.3.59.
15.3.60.
15.3.61.
15.3.62.
15.3.63.
15.3.64.
15.3.65.
15.3.66.
15.3.67.
15.3.68.
15.3.69.
15.3.70.
15.3.71.
15.3.72.
15.3.73.
15.3.74.
15.3.75.
15.3.76.
15.3.77.
15.3.78.
15.3.79.
15.3.80.
15.3.81.
15.3.82.
15.3.83.
15.3.84.
15.3.85.
15.3.86.
15.3.87.
15.3.88.
15.3.89.
15.3.90.
15.3.91.
15.3.92.
Total # of inmates prescribed medical medications to include over the counter
ordered by a provider
Total # of inmates on psychotropic medications
Total # of inmates on non-formulary medications (medical and psychotropic)
Total # of inmates seen in pulmonary chronic care clinic during the month
Total # of inmates seen in diabetic chronic care clinic during the month
Total # of inmates who received dialysis during the month
Total # of inmates seen in human immunodeficiency virus (HIV) chronic care clinic
during the month
Total # of inmates seen in pregnancy clinic during the month
Total # of inmates seen for hepatitis during the month
Total # of inmates seen in cardiac chronic care clinic during the month
Total # of inmates seen in seizure chronic care clinic during the month
Total # of inmates seen in thyroid chronic care clinic during the month
Total # of inmates seen in tuberculosis (TB) chronic care clinic during the month
Total # of inmates seen in other chronic care clinic during the month (wound care,
prosthetics)
Total # of purified protein derivatives (PPDs) planted in the month
Total # of PPDs read during the month
Total # of PPDs measuring over 10 millimeter (mm) during the month plus those
measuring over 5mm in high risk groups.
Total # of X-Rays taken due to positive PPDs or based on negative test with
symptoms
Total # of patients with active TB which require negative pressure room and isolation
Total # of inmates receiving an HIV test on-site
Total # of all positive HIV results from on-site testing.
Total # of HIV positive inmates, to include previous or new positive
Total # of inmates with a diagnosis of positive Hepatitis A
Total # of inmates with a diagnosis of positive Hepatitis B
Total # of inmates with a diagnosis of positive Hepatitis C
Total # of inmates who tested positive for and were started on treatment for
Chlamydia
Total # of inmates who tested positive for and were started on treatment for
Gonorrhea
Total # of inmates who tested positive for and were started on treatment for Syphilis
Total # of inmates who tested positive for and were started on treatment for pelvic
inflammatory disease (PID) or any other type of sexually transmitted disease (STD)
not listed
Total # of inmates treated for lice or crabs
Total # of inmates treated for scabies
Total # of inmates with skin infections that cultured positive for methicillin-resistant
staphylococcus aureus (MRSA)
Total # of inmates who were started on treatment for a positive MRSA culture
Total # of inmates started on MRSA treatment without a positive culture
Total # of medical grievances received during the month
Total # of grievances related to medical care
Total # of grievances related to dental care
Total # of grievances related to mental health
Total # of grievances related to Contractor staff conduct
Total # of grievances related to delay in care
Total # of grievances related to medications
15
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
15.3.93.
15.3.94.
15.3.95.
Total # of grievances related to access to care
Total # of grievances related to other areas of Contractor responsibility
Contractor shall notify Contract Administrator about potential high cost claims.
Vendor Response:
16. MEDICAL RECORDS
16.1.
The County has a separate agreement with CorEMR for electronic medical records and has
no desire to change from CorEMR for record keeping. The County will be responsible for
ongoing CorEMR licensing and server costs. CorEMR interfaces with the County’s Jail
Management System Tiburon and current pharmacy vendor.
16.2.
Inactive medical records will be maintained in accordance with the laws of the State of
Colorado and the American Medical Association. The Larimer County Sheriff's Office will
be responsible for the storage of active and inactive files.
16.3.
All contact with inmates related to health issues must be documented in the healthcare
record.
16.4.
All requests for healthcare, i.e. paper requests, phone requests, verbal requests, and
grievances must be documented in the inmate’s medical record.
16.5.
Contractor shall maintain complete and accurate medical, dental, and mental health records
separate from the confinement records of the inmate.
16.6.
All medical records (including mental health or dental records, medication logs, treatment
logs, and charts) shall be made available immediately upon request to Contact Administrator
as needed throughout the Contract.
Vendor Response:
17. GRIEVANCES AND LITIGATION
17.1.
In any case where medical care is at issue, or in any criminal or civil litigation where the
physical or mental condition of an inmate is at issue, Contractor shall make accessible to
the Sheriff, Jail Commander, Contract Administrator, Internal Affairs Investigator, District
Attorney, or County Attorney such records and, upon request, provide copies within twentyfour (24) hours of notice.
17.2.
Contractor acknowledges and agrees that all records prepared or acquired by Contractor
during performance of services in the Contract will immediately become the property of the
Sheriff's Office.
17.3.
Contractor shall comply with the grievance review process and provide timely responses to
grievances pursuant to Jail Policy and Procedure.
17.4.
Contractor shall describe remedies available for any medical grievance that is sustained by
the County at the last stage of the grievance process.
17.5.
Any and all legal actions or requests affecting inmates and/or Contractor must be provided,
in writing, to the Contract Administrator within twenty-four (24) hours of notice.
17.6.
Contractor acknowledges, agrees and shall comply to any actions requiring participation that
personnel may, from time to time, be subpoenaed to testify in court regarding medical
treatment and accepts responsibility in responding and managing these court requests. All
parties agree that any overtime associated with this obligation is the responsibility of
Contractor.
Vendor Response:
16
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
18. STAFFING REQUIREMENTS
18.1.
All parties agree that Contractor will enforce minimum staffing requirements to avoid
increasing other County costs for Jail healthcare inclusive of mental health care. For
example, if a Medical Director’s hours are less than the specified minimum requirements
there exists the potential for referrals to external physicians to be more frequent. This results
in a higher requirement for deputy transports for medical care. To further emphasize, if
hours for all staffing (Health Service Administrator, Medical Director, Physician Assistant,
Registered Nurse and Nurse Practitioner) were to fall short of minimum staffing
requirements, the potential for emergency room visits, hospital admissions, and inmates on
non-formulary drugs along with deputy transports would potentially rise resulting in
significant additional charges to the County beyond the agreed upon fee. Contractor shall
reimburse the actual cost of deputy transports when staff positions remain unfilled or
uncovered. Prior to invoking any penalties, the Contract Administrator shall meet with the
Health Services Administrator to discuss and validate non-performance. Notice of nonperformance will then be provided in writing to Contractor. Should any of the penalties be
invoked, they shall be paid as a credit against monthly billing for Contract services.
Vendor Response:
18.2.
Contractor shall recruit, interview, hire, train and supervise staff. Contractor must provide
required personnel for all shifts and fully meet all expectations, requirements and
performance standards. Contractor shall provide for effective staffing to meet the service
level expectations of the Contract obligations which include, but are not limited to:
18.2.1.
Twenty-four (24) hours per day and seven (7) days per week Registered Nursing
(RN) coverage
18.2.2.
Daily sick call and follow-up on a daily basis to include weekends and holidays.
18.2.3.
Dispense medications as prescribed.
18.2.4.
Staffing must be sufficient to complete medication rounds and sick call every morning
between 7:00am and 10:30am; and evening between 6:30pm and 10:00pm.
18.2.5.
Timely response to medical needs and emergencies.
18.2.6.
Physician support services.
18.2.7.
Twenty-four (24) hour emergency/on-call physician and psychiatric consultation.
18.2.8.
Contractor shall provide sufficient clerical staff to support the medical Contract.
18.2.9.
Meeting a two (2) hour window of time to screen every new Jail arrival for medical,
dental, or mental health problems.
18.2.10.
Full physical for all inmates within fourteen (14) days of admission.
18.2.11.
Full dental exam within twelve (12) months of admission in addition to the initial
dental screen performed during intake.
18.2.12.
Inmates identified with clinically significant findings as a result of a comprehensive
intake screening receive an initial health assessment as soon as possible, but not
later than two (2) working days after admission.
18.2.13.
Mental health screening (per 25.1.11).
18.2.14.
Inmates with positive screens for mental health issues receive an initial mental health
evaluation within fourteen (14) days of admission (NCCHC J-E-05).
18.2.15.
On-call coverage is provided by Contractor for after-hours and overnight
emergencies twenty-four (24) hours per day and seven (7) days a week. When a
page is received, the Contractor or Sub-Contractor responds within fifteen (15)
minutes by telephone. While on-call, the professional is available to be on-site within
one hour. In the event there is a suicide attempt in which the inmate requires
significant medical intervention and there is no counselor in the building, the on-call
17
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
counselor will be on-site within one (1) hour to provide assistance for staff and any
inmate who may have witnessed the attempt.
Vendor Response:
19. STAFFING PLAN
19.1.
Contractor shall provide at the time of proposal specific written job descriptions and protocols
to define specific duties and responsibilities for all assignments outlined in the RFP.
Positions include and are not limited to:
19.1.1.
A full-time, on-site Health Service Administrator who shall have overall responsibility
for the successful delivery of healthcare at the Jail. The Health Service Administrator
must be qualified as a Registered Nurse (RN) at minimum. The proposal shall
address what part of on-site time provided by the Health Services Administrator shall
be committed to in-service training, recruitment and quality assurance. The proposal
shall specify the on-call hours of the Health Services Administrator.
19.1.2.
A single designated physician health authority, a Medical Director, with the
responsibility for assuring the appropriateness and adequacy of inmate healthcare
shall be provided. The proposal shall address what part of on-site time provided by
the Medical Director is committed to administrative duties, direct inmate care, and
the involvement in quality assurance. The proposal shall specify the on-call hours of
the Medical Director.
19.1.3.
