Introduction and General Information A I: Partnership Prove? 1. INTRODUCTION AND GENERAL INFORMATION 1.1 Introduction I 1.1.1 Introduction Pursuant to the provisions of section 217.230 the State of Missouri intends to establish a contract for offender comprehensive health care services on a statewide basis. This document constitutes a request for I Lcompetitive, sealed proposals for the provision of comprehensive health care services as set forth herein. Corizon has reviewed and complied with this RFP requirement. Corizon understands that pursuant to the provisions of section 217.230 the State of Missouri intends to establish a contract for offender comprehensive health care services on a statewide basis and that RFP number 33214039 constitutes a request for competitive, sealed proposals for the provision of comprehensive healthcare services. 1.1.2 RFP Questions It is the offeror? responsibility to ask questions, request changes or clari?cations, or othemise advise the Divisional of Purchasing and Materials Management if the o?eror believes that any language, speci?cations, or requirements are: ambiguous, (2) contradictory or arbitrary, or both, (3) violate any state or federal law or regulation, (4) restrict or limit the requirements to a single source, or (5) restrict or limit the ofteror?s ability to I submit a proposal. i a. Except as may be otherwise stated herein, the offeror and the offeror?s agents (including subcontractors, . employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the solicitation process, the evaluation, etc, to the buyer of record indicated on the ?rst page i of this RFP. inappropriate contacts to other personnel are grounds for suspension andfor exclusion from speci?c i procurements. O?erors and their agents who have questions regarding this matter should contact the buyer. i 1] The offeror may contact the Of?ce of Equal Opportunity (0E0) regarding MBEMBE certification or i subcontracting with MBEIWBE companies. b. All questions and issues should be submitted at least ten {10] working days prior to the due date of the i proposal. If not received prior to ten (10) working days before the proposal due date, the DPMM may not be able to fully research and consider the respective questions or issues. Questions and issues relating to the RFP, including questions related to the competitive procurement process, must be directed to the buyer, Julie Kleffner. 5 it is preferred that questions be emailed to the buyer at lulie.itleffner@oa.mo.gov. i c. A document will be created after issuance of the RFP that contains a continual listing of questions i received from potential offerors up until the RFP closing date. This document will be maintained on the DPMM website as a separate link to the RFP (the names of the offerors submitting questions shall not be disclosed on the document]. I I d. The DPMM will attempt to ensure that an offeror receives an adequate and prompt response to questions, if applicable. Upon DPMM's consideration of questions and issues, if DPMM determines that changes are necessary, the resulting changes will be included in it subsequently issued RFP amendmentls); absence of such response indicates that the questions and issues were considered but deemed unnecessary for RFP amendment as the questions and issues did not provide further clarity to the RFP. All offerors will be advised of any change to the language, speci?cations, or requirements by a formal amendment to the EFF. introduction and General information - 1 Proven @Partnership WOTE: The only of?cial position of the State of Missouri shall be that which is contained in the RFP and any ?amendments thereto. Corizon has reviewed and complied with this requirement. Corizon understands our responsibility to ask questions, request changes or clarifications, or otherwise advise DPMM of any questions regarding language, specifications or requirements. We are aware that all questions are to be directed to Buyer, Julie Kleffner and that a listing of these questions will be maintained on the DPMM website. We have submitted written questions as required to Ms. Kleffner and also asked questions verbally at the pro-proposal conference. Corizon understands necessary responses to these questions and any changes in language, specifications or requirements, have been incorporated into the RFP by a formal amendment. 1:1.3 Organization 6} Pricing Pages 7} Exhibits A 3) Terms and Conditions 9) Attachments 1 ~175 - The offeror is advised that attachments exist to this document which provide additional information and instruction. These attachments are separate links that must be downloaded from the Division of Purchasing and Materials Management? 5 internet web site at: it shall be i the sole responsibility of the offeror to obtain each of the attachments. The offeror shall not be relieved of any i: responsibility for performance under the contract due to the failure of the offeror to obtain a copy of the i attachments. This document, referred to as a Request for Proposal (RFP), is divided into the following parts: i 1) introduction and General information i 2) Contractual Requirements - General Medical Care Services and Mental Health Care Services 1 3) Contractual Requirements - Speci?c Medical Care Services 1 4) Contractual Requirements - Specific Mental Health Care Services 1 5) Proposal Submission Information I j! i i i Corizon has reviewed and understands the dividing of the proposal and its attachments. 1.2 Onsite Inspection of Correctional Facilities 1.2.1 The correctional facilities? on-site inspections of the medical units and those areas occupied by mental health staff 1 i are as designated in the following table. All potential offerors are encouraged to attend the on-site inspections. i a. Offerors shall not be permitted to schedule an on?site inspectionlsl at a different time or date other than I i ose dates and times speci?ed in the chart above. The offeror shall not be allowed to communicate with the '1 i Department of Corrections other than during the on?site inspection, Medical Departmental Electronic Medical 1 i System demonstration, and the pro-proposal conference. b. The purpose of the on-site inspections is to allow offerors the opportunity for visual evaluation and ,l familiarization with the correctional facilities prior to submitting a proposal, and ask questions regarding the i conectional facilities. Offerors are requested to hold all questions/comments during the on-site inspection of each introduction and General information 2 1-2-2 Chewsesejen Proven A ?Partnership correctional facility. Immediately following each on?site inspection, a discussion session will be held. Offerors shall be prohibited from asking questions pertaining to the RFP and the RFP process. 1 1) Questions relating to the RFP and the RFP process must be submitted to the Buyer of Record. c. Offerors should carefully inspect each correctional facility prior to submitting a proposal in order to accurately respond to all requirements associated with the contract. Each offeror is solely responsible for a prudent and complete personal inspection, examination, and assessment of each of the correctional facilityliesi and 3W other existing condition, factor, or item that may affect or impact the performance of service described and required in the Contractual Requirements - General Medical Care Services and Mental Health Care Services, Contractual Requirements - Speci?c Medical Care Services, and Contractual Requirements - Specific Mental 1 Health Care Services. The awarded offeror shall not be relieved of performance of the provisions and re?uirements speci?ed herein due to the awarded offeror?s failure to prudently inspect the correctional 1 facilitylies) during the on~site inspection of the correctional facilitylies). Corizon has reviewed and compiled with this RFP requirement. Corizon understands the schedule for onsite inSpections and understands the importance of carefully inspecting each correctional facility. We participated in all of the site tours associated with this procurement. As the current provider, and as a result of our 21~year partnership with the MDOC, we are familiar with the MDOC facilities and our current and future medical and mental healthcare program will be uniquely tailored to the MDOC system. Our hands-on experience at MDOC has allowed us to develop a proposal that takes into consideration the distinctivefunique environment of each individual MDOC facility. At least ten (10) calendar days prior to the scheduled on-site inspection of a correctional facility, any potential offeror interested in attending the on-site inSpectionls) must provide the full name, date of birth, and either a valid Missouri driver license number or social security number of each individual planning to attend the on?site inspection. The potential o?eror must submit the required information Julie Kleffner of the Division of Purchasing and Materials Management to for approval. a. Only those individuals identi?ed and approved will be allowed access into the correctional facilitylles). b. Each potential offeroi?s ?rm is limited to requesting no more than three (3) individuals per art-site inSPECliOn- All individuals attending the on-site inspectionls) must bring photo identi?cation, preferahlv a current I i i i driver's license, to the correctional facility. c. No medications, gum, tobacco products, purses, cell phones, tape recorders, cameras, papers, or items i that could be used as a weapon will be permitted into the correctional facilities. Corizon has reviewed and complied with this RFP requirement. Corizon understands the information required for onsite inspections and provided this information to Julie Kleffner prior to the onsite inspection deadline. lntrodu ction and General Information - 3 i Proven "i A fiPartnership 1.2.3 Onsite Inspection Records . i A record of those participants attending the on-site inspections will be maintained. The offeror shall be 1 - responsible for ensuring the offeror?s attendance at the inspection is documented. 1 Corizon understands that attendance records to the onsite inspections have been maintained. 1.2.4 Scheduling WW mm he.? (?Offerors are strongly encouraged to advise the Division of Purchasing and Materials Management, at least ?ve (57] 1 days prior to the scheduled on?site inspection of the facility, of any special accommodations needed for disabled personnel who will be attending the on?site inspection so that these accommodations can be made. Corizon understands and will advise DPMM of any special accommodations required for onsite inspections. We did not require any special accommodations. 1.3 Medical Departmental Electronic Medical Record System Demonstration 13-1 Medical Record 1 A Medical Departmental Electronic Medical Record System demonstration will be held on October 9, 2013 at 8:307 in the Training Room at the Jefferson City Correctional Center, 8200 No More Victims Road, Jefferson 1 City, Missouri, 65101. a. The length of the Medical Departmental Electronic Medical Record System demonstration is anticipated Message; ewm . . . Corizon has reviewed and complied with this RFP requirement. Corizon understands the schedule for the Electronic Medical Record System Demonstration. Corizon was in attendance for the Medical Departmental Electronic Medical Record System Demonstration in which the current EMR, MARS and the new Medical Module of MOCIS was previewed. During the demonstration, Corizon was able to gain further knowledge as to vision for the future of healthcare record keeping for its offenders. Corizon also sees many opportunities to collaborate with the MDOC in expanded offerings that will complement the new MOCIS medical module such as Our proposed and interfacing to the various providers, including lab and pharmacy as well as community providers. The pages that follow introduce our proposed and an innovation that will test the possibility of tablet usage across the system to allow our healthcare staff to easily and readily retrieve patient data from a Visionary Healthcare Program for 2014-2021 Pilot WivFi Tablet Program - In an effort to continue our dedication to program innovation, Corizon is proposing the implementation of a pilot Wi-Fi network and Windows Tablet Program in the medical unit and infirmary at the facility. Corizon will purchase, install and support all the hardware necessary to run the pilot and will work a coordinated e?ort with MDOC staff to ensure secure and ef?cient implementation. . introduction and General information - 4 12353;}. Proven A Partnership Corizon also intends to outfit the clinical staff with Microsa? Surfacez Pro or comparable portable Windows slate/tablet devices for gathering and retrieving patient data from and other clinical sources. It is important to note that we are acutely aware of the challenges that accompany the installation of a Wi-Fi network in the facility and will work closely with the MDOC throughout the process to obtain approval for the program and then to ensure security