Physician services must be sufficient to provide the required needs of the day and
assure medical evaluation/follow-up within a reasonable time of post nursing triage
referral (including weekends and holidays). In addition, twenty-four (24) hour
physician on-call services with the availability for consultation and ability to meet the
on-site needs are required. This shall include after-hours, weekends, and holiday
needs for ordering and dispensing medications. A pager service shall be utilized and
specified in the proposal.
19.1.3.1. Physician services are available for no less than eight (8) hours per week per one
hundred (100) inmates.
19.1.3.2. Up to seventy (70) percent of physician services may be provided by physician
extender services, i.e., Physician’s Assistants or Nurse Practitioners.
19.1.3.3. Physician and physician extender services shall be scheduled such that services
are distributed over each day of the week including weekends as well as evening
hours.
19.1.3.4. Physician and/or physician extender hours shall be scheduled or on-call such that
sutures can be done in the medical unit in most cases in order to reduce transports
to local hospitals for this treatment.
Vendor Response:
19.2.
Annual staffing plan must contain billing rates for all positions and include information on
which positions are back-filled and which are not: i.e. registered Nurse would be back-filled
if they call in sick, the manager would have paid time off and not be back-filled.
Vendor Response:
19.3.
Contractor shall make provisions in their staffing plan to cover periods of vacation,
educational, weekends, holidays and sick time by including appropriate relief factors and
per-diem staff. Proposals must show a complete and detailed staffing matrix, by degree of
competency, which shall provide adequate support for the successful operation of the
18
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
healthcare delivery system. Staffing plans are to outline the total number of full-time, parttime and per-diem employees, with full time considered to be a minimum of thirty-two (32)
hours per week on-site. Include position titles and license/certification; reporting order; and
total number of positions per day, per shift. Contractor shall specify in their staffing plan
relief factors.
Vendor Response:
19.4.
The annual staffing plan is intended for budgeting purposes and includes a standard monthly
cost. Fluctuations in staffing shall be allowed for administrative positions. The positions
related to direct healthcare as represented in the minimum staffing plan shall be required to
be filled for each day and each shift. At no time, shall the County pay in excess of the
monthly standard amounts.
Vendor Response:
19.5.
Contractor shall provide proof that the staff providing services in this Contract are licensed
or certified to practice in the State of Colorado and comply with all current and future
applicable Colorado professional practice act regulations. Mental health counselors must
be licensed or pursuing licensure.
Vendor Response:
20. SECURITY CLEARANCE
20.1.
The County shall conduct a comprehensive background investigation on all Contractor and
Sub-Contractor staff recruited to work in the Jail. All Contractor and Sub-Contractor staff
shall be required to pass this full background check prior to working in the Jail even on a
temporary basis. Any Contractor and Sub-Contractor employee who does not satisfy the
security clearance, at the sole discretion of the Contract Administrator, is not allowed access
to the Jail. Contractor shall anticipate that any Contractor or Sub-Contractor employee
involved in a security breach shall be dismissed immediately at the sole discretion of the
Contract Administrator. Contractor shall provide a plan to fill vacated positions temporarily
within twenty-four (24) hours of any such dismissal.
Vendor Response:
20.2.
Contractor and Sub-Contractor staff shall be subject to and shall comply with all security
regulations and procedures of the Jail. Violations of the regulations may result in the
Contractor and Sub-Contractor employee being denied access to the Jail. In this event,
Contractor shall provide alternate personnel.
Vendor Response:
20.3.
Contractor and Sub-Contractor staff shall adhere to the same standards in place for County
employees with regard to harassment, alcohol and drug free workplace, violence in the
workplace, Prison Rape Elimination Act (PREA), Electronic Systems and Equipment Use
Policy, or any other current or future policy that impacts County employees.
Vendor Response:
19
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
20.4.
All parties agree that the Contract Administrator, in their sole discretion, may require
replacement of any Contractor or Sub-Contractor employee at any time, for any reason.
Vendor Response:
20.5.
All Contractor or Sub-Contractor staff shall have an ongoing duty to report criminal arrests
or violations to Contract Administrator.
Vendor Response:
20.6.
In the event of a Contractor employee or Sub-Contractor employee termination, Contractor
shall collect all identification badges, access keys, or other County property assigned to that
employee and submit the items collected to the Contract Administrator, or designee
immediately.
Vendor Response:
21. CONTRACTOR TRAINING
21.1.
Contractor shall prove that all Contractor staff receive a minimum of seventy (70) hours of
on-the-job training by a Nurse preceptor provided by Contractor, before being allowed to
work independently in the Jail. Contractor staff time spent in this preceptorship is paid by
Contractor.
Vendor Response:
21.2.
All Contractor staff shall receive a minimum of five (5) hours of training by Jail staff.
Contractor staff time spent in this training is paid by Contractor. Topics include:
21.2.1.
Personal qualities that will ensure your success working in a Jail
21.2.2.
Safety first
21.2.3.
Rules, policies and procedures
21.2.4.
PREA (Prison Rape Elimination Act)
21.2.5.
Correctional environment
21.2.6.
An introduction into the unique world you are about to enter
21.2.7.
How to navigate the Jail
21.2.8.
Checking in and checking out procedures
21.2.9.
Dress code and contraband
21.2.10.
Housing areas and program classrooms
21.2.11.
Collecting and moving inmates
21.2.12.
Use of elevators
21.2.13.
Codes and emergency procedures
21.2.14.
Effective service; how to meet the needs of those you will serve
Vendor Response:
21.3.
All Nurses and medical assistants shall complete continuing education each year, to comply
with NCCHC standards. Contractor staff time spent in this training is paid by Contractor.
Vendor Response:
22. EQUIPMENT AND SUPPLY RESPONSIBILITIES
20
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
22.1.
Contractor provides stock medical supplies. Contractor supplies, at its expense, all other
supplies required to perform, including but not limited to; books, manuals, medical forms,
laboratory fees, hand instruments, needles and sharps, special medical items, testing
devices, containers and clinical waste receptacles, individual and group materials, gloves
and coverings, and disinfectants.
Vendor Response:
22.2.
Contractor supplies, at its expense, on-site office equipment such as fax machines, pagers,
calculators, additional telephones, and computer paper. Three (3) desktop computers, six
(6) laptops, and two (2) printers are provided by the County. A copy machine is provided by
the County and the County is responsible for paying the maintenance Contract. Supplies
required to operate, such as toner cartridges, copy paper, are the responsibility of
Contractor.
Vendor Response:
22.3.
All equipment in the inventory that is owned by the Jail may be used in conjunction with the
equipment furnished by Contractor. Any additional equipment to be purchased during the
Contract shall be approved for purchase by the Contract Administrator and shall become
property of the Jail.
Vendor Response:
22.4.
All equipment purchased by the County for the purposes of executing the Contact is the
property of the County and remains on-site upon termination of the Contract. In addition, all
supplies, including pharmaceuticals, purchased for use in the performance of the Contract
shall be the property of the County and shall remain on-site at termination of the Contract.
Vendor Response:
22.5.
The County is responsible for the maintenance and repair of all medical equipment and office
equipment supplied and owned by the County for use by Contractor. Should such equipment
become non-serviceable due to routine use, the County will be responsible for its
replacement. Inventory includes:
22.5.1.
Narcotic cabinet
22.5.2.
Autoclave
22.5.3.
Gurney/stretcher
22.5.4.
Peripro film developer
22.5.5.
Wall mounted ophthalmoscope and otoscope
22.5.6.
Dental Chair
22.5.7.
Fetal doppler
22.5.8.
Dental vacuum pump
22.5.9.
Thermo scan thermometer (2)
22.5.10.
Dental vacuum/cup/tray/attach
22.5.11.
Electric scale (2)
22.5.12.
Canes (6)
22.5.13.
Examination table
22.5.14.
Crutches (6 pair)
22.5.15.
Blood pressure cuff (8)
22.5.16.
Nebulizer (2)
21
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
22.5.17.
22.5.18.
22.5.19.
22.5.20.
22.5.21.
22.5.22.
22.5.23.
22.5.24.
22.5.25.
22.5.26.
22.5.27.
22.5.28.
Medication cart (2) provided by pharmacy Contractor
Refrigerator (10 cubic foot)
Wheelchair (3)
Refrigerator, small (2) narcotic, labs
X-Ray Unit
Pulse oximeter (6)
Locking dental equipment cart
Peak flow meter (15)
Dental compressor
Optical microscope, Kenovision
Centrifuge (Note: provided by hospital)
EKG machine
Vendor Response:
22.6.
Contractor shall furnish and pay for all medically necessary prosthetic devices and
appliances.
Vendor Response:
23. BIO-WASTE
23.1.
Contractor shall be responsible for the disposal of all general waste, including infectious or
hazardous bio-waste. Jail storage is limited and waste needs to be removed on the basis of
need, but at minimum every other week. All bio-waste material must be removed from the
Jail and disposed of as regulated by federal, state, and local laws. All costs related to the
removal and disposal shall be at the expense of Contractor.
Vendor Response:
23.2.
Contractor agrees to provide documentation and training on a bi-annual basis on how to
handle bio-waste to all Jail staff that may be involved in the removal of such waste within the
housing areas of the inmates.
Vendor Response:
24. EMERGENCY RESPONSE REQUIREMENTS
24.1.
Contractor shall review and revise, as needed, the policies and procedures for internal and
external emergencies such as natural or manmade disasters, man-down situations, or
pandemic flu outbreak. These procedures will be flexible enough to allow for coping with a
major emergency. The scope and size of the disaster will determine the extent that the
emergency response plan is to be carried out, based on the type and location of the disaster.
The Contractor, with the direction of the Contract Administrator, shall be prepared to respond
immediately and in a professional manner to emergency situations that may arise. The
emergency response plan shall be practiced at least annually.
Vendor Response:
22
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
24.2.
Contractor shall provide within their proposal a contingency plan to provide for services in
the event of unexpected interruptions of the normal working conditions; i.e., power failure,
fire, inclement weather, riot, lock-down, labor strikes, or acts of God that would preclude
normal operations.
Vendor Response:
24.3.
Contractor shall, in times of emergency or threat thereof, whether accidental, natural, or
man-made, provide medical assistance to Larimer County to the extent or degree required.
Vendor Response:
24.4.
Contractor agrees to provide emergency medical treatment and first aid twenty-four (24)
hours a day, seven (7) days a week to any Jail staff, visitor, employee, or Sub-Contractor
who becomes ill or injured and requires emergency care while on the premises.
Vendor Response:
24.5.
Contractor agrees to provide emergency medical services twenty-four (24) hours a day,
seven (7) days a week, for any inmate accepted into custody at the Jail. Contractor staff
shall respond to all emergencies upon notification by reporting to the area of the emergency
with necessary emergency equipment and supplies. Contractor staff shall notify the on-call
physician as soon as the situation allows. Contractor shall stabilize the inmate on-site if
appropriate and then coordinate transfer of the inmate to an appropriate local emergency
room for treatment. Contractor staff who provide emergency services to inmates, completes
any necessary reports or documentation related to such services.
Vendor Response:
24.6.
Contractor shall coordinate with local hospitals as appropriate in emergency situations and
shall coordinate emergency transport and ambulance services as needed. Contractor shall
establish a physician/mid-level provider “call back” schedule during off hours so that urgent,
but non-emergent services can be provided on-site. Contractor Medical Director shall
conduct a retrospective review following an emergency room referral to ensure that action
was appropriate and to identify any additional staff training needed. Contractor shall provide
a copy of the retrospective review to the Contract Administrator.
Vendor Response:
24.7.
Contractor shall provide customized monthly reports to the Contract Administrator of
emergency room visits, with data including but not limited to each inmate’s name and
identification number, the date of the emergency services, the inmate’s disposition, and any
emergency treatment received.
Vendor Response:
25. INMATE HEALTH SCREENING REQUIREMENTS
25.1.
There is a daily average of thirty-five (35) intakes per day. Jail staff completes the initial prebooking medical screenings. Contractor staff must respond immediately if Jail staff has
concerns, twenty-four (24) hours per day, seven (7) days per week. Anyone arriving at the
Jail for booking receives necessary medical attention prior to being accepted into custody.
23
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
The receiving screening shall take place for all inmates as soon as possible after their arrival
at the Jail. Initial health screenings for all new inmates to the Jail must be completed within
two (2) hours of arrival and before the inmate enters the general population of the Jail.
Screening includes, but is not limited to:
25.1.1.
Inquiry into current illnesses, health problems, mental health problems and
conditions
25.1.2.
Identify inmates who require emergency medical care which cannot be provided at
the Jail; ensure the arrestee is referred immediately for care prior to medical
clearance into the Jail Verification of current medication
25.1.3.
Verification of medically necessary special diets or special health requirements
25.1.4.
Identify and isolate inmates who appear potentially contagious
25.1.5.
Observations of behavior, including state of consciousness, mental status,
appearance, conduct, tremors and sweating
25.1.6.
Notation of body deformities, trauma markings, ease of movement, bruises and
jaundice
25.1.7.
Notations of conditions of skin and body orifices, including rashes and infestations,
needle marks or other indications of drug abuse
25.1.8.
Provision of information to inmates regarding the medical grievance process and the
right to healthcare and health services during their admission
25.1.9.
Identification of inmates who are deaf or hard of hearing, who either request or
otherwise need sign language interpreting services for effective communication and
immediate notification of Jail staff
25.1.10.
Notification to Jail staff regarding any medical special diet requirements, special
housing issues or medically necessary work restrictions
25.1.11.
Provide a mental health screening as part of the initial receiving screening process;
inmates with critical mental health needs will be immediately placed in appropriate
housing and referred to see a counselor
25.1.12.
Contractor will use over-the-counter products to delouse any inmate entering the Jail
with scabies or lice, with the exception of inmates that are pregnant, have allergies,
open sores, or who are on seizure medication.
25.1.13.
Inquiry and documentation of inmate third party health insurance and/or
documentation of information necessary to determine eligibility under the Affordable
Care Act.
Vendor Response:
25.2.
Contractor shall provide a Registered Nurse, or higher rated clinician, to complete medical
clearance triage on all individuals brought to the Jail in accordance with the established
rejection criteria mutually approved by Contractor and the Contract Administrator
Vendor Response:
25.3.
Contractor will examine and provide medical clearance for all inmate workers, as requested
by the Jail. The medical clearance process shall be completed after receiving the inmate
worker application, and after the health assessment has been completed, which is within
fourteen (14) days of admission, unless laboratory testing increases the time required to
clear the inmate.
Vendor Response:
24
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
26. MEDICAL REQUIREMENTS
26.1.
Contractor shall provide for a medical, dental, and psychiatric clinic.
Vendor Response:
26.2.
Contractor shall perform a comprehensive health assessment on all inmates within fourteen
(14) calendar days of admission of the inmate. Health assessments will include the following
components:
26.2.1.
Review of the receiving screening results
26.2.2.
Collection of additional data to complete the healthcare, dental, and mental health
histories
26.2.3.
Record of the inmate's height, weight, pulse, blood pressure, and temperature
26.2.4.
Additional testing as clinically indicated
26.2.5.
A complete and thorough physical examination including comments about mental
status
26.2.6.
Review of significant findings of the health assessment, tests, and identification of
problems by physician
26.2.7.
Initiation of therapy and immunizations when appropriate
26.2.8.
For pregnant inmates, the health appraisal will also include:
26.2.8.1. Pregnancy test to confirm positive pregnancy
26.2.8.2. Routine prenatal education and care
26.2.8.3. High risk prenatal education and care, if necessary
26.2.8.4. Management of chemically addicted pregnant inmates
26.2.8.5. Postpartum follow-up care
Vendor Response:
26.3.
Routine medication rounds shall occur at least two (2) times per day and nursing sick call
shall also occur at least two (2) times per day. Staffing must be sufficient to complete
medication rounds and sick call every morning between 7:00am and 10:30am; and evening
between 6:30pm and 10:00pm. Medication rounds and nursing sick call are combined in
such a manner to adhere to health insurance portability and accountability act (HIPAA)
standards.
Vendor Response:
26.4.
Contractor shall provide a Registered Nurse, or higher rated clinician, to triage all health
related requests by inmates.
Vendor Response:
26.5.
Contractor shall identify the need, schedule, coordinate and pay for all qualified medical
professional services rendered to inmates. Contractor shall provide a responsible physician
to supervise all medical care provided, a “qualified medical clinician” who shall conduct sick
call and generally provide such care as is available in the community. The “responsible
physician” or another covering physician shall be on call seven (7) days per week, twentyfour (24) hours per day for emergency situations.
Vendor Response:
25
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
26.6.
Contractor shall provide a chronic disease program to decrease the frequency and severity
of symptoms, prevent disease progression and complications and improve function of the
affected inmates. Chronic care inmates shall be provided a review by a qualified medical
clinician every three months at a minimum.
Vendor Response:
26.7.
Contractor shall provide an infection control program that monitors the incidence of infectious
and communicable diseases, seeks to prevent their incidence and spread, and provides for
the care and treatment of inmates so infected. The infection control program shall be
reviewed with the Contract Administrator annually.
Vendor Response:
26.8.
Contractor shall closely monitor communicable diseases such as tuberculosis (TB), HIV,
acquired immune deficiency syndrome (AIDS), hepatitis, and sexually-transmitted diseases
(STDs). Screenings for TB, STDs, HIV, and hepatitis will be conducted as clinically
indicated. When communicable diseases are diagnosed, provider will take appropriate
isolation precautions and will treat the individuals in accordance with protocols established
by the local health department and the Center for Disease Control (CDC). Contractor shall
utilize the negative pressure rooms in the Jail for inmates requiring isolation. Reports of
communicable diseases will be sent to the state health department.
Vendor Response:
26.9.
Contractor shall provide a program for meeting special needs inmates, to include, but not
limited to, pregnancy, hypertension, and diabetes.
Vendor Response:
26.10.
Contractor shall provide, upon pregnancy confirmation, a prenatal management program
throughout the pregnancy that focuses on management of care.
Vendor Response:
26.11.
Contractor shall provide ongoing medical care discharge planning services. The discharge
planning includes prescription medication information, referrals and any follow-up treatment.
Vendor Response:
27. TRANSPORTATION
27.1.
Contractor shall arrange and coordinate with Contract Administrator or designee for the
transportation of any inmates requiring off-site care.
Vendor Response:
27.2.
The County shall be responsible for the costs of any transportation provided by Larimer
County and for the security for such off-site services.
Vendor Response:
26
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
27.3.
Contractor shall prepare inter-correctional transfer summaries to be sent with inmates being
transferred to the Colorado Department of Corrections or any other law enforcement agency
accepting custody of such inmates. Contractor shall ensure that inmates and health
summaries are prepared for transfer within twenty-four (24) hours of receiving the list of
inmates being transferred.
Vendor Response:
28. LABORATORY AND RADIOLOGY REQUIREMENTS
28.1.
Contractor shall utilize on-site facility ancillary services to their fullest extent and shall be
responsible for the cost of all on-site and off-site laboratory charges, pathology, X-Ray, and
other diagnostic services as required, indicated, or ordered by Contractor.
Vendor Response:
28.2.
Laboratory services shall comply with all standards set forth by the American College of
Pathology and all Colorado state requirements for medical pathology, specimen handling,
testing and reporting. On-site laboratory services shall be performed in accordance with the
Clinical Laboratories Inspection Act (CLIA) and shall comply with the Clinical Laboratories
Improvement Amendments of 1988. All X-Rays and radiology special studies shall be read
by a board-certified radiologist, who shall provide a typed and/or automated report within
twenty-four (24) hours. Contractor shall train all on-site staff on laboratory policies and
provide a diagnostic procedure manual that includes reporting on STAT and critical values.