and network integrity is not compromised. The Pilot will allow the clinical care givers access to patient data in MOCIS as well as immediate data input capability during an encounter while it is happening and not later. This will alleviate taking hand written notes or completing paper forms that waidd need to be transcribed or scanned into MOCIS at a later time leaving room for human error or lost documentation. It will also minimize duplicate work and incorrect data entry all while increasing the patient outcomes with correct timely data input as opposed to delayed input that leads to incomplete and inaccurate records. Corizon anticipates that this will be a very successful pilot program that will lead to the installation of more Wi-Fi throughout critical encounter areas in facilities across the MDOC. Corizon will work with the MDOC throughout the process to ensure that the scope of work developed around the expansion is agreed upon. We want to put the power of the EMR and clinical data in the hands of our employees at the point of care to ensure the highest quality care is always provided. We feel that the success of this project at will lend itself to the best ?showcase? for the rest of the MDOC facilities to adopt the Wi- Fi use and make the project successful system wide. ,3 Visionary Healthcare Program for 2014-2021 HCS Electronic Medication Administration Record ln coordination with our 2014 contract, Corizon is committed to working with the MDOC, PharmaCorr, and Health Care Systems (HCS) to implement a robust application that will effectively enhance the medication administration process at MDOC. Corizon has a team of professionals who are trained on the HCS A software. This team will support the MDOC implementation to ensure that we maximize the potential of the technology, exceed contractual obligations and, as a result, improve MDOC patient outcomes. Corizon is confident in its ability to exceed expectations in the delivery of healthcare services as well as an implementation. HealtbCIarc System-i PharmaCorr at the Forefront PharmaCorr, Corizon?s pharmacy company, is a leader in the correctional pharmacy industry and is at the forefront of innovative technical systems. PharmaCorr?s knowledge of both correctional medical and pharmacy industries coupled with the experience of Health Care Systems, Inc. (HCS) will allow us to provide an electronic medication administration record that is designed to meet the needs of MDOC. introduction and General Information 5 The implementation of an Electronic Medication Administration Record will allow MDOC to eliminate the labor-intensive, manual maintenance of the paper medication administration record, resulting in more ef?cient use of valuable staff time and a reduction in medication administration errors. We will collaborate with the MDOC in the planning, implementation, integration with MOCIS and staff training during the installation as well as support for the product upon its adoption. Key benefits of the HCS System include: Provides clinical staff an easy to use tool with a similar look and feel to a paper MAR. Standardized work flow with configurable alerting based on set business rules. Ability to schedule administrations once the order has been placed. Ability to retrieve a list of patients with orders to be administered at a given time. Comprehensive documentation of administration results: noting missed doses, keep-on-person (KOP) administrations, refused and administered orders. Provides access to all patient medication information in a single record, including access to historical MAR information from previous offender patient incarcerations. Decreases preventable adverse drug events and improves offender patient safety through: I Barcode driven medication administration II Five rights checking (Right patient, dose, medication, route, and time) I Document observations such as blood pressure or glucose monitoring I Clinical screening and alerts Decreases medication administration "turn?around" time through electronic integration. Provides management and operational reporting as well as statistical analysis capabilities, which enables us to provide better metrics to our correctional clients. Functionality and Features 0 0' Ability to search for patients by: I Facility I Housing unit I Drug Name I Patient name I Due Date RangejAdministration Timeframe Manually assign administration times to handle unusual medication frequencies. Capability to view the patient?s MAR history as recorded in the Provides detail of medications diSpensed by date range. I The historical representation serves as a quick, visual queue to any nonacompliant issues. introduction and General information 6 apartnel?ship - The forward-looking information provides the user noti?cation that the patient?s medication supply is running low. The administration screen format is similar to the paper MAR. (as shown within the inset} 7i .. . nsunl: ml . i. Ability to find all patients with ?not administered? medications for a specific pill pass time. Functionality to mark all medications as ?no show? for a patient at one time. Functionality to mass update records for groupings of patients as "no show?. Con?gurable options to manage set up data such as housing units, pill pass times, etc. Ability to document Keep-On?Person (KOP) medication administration. When an offender is released or paroled (changed to inactive status in the offender tracking system), the will no longer prompt to have medications administered. Manage and input offender medication refills electronically and print a summary report. Training and Support Corizon?s Operations Information Technology Office (located in Saint Louis, MO.) personnel with the assistance of HCS will provide system support for temporary and} or random software malfunctions and system failures 24 hours a day, seven days a week. in addition, HCS technical trainers will provide comprehensive training to MDOC Regional Office help staff during the implementation and transition phase of the programs installation. This will allow Corizon Regional Staff to address minor operational issues in~house. Components to be addressed during the customized technical training sessions will include at a minimum: introduction to Accessing the Administration and Exception Reasons Managing Administration Schedules Medication Administration Locations Recording Medication Administration Ordering Medication Refills Running Reports Basic troubleshooting tips Introduction and General Information - 7 Proven A a Partnership HCS implementation Plan The HCS transition will be accomplished using an industry-standard implementation approach: Project initiation and Planning A Kickoff meeting will be scheduled with MDOC leadership at an agreeable time after the contract state date to establish an implementation timeline and expectations. Corizon will identify project team members and complete a detailed implementation project plan for review and approval by MDOC following the kick-off meeting. Corizon will partner with technical staff to better understand infrastructure needs and conduct a full assessment of the scope of the facilities following the kick?off meeting, including the following: - Conduct a gap assessment of Corizon defined workflows and configurations with MDOC Specific requirements to standardize at a state or regional level while recognizing the unique differences required at each site. - Define the data integration processing requirements for MOCIS. Project Execution: Complete business requirements and all of the speci?c con?gurations and workflow updates. Partner with MDOC to ensure the appropriate infrastructure is in place, such as network connectivity and installation of all computer equipment, hardware, and software to support the solution. Partner with MDOC to complete the development of interfaces to the necessary systems and HCS Collaborate with the MDOC to plan and execute end-to?end system integration testing that focuses on quality assurance principles for the solution. Project Transition: Partner with the MDOC to conduct training for all personnel identified as a required user on the system. The following training will be provided: Soper User development I Speci?c role-based (physician, nursing, medical records clerk) training I Onsite training ?Go?Live? coaching and mentoring Facilitate the Go Live, in partnership with MDOC to ensure a successful implementation. introduction and General Information - 8 I a Partnership Project Timeline A detailed work plan will be created following discussions with the MDOC on specific tasks, assigned resources and timeframes with the goal to implement all MDOC facilities within 12-18 months from the start of the project. The installation period will begin immediately after the contract award, to ensure all timelines and goals are met within the required timeframe. This ensures that analysis and con?guration of the system is based on established site processes and procedures. It is important to note that timelines for implementations are based on the assumption that an adequate offender management system (OMS) feed can be established between Corizon and MDOC in a timely manner. Additionally, timelines are based on implementation of the HCS system as its features and functions exist today. The following grid shows the major milestones required for project completion. Dates will be determined and added in coordination with MDOC once the project begins. Major Milestone For Project Completion Task Responsible Party Contract Award through Contract Stabilization Corizon/M DOC Project Kick-off Corizon Develop Project Plan CorizonfMDOC Identify Project Team, Roles Responsibilities CorizonfMDOC Network Infrastructure and Connectivity Assessment Corizon/MDOC Site infrastructure Analysis and Recommendations CorizonlMDOC Order Site lnfrastru ctu re (PC's, and Peripherals) Corizon/?MDOC Install Site Infrastructure (PC's, and Peripherals) Corizon Assess, Procure, and Install Hosting Infrastructure Corizon MDOC Assessment and Con?guration CorizonlMDOC Interface (OMS, Pharmacy, Lab) Development 8: Testing Corizon Forms and Report Customization MDOC Application Testing MDOC Site Deployments (includes Site Speci?c Con?guration, Training, and Go- Corizon live Activities) Introduction and General Information - 9 Proven a Partnership Project Outcomes/Objectives/Success Factors Project Components - HCS Software Recommended Hardware: Desktop PC - Dell Optiplex w! HP Network Printer (MDOC Approved). Network: Corizon will coordinate with the MDOC to ensure the appropriate network is in place for access to the HCS application. Project Scope To accomplish the implementation of the HCS outlined above, the project team must have the commitment and focus of all involved parties: Corizon, the MDOC, and other healthcare vendors and agencies. Corizon considers the following within the scope of the implementation. One interface with Pharmacy System a One interface with the Offender Management System to Corizon?s Offender Master Data Warehouse (already working). - Five custom reports will be provided, in addition to the standard reports provided as part of the HCS application. - Training will be coordinated by Corizon to all necessary Corizon and MDOC staff. Introduction and General Information - 10 Providers We"! mach Who MM Medal! Medicatmn Orders Interfaces My unlit Otter-tier Mutt. System Patient 2 sun Sm tram um Customers my Com Harman,- mm Gov. Mon-outwit} Malawian! Maintains-um mums? Introduction and General Information - 11 Proven '3 Partnership Resource Roles and Responsibilities Corizon corporate commitment of resources is as follows. lT Project Management: I Coordinating and overseeing the operational activities for the project. I Supervising the fiscal management of the contract services. I Serving as the direct liaison with client officials and the third party project managerls}. I Establishing and maintaining productive working relationships with secondary care service providers at all sites. I Working collaboratively with the MDOC team, ensuring proper project planning and reporting between the MDOC staff and Corizon. I Maintaining executive oversight and reporting at the state or regional engagement level IT Development: I Provides integration and customization services as needed to meet project scope and objectives. Clinical Pregram leadership: I Ensure Corizon delivered solutions meet Corizon, the MDOC, and clinical accepted standards ACA, and all MDOC Regulations]. I Provide application support and clinical process and documentation expertise. I Supply on~site coaching and mentoring as required. Customer Support: I Provide technical and application support for Corizon deployed application. I Supply on-site coaching and mentoring as required. Trainers: I Create customized training materials for Corizon supplied applications. I Train Corizon, MDOC, and contracted vendor personnel on Corizon supplied applications. The MDOC will provide leadership and commitment of resources for the following: Review and approve the project plan. Participate in workflow and application configuration design. Assist in or expedite facility access (Le. security clearance) for trainers and other HCS project team personnel. Require training attendance for the MDOC's other healthcare vendors and agencies who will use the HCS Manage MDOC resources and monitor other healthcare vendors and agencies in task completion. introduction and General information 12 Proven A @Partnership - Participate in work?ow application configuration design. - Require the MDOC's and other healthcare vendors and agencies super users to support continued application training and coaching to new and existing vendor and agency staff. - Monitor and promote ongoing utilization of the HCS application. - Review and approve project documentation as requested by Corizon project manager. - Verify and approve project deliverables have been met. Infrastructure A reliable network with the appropriate bandwidth allocated for the will be the difference in an the healthcare staff will use and one they will not. Corizon?s technology infrastructure plans include dedication of bandwidth; in addition to continued infrastructure maintenance and troubleshooting as these are foundational to a successful implementation. Corizon will assess the infrastructure and implement the infrastructure required to support the application as directed by the MDOC. Corizon will utilize the existing, and proposed upgraded, infrastructure that is in Operation today. Should the need arise for additional bandwidth Corizon will upgrade existing circuits to accommodate any new traffic demands that could result from this added traffic on the network. At this time the current network with the proposed upgrades is expected to be suf?cient for this new solution. Training Corizon has extensive training and system implementation knowledge and will provide the clinical staff with assistance and direction until the implementation is accomplished. Training can be delivered in a variety of ways: on?site coaching and mentoring, Super User development, Train-the-Trainer, on-line tutorials, and webinars delivered by Corizon or HCS Trainers, as well as the establishment of a MDOC HCS user?s group for ongoing user education and user community communications. The hands?on training can be broken out by specialty with individuals grouped by the functionality they use within the system. These training courses are developed to be rich in material, and practice scenario driven. This approach reduces cost and maximizes the learning process for the individual users, while minimizing disruption in day?to-day healthcare delivery. A description of a typical training approach is outlined below. Corizon will work with the MDOC to devel0p a customized training program that meets the needs of its user community. Class Room Training - Basic Skills; Four hour block This training teaches mandatory skills within the program Logging on Starting a new encounter Navigation and lookup of information It Entering information [check boxes vs. text) II Printing I Email introduction and General information - 13 - Medical; Two 3-4 hour blocks - Physicians and nurses attend this training. The program is segregated into two phases. This approach allows additional time for Specific questions without rushing those that may be more challenged on certain aspects of the training. I Entering Sick Calls, Chronic Care Clinics, etc. I Entering Consult Requests, Ordering Labs, Radiology, Medications and other speci?c tasks . Mental Health; 3-4 hour block - Focus on training on the Mental Health component of the Dental; 3?4 hour block - Focus on training on the Dental component of the Dnsite Coaching/Mentoring Unique to the Corizon implementation process, onsite coaching can be better referred to as "On the Job Training". Coaching involves two days of onsite tutoring as the user community first experiences the application in their daily activities. This program allows users to gain a higher comfort level with the application and increases acceptance among the user community by helping them overcome the initial hurdles created by interjecting any new system of this magnitude. Knowledgeable individuals will be onsite and available for general questions, technical problems and assisting the users with using the application to complete daily activities as they first experience the system in a live environment. After the coaching period, users active on the system are much better prepared to utilize the Coaches work to further develop a site?s super user(s) to address user questions after the intended 48 hour coaching period. Train the Trainer Program An important component of training and coaching is a successful train-the-trainer (Super User devel0pment) program. The requires capable individuals (Super Users) at each shift for training/coaching new hires and coordinating resolution of issues that arise in the daily workflow. Super Users are provided a comprehensive training experience; medical, mental health, dental, etc., to enable them to train new staff and further support site staff. These individuals provide training based on materials developed and used to train other employees. Training will be consistent throughout the contract so that everyone is following similar methodology. The train?the-trainer program will occur in conjunction with regularly scheduled training events to minimize site staffing disruptions and maximize the learning ability of the trainers. Introduction and General Information - 14 Proven @Partnership 1.3.2 Medical DepaaneHn?tmadlehlec-trogic Medical Record System Demonstration 1? The Medical Departmental Electronic Medical System demonstration is an opportunity for offerors to review the i Medical Departmental Electronic Medical System and ask questions regarding the system. The o?eror shall not be i allowed to communicate with the Department of Corrections other than during the on-site inspection, Medical 1 Departmental Electronic Medical System demonstration, and the ore-proposal conference. Offerors shall be prohibited from asking questions pertaining to the RFP and the RFP process. i 3. Questions relating to the the RFP process must be submitted to the Buyer of Record. i i Corizon has reviewed and complied with this RFP requirement. Corizon was in attendance for the Medical Departmental Electronic Medical Record System Demonstration in which the current EMR, MARS and the new Medical Module of MOCIS was previewed. During the demonstration, Corizon was able to gain further knowledge as to MDOC's vision for the future of healthcare record keeping for its offenders. Corizon also sees many opportunities to collaborate with the MDOC in expanded offerings that will complement the new MOCIS medical module such as the preposed and interfacing to the various providers, la b, and pharmacy as well as community providers. Corizon looks forward to continued new and innovative collaboration with the MDOC to bring the best tools and clinical practices to the offenders of Missouri. Corizon understands that questions may not be asked about the RFP during the Electronic Medical Record System Demonstration. All questions were submitted in writing to Julie Kleffner and/or asked verbally at the pro-proposal conference. 1.3.3 Medical Departmental Electronic Medical Record System Demonstration Scheduling . Offerors are strongly encouraged to advise the Division of Purchasing and Matenals Management Within five (5) i i working days of the scheduled Medical Departmental Electronic Medical Record System demonstration of any special accommodations needed for disabled personnel who will be attending the conference so that these i w?e- WW 1 Corizon understands and will advise DPMM of any special accommodations required for the Electronic Medical Record System Demonstration. We did not require any special accommodations. 1.3.4 Medical Departmental Electronic Medical Record System Demonstration Scheduling WW i The Medical Departmental Electronic Medical Record System hand-out that was available at the Medical I Departmental Electronic Medical Record System demonstration is included as Attachment 633, Entire MOCIS i MedicalfMental Health Training Module and Attachment Department of Corrections Medical Accountability Records System. Corizon understands that the Medical Departmental Electronic Medical Record System hand~out that was available at the Medical Departmental Electronic Medical Record System demonstration is included as Attachment 63a, Entire Medical/Mental Health Training Module and Attachment 63b, Department of Corrections Medical Accountability Records System. introduction and General information - 15 1.4 Pro-Proposal Conference Conference A pro-proposal conference will be held on October 10, 2013 at 9:00 in the Training Room at the I Jefferson City Correctional Center, 8200 No More Victims Road, Jefferson City, Missouri, 65101The length of the pro-proposal conference is anticipated to be at least four hours. Corizon understands the scheduling for the pre-proposal conference. Corizon representatives were in attendance at the ore?proposal conference. Conference Instructions I i The offeror should bring a copyithemRFP since it will ?ied as the wagenda for the prenproposai conference. Corizon understands and brought copies of the RFP to the pre?proposal conference. 1-4-3 Ere-Po?salgefsteece lea?ess All potential offerors are encouraged to attend the ore-proposal conference as it will be used as the forum for questions, communications, and discussions regarding the RFP. The offeror should become familiar with the RFP and develop all questions prior to the conference in order to ask questions and otherwise participate in the public communications regarding the RFP. 3. Prior to the pro-preposal conference, the offeror may submit written communications and questions regarding the RFP to the buyer identi?ed on page one. The offeror is strongly encouraged to submit written communications and questions at least five working days prior to the pre?proposal conference date. Such prior communication will provide the State of Missouri with insight into areas of the RFP which may be brought up for l' discussion during the conference and which may require clari?cation. b. During the pro-proposal conference, it shall be the sole responsibility of the offeror to orally address all issues previously presented to the buyer by the offeror, including any questions regarding the RFP or areas of the i RFP requiring clari?cation. 1. i if c. The offeror shall not be allowed to communicate with the Department of Corrections other than during 3 the on-site inspection, Medical Departmental Electronic Medical System demonstration, and the pro-proposal conference. d. Any changes needed to the RFP as a result of discussions from the pro-proposal conference will be i accomplished as an amendment to the RFP. Formal minutes of the pre-proposal conference will not be . maintained. Corizon understands the importance of attending the pro?proposal conference. in accordance with RFP directives, we provided our questions for the ore?proposal conference at least 5 days in advance. in addition, we fully understand our responsibility to orally address all issues to DPMM. Corizon understands and will not communicate with the MDOC other than during onsite inspections, Medical Departmental Electronic Medical System demonstration and the pro-proposal conference. Introduction and General information - 16 Proven aPartnership Corizon understands that any changes to the RFP as a result of the ore-proposal conference will be . addressed in a formal amendment and that formal minutes of the pro?proposal conference will not be maintained. $4.4 Scheduling WW Offerors are strongly encouraged to advise the Division of Purchasing and Materials Management within ?ve (5) working days of the scheduled pro-proposal conference of any special accommodations needed for disabled ?personnel who millage attending the conference so that these accommodations can be made. Corizon understands and had no special accommodation requirements for the ore?proposal conference. 