Documentation of the training shall be provided to the Contract Administrator annually.
Vendor Response:
28.3.
Contractor shall arrange and bear the cost of all radiology services (also referred to as XRay services) ordered by Contractor physician for the inmates. Laboratory services include
the provision of necessary laboratory supplies, timely pickup and delivery of specimens, and
accurate reporting within twenty-four (24) hours on most laboratory services. Documentation
of radiology services shall be provided to the Contract Administrator upon request.
Vendor Response:
28.4.
Contractor shall arrange on-site radiology services whenever reasonably possible.
Contractor shall work with its Contract radiology provider to establish a routine schedule for
on-site radiology services at the Jail, including mobile X-Ray services, ultrasounds,
sonograms, Doppler studies, mammograms, pulmonary function tests, Holter monitor
studies and upper gastrointestinal (GI) X-Rays. To the extent radiology services are required
and cannot be rendered on-site, Contractor shall make appropriate off-site arrangements for
rendering radiology care.
Vendor Response:
28.5.
The radiologist shall call the medical provider if a report necessitates immediate intervention.
Contractor Medical Director or physician/mid-level designee shall be notified of all abnormal
radiology results and shall review, initial, and date all X-Ray reports within five (5) working
days.
Vendor Response:
27
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
28.6.
Contractor Medical Director or physician/mid-level designee shall meet with inmates to
discuss radiology results and establish a plan of care as appropriate. Contractor shall
document and store digital images and radiology reports in the inmate’s medical record and
any follow-up with the inmate shall be noted in the medical record. Contractor shall maintain
a log to document the type and number of X-Rays completed and the results received.
Contractor personnel shall review the log on a daily basis to determine if any test results are
outstanding and shall document such daily review.
Vendor Response:
28.7.
Contractor shall provide bloodborne pathogen testing when it is determined that Jail staff or
Contractor staff have been exposed by an inmate.
Vendor Response:
28.8.
Contractor shall identify the need, schedule, coordinate and pay for all support diagnostic
examinations. Contractor shall also provide and pay for all laboratory services, as medically
indicated.
Vendor Response:
29. DENTAL HEALTH REQUIREMENTS
29.1.
Contractor shall provide and bear the cost of a licensed dentist to provide dental services for
the entire inmate population. Basic dental services include what is necessary to relieve pain,
infection, and preserve salvageable teeth.
Vendor Response:
29.2.
Contractor shall refer inmates to a dental specialist if needed.
Vendor Response:
29.3.
Contractor shall arrange for emergency dental services to be available on a twenty-four (24)
hours per day basis.
Vendor Response:
29.4.
Contractor shall provide a full dental exam within twelve (12) months of admission in addition
to the initial dental screen performed during intake.
Vendor Response:
29.5.
Dental sick call services are provided so that there is no more than a ten (10) day waiting
period to be seen.
Vendor Response:
30. VISION CARE REQUIREMENTS
30.1.
Contractor shall provide basic vision services to inmates, in addition to providing care for
eye injuries or diseases.
28
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Vendor Response:
30.2.
Contractor shall provide any inmate with one (1) pair of medically necessary reading or
prescription eyeglasses if prescribed and deemed necessary by a physician for minimal
function by such inmate. Contractor shall provide such additional and/or replacement
eyeglasses as necessary, however, the cost of any additional or replacement eyeglasses
shall be borne by the inmate.
Vendor Response:
31. HEARING CARE REQUIREMENTS
31.1.
Contractor shall be responsible for providing any necessary replacement batteries for
inmates with hearing aid devices.
Vendor Response:
32. DIALYSIS
32.1.
Dialysis is not currently provided on-site, nor are these services part of this RFP request. All
costs associated with dialysis are the responsibility of the County.
Vendor Response:
33. PHARMACY REQUIREMENTS
33.1.
Contractor shall provide full pharmacy services to the Jail. Pharmaceutical services include
a qualified medical clinician prescribing the medication, filling of the prescription, dispensing
of medication, and necessary record keeping. Contractor shall comply with all applicable
state and federal regulations regarding prescribing, dispensing, administering, procuring and
storing pharmaceuticals.
Vendor Response:
33.2.
Current stock medications are listed in appendix “A” in this document.
Vendor Response:
33.3.
Contractor shall provide for pharmaceutical services to assure the availability of prescribed
medications within eight (8) hours of the order of issue being written.
Vendor Response:
33.4.
Pharmacy services shall be monitored by a licensed, qualified pharmacist. State and
Federal inspection requirements, such as the quarterly inspections, must be facilitated and
paid for by Contractor.
Vendor Response:
33.5.
Contractor shall use a formulary that allows generic medications to be substituted for brand
name medications whenever possible.
Vendor Response:
29
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
33.6.
Contractor shall be responsible for the costs of all drugs administered. Contractor shall
maintain and track pharmacy budgetary costs and formulary. Pharmacy costs, inclusive of
psychotropic medications, are thirty-thousand ($30,000) per month on average.
Vendor Response:
33.7.
Contractor will provide the following reports: monthly drug usage, monthly psychotropic
usage, monthly medication administrative reports, monthly number of prescriptions by
category, monthly prescriber report which lists all prescriptions written by the prescriber, and
a monthly itemized billing for each inmate.
Vendor Response:
33.8.
For inmates who have a need to continue medications after release, Contractor shall supply
a written prescription for those medications (by either giving to the inmate directly or faxing
to a local pharmacy) so that the inmate may obtain needed medication in a timely manner.
Vendor Response:
33.9.
Contractor shall maintain stock medications which, if not readily available, could compromise
an inmate’s health status. Contractor shall have agreements in place with local pharmacies
for emergency purchases of medications to avoid out-of-stock situations. Agreements shall
be reviewed with the Contract Administrator annually.
Vendor Response:
33.10.
Contractor shall ensure that the Jail has emergency drug kits stocked. All stock medications
will be maintained to a maximum supply of sixty (60) days.
Vendor Response:
33.11.
Contractor shall record the administration of all medications to include documentation that
inmates are receiving and ingesting their prescribed medications. Documentation shall also
be required when an inmate's ordered medication was not administered and the reason.
Inmates on scheduled medications must be monitored closely and a follow-up plan of care
outlined must be documented.
Vendor Response:
33.12.
Contractor shall notify the Contract Administrator immediately should an inmate not receive
their medication for any reason other than refusal by the inmate.
Vendor Response:
33.13.
Inmate’s family members may bring in an inmate’s pharmaceuticals, if they have at least a
two (2) week supply, however, no capsules and no controlled substances are allowed to be
brought in.
Vendor Response:
30
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
33.14.
Psychiatric medications are provided to inmates. Current prescriptions are confirmed by a
Nurse and reviewed by the physician’s assistant before being given to the inmate. The
physician’s assistant may start a prescription for an inmate seen at medical clinic. Any
questions, requests or concerns inmates have about their medications are referred to or
passed on to the prescribing source. Any concerns regarding medication issues are
discussed with the Psychiatrist. If serious side effects are noted, this information is
documented and action is taken. Contractor makes every effort to provide education
regarding tools to help inmates cope with their complaints or symptoms.
Vendor Response:
33.15.
Contractor agrees to adopt the Over-the-Counter Keep-on-Person (KOP) medication
program for the jail. Inmates are provided the following instructions: You may only order
KOP medications when it is medically necessary. There must be no unfavorable
interactions with other current KOP or prescription medications. If you are prescribed
medication that is contra-indicated to KOP in your possession, the KOP will be confiscated
and returned at the discretion of the Medical Unit. Hoarding KOP is not allowed. You may
not have more than one (1) card of the same KOP medication in your possession. You
may not share, trade, or sell any KOP medications with other inmates. Current or past
abuse of any prescribed or KOP medication may deem you ineligible for KOP. You are
prohibited from participating in the KOP program if there are safety and security
concerns. If you have lost KOP privileges and these medications are medically indicated,
the clinician may approve KOP medications as prescription medication. Prescribed KOP
medications are subject to a fee and will be administered to you during morning and
evening medical rounds. If you have lost your KOP privileges, you will be ineligible to
order KOP for a period of six (6) months from the time you lose your KOP privileges. At
the end of the six (6) months, your eligibility to order KOP will be re-evaluated.
Vendor Response:
33.16.
Contractor shall ensure that all inmates receive their medications as prescribed. The clinician
prescribes medications. A licensed Nurse administers and documents the medications
given. Services shall include prescription medications and over-the-counter medications
through the KOP Program.
Vendor Response:
34. INTOXICATION AND WITHDRAWAL
34.1.
Contractor shall have a protocol to provide intoxication and withdrawal treatment, support
and medical services for drug and/or alcohol addicted inmates.
Vendor Response:
34.2.
Contractor shall advise the Contract Administrator on best practices regarding starting a
program to provide medications to those inmates who may benefit from Methadone or other
similar medication upon release. Contractor shall provide Methadone or other appropriate
treatment program accessibility to pregnant addicted inmates.
Vendor Response:
31
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
34.3.
Contractor shall provide intermittent monitoring of the inmates showing signs of intoxication
or withdrawal to determine the health status of those individuals. In severe cases, monitoring
shall include, at a minimum, documented vital signs and determination of the level of
consciousness every one (1) hour, and medically appropriate detoxification treatment.
Vendor Response:
35. SECURITY REQUIREMENTS
35.1.
All controlled substances, syringes, needles and surgical instruments and any other sharps;
e.g., scissors, staple removers, shall be stored under security conditions acceptable to the
Contract Administrator. Security conditions are reviewed by the Contract Administrator at
least annually.
Vendor Response:
35.2.
Inmate labor is not utilized to provide any healthcare services, including recordkeeping.
Vendor Response:
35.3.
Contractor staff shall never bring in their own instruments if they are sharp, edged, or bladed,
such as scissors and knives.