1.5 Correctional Facility Information as i The Department of Corrections is an agency dedicated to public safety thrOugh the successful management and supervision of offenders. The Department of Corrections serves a population currently con?ned in twenty-one (21) state correctional facilities and two community release centers. a. The locations and information about the correctional facilities and the community release centers are Provided as Attachment 1. b. Most of the Department of Correction's twenty-one [21] correctional facilities are located in rural I 1 settings. . i c. There are female correctional facilities: Chillioothe Correctional Center and the Women's Eastern I . Reception, Diagnostic and Correctional Center. Currently, there are no female juveniles in the female correctional facilities. Corizon understands the MDOC population is currently con?ned in 21 state correctional facilities and 2 cummunity release centers. in addition, we understand that the locations and information for the correctional facilities and community release centers is provided in Attachment 1 of the RFP. As the current provider of healthcare services, we are very aware that the majority of facilities are located in rural settings, and as a result, our recruiting and retention programs have been developed to ensure our ability to staff our programs in those rural areas. in addition, our healthcare program has been tailored to the Speci?c and unique healthcare needs of the female population currently house at and WERDC. a Visionary Healthcare Program for 2014-2021 New Medical Facility for ACC For our 2014 contract, Corizon proposes the addition of a new functioning medical facility that would include an mite br?rmory as well as arr-site x?roy services for Algoa Correctional Center (ACC). All design and construction plans would ?rst be reviewed and approved by the Of?ce of Administration, Facilities Management Design and Construction. introduction and General Information - 17 Proven Current Medical Area at ACC The Problem As the reader may already be aware, the medical area at ACC is located in the attic of a housing unit. Access to the medical unit requires that the offender patient traverse three flights of stairs (no elevator is available). We have feund that the elderly offender population and those offenders that are non?ambulatory requiring crutches or canes) due to injury or chronic conditions (chronic COPD for example) experience problems climbing the stairs. In addition, there is no covering or shelter area; during medication pass the area is even more crowded, and when raining or cold, offenders do not report for their medications and typically report the problem with the weather and standing in the cold, heat or rain as the reason for the missed medication. Over the years, Missouri State representatives have toured the facility and often have a surprised and/or negative reaction to the conditions at ACC. For example, early in 2013, Missouri Representative Paul Fitzwater toured ACC with Warden Scott Lawrence While attending the Puppies for Parole Graduation. During this tour, Representative Fitzwater was vocal about how old the unit is and how small and cramped the space is, especially the ER area. He asked Warden Lawrence several times if any other representative had ever taken a tour of our unit and Warden Lawrence replied yes. Representative Fitzwater also asked if Warden Lawrence had ever submitted a formal request for improvements to the unit and Warden Lawrence told him that every year, when he submits his budget, his ?rst priority is always a new medical unit but that thus far, the budget has not allowed improvements. Offenders waiting to be seen at nurse sick call, doctor visits, dentist appointments, treatments, laboratory draws), at ACC are all required to stand in or on the stairwell. When counts are called, offenders are returned to their housing unit. Very ill or non?ambulatory offenders often require transfer to another facility due to inability to access the medical unit because of the three flights of stairs required for access. When an emergency occurs, the Corizon healthcare team must clear the nurse sick patients because the area is in use for dual purpose and limited on space. The medical supply area is in the slope angle attic area. This area gets so hot it can affect some supplies stored there during the summer months. In addition, one room of the medical unit was closed off due to asbestos and only accessible by maintenance intermittently over the past few years. Because of limited infirmary bed space within MDOC, transports have been required to other facilities with an in?rmary; at times to facilities across the state. In a 12 month period, there were 83 transfer admissions to another site. This level of transports equates to 176 trips by custody, at a minimum, to take and retrieve offenders. This number does not take into account when these trips are after hours and custody and the offender must travel across the state to sites such as PCC, FCC, and Our proposal below can avert transportation costs totaling more than $52,000 annually while further eliminating security risks to the public. Introduction and General Information - 18 a Partnership Current Medical Area at ACC Corizon?s Proposed Solution Corizon proposes that we oversee, and ?nance, the addition of a modular unit to house the ACC medical unit; we assert that this modular unit will be built as a permanent solution. As stated at the introduction of this section, all design and construction plans would first be reviewed and approved by the Of?ce of Administration, Facilities Management Design and Construction. However, Corizon will serve as the project manager overseeing all plans and oversight of the modular unit?s installation. We have researched the possibility and feasibility of this addition and, during our research, ascertained that the modular building will include: a? Galvanized duct-work to prevent disease transmission - Laminate casework for easier cleaning . Interior wall insulation to prevent sound transmission between exam rooms and offices . Metal clad conduit to meet Missouri Health Care Codes . No windows a Steel Exterior Doors ?James Hardie? Panel Exterior (concrete composite board) - Rubber Membrane Roof The photos within the inset represent the exterior of the modular units that are similar in design to the ones we will present to the Division of Facilities Management Design and Construction. During the due diligence phase of our proposal development, Corizon Missouri regional of?ce representatives visited Several modular units to assess their for needs. We have researched the speci?cations of the buildings and are prepared to purchase the modular units immediately upon MDOC approval. Additional information regarding this initiative is provided within our transition plan. introduction and General information 19 Proven A ijartnership The following photos represent the interior of the modular units that are similar in design to the ones we will present to the Division of Facilities Management Design and Construction. . ACC Potential Administrative Of?ce Area ACC Potential Administrative Office Area introduction and General Information 20 Proven (Aapartnership Proposed Changes in Staf?ng at ACC Upgrades to the medical unit at ACC would be augmented by changes in Corizon?s staf?ng plan for the facility, particularly to ensure appropriate coverage for the additional infirmary beds located within the unit. Although tentative, Corizon anticipates the following changes in FT mix once the new unit is operational: Proposed RN FT Changes - Current: 3.0 - Proposed Once New Building in Operational: 8.0 Proposed LPN FT Changes - Current: 10.4 - Proposed Once New Building in Operational: 9.0 (2342,; 4% 624450 0m 1?00 Liam '7 1 {may in In?rmary Beds . Addition of6~8 beds Advantages to this upgraded unit will allow for a more credible and safer health care unit in medical, dental and mental health for the offender population at ACC. We will ensure private consults for the patients in an ADA compliant unit. Staff and offenders will not have to endure accessing a 3 story, outdated unit with no privacy and fluctuations in climate control (services placed in the attic). A modular unit blended into the landscape of ACC providing comprehensive services and an additional in?rmary beds is just what the "Doctor Ordered?. These additional infirmary beds for offenders with scores up to Custody 3 and M55 and MHSs will allow less transportation costs to the MDOC and eliminate the security risk to the general public when having to transfer ACC offenders to TCC or other places across the state. Corizon is pleased to assist the MDOC and the State of Missouri with this dilemma that has existed since prior to 19.92. a Visionary Healthca re Program for 2014-2021 Addition of Infirmary Beds to the MECC Unit in addition to our proposed modular healthcare clinic for ACC as described above, Corizon is also proposing the addition of four infirmary beds at Missouri Eastern Correctional Center (MECC). MECC currently does not have infirmary services. However, there are two cells, with two beds each, which are being used as ?observation? cells for any offender needing observation for less than four hours. After four hours, if the offender still needs observation, he must be transported to another site that has an infirmary. The closest site is approximately 1.5-2 hours away; PCC or ERDCC. Corizon understands the security risks any time an offender is transported offsite and proposes to utilize these two cells as a four~ bed in?rmary with RN coverage 24!? to ensure continuity of care. With the approval and input from the Introduction and General Information 21 Proven . A ijartnership MDOC, Electrical outlets will need to be added to each cell to ensure any medical devices, such as pumps or oxygen concentrators will be able to be used for specific offender treatments. MECC averages approximately 1?2 offenders per week housed in other MDOC facility infirmaries for care to include: . Post-op outpatient surgery recovery . Conditions needing observation . Oral surgery recovery . Post hospital admissions . antibiotic treatment . Unstable Diabetes . Newly diagnosed conditions needing close monitoring and nursing care, end-of~life conditions, hunger strikes, post ER visits, or sports related injuries. A four-bed infirmary at MECC would recognize cost savings to the MDOC not only for reducing the need for officers to transport offender?s across the state but would add four beds that will be utilized to move offenders from hospital inpatient settings back into the secure facilities. Finally, Corizon will add 4.2 FTEs of RM and 0.25 FTE of physician hours to assist with the staffing needs of the infirmary Upgrade at MECC. The advantages outlined above will ensure a more efficient medical unit for the MDOC, allowing offenders to stay onsite f0r infirmary care, allowing patients to return sooner from inpatient and out-patient services within the community and, finally, eliminating unnecessary security risks to the general public. Visionary Healthcare Program for 2014-2021 Addition of lnfirmary Beds to MCC Moberly Correctional Center (MCC) The Problem MCC currently houses many chronic offenders and all of the male dialysis patients within the MDOC system. This inc Udes both renal and peritoneal dialysis for a total of 30 patients with one female offender being housed at WERDCC. The current infirmary at MCC has 14 beds, some private rooms and others bays with up to 3 beds in them. Many of the dialysis patients (11 total) are permanently housed in the infirmary at MCC, only allowing for 3 beds to be used for general population or segregation. MCC Correctional Of?cers have to transport offenders around the entire state of Missouri for r'n?rmary placement thus adding costs to the MDOC, MCC and increasing the security risk to the general public. introduction and General information - 22 Proven fa Partnership Moberly Correctional Center (MCC) . The Solution By working with MDOC, MCC and our staff, Corizon proposes to bring additional beds online for Custody 3 Offenders with scores as high as M55 and MHSs for admission into the infirmary. This will assist both medical and mental services for the entire facility. Corizon, through a pre-approved modular unit similar to the ones included in the pictures provided above regarding ACC, will add up to 8 infirmary beds at MCC for general population and segregation. We will ensure the existence of isolated rooms for segregation available for the MDOC. MCC and MDOC would no longer have additional costs, as they do now, for in?rmary bed space and more importantly would eliminate or reduce the security rislr to the general public. Corizon will add 4.2 FT Es of PMS to ensure the in?rmary is staffed accordingly and per the standards in the RFP. Corizon will purchase and provide these units to the State of Missouri and the MDOC. Corizon will ask for MDOC to install the units, arrange for plumbing and electrical hook ups and wiring as needed. Corizon will pay for the delivery of the units to ACC and MCC. Also, Corizon would ask MDOC to pay for any modifications to the existing MCC medical unit that would need to occur so the building and the modular unit would become one. By adding these units and providing the upgrades at MECC, we would add another 20 in?rmary beds to the existingZ 15 beds or an 11% increase. We believe the additional 20 beds will have repeated savings . month-over?month to the MDOC for all the reasons stated above. CorredionalfgciMAdeance At the present time, all male offenders are admitted to the Department of Corrections through the Fulton Reception and Diagnostic Center, the Eastern Reception, Diagnostic and Correctional Center or the Western it Reception, Diagnostic and Correctional Center with the exception of male, capital punishment offenders who are admitted directly to the Potosi Correctional Center. The Women's Eastern Reception, Diagnostic and Correctional i Center is currently the admission site for all female offenders. Offenders spend an average of approximately sixty i (60) calgidar days at ?eceptio?entm before being Ewed to the permanent housing location. i Corizon understands that at present time, male and female offenders are admitted through different facilities, with the exception of male, capital punishment offenders who are admitted directly to the Potosi Correctional Center. We understand that MDOC offenders spend an average of approximately sixty (60) calendar days at a reception center before being transferred to the permanent housing location. Introduction and General Information - 23 42 Proven aPar?tnership 1.5.3 Correctional Facility Population Information a. Population Information - The population information for fiscal year (FY) 09 through FY12 and tha . correctional facility population sorted by age as of June 30, 2013 is provided in Attachment 2. Population information for the community release centers is not included in Attachment 2. The Department of Corrections anticipates moving approximately 900 offenders from various correctional facilities to the community release I centers. The offenders at the community release centers will have a rating of M-1, M-2, Mil-1, or Mil-2 and will be due for release within six (6) to nine i9) months. b. Future Population Growth - 1) The Department of Corrections cannot predict population growth, but the Department of Corrections does not anticipate any major average daily population changes over the next three years. The Department of Corrections expects the female offender population to continue to grow. 2) The Department of Corrections does expect population increases due to changes in Missouri State Statutes that would provide for longer sentences. This is especially true for some sex offenses against children and DWI offenses. The Department of Corrections cannot determine, at this time, the full impact of these or any other i new criminal statutes the legislature may enact. 3) The Department of Corrections assumes there will be no funding for new correctional facilities in the near future. In the event of population increases, the Department of Corrections may either provide additional I saturation housing or reapen the Central Missouri Correctional Center (1,000 beds]. 1 4) The table below provides the population forecast using a four?year regression rate of .54 per day until 1 FY19. End of Fiscal Year (FY) . {June 30) Population Capacity Net Capacity . FY2012 31,057 31,316 259 i FY 2013 31,505 31,533 33 i FY 2014 31,698 31,563 (135] i FY 2015 31,895 31,563 (332) FY 2016 32,091 31,563 (528) i i FY 2017 32,287 31,563 (724) FY 2018 32,483 31,553 (920) I 3 FY 2019 32,679 31,563 (1,116} . This capacity does not include the closure of the Central Missouri Correctional Center (1,000 beds). 1 I Corizon understands that population information is provided in Attachment 2, with the exception of papuiation information for community release centers and that, furthermore, the MDOC cannot predict pepulation growth. Corizon understands that the MDOC cannot predict the population impact of new criminal statues the legislature may enact. Finally, we are aware that the MDOC doesn?t foresee any funding for new correctional facilities. We fully understand the population forecast from the table provided. Introduction and General information - 24 Proven '4 a Partnership ?115i! Egregation Beds by Correctional Facilityww? As of March 31, 2012, the number of segregation beds at each correctional facility is listed on Attachment 3; however, this number may change due to the needs of the correctional facilitylies) and the Department of i {Entrees - m?J Corizon understands the number of segregation beds as listed in Attachment 3 are subject to change. 1-55 Medal Unit; '1 Currently, a total of twenty-one [21) medical units are available throughout the state of Missouri with one (1) i medical unit at each correctional facility. Attachment 4 provides information regarding isolation rooms at each correctional facility. While network connections are available in some rooms but not available in each room of I ,1 each of the medical units, power outlets and a dedicated phone line are available in each room of the medical Corizon understands that information regarding isolation rooms at each correctional facility is located in Attachment 4. 1.5.5.a ?ledical Units The Department of Corrections? maintenance staff is responsible for the annuallroutinefnecessary maintenance (F iwthe isolation rooms and negative pressure rooms. Currently, all negative pressure rooms are operational. Corizon understands the Department of Corrections? maintenance staff is responsible for the annualfroutinefnecessary maintenance of the isolation rooms and negative pressure rooms. Currently, all negative pressure rooms are operational. 1.5.6 ipecial Mental Health Units Currently, the Department of Corrections has ?ve special mental health units and, through an inter- i ii departmental agreement, utilizes one Department of Mental Health facility when needed. Admissions and discharges to these special mental health units are managed by teams of the current mental health care - i contractor?s personnel and other staff from the correctional facilities. 1 i a. information for the special mental health units is listed below: 1] Biggs Correctional Treatment Unit A Department of Mental Health facility that has acute evaluation and treatment services for dangerous or gravely disabled offenders with severe mental impairment. 1 5- - Currently located at the Fulton State Hospital within the Biggs Forensic Center in Fulton, MO. - Admissions to Riggs from the Department of Corrections have decreased dramatically in recent years as i the Department of Corrections current mental health care contractor is expected to manage offender mental 3 health needs within the correctional facilities except in rare circumstances. I - No beds are reserved for Department of Corrections? offenders. i 2) Corrections Treatment Center The Department of Mental Health operates the CTC with the current mental health care contractor ?5 providing services for that twenty [20) .?bed unit. The Department of Mental Health provides nursing staff as well as various rehabilitative therapies. The Department of Corrections anticipates that services currently I imbmy the Missouri Department of Mental Health will continue. introduction and General information - 25 @Padnership id- CT provides intermediate and long-term inpatient treatment for the Department of Corrections? offenders who have been determined to not be functioning at a high enough level to return to a general population placement. - Currently located at the Farmington Correctional Center. 0 includes a twenty {20) male-bed unit. 3) Social Rehabilitation Unit (SRU) SRU is a transitional living program for severely mentally impaired offenders whose level of functioning is so impaired as to require a sheltered corrections housing unit. 0 Currently located in a corrections housing unit located inside the perimeter of the Farmington Correctional Center in Farmington, M0. 0 includes one-hundred [100) male beds. 4) Special Needs Unit (SNU) - SNU's programming is targeted at developmentally disabled or intellectually de?cient offenders with severe behavioral problems who are classified as maximum security offenders. - Currently located in a correctional housing unit within the fence of Potosi Correctional Center (FCC) in Mineral Point, M0. 0 includes forty-six (46) male beds. WSRU is a unit for severely mentally?impaired offenders whose level of functioning is so i impaired as to require a sheltered corrections housing unit. - Currently located at the Women's Eastern Reception, Diagnostic and Correction Center in Vandalia, MO. f- The total number of beds at WSRU varies. Currently, there are thirteen (13) offenders in this program. 6) Secure Social Rehabilitation Unit -, I SSRU's programming is targeted at severely mentally ill maximum security offenders. . - Currently located at Jefferson City Correctional Center in Jefferson City, MO. i i - includes thirty-?ve (35) cells with a capacity that varies from thirtye?ve (35) to ?fty-two (52). depending i on how many offenders are capable of sharing a cell. The Department of Corrections may expand this unit. b. The average occupancy level for each of the Special mental health units except for SSRU is currently at maximum. The average occupancy level at SSRU is forty-?ve (45). in addition, Attachment 5 identi?es the admissions and discharges for each special mental health unit in calendar year 2011 and Attachment 6 identi?es the admissions and discharges for each special mental health unit in calendar year 2012. The Department of i Corrections cannot anticipate if the occupancy rates of units other than the SSRU may change. If i c. Cerrectional facilities may develop other housing units to meet speci?c needs of offenders. For example, Potosi Correctional Center has an innovative program .to rehabilitate long-term, single-celled administrative segregation offenders. It is estimated that this program takes approximately eight to ten (8-10} hours of time per week. The current mental health care contractor?s personnel provide some group programming, participate in the unit team discussions, and consult on behavioral management of these offenders. 5) Women?s Social Rehabilitation Unit (wsaui Corizon understands the information listed for BCTU, CTC, SRU, SSNU, WSRU AND SSRU. We are also aware that the details regarding occupancy levels for each special mental health unit are listed in Attachment 5 and 6. We also understand that the MDOC may develop more housing unit programs during the life of the contract that results from this procurement. Corizon?s proposed programming for offenders housed in Special Mental Health Units is located in the section of this proposal titled ?in tegroted Multidisciplinary Treatment Approach Positive Outcomes/Multidisciplinary Treatment Team Planning?. introduction and General information - 26 1 i 5. who need to complete the capacity will need to increase. The Department of Corrections desires to develop a targeted treatment program whereby an intensive treatment program will be available for offenders of higher needs, and a separate program will be available for offenders of lower need. i fiPartnership a. Missouri Sex Offender Program - Currently there are approximately ?ve thousand three hundred two [5302) male and ninety-two (92) female sex offenders in the custody of the Department of Corrections who are required to complete by Missouri statute, the Department of Correction?s policy, and/or by the Board of Probation and Parole. Presently, approximately ?fty-four [54) offenders are in Phase I, one hundred forty (140) have completed Phase I and are awaiting entrance into Phase ll, and three hundred ?fteen (315) are in Phase ll. Approximately eight hundred forty eight (848) offenders are set to enter in the next two (2) years. 1] The current Missouri Sex Offender Program historically has met the treatment needs of the population. At present, MOSOP is transitioning from a relapse-prevention orientation to a program that incorporates the Good Lives Model, as well as other approaches based on Risk, Needs, and Responsivity principles. 2} The table below provides the number of male and female sex offenders who enrolled in and have completed i Fiscal Year Total 2009 259 2010 312 2011 347 2012 311 2013 34? 3} Given that the Department of Corrections has approximately four hundred twenty-four (424) offenders I 4) The therapeutic community unit for is located at the Pennington Correctional Center and has a . maximum of two hundred seventy-six (27B) offenders. Programming for offenders with medical needs, other I special needs, and those who speak Spanish is currently provided at Eastern Reception Diagnostic Correctional Center in Home Terre. However, the Department of Corrections is planning on moving the currently - offered at Eastern Reception, Diagnostic and Correctional Center to the Crossroads Correctional Center, with a maximum capacity of seventy offenders. The Department of Corrections anticipates moving the end of calendar year 2014. It is possible that some adjustment to where services are offered may need to be made to meet demand. 