Vendor Response:
36. TRAINING/SERVICES TO JAIL STAFF
36.1.
Contractor shall provide training of comprehensive health issues for Jail staff as well as
continuing training updates on current and pertinent Jail health issues. Training must comply
with the NCCHC standard number J-C-04 Health Training for Correctional Officers.
Contractor shall provide four (4) hours of annual training to all deputies relative to medical
issues and especially with respect to interacting with persons with mental impairments as
well as physical impairments. The training shall reinforce areas of improvement with respect
to interaction with individuals with mental impairments and other disabilities in creating
proper interaction with such persons. The specific areas of concentration should be
centered on ADA covered disabilities.
Vendor Response:
36.2.
Contractor provides management of the Hepatitis B vaccination program for all designated
Jail employees. Larimer County will bear the costs of the vaccine.
Vendor Response:
36.3.
Contractor provides an annual TB screen for all designated Jail employees. There are
approximately two hundred fifty (250) employees that require annual TB testing. All new
hires are offered the three (3) series Hepatitis B vaccinations.
Vendor Response:
32
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
37. MENTAL HEALTH OVERVIEW
37.1.
Considering the provisions of the Contract, the Jail is interested in creating a community
partnership and considers SummitStone Health Partners a leader in creating the mental
health connection with an inmate’s overall healthcare. The scope of the inmates needs will
be intake, acute care and general counseling.
Vendor Response:
37.2.
Mental health services will include, but are not limited to, those provided by qualified
Contractor or Sub-Contractor’s mental health professionals who meet the educational and
license certifications criteria specified by their respective professional disciplines.
Vendor Response:
37.3.
Medication to alleviate psychotic symptoms and mood disturbances is an important aspect
of treatment for inmates with mental illness. Contractor shall be responsible and for
managing pharmaceuticals for the Jail including medications prescribed by Contracted
vendor for psychiatric care. Contractor shall bear the cost.
Vendor Response:
37.4.
Based on the most current estimates, the Jail may have at any one time, a range of one
hundred (100) inmates with mental health concerns. Currently, as a typical average, thirty
(30) of those inmates are on fifteen (15) or thirty (30) minute watches for acute care.
Vendor Response:
38. SUICIDE PREVENTION
38.1.
Suicide prevention that includes therapeutic contact and monitoring of inmates on
Emotional Instability (EI) watches or assessment of inmates is brought to Jail staff's
attention. Individuals brought to Jail staff's attention, but not on a watch, and inmates on
constant or fifteen (15) minute EI watches are prioritized first, followed by thirty (30) minute
EI watches.
Vendor Response:
38.2.
Effective management of suicidal inmates depends on communication between the Jail’s
staff and Contractor staff. Because inmates can become suicidal at any point during
confinement, Jail and Contractor staff must be trained to maintain awareness, share
information, and make appropriate referrals. Various high-risk periods are associated with
potentially suicidal behavior, including whether the inmate has an upcoming date for a court
hearing and following a telephone call or scheduled visit.
Vendor Response:
38.3.
Two levels of observation are generally recommended for suicidal inmates: Watches are
recommended for the inmate who is not actively suicidal, but expresses suicidal ideation
and/or has a recent history of self-harming behavior. In addition, an inmate who denies
suicidal ideation or does not threaten suicide, but demonstrates other behavior (through
33
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
actions, current circumstances, or recent history) that could indicate the potential for selfinjury, is placed on a watch. Jail staff observe such an inmate in a protrusion-free cell at
staggered intervals not to exceed every fifteen (15) minutes (e.g., at five (5) minutes, ten
(10) minutes, seven (7) minutes).
Vendor Response:
38.4.
Because medical experts warn that brain damage from asphyxiation caused by a suicide
attempt can occur within four (4) minutes and death can occur within five (5) to six (6)
minutes (American Heart Association 1992), observation at fifteen (15) minute intervals is
only sufficient under the following conditions—surveillance by Jail staff must be conducted
at staggered intervals (e.g., five (5) minutes, ten (10) minutes, seven (7) minutes).
Vendor Response:
38.5.
Constant observation is recommended for the inmate who is actively suicidal (i.e., either
threatening or engaging in suicidal behavior). Jail staff observe such an inmate on a
continuous, uninterrupted basis.
Vendor Response:
38.6.
Contractors and/or Sub-Contractors assess and interact with (not just observe) the suicidal
inmate daily. The daily assessment focuses on the inmate’s current behavior as well as
changes in thoughts and behavior during the past twenty-four (24) hours. For example,
professionals can ask the following questions: “What are your current feelings and
thoughts?”, “Have your feelings and thoughts changed over the past twenty-four (24)
hours?”, and “What are some of the things you have done or can do to change these
thoughts and feelings?”
Vendor Response:
38.7.
An individualized treatment plan (including follow-up services) is developed for each
inmate on suicide precautions. Contractor shall develop the plan in conjunction with the
inmate, medical and Jail personnel. The treatment plan describes signs, symptoms, and
the circumstances under which the risk for suicide is likely to recur; how the inmate can
avoid having suicidal thoughts; and actions the inmate and Jail staff will take if suicidal
ideation recurs.
Vendor Response:
39. SUICIDE PRECAUTION TRAINING
39.1.
Contractor and/or Sub-Contractor’s mental health professionals shall provide eight (8)
hours of initial mental health and suicide prevention training for new Jail, Contractor and
Sub-Contractor staff. Training sessions shall be scheduled four (4) times per year.
Vendor Response:
34
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
39.2.
Contractor and/or Sub-Contractor’s mental health professionals shall provide two (2) hours
of refresher mental health and suicide prevention training for all current Jail, Contractor
and Sub-Contractor staff. Training sessions shall be scheduled six (6) times per year.
Vendor Response:
39.3.
The suicide-prevention program is approved by the Contractor’s health authority, reviewed
annually and signed by the Contract Administrator.
Vendor Response:
39.4.
The program includes specific procedures for handling intake, screening, identifying and
supervising of a suicidal inmate. In addition, the program actively involves Jail, Contractor,
and Sub-Contractor staff and includes an inmate critical incident debriefing that covers the
management of suicidal incidents, suicide watches and death of an inmate or staff
member.
Vendor Response:
39.5.
The program ensures a review of critical incidents by administration, security and health
services.
Vendor Response:
39.6.
Training specifically includes, but is not limited to:
39.6.1.
Identifying the warning signs and symptoms of impending suicidal behavior
39.6.2.
Understanding the demographic and cultural parameters of suicidal behavior,
including incidence and variations in precipitating factors
39.6.3.
Responding to suicidal and depressed inmates
39.6.4.
Communicating between Jail and Contractor personnel
39.6.5.
Using referral procedures
39.6.6.
Housing observation and suicide-watch level procedures
39.6.7.
Follow-up monitoring of inmates who make a suicide attempt
Vendor Response:
39.7.
The eight (8) hour initial training includes, at a minimum, the following topics: administrator
and staff attitudes about suicide and how negative attitudes impede suicide-prevention
efforts, ways in which correctional facility environments are conducive to suicidal behavior,
potential predisposing factors to suicide, high-risk suicide periods, warning signs and
symptoms, how to identify suicidal inmates even if they deny they are at risk, components
of the Jail’s suicide-prevention policy, and liability issues associated with inmate suicide.
Training includes a general discussion of any recent suicides and/or suicide attempts in the
Jail.
Vendor Response:
35
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
39.8.
The two (2) hour refresher training shall review the topics discussed during the initial
training and also describe any changes to the Jail’s suicide-prevention plan. Training
includes a general discussion of any recent suicides and/or suicide attempts in the Jail.
Vendor Response:
39.9.
Mock drills shall be incorporated into both the initial and refresher training for all Jail,
Contractor, and Sub-Contractor staff.
Vendor Response:
40. REVIEW OF BEHAVIORAL HEALTH NEEDS
40.1.
Each Contractor or Sub-Contractor’s mental health professional starts their shift by
reviewing documentation of the behavioral health needs of the inmates in the Jail. A
continuous review of behavioral health needs of inmates is required throughout the work
day.
Vendor Response:
41. MENTAL HEALTH APPRAISALS
41.1.
All inmates receive a Mental Health Appraisal by a qualified mental health professional
within fourteen (14) days of admission to the Jail. However, if there is documented
evidence of a Mental Health Appraisal within the previous thirty (30) days, an abbreviated
Mental Health Appraisal is completed. Inmates with severe mental illness or who are
severely developmentally disabled receive a Mental Health Evaluation. Where appropriate,
these inmates are referred for placement in non-correctional facilities or in units specifically
designated for handling this type of inmate. Mental Health Appraisals include, but are not
limited to the following:
41.1.1.
Assessment of current mental status and condition.
41.1.2.
Assessment of current suicidal potential and person-specific circumstances that
increase suicide potential. Examples of person-specific circumstances are the first
time inmate with high profile or sensitive charges; or an inmate that has a history of
having worked for law enforcement or other public service organizations.
41.1.3.
Assessment of violence potential and person-specific circumstances that increase
violence potential. An example of person-specific circumstances would be past
assaultive behavior while in custody or a criminal history containing multiple crimes
of violence.
41.1.4.
Review of available historical records of inpatient and outpatient psychiatric
treatment.
41.1.5.
Review of history of treatment of psychotropic medication.
41.1.6.
Review of history of psychotherapy, psycho-educational groups, and classes or
support groups.
41.1.7.
Review of history of drug and alcohol treatment.
41.1.8.
Review of educational history.
41.1.9.
Review of history of sexual abuse victimization and predatory behavior.
41.1.10.
Assessment of drug and alcohol abuse and/or addiction.
41.1.11.
Use of additional assessment tools, as indicated.
41.1.12.
Referral to treatment, as indicated.
36
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
41.1.13.
Recommendations concerning housing, job assignment and program participation.
Vendor Response:
42. MENTAL HEALTH REFERRALS
42.1.
Inmates referred for mental health treatment receive a comprehensive evaluation by a
licensed mental health professional. The evaluation is completed within fourteen (14) days
of the referral request date and include, at a minimum:
42.1.1.
Review of mental health screening and appraisal data.
42.1.2.
Direct observation of behavior.
42.1.3.
Collection and review of additional data from inmate diagnostic interviews and tests
assessing personality, intellect and coping abilities.
42.1.4.
Compilation of the inmate’s mental health history.
42.1.5.
Development of an overall treatment/management plan with appropriate referral to
include transfer to a mental health facility for inmates whose psychiatric needs
exceed the treatment capability of the Jail.
Vendor Response:
43. EMOTIONAL INSTABILITY WATCH GUIDELINES
43.1.
Once a week, all inmates on EI watches are reviewed.
Vendor Response:
43.2.
EI Watch Fifteen (15) minute: Inmates on a fifteen (15) minute EI watch are seen on a
daily basis. Inmates are placed on a fifteen (15) minute EI watch if they meet one or more
of the following criteria:
43.2.1.
Had a suicide attempt within the last year.
43.2.2.
Have current thoughts of suicide.
43.2.3.
Are actively making suicidal gestures and/or a suicidal plan that is relevant to the
Jail environment.
43.2.4.
Have charges relating to the death of the victim or heinous/high profile sexual
assault charges.
43.2.5.
Have any Special Weapons and Tactics (SWAT) extraction that makes reference to
“suicide by cop” from the arresting agency during the current arrest.
43.2.6.
Are a juvenile placed in custody.
43.2.7.
Have family or professional contact that may indicate the inmate is suicidal.
43.2.8.
Have previous attempts in an institution within the past five (5) years.
43.2.9.
Have been directly transferred from a mental health facility.
43.2.10.
Have a history of having worked for law enforcement or other public service
organization.
Vendor Response:
43.3.
EI Watch Thirty (30) minute: Inmates on a thirty (30) minute EI watch are seen three (3) to
four (4) times a week, unless a treatment plan has been revised. Any inmate that has had
a suicide attempt one (1) to three (3) years ago or has been identified as developmentally
disabled or chronically mentally ill is placed on a thirty (30) minute EI watch.
Vendor Response:
37
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
43.4.
Guidelines to Progress Off a Watch
43.4.1.
The level of EI watches are constant, fifteen (15) minute, thirty (30) minute, no
watch. Watches are progressed in sequential order. If a watch is dropped a
Lethality Checklist shall be completed and is reviewed during the next business day
by the mental health authority.
43.4.2.
An inmate remains on the level of EI watch for a minimum of two (2) days until they
can progress to the next level. An inmate’s EI watch is not modified if they are
making statements of self-harm.
Vendor Response:
43.5.
Booking and EI Watches
43.5.1.
If an inmate on an EI watch remains in Booking for longer than twelve (12) hours,
Contractor shall complete a chart note once every shift until the inmate is returned
to housing. The chart note summarizes the inmate’s behavior, emotional status,
orientation to time, place, and person, and if they are a danger to self or others.
Vendor Response:
44. CLASSIFICATION OF INMATES
44.1.
Contractor makes recommendations regarding inmate classification. Recommendations
are made considering the inmate's watch level, housing, programs, separations, and
special needs. Additional consideration is made based on the nature of the inmate's
charges.
Vendor Response:
44.2.
A Contractor or Sub-Contractor’s mental health professional will be present for
Classification Board to provide the board with input on currently held inmates from a
mental health perspective.
Vendor Response:
45. INMATES PRONE TO VICTIMIZATION
45.1.
Inmates with any physical impairment, intellectual impairment, or sensitive charges are
prone to victimization. Sensitive charges can include any type of sexual charge and may
require Protective Custody (PC) or a type of modified PC status. If any type of PC status is
required, a recommendation is made for appropriate housing.
Vendor Response:
45.2.
Not all inmates with sensitive charges require special management. Factors that influence
the decision include the profile level of the case, the type of case (e.g. sexual assault on
child), and the behavior of the inmate. A close review of the inmate's mental status is made
upon the initial entry to the Jail and continued throughout the inmate's incarceration at the
Jail to determine any risk of self-harm.
Vendor Response:
38
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
46. INMATES WITH PREDATORY BEHAVIOR
46.1.
An inmate with a history of and/or current behavior that indicates predatory or aggressive
behavior may require high security housing. Recommendations for housing are brought to
the attention of the security shift supervisor.
Vendor Response:
47. MENTAL HEALTH ON-CALL COVERAGE
47.1.
On-call coverage is provided by Contractor and/or Sub-Contractor for after hours and
overnight emergencies twenty-four (24) hours per day, seven (7) days a week. When a
page is received, the Contractor or Sub-Contractor shall respond within fifteen (15)
minutes by telephone. While on-call, the professional is available to be on-site within one
(1) hour in the event there is a suicide attempt in which an inmate requires significant
medical intervention. The Contractor or Sub-Contractor provides assistance for security
and other inmates who may have witnessed the attempt.
Vendor Response:
48. EMOTIONAL INSTABILITY WATCHES
48.1.
The Suicide Prevention and Intervention policy requires that inmates on a fifteen (15)
minute EI watch be evaluated by Contractor prior to release to determine if they pose an
imminent danger to themselves or others or are gravely disabled due to mental illness. If
an inmate placed on a fifteen (15) minute EI watch by security or medical upon arrival is
ready for release, a Contractor or Sub-Contractor’s mental health professional is
contacted. Contractor may consult with other disciplines in the Jail, speak to the inmate on
the phone or come in for a face to face interview prior to authorizing the release of the
inmate. When a face-to-face interview is necessary, Contractor responds within one (1)
hour.
Vendor Response:
49. INVOLUNTARY MENTAL HEALTH HOLDS (M-1 HOLD)
49.1.
An Involuntary Mental Health Hold (M-1 hold) is used when an inmate poses an imminent
danger to self or others due to a mental illness (suicide intent is considered mental illness)
or gravely disabled. In all cases, if Contractor determines there is imminent danger to the
public or to the inmate, an M-1 hold is signed in order to detain the person in custody. In
addition to qualified mental health professionals, involuntary Mental Health Holds may be
signed by any Certified Peace Officer.
Vendor Response:
49.2.
Once the paperwork is completed, Contractor contacts the Transportation or Security
Supervisor to coordinate transportation to the hospital. Contractor also contacts the Crisis
Assessment Center (CAC) response team at the hospital to advise them of the transfer.
Jail staff informs and documents that the inmate was notified of a pending transfer to a
non-correctional facility. Once the notification is made, the inmate is not permitted access
to the phone. A photocopy of the M-1 hold form is scanned in CorEMR. If an M-1 hold is
initiated during non-business hours, the on-call counselor will be notified. Contractor will
39
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
assist the certified peace officer in completing the 27-65-105 paperwork and provide
guidance to the security supervisor to ensure the inmate is transferred to a hospital.
Vendor Response:
49.3.
If an inmate is intoxicated or under the influence of drugs and a valid evaluation of their
underlying mental condition cannot be made, evaluation for placement of a mental health
hold is delayed until a reasonable period of time has passed when the effects of the
substance(s) used is no longer evident. An eight (8) hour time frame generally applies to
drug and alcohol use, but judgment shall be used in determining the appropriate timing of
an evaluation.
Vendor Response:
49.4.
If an individual arrives at the Jail with a mental health hold signed by an arresting peace
officer, the arresting peace officer is instructed to go to the hospital to have the hold upheld
or dropped. The individual may not return to the Jail unless the hold is dropped.
Vendor Response:
49.5.
A mental health hold may also be used for an inmate who is determined to be “gravely
disabled” due to a mental illness. In this case, it must be clearly evident that the inmate is
incapable of attending to their own daily needs or maintaining life or reasonable personal
safety due to mental illness. These inmates are determined to be in clear and lifethreatening jeopardy without hospitalization. In this case, a hold is not signed unless that
inmate is being released from custody.
Vendor Response:
49.6.
SummitStone Health Partners is contacted to evaluate inmates for involuntary commitment
to the Colorado Mental Health Institute-Pueblo. During regular business hours,
SummitStone Health Partners is contacted to do a courtesy evaluation to help determine if
the person should be placed on an M-1 hold. SummitStone Health Partners has legal
responsibility for the management of inmates on an involuntary treatment commitment.
SummitStone Health Partners is notified whenever an inmate is in custody and has a valid
M-1 hold. A SummitStone Health Partners evaluator (in consultation with one of their
licensed staff, as needed) determines whether the M-1 hold is valid, i.e., whether the
inmate meets 27-65-105 criteria at the time of their evaluation. If the hold is upheld, the
SummitStone Health Partners staff is responsible for arranging hospital placement,
drawing up necessary paperwork for the hospital and leaving appropriate forms and
information. If the hold is dropped, the inmate may continue to be housed and treated at
the Jail only if there are criminal charges pending. SummitStone Health Partners staff also
completes the appropriate forms for dropping the hold. SummitStone Health Partners staff
evaluators may place holds based on a courtesy evaluation done at the Jail and are
notified about all mental health holds.
Vendor Response:
50. MENTAL HEALTH INTAKE ASSESSMENT REPORT
50.1.
If an inmate has no immediate need for mental health services, a Mental Health Appraisal
that documents the inmate is cleared for General Population or other assigned housing
40
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
area is completed. When an intake is complete, Contractor will enter an "INTA" under the
inmate’s name in Tiburon under the events tab. Contractor makes recommendations for
housing in remarks.
Vendor Response:
51. MENTAL HEALTH CHART NOTES
51.1.
Contractor writes notes in the “Chart Notes” tab in CorEMR. Notes for inmates on an EI
watch shall be completed after each contact or a minimum of three (3) notes per week.
These notes include, but are not limited to, any changes to a person’s watch status, a note
for each contact with the inmate, and any crisis or watch change deemed important to
document. The following are examples of topics reflected in a chart note:
51.1.1.