5) is currently divided into two phases. Phase is educational, consisting of classes to acquaint offenders with basic facts about human nature, how treatment can be helpful, how the treatment process works, and to clarify expectations regarding treatment. Phase also includes intake assessments. i Phase ll is presently the intensive group therapy component of the program. Participants are placed in groups based upon the offender's criminal history, intellectual level, and interpersonal style. Generally, . all treatment groups receive the same course of therapy but there is differential emphasis on issues to meet the needs of classes of offenders and the pace is modi?ed for the lower-functioning offenders. It is expected that there will be some changes in the structure and curriculum of this program to address more individualized criminogenic needs. Phase ll focuses on issues such as problem solving skills, empathy, assertion skills, sexual abuse cycles, victim impact and relapse prevention. Participants are required to develop an understanding of these issues and - demonstrate application in their daily lives. The offenders are expected to accept accountability for their Introduction and General information - 27 Proven A fiPartnership irreSponsible behaviors and identify cognitive errors that lead to these behaviors. Phase ii is very structured and 1 rigorous. b. Sex Offender Assessment Unit - The SOAU is a specialized assessment process that provides 1 Missouri circuit courts presentencing information regarding an offender's risk to re-offend sexually. During i calendar year 2011, the SOAU conducted eighty-one (81) evaluations for the courts. SOAU evaluations of male 1 offenders occur at the Farmington Correctional Center while evaluations of female offenders occur at the 5 if Women?s Eastern Reception, Diagnostic and Correctional Center. in addition, the SOAU conducts end-of- confinement evaluations of sex offender offenders who may qualify as sexually violent predators. During calendar year 2011, the SOAU evaluators testi?ed at twenty-eight (28) probable cause hearings. In 2011, four hundred .: sixty-nine {469} Sexually Violent Predator (SVP) screening evaluations were completed with twenty-eight (28) being forwarded on as possible SVPs. The Department of Corrections anticipates the level of evaluations will i Sex Offender Assessment and Treatment Services Corizon understands that is transitioning from a relapse?prevention orientation to a program that incorporates the Good Lives Model, as well as other approaches based on Risk, Needs and Responsivity principles. Our proposal response, beginning in the section of this proposal titled "Missouri Sex Offender Program addresses how we will work with the MDOC to ensure the implementation of these models in coordination with our program for MDDC. Our program has been developed in collaboration with Dr. Kurt Bumby, a nationally renowned expert in the treatment of sex o?ender services. As the current healthcare provider, we are fully aware of the following and have incorporated each into our preposed program, described in response to RFP Sections 4.5 through 4.5.2.6. - it is the desire to develop a targeted, intensive treatment program for offenders with higher needs, and a separate program for offenders with lower needs. - The therapeutic community unit for is located at the Farmington Correctional Center and that some adjustment to where services are offered may need to be made to meet demand. - is divided into two phases: Phase land Phase II. The SOAU evaluations occur at different facilities for male and female offenders. We also understand that SOAU conducts end-of-con?nement evaluations of sex offenders who may qualify as sexually violent predators. Corizon understands the level of evaluations will remain steady. 1.5.8 Correctional Facility Substance Abuse Treatment Centers and Programs l_The Department of Corrections currently supports the following correctional facility substance abuse treatmen? if centers and programs: i All reception and diagnostic centers substance abuse assessment and classifi cation diagnostic centers; i if Ambulatory Restricted (ARM) Program for Short Term Treatment at Boonville Treatment Center; 5 Chillicothe Correctional Center; Cremer Therapeutic Community Center; Farmington Treatment Center; i Maryville Treatment Center; 1 Missouri Eastern Correctional Substance Abuse Educatiorlfiogrwam; ?a 3' Law i .r arson noes: Introduction and General information - 28 Moberly Correctional Center Substance Abuse Education Program; Northeast Correctional Center; Ozark Correctional Drug Treatment Program; Western Reception Partial Day Treatment Program; Western Regional Treatment Center and Women?s Eastern Treatment Center a Corizon understands that the MDOC supports substance abuse treatment centers and programs at the facilities listed above. Eejgm?oximsmuwemw 1W1 i a. All correctional facilities have access to the internet and use either Microsoft Office or Open Of?ce. i Windows XP Pro or Windows 7 are the current operating systems used. Microsoft Exchange/Outlook presently i supports the Department of Corrections? e-mail capabilities. i i b. The Department of Corrections uses Ethernet topology and to communicate with application i servers and other services. The Department of Corrections has a wide area network (WAN) connecting all major i correctional facilities. For those sites not connected via the WAN, a VPN through dial-up or broadband (DSL or 1 cable) is utilized. Corizon understands the technical Speci?cations of the MDOC. 1.5.10 Telehealth Services I a. services are provided in ?fteen {15) correctional facilities as identi?ed below. The current medical health contractor owns all of the equipment in the correctional facility to provide the telemedicine i services. i 1) Chillicothe Correctional Center 1 2) Crossroads Correctional Center 3) Eastern Reception, Diagnostic and Correctional Center i 4) Farmington Correctional Center 5) Fulton Reception and Diagnostic Center i 6) Jefferson City Correctional Center I 7) Moberly Correctional Center 8) Northeast Correctional Center 9) Potosi Correctional Center 10) South Central Correctional Center 11) Southeast Correctional Center i. 12) ?lipton Correctional Center 13) Western Missouri Correctional Center 14) Western Reception, Diagnostic and Correctional Center 1 15) Women's Eastern Reception, Diagnostic and Correctional Center b. Currently, telemental health services are provided in all of the twenty-one (21) correctional facilities. The current mental health contractor owns all of the equipment in the correctional facility to provide the telemedicine i services. Corizon understands telehealth services are provided in 15 correctional facilities and telemental health services in 21 correctional facilities. We have proposed several enhancements to our current telehealth introduction and General Information - 29 Proven apadnership program at MDOC and look forward to additional discussion and implementation upon MDOC approval of each technical and programming enhancement we have proposed. 1.5.11 Current Electronic Health System (MARS - Medical Accountability ?eo?smml Currently, offender health records are maintained with MARS and with hard-copy reports and documentation. i i MARS resides on a centrally located AS400 system which holds various products and implementations. Other than 2 the A5400, no other server is involved. Schematics of the hardware and WAN con?guration are not available. I a. Department of Corrections personnel initially developed MARS. The Department of Corrections is . responsible for maintaining the WAN, hardware maintenance and repair (servers and workstations), hard disk and 5 other data storage upgrades and additions. software version upgrades and other programming upgrades, after? hour emergency support, and maintenance or upgrades to data. 1 b. All reports from MARS are run by executing an online menu transaction for each report. Some reports are i, designed to be speci?c to the physical location while others are designed to be system-wide. The internal security . assignment and user ID of the user determines the reports and locations that each particular user can select. c. MARS will be replaced with a healthcare module of the Missouri Corrections Integrated System application. MOCIS is the new comprehensive offender management system being developed for use by the Department of Corrections personnel. Anticipated implementation of the healthcare module is ?scal year end Corizon understands that medical records are currently maintained with MARS, a system maintained by MDOC personnel. Further, we understand that all reports from MARS are run through an online menu transaction. Corizon understands that MARS will be replaced with a healthcare module of the Missouri Corrections Integrated System (MOCIS) application; implementation is anticipated by calendar year end 2013. 6 Visionary Healthcare Program for 2014-2021 Scanners for Each Facility Will Enable Downloading of Documents into EMR Corizon understands that it is the objective to be as paperless as possible. Doing so will ensure a more complete offender record is kept and accessible from a single location, MOCIS. With this objective in mind. Corizon will install high speed document scanners at each facility for use by the staff in scanning documentation that would ordinarily be kept in a paper format into the M005 module. Housing paper records and electronic records creates a hybrid chart that does not offer the care giver access to the complete medical history in a single location. We believe this initiative will provide better historical chart keeping and in the end, better patient outcomes. introduction and General Information - 30 Proven ?3 Partnership 1.5.12 Medication Assisted Treatment {medication Assisted Treatment Currently, medication assisted treatment is provided at the following three (3) correctional facilities: i i a. Northeast Correctional Center a b. Ozark Correctional Center I a Corizon understands that medication assisted treatment is currently provided at Northeast Correctional Center, Ozark Correctional Center, and Maryville Treatment Center. 1.5.13 Accuratellnformation $15.13 Alma?ugh an attempt has been made to provideaccurate and up-to-date information, the State of] 3 Missouri does not warrant or represent that the correctional facility information provided herein re?ects all relationshimr existing conditions related to this Request for Proposal. Corizon has read and understands that an attempt has been made to provide accurate and up?to-date information and that the State of Missouri does not warrant or represent that the correctional facility information provided herein re?ects all relationships or existing conditions related to this Request for Preposal. 1.6 Background Information memw we, we 3 The Department of Corrections ?rst outsourced offender health care services in 1992. This RFP, the ?fth for the I Department of Corrections, encompasses both medical care services and mental health services and is issued with a, the expectation that offenders in the Department of Corrections? correctional facilities receive cost effective health care that meets community standards. a. Corizon, Incorporated is currently contracted to provide medical services for the Department of Corrections under contract 0307020001. Effective ?scal year (FY) 2013 [July 1, 2012 through June 30, 2013), the i contract price is $10,545 per diem, per offender for comprehensive medical services; the contract price in FY14 is $11.20. The contract expires on June 30, 2014. i, b. MHM Correctional Services, incorporated is currently contracted to provide mental health care services 5 for the Department of Corrections under contract (3307020002. Effective FY13, the contract price is $2.413 per i diem, per offender, for comprehensive mental health services and includes a pharmacy rebate guarantee of no 1 less than $1,000,000.00 annually. The comprehensive mental health services price for FY14 is $2.512 per offender. The contract expires on June 30, 2014. c. A copy of each of the contracts, including contract related documentation such as contract amendments, contract renewals, MBEIWBE participation reports, can be viewed and printed from the Division of Purchasing and Materials Management?s Awarded Bid Contract Document Search System located on the internet at: 5 i search. in addition, all proposal and evaluation documentation leading to the award of the contracts may also be viewed and printed from the Division of Purchasing and Materials Management's Awarded Bid 8; Contract Document Search System. Picass- reference the Bid number 33207020 or the contract numbers shown above I when searching for these documents. Introduction and General Information - 31 Proven - apa?nership llarrent infomnation regarding Participation f3? each contract igrovided in Attachment 64. . 