Assessment of risk of harm to self or others
51.1.2.
Initial assessments, histories, recommendations and plans
51.1.3.
Changes in EI watches
51.1.4.
Mental health management plans
51.1.5.
Significant contacts/crisis interventions
51.1.6.
Case management plans or referrals
51.1.7.
Releases of information signed
51.1.8.
Any refusal to sign a disclosure form
Vendor Response:
52. MENTAL HEALTH FOLLOW-UP
52.1.
Inmates who have been identified with serious and persistent mental illness who have
progressed off an EI watch will be monitored by the Contractor throughout their
incarceration. The inmate will be seen by Contractor one (1) time per month at a minimum
for follow-up counseling.
Vendor Response:
52.2.
Contractor will create a task for EI follow-up when an inmate’s EI watch is dropped. A
subsequent task will be created for monthly or bi-monthly contacts as deemed appropriate.
Vendor Response:
52.3.
The inmate will be seen at least two (2) times per month if competency has been ordered,
if they have been found incompetent to proceed or they are returning from Colorado
Mental Health Institute Pueblo (CMHI-P) or the RISE program.
Vendor Response:
52.4.
A “Mental Health Follow-Up” alert is added in CorEMR.
Vendor Response:
52.5.
A “Progress Note” is entered in CorEMR outlining the inmate’s current presentation.
Vendor Response:
41
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
52.6.
The Contractor or Sub-Contractor’s mental health professional shall “Task” their supervisor
to review the progress note.
Vendor Response:
52.7.
Inmates on “Mental Health Follow-Up” status will be reviewed weekly.
Vendor Response:
53. LETHALITY CHECKLIST
53.1.
A lethality checklist is completed prior to dropping an EI watch or releasing an inmate on a
fifteen (15) minute EI watch from Jail.
Vendor Response:
53.2.
When an EI watch is modified, the "Alert" tab in CorEMR is updated reflecting the changes.
Vendor Response:
54. HUNGER STRIKE
54.1.
If a Hunger Strike protocol is initiated, Contractor or Sub-Contractor’s mental health
professionals shall meet with the inmate and document in CorEMR as to the possible
reasons behind the strike. The Psychiatrist will also be notified to review the chart.
Contractor shall review the inmate's chart daily and provide contact with the inmate a
minimum of three (3) times per week throughout the protocol. An EI watch may be initiated
based on the evaluation.
Vendor Response:
55. MENTAL HEALTH PROGRAMS
55.1.
Screening for mental health problems on intake as approved by the Contractor or SubContractor’s mental health professional.
Vendor Response:
55.2.
Referral to outpatient services for the detection, diagnosis and treatment of mental illness.
Vendor Response:
55.3.
Crisis intervention and the management of acute psychiatric episodes.
Vendor Response:
55.4.
Stabilization of the mentally ill and the prevention of psychiatric deterioration in the
correctional setting.
Vendor Response:
42
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
55.5.
Referral and admission to licensed mental health facilities for inmates whose psychiatric
needs exceed the treatment capability of the Jail.
Vendor Response:
55.6.
Obtaining and documenting informed consent.
Vendor Response:
56. CRISIS INTERVENTION
56.1.
Contractor responds to inmates having emotional reactions to problems, life events or
mental health related problems that are significantly impairing the inmate’s ability to cope
appropriately in the Jail and that without intervention may result in behavior management
crises or risk of harm to self or others in accordance with policy.
Vendor Response:
56.2.
Contractor is aware of the criteria for “duty to warn” and consults the supervisor when they
believe the criteria exists. This criterion includes, but is not limited to the inmate making
realistic threats of harm to a specific inmate with a reasonable belief that the threat poses a
serious danger to the other party. A release of information is not necessary in cases in
which the counselor feels that the threat to the other person is legitimate.
Vendor Response:
56.3.
When standard issued clothing presents a security or medical risk, the inmate is supplied
with a security garment that promotes inmate safety and prevents humiliation and
degradation.
Vendor Response:
57. URGENT EVALUATIONS
57.1.
Urgent evaluations are made of inmates who may warrant an M-1 hold or require special
management due to mental illness, emotional state or cognitive impairment. Among urgent
evaluations, are persons being held in Booking for evaluation prior to housing who have
been placed on a fifteen (15) minute EI watches. This includes inmates on fifteen (15)
minute EI watches at the time of release.
Vendor Response:
58. STABILIZATION AND MAINTENANCE OF MENTALLY ILL INMATES
58.1.
Stabilization includes brief therapeutic contact and monitoring of inmates with chronic or
acute mental illness, treatment planning and case management for release planning.
Vendor Response:
58.2.
Inmates with adjustment disorders, not posing a danger to self or others, receive brief
therapeutic contact as needed.
Vendor Response:
43
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
58.3.
Counselors provide cognitive behavioral intervention and education for non-urgent issues
that are impacting the inmate’s behaviors in the Jail, such as anger management or
anxiety management.
Vendor Response:
58.4.
Interventions for inmates with anger or behavior management issues that are having
difficulty in the Jail may be referred to classes within the Jail.
Vendor Response:
59. RELEASE PLANNING AND REFERRAL
59.1.
To help inmates develop a release plan that includes referring them to outside agencies for
support and aid. This may also include contacting agencies, gathering information, or
setting up appointments.
Vendor Response:
59.2.
A liaison from Connections/Prescription Assistance comes to the Jail twice a month to do
initial intake interviews for their services. Inmates are referred to this program if they are
currently a client at SummitStone Health Partners, on medication while incarcerated at the
Jail, need to continue that medication upon release, and upon release, reside in Larimer
County and are willing to follow through with services. In order to share information with
Connections/Prescriptions Assistance, the inmate must sign a Release of Information form.
If an inmate is likely to be released prior to the liaison’s next visit and appears to be an
appropriate referral to SummitStone Health Partners, the professional can place a call to
the liaison to inform them of the referral. In addition, the inmate is given information on the
Prescription Assistance Program through Poudre Health Services.
Vendor Response:
60. JAIL BASED BEHAVIORAL SERVICES
60.1.
The Larimer County Sheriff’s Office Jail partners with SummitStone Health Partners to
deliver Jail Based Behavioral Health Services (JBBS) to inmates. The JBBS program
provides dual diagnosed inmates group therapy. This program is funded by a grant
managed by the Colorado Office of Behavioral Health Department of Human Services.
The provision of these services is not part of this solicitation.
Vendor Response:
61. QUALIFICATIONS
61.1.
To be considered for award of this Contract, Contractor MUST meet the following
requirements:
Vendor Response:
61.2.
Contractor must have at least three (3) years of experience in providing healthcare
services in a correctional environment.
Vendor Response:
44
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
61.3.
Contractor must have demonstrated experience and the quality of care by having obtained
the accreditation of the National Commission on Correctional Health Care (NCCHC) in
delivering healthcare services to inmates.
Vendor Response:
61.4.
Contractor must demonstrate the ability to provide a healthcare delivery system specific to
the Jail. Contractor must illustrate that it has the ability for a thirty (30) day start-up from
notice of award, that it has a proven system of recruiting staff, and that it has adequate
support staff in its central office capable of competently supervising and monitoring its
operation in Larimer County.
Vendor Response:
62. PROPOSAL SUBMITTAL REQUIREMENTS:
62.1.
It is critical that all inclusions referenced in this RFP be specifically addressed in your
proposal, in the order listed:
Vendor Response:
62.2.
Signed Signature Page of this RFP.
Vendor Response:
62.3.
Cover or introduction letter describing your company and background information.
Vendor Response:
62.4.
Explain how your company meets minimum qualifications.
Vendor Response:
62.5.
Provide agency name, contact, phone and fax numbers where your company has provided
healthcare services in a correctional environment to show you have a minimum of three (3)
years of experience.
Vendor Response:
62.6.
All proposals must list by name, address, phone and Contract Administrator all correctional
institutions where proposer is currently providing medical care and the length of time that
each Contract has been in effect.
Vendor Response:
62.7.
All proposals must list by name, address, phone, and Contract Administrator all
correctional institutions where proposer had terminated services, been terminated for any
reason or lost a rebid as the incumbent. Describe the reason for the termination.
Vendor Response:
45
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
62.8.
Include a statement that you agree to pay a penalty of fifty thousand dollars ($50,000) for
failure to achieve and maintain NCCHC accreditation.
Vendor Response:
62.9.
Describe your ability to provide a healthcare delivery system specific to the Larimer County
Jail
Vendor Response:
62.10.
Describe your ability to provide a thirty (30) day start-up from Notice of Award, a proven
system of recruiting staff, and have adequate support staff in your central office capable of
competently supervising and monitoring your operation in Larimer County.
Vendor Response:
62.11.
Provide a list of medical services personnel required to fulfill Larimer County Jail needs.
Vendor Response:
62.12.
All proposals must contain a letter of intent from an insurance company authorized to do
business in the State of Colorado stating its willingness to insure the proposer pursuant to
the terms of the Contract.
Vendor Response:
62.13.
Describe your proposed staffing plan using a matrix by degree of competency which shall
provide adequate support for the successful operation of healthcare delivery system.
Staffing plans are to outline the total number of full-time employees (full time is considered
a minimum of thirty-two (32) hours per week on site) and part-time and/or per-diem;
position titles and license/certification; reporting order; total number of positions per shift,
including weekends and holidays. Adequate Medical Services personnel are required to
be on-site twenty-four (24) hours per day, seven (7) days per week. RN coverage must be
provided twenty-four (24) hours per day, seven (7) days per week. RNs account for twothirds (2/3) of the nursing staff.
Vendor Response:
62.14.