'l The Missouri Accountability Portal located on the internet at: 5 f. provides ?nancial data related to the purchase of the services under the contract. Be sure to read the information provided in the links to ?Site Information? and ?Disclaimer?. Corizon understands that this RFP encompasses both medical care services and mental health services and is issued to receive cost-effective healthcare solutions that meet community standards. Corizon has submitted a response for standalone medical services, stand-alone mental health services, and a comprehensive response for both medical and mental health services. We also understand that copies of each contract and documents leading up to award can be viewed on website. Finally, we understand that MAP is located on the internet and contains financial data related to the purchase of the services under each contract. We understand that current information regarding MBEXWBE Participation for each contract is provided within Attachment 64. _1.6.2 Current Medical Care and Mental Health Care Staf?ng Information a. Attachment 7, Current Medical and Mental Health Staf?ng Plan, provides the most current (June 2613?! i staf?ng plan available that is utilized by the current medical care contractor and current mental health care contractor. The Department of Corrections does receive Open vacancy reports from the current medical care contractor and current mental health care contractor. The current staf?ng turnover rate for the medical care and 5 mental health care is indicated in the tables below: - a i SERVICE STAFFING TURNOVER RATE . I I 5 Medical Care 30% Mental Health Care - 4% i b. The Department of Corrections gave credit toward required number of staf?ng hours for the use of practicing registered nurses (PRNS), overtime, temporary staf?ng agencies, and Locum Tenens staf?ng. The Department of Corrections is aware of recent increases/ma rket adjustments for nursing staff to their hourly wages and increase to shift differentials. in addition, the current medical care contractor has provided market adjustments to dental staff. The current mental health care contractor has also made market adjustments for professional staff. The Department of Carrections is also aware of the current medical care contractor?s use of signing and referral fees for professional/licensed staff and a private medical staf?ng agency to supplement existingfvacant staff positions. The Department of Corrections is aware of extensive recruitment campaigns through local newspapers, professional journals, job fairs, and mailings on the part of the current medical care contractor and the current mental health care contractor. Attachment 8 is the Missouri Narrative and Statistical Report for March 2013. 1 c. Attachment 9 shows the payback {credit issued toward invoicing) provided from July 2010 through .lune 2012 for full time employees required via the current contract, hours required via the current contract, actual hours provided and payback amounts. The August 2013 Position Control Report is included as Attachment d. Administrative Of?ce Personnel i 1) The current medical care contractor?s regional administrative of?ce personnel total twenty-two and eight 1 tenths (22.8) full-time employees. Attachment 10, Current Regional Of?ce Staf?ng Plan [medical care), provides . i the current medical care contractor? 5 central of?ce staf?ng plan. a . introduction and General information 32 Proven generates Service f. Turnover Data - As of August 2013, the regional turnover rate is at twenty-eight and ?fty?six one? A fa Partnership 2) The current mental health care contractor's central administrative office personnel total fourteen [14) full-time employees. Attachment 11, Current Regional Office Staf?ng Plan {mental health care), provides the current mental health care contractor?s staf?ng plan. e. The de?ciencies in the minimum hours required via the current contract for medical treatment for professional staff at each correctional facility in FY11 and FY12 is included in Attachment 65. hundredths percent (28.56%) annualized for the last twelve {12) months and twenty-five and thirty-five one- Lh?r?g?t?s?ggnt] 25.35% for 2013. I Corizon understands that Attachment 7 contains the Current Medical and Mental Health Staffing Plan and that Attachment 8 contains the Missouri Narrative and Statistical Report for March 2013. We understand and have reviewed Attachment 9 as it illustrates paybacks provided from July 2010 through June 2012 for staf?ng de?ciencies. We have also closely reviewed each Attachment provided by the MDOC to accompany RFP 33214039 and are cognizant that Attachment 10 contains the Current Regional Of?ce Staf?ng Plan (medical care) and Attachment 11 contains the Current Regional Of?ce Staf?ng Plan (mental health care). Corizon understands the deficiencies in minimum hours required via the current contract listed in the table provided. Finally, Corizon understands the regional turnover rates as published in the RFP for 2013. The director of the Department of Corrections is responsible, per Chapter 217.230, [2011), to ensure that offenders are provided appropriate health care in the least restrictive environment while conserving resources and I maintaining safety in the correctional facility and in the community. information related to medical care services is provided below: a. On-Site Clinics - Attachment 123, Attachment 12b, and Attachment 12c provides a listing by correctional facility, specialty, and offenders enrolled, of on-site clinics currently being conducted and statistics for services provided during FY13. i b. Hours of Operation - Currently, medical care services are provided twenty-four (24) hours per day, seven days a week, including weekends and holidays, at each correctional facility with the exception of the Cremer Therapeutic Community Center. Medical care services are provided from 5:30 am. to 10:00 pm, with on-call coverage, at the Cremer Therapeutic Center. . c. Diagnostic Evaluation During FY11, the total number of offenders who entered the reception and .r diagnOstic centers was eighteen thousand eight hundred seventy (18,870). During FY12, total number of offenders - who entered reception and diagnostic centers was nineteen thousand twenty-six (19,026). i d. Laboratory and EKG Services - Currently, laboratory and EKG services are provided on-site. Radiology services are provided both on-site and off?site. e. Abnormal PAP or Mammogram - Currently, the Department of Corrections has an agreement with the Department of Health and Senior Services for women close to release who have an abnormal PAP or mam mograntwhich allong DHSS for diagnostic procedures only. i introduction and General information - 33 Proven apartnel'Ship "H'Mmm ?m MW WNW i f. Dialysis - Currently, dialysis services for both male and females are only performed at the Moberly Correctional Center, but services will be moving to the Fulton Reception, Diagnostic Correctional Center at a date yet to be determined. During FY12, four thousand seven hundred seventy-seven dialysis treatments were performed. Currently, there are ten (10) dialysis stations owned by the current medical care contractor. Within the past twenty-four (24) months, thirty-live [35) offenders received renal dialysis treatments and one (1) offender received peritoneal dialysis treatment. Currently, twenty-six (26) offenders receive hemodialysis and two (2) offenders receive peritoneal dialysis. There were three hundred seventy?one (371) on-site dialysis treatments for . the month of August 2013. g. - Currently, three hundred twanty?five (325) offenders have been diagnosed with HIWAIDS. Approximately two hundred sixty-one (261) offenders diagnosed with the HIV infection are being treated with Highly Active Anti Retro Viral Therapy (HAART). Attachment 13 provides additional information concerning the i number of offenders affected with HIV. i 3 h. Transplants - - 1) During the past two years, approximately six cornea transplants were performed. There are currently no offenders on a transplant waiting list. i 2) There have not been any kidney, liver, or heart transplants performed. Currently, the Department of 1 Corrections is unaware of any pending transplants. 1) Currently, approximately four thousand one hundred eleven (4,111] offenders are in the Hepatitis . Chronic Care Clinic. In the past two years, one hundred seventy-?ve (175) offenders were treated with Alpha I i i. Miscellaneous Health Data i i Interferon. Presently, thirtyethree (33) offenders receive Hepatitis Virus (HCV) treatment and eleven [11) Telaprevir. 5 2) Currently, approximately one thousand (1,000) offenders receive oral or injectable medications for diabetes and approximately three thousand two hundred (3,200) offenders are being treated with inhalers or respiratory medications. 5. 3) Attachment 14 provides the number of offenders enrolled in chronic care clinics including offenders with Hepatitis and diabetes. 4) Attachment 15 provides statistical data for the past twelve {12) months for the offenders at all i i correctional facilities determined through health service reports. - I 5) Attachment 16 provides statistical data regarding outpatient referrals for the past twenty-four {24) months for the offenders at all correctional facilities determined through health service reports. 1 j. Medical Treatment Backlog - The identi?ed backlogs in medical treatment in the past twelve (12) months, 1 which were cited in the health services report, were sick call, chronic care clinics, and annual and triennial '3 physicals. The current chronic care backlog is included as Attachment current sick call backlog is included as i Attachment 78, and the current physical status backlog is included as Attachment 79. NJ {was Mm was introduction and General Information 34 Proven @Partnership k. Location Summary - Attachment C?Score Location Summary (medical), provide current i offender status of medical scores at each correctional facility. l. Medication/'Prescriptions 1? 1) As of July 2013, approximately four thousand nine hundred ninety-two (4,992) offenders are prescribed at least one medication. Since mental health services were privatized (December 2001), the number of i offenders on medications has risen from ten percent to sixteen and eight-tenths percent a of the total population. The Department of Corrections receives statistical reports from the current mental health care contractor reflecting these amounts. Injection, liquid, and tablet medications are administered 1 to offenders. The top ten (10) medications, in order highest usage to lowest usage, are identi?ed on Attachment 18. 2) The average number of prescriptions per offender based on census is two and two-tenths (2.2). For the 5 1 approximately sixteen and eight-tenths percent of offenders on mental health medications, the average i does not include both somatic and medications. The average number of prescriptions for medications is two and five-tenths (2.5). Attachment 19 provides statewide drug utilization for June i i 2013. The top medications used by dollars spent and units dispensed are identi?ed on Attachment 20. 3) Currently, medications are administered through pill lines and medication passes. Medications are administered approximately four (4) times per day per correctional facility. i 4) For the past three (3) ?month period, there was an average of seven thousand eight hundred sixty-five (7,865) floor stock prescriptions filled per month. i 5) For the past three (3) ?month period, there was an average of sixty-two thousand, two hundred twelve (62,212) patient speci?c prescriptions ?lled per month. i 6) Currently, the average percentage of patients on medication is sixty-nine percent i 7) Currently, medications are in bubble packs with patient and medication information on the top of each i- Card. i m. Medical Parole - ln calendar years 2010 through 2012, the Department of Corrections received one hundred fourtem (114) applications for medical parole as identi?ed in Attachment 21; seven were granted parole, thirty-three (33) were denied parole, and no decision was made on two (2) applications. Twenty-four (24) .. offenders died with a decision pending, and forty-?ve (45) offenders were not eligible. in addition, two (2) requests were withdrawn and one (1) offender was released before a decision was made. i n. Attachment 22 provides a list of medical items available to offenders through the offender canteens. As the current healthcare partner, we understand all of the information related to medical care services at MDOC as provided in RFP 1.6.3. 1.6.4 Mental Health Care Service The Department of Corrections screens, identi?es, assesses, monitors, treats, and tracks offenders with 1 diagnosable mental disorders. Currently, mental health services are primarily provided to offenders with severe and persistent mental disorders as de?ned in Attachment 23; the Department of Corrections anticipates, but does not guarantee, this provision will not change. Information related to mental health care services is provided below: Introduction and General Information - 35 - a ?Partnership m?ml a. On-Site Mental Health Services - Currently, mental health staff are available at each correctional facility as needed for at least forty (40) hours per week, Monday through Friday, and as needed. Currently, no mental health 3 services are provided to offenders that are not located at a correctional facility. i b. Mental Health 120 - in calendar year 2012, the State of Missouri enacted a new law that allows courts to i send certain mentally ill offenders for one-hundred twenty (120) calendar days of treatment and evaluation in the a i correctional facilities. The current mental health care contractor provides the mental health care services, including a written evaluation report summarizing the offender?s treatment and supervision needs. The written .: 1, evaluation report is provided to the Institutional Probation and Parole of?cer. The court uses the information in the written evaluation report as part of its decision-making process in determining whether or not to grant I probation to an offender. 