Include a proposal price sheet that outlines the amount for which Contractor offers to
provide the services and meet all requirements of the RFP for the period of January 1,
2017 - December 31, 2017. The price shall consider an Average Daily Population (ADP) of
five hundred thirty-five (535). If the ADP falls under five hundred thirty (530), the vendor
shall provide a per-inmate, per-day amount to be deducted from the monthly invoice for
services provided. If the ADP goes over five hundred forty (540), the vendor shall provide
a per-inmate, per-day amount to be added to the monthly invoice for services provided.
Your proposal price sheet shall include:
62.14.1.
Cost (per-diem) of inmate average daily population over five hundred forty (540)
and reduction for inmate population under five hundred thirty (530).
46
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
62.14.2.
62.14.3.
62.14.4.
A matrix showing salary ranges for every category of staff positions, e.g., RN, CNA,
Physicians, Administrative and Clerical along with a summary of benefits available
to medical staffing.
Explanation of the formula for inflationary increase any subsequent year renewals.
Insurance (including number of employees)
Vendor Response:
62.15.
A breakdown of the lump sum price by line item descriptions and amounts (e.g. staffing,
consulting/specialty care, inpatient hospital care, pharmaceuticals, hospital emergency
care costs, supplies, misc. expenses, general administrative and operating costs, etc.).
The total for the line items should be the same as the stated lump sum base price.
62.15.1.
Total Cost of Second Year Contract, renewal year one (January 1, 2018 December 31, 2018)
62.15.2.
Total Cost of Third Year Contract, renewal year two (January 1, 2019 - December
31, 2019)
62.15.3.
Total Cost of Fourth Year Contract, renewal year three (January 1, 2020 December 31, 2020)
62.15.4.
Total Cost of Fifth Year Contract, renewal year four (January 1, 2021 - December
31, 2021)
62.15.5.
Explanation of the formula for inflationary increases, if any, for the subsequent year
renewals.
Vendor Response:
62.16.
A summary of benefits available to medical staff, by category of staff position.
Vendor Response:
62.17.
Contractor shall provide in their response to this RFP a list of executive and line staff turnover
and layoffs within the past forty-eight (48) months.
Vendor Response:
47
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Current Stock Medications
Medication
Acyclovir
Albuterol (Proventil) Soln
Strength
200 mg
800 mg
Quantity
2
2
0.08%
1 box
90 mcg
6
inhalers
Medication
Buspar
Strength
5 mg
10 mg
15 mg
Bismuth (Pepto)
Albuterol Inhaler
Aldactone
25 mg
100 mg
1
1
Allopurinol
100 mg
300 mg
1
1
Amoxicillin (100 ct)
500 mg
2 bottles
Quantity
2
2
2
2 boxes
Celexa
10 mg
20 mg
40 mg
1
2
2
Chlortirmetron (CTM)
4 mg
2
Ciproflaxin
250 mg
2
Claritin
10 mg
2
Antivert
25 mg
4
Clindamycin
150 mg
2
Artane
2 mg
5 mg
2
2
Clonidine
0.1 mg
2
Artificial Tears
15 mL
2 bottles
Cogentin
1 mg
2 mg
2
1
Aspirin
81 mg
2
Colace
100 mg
2
Coreg
6.25 mg
1
Coumadin
1 mg
2 mg
2.5 mg
2
2
2
4 mg
5 mg
10 mg
2
2
2
25 mg
1
Atenolol
12.5 mg
25 mg
50 mg
1
2
2
Ativan IM
1 mg/mL
15 vials
Atrovent
12.9 g
2
inhalers
Augmentin
500 mg
875 mg
1 bottle
1 bottle
Cozzar
Azithromycin
250 mg
2
Baclofen
10 mg
2
Debrox Ear Drops
4 boxes
48
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Current Stock Medications
Medication
Strength
15 mg
20mg
Bacitracin Ointment
Bentyl
Medication
Depakene
Strength
250 mg
Quantity
1
Depakote
250 mg
500 mg
2
4
Diflucan
150 mg
200 mg
1
1
Dilantin
100 mg
2
Ditropan
5 mg
2
Strength
Quantity
3 boxes
6 tubes
Bactrim DS
Benadryl
Quantity
2
2
2
50 mg/mL
25 vials
10 mg
20 mg
2
2
Stock Medications
Medication
Doxepin
Strength
10 mg
50 mg
Quantity
1
1
Medication
Hemorrhoidal Suppository
150 mg
2
Hydrocortisone Cream
Hydrocortisone Ointment
Dulcolax
5 mg
1
Ibuprofen
800 mg
2
Effexor
37.5 mg
50 mg
75 mg
100 mg
2
2
2
2
Imodium
2 mg
4 bottles
Inderal
10 mg
20 mg
2
2
5%
2 tubes
Indocin
25 mg
50 mg
100 mg
2
2
2
25 mg
50 mg
2
2
Insulin
Enulose
10g/15mL
3 bottles
Regular
Lantus
NPH
70/30
2
2
1
1
E'Mycin
500 mg
2
Keflex
500 mg
2 bottles
Estradiol
1 mg
1
Keppra
250 mg
2
Doxycycline
Elamite Cream
Elavil
2 tubs
2 tubs
49
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Stock Medications
Medication
Ferrous Sulfate
Strength
325 mg
Fioricet
325/50/40 mg
2
Flagyl
250 mg
2
Flomax
0.4 mg
2
Flonase
50 mcg
Quantity
2
2 bottles
Medication
Strength
500 mg
Quantity
4
Labetalol
100 mg
2
Lamictal
25 mg
100 mg
200 mg
2
2
2
Lasix
20 mg
2
Folic Acid
1 mg
2
Levofloxacin
750 mg
1
Glipizide
5 mg
2
Levothyroxine
500 mg
1000 mg
2
2
25 mcg
75 mcg
88 mcg
100 mcg
2
2
1
2
Glyburide
5 mg
2
Librium
25 mg
8
Haldol
1 mg
2 mg
5 mg
10 mg
1
1
1
1
Lidocaine
2%
3 vials
Lidocaine with Epi
2%
2 vials
5 mg
10 mg
20 mg
30 mg
40 mg
25 mg
50
mg/mL
2
2
2
2
2
2
25 vials
75 mg
2
Glucophage
Lisinopril
HCTZ
12.5 mg
25 mg
2
2
150 mg
6 tubes
2
300 mg
2
Lopid
600 mg
2
Plavix
Lopressor
25 mg
50 mg
2
2
Polymyxin B Opth gtts
Hemorrhoidal Ointment
Lithium
Phenergan
Potassium
Maalox
6 bottles
3 boxes
10 mEq
20 mEq
2
2
50
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Stock Medications
Medication
Mag Citrate
Strength
Metamucil
Mevacor
Quantity
6 bottles
3 boxes
20 mg
40 mg
2
2
Milk of Magnesia
6 bottles
Miconazole Nitrate
6 tubes
Minipress
Mobic
1 mg
5 mg
7.5 mg
15 mg
Mupirocin
Naproxen
500 mg
2
Neo/Gram/Poly Opth Soln
3 boxes
Neurontin
100 mg
300 mg
600 mg
2
3
3
Nitroglycerin
0.04 mg
2 vials
Nix Lice Treatment
Omeprazole
2
10 mg
20 mg
1
3
Prozac
10 mg
20 mg
40 mg
2
2
1
Remeron
15 mg
30 mg
2
2
Risperdal
0.5 mg
1 mg
2 mg
2
2
2
Robaxin
500 mg
750 mg
4
4
6 tubes
1
Quantity
2
2
2
Protonix
2
2
10 mg
Strength
5 mg
10 mg
20 mg
Prenatal Plus
2
1
Nadolol
Norvasc
Medication
Prednisone
Robitussin Syrup
4 bottles
Rocephin
250 mg
1 gm
1 box
1 box
Seroquel
25 mg
50 mg
100 mg
200 mg
4
4
4
4
2 boxes
2.5 mg
5 mg
10 mg
1
2
2
Sterile Water for Injeciton
20 mg
4
Sumatriptan
Sulfacetamide Opth Soln
2 vials
10%
2 boxes
50 mg
100 mg
2 boxes
2 boxes
51
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Stock Medications
Medication
Paxil
Penicillin VK
Tegretol
Strength
10 mg
20 mg
Quantity
2
2
500 mg
2 bottles
100 mg
200 mg
4
4
Medication
Tenex
Quantity
0.5 mg
1 mg
1
1
4
mg/2mL
Zofran
Zofran ODT
Tetanus Toxoid
Strength
25 vials
4 mg
2 boxes
Zoloft
25 mg
50 mg
100 mg
2
2
2
Zyprexa
2.5 mg
5 mg
7.5 mg
10 mg
20 mg
1
2
1
2
1
1 box
Thiamine
100 mg
200 mg/mL
4
10 vials
Topamax
25 mg
100 mg
2
2
Thorazine
25 mg
50 mg
100 mg
1
1
1
KOP MEDICATIONS
Toradol
30 mg/mL
25 vials
Trileptal
150 mg
300 mg
1
1
Tramadol
50 mg
Trazadone
Strength
325 mg
Quantity
30
Acetaminophen (1000 ct)
325 mg
2 bottles
3
Aspirin
325 mg
30
25 mg
50 mg
75 mg
100 mg
150 mg
4
4
4
4
4
Aspirin (100 ct)
325 mg
4 bottles
Benadryl (1000 ct)
25 mg
2 bottles
Ibuprofen
200 mg
30
Triamcinolone Cream
1%
2 tubs
Ibuprofen (500 ct)
200 mg
4 bottles
Triamcinolone Ointment
1%
2 tubs
Multivitamin (1000 ct)
4 vials
Zantac
Tuberculin PPD
Medication
Acetaminophen
2 bottles
75 mg
30
52
LARIMER COUNTY JAIL MEDICAL DOCUMENT - ATTACHMENT A
Appendix “A”
Stock Medications
Medication
Vistaril
Strength
25 mg
50 mg
50 mg/mL
Quantity
4
4
25 vials
Vitamin B-6
50 mg
1
Wellbutrin
75 mg
100 mg
6
6
53