1) At present, the program is expected to handle ?fteen (15) to thirty [30) evaluations per year. Currently, 5 i all the evaluations are conducted at the reception and diagnostic centers. i 2) Currently, this is a three year pilot program. This program may or may not continue past August 2016. c. Off-Site Mental Health Services - Currently, the only mental health services provided off-site are at the Biggs Correctional Treatment Unit at Fulton State Hospital [operated by the Missouri Department of Mental Health). 1) Over the past few years, admissions to the Biggs Correctional Treatment Unit from the Missouri Department of Corrections have declined dramatically. During each of the past two (2) ?scal years, there has been one (1) admissionperyear. )5 2) Offenders referred to the Biggs Correctional Treatment Unit for admission must be medically stable. 3) Consultation with staff at the Biggs Correctional Treatment Unit is required prior to any admission to that i unit, and the Biggs Correctional Treatment Unit staff must approve any admission. d. intellectual De?ciency Screenings and Impairment Assessments- I 1) The current volume of the intellectual de?ciency screenings and impairment assessments are as follows: i- lntellectual De?ciency Screenings (BETA) one thousand ?ve hundred (1,500) per month statewide; i - Wechsler Full Scale IQ Tests - forty-?ve (45) per month statewide; and 1; - impairment Screening sixty-nine (69) per month statewide. i 2) The Department of Corrections expects the number of intellectual deficiency screenings to decrease. Currently, the Department of Corrections screens every offender entering the system. The Department of Corrections plans to change this toscreening every offender who has not been screened within the past three years unless there are speci?c reasons to reassess. 9? Mental Health Treatment - The identi?ed backlogs in mental health treatment in the past twelve i (12) months, which were cited in the mental health report, include intakes and follow-ups, primarily at wenocc. I f. C?Score Location Summary - Attachment 24, C-Score Location Summary (mental health), provide current Introduction and General Information - 36 A ?iPartnership Corizon understands Attachment 23 contains information for mental health services and the MDOC anticipates, but does not guarantee, the provision will not change. -1 a. Drug Enforcement Agency (DEA) RegistrationIState-Licensed Pharmacy Permit - The current medical of pharmacies at each correctional facility. i b. Medical Equipment and Equipment Repairs i 5 1) Medical equipment is primarily owned by the Department of Corrections. An inventory of each i correctional facility's equipment valued at $1,000 and above, and owned by the Department of Corrections, is provided as Attachment 25. 2) Attachment 26 provides a list of all equipment repair costs in excess of $1,000.00 that the Department of Corrections has been financially responsible for in the past twelve {12} months. c. Secure Unit - The Department of Corrections is not aware of any hospital in the State of Missouri that has a secure {locked down} unit for the Department of Corrections' offenders. There is a secure outpatient oncology i unit located in a private facility established by Dr. Tamara Hopkins in Jefferson City, Missouri. d. Hospice Care by Correctional Facility - Attachment 2? provides the average number of offenders listed by correctional facility receiving hospice care over the past three (3) years. 1) Hospice programs are currently provided at Potosi Correctional Center, Women's Eastern Reception, Diagnostic Correctional Center, Jefferson City Correctional Center, Northeast Correctional Center and Chillicothe Correctional Center. e. Autopsies - Separate contracts exist for autopsy services for the Department of Corrections, pursuant to I jurisdictional guidelines covering the location of any offender death. The Department of Corrections is ?nancially responsible for the autopsies initiated by the Department of Corrections. f. Suicides For the period of September 2012 through August 2013, there were ninety-two [92) suicide completed suicides by correctional facility. 3. Computers - The number of computers utilized by medical care staff and mental health care staff are identi?ed in Attachment h. Health Services Reports The Medical HSR Survey for: 1] Fiscal Year 2012 is included as Attachment 68; 2) June 2012 is included as Attachment 69,- 3] March 2012 is included as Attachment 70,- 4) February 2012 is included as Attachment 71; 5) January 2012 is included as Attachment 72; 6) December 2011 is included as Attachment 73; and 7) July 2011 is included as Attachment 74. i. Community Long-Term Care Facilities - No offenders are Currently housed in community long-term care I facilities. introduction and General Information - 37 health care contractor and mental health care contractor is responsible for all costs associated with the operations i attempts (SR3 events] and two (2) completed suicides. Attachment 66 contains a breakdown of SR3 events and . i 3. Miscellaneous Statistical Data Miscellaneous statistical data for the month of August 2013 is provided . below: i 1] Number of inpatient offsite hoSpital days one hundred one [101) 2) Number of outpatient surgeries ninety-one (91) i 3] Number of trips to the emergency department - one hundred six (106] 4) Number of emergency room referrals resulting in hospitalization - thirty-six (36) 5) Number of ambulance transports ?fty-four (54) Corizon understands that we are reSponsible for all costs associated with the operation of pharmacies at each correctional facility. in addition, we are cognizant that Attachment 25 contains inventory information for medical equipment over $1,000 owned by the MDOC and Corizon. Corizon understands Attachment 26 provides a list of all equipment repair costs in excess of 51,000 that the MDOC has been responsible for in the past 12 months. Corizon understands Attachment 2? addresses Hospice Care by Correctional Facility. Corizon's approach to hospice scare and our planned improvements to our current program are addressed, in detail, in the section of this pro posal titled ?Corizon?s Patient-Centered Approach to Hospice?. Co rizon understands separate contacts exist for autopsy services for the MDOC, pursuant to jurisdictional guidelines covering the location of any offender death; the MDOC is responsible for this. . Visionary Healthcare Program for 2014-2021 Corizon Payment for Autopsies As the reader may be aware, over 95% of the MDOC pOpulation will return to the public. However, there are instances where offenders expire during incarceration within MDOC. Corizon understands it is important to know the cause(s) of death in each instance to understand what improvements, if any can be implemented within the offender population. Corizon, along with MDOC and our Morbidity and Mortality Committee, would like to know the cause of each offender death. Corizon proposes to pay for all autopsies for each unknown offender death by either contracting directly with examiners from the Kansas City Columbia and St. Louis areas or reimbursing the State of Missouri for each instance. Obviously, offenders whom expire with known diagnosis such as various forms of cancers, cardiac disease, etc., will not need autopsies; we will provide autopsies for only those offenders whereby an exact ca use of death was not established. Co rizon will also ensure that the autopsy report is sent directly to DAIIDORS from the examiner?s office. introduction and General information 38 3? 'y A a PartnerShip WMWW Missouri's Telehealth Network has its central location at the University of Missouri Columbia. It currently has - two hundred ten [210) sites statewide in sixty-seven (67] counties and the City of St. Louis. In 2012, more than i twenty-six thousand {25,000} clinical encounters were conducted over the network. a. The sites include hospitals, Federally Quali?ed Health Centers Rural Health Centers Community Mental Health Centers Department of Mental Health (DMH) state facilities, two schools of Medicine, nursing homes, etc. b. The state provides $437,000 through an annual appropriation to support the core functions of the telehealth networkredgcing the costs that must be charged to its users. I Corlzon has reviewed, understands and will comply with the performance standards as written in this requirement. The Corizon Telehealth network that is Currently established for MDOC is a private high?speed broadband service that provides tele health capabilities connecting providers to our patients throughout the MDOC facilities. We understand that the state provides $437,000 through an annual appropriation to support the core functions of the telehealth network reducing the costs that must be charged to its users. Information Although an attempt has been made to provide accurateand upitO-date information, the State of Missouri does not warrant or represent that the background information provided herein re?ects all relationships or existing conditions related to this Request :or Proposal. - Corizon understands that the MDOC has made every effort to provide accurate, up~to?date information and this information may not warrant or represent all relationships or existing conditiOns. 1.7 Documentation J?i?cc?g Docume?gail?m? Reference is made herein to the National Commission on Correctional Health Care Prison Standards. i Offerors may obtain information on the by contacting the National Commission on Correctional Health Care, 1145 w. Diversey Pkwy, Chicago, IL 60614, (773) 880-1460, a. National Commission on Correctional Health Care Standards for Health Services in Prisons (2008) - Details I standards for acceptable medical and mental health care and treatment of prison offenders and administrative and personnel practices related to health care, support, services, handling of medical records, and resolution of medical-legal issues that are appropriate for federal or state prisons of any size. Following each standard is a written narrative providing further in-depth information that contains sample policiesfprocedures, training materials, protocols, and forms. b. National Commisan on Correctional Health Care Standards for Health Services in Juvenile Detention and Con?nement Facilities {2011) - The newly-revised standards outlines acceptable care and treatment of juveniles held in con?nement and detention facilities and administrative and personnel practices related to health care, 5 support services, handling of medical records, and resolution of medical legal issues that are appropriate for use in I Introduction and General Information - 39 Proven r? a rtnefshiP luven'lle datention and con?nement settings. Following each standard is a written narrative providing further in- 3' depth gplanation that contains sample policies and procedures, training materials, protecols, and forms. . Corizon understands that reference is made throughout the RFP to the M0005 desire for proposed programs to be provided in compliance with standards. Corizon is extremely proud of our track record working together with the MDOC to attain accreditation in each MDOC facility when sought. in fact, Corizon worked in partnership with the MDOC to initiate the accreditation process upon the award of our initial contract in 1992. Over the past 21 years, we have continued to work in partnership with the MDOC to ensure that each site seeking accreditation has been successful in obtaining accreditation and re-accreditation by the NCCH C. As of November 2013, 21 MDOC facilities have been accredited by making the State of Missouri #1 in the 0.5. in terms of the number of accredited facilities. No other correctional system in the United States has had the level of accreditation success that MDOC has had with MDOC. Corizon?s approach to ensuring accreditation is addressed in detaii in the section of this prOposaI titled ?Corizon?s Companywide Accreditation Success?. introduction and General Information - ?10 Contractual Requirements - Medical and Mental Health Services I Proven gPartnership 2. CONTRACTUAL REQUIREMENTS -- GENERAL MEDICAL CARE SERVICES AND MENTAL HEALTH CARE SERVICES 2.1 General Requirements 2.1.1 General Requirements The contractor shall provide medical care services or mental health care services, or both, whichever is speci?ed in the Notice of Award issued by the State of Missouri (hereinafter referred to as Notice of Award), for the offender C. ijg?_not operated by the state agency. a population in the correctional facilities and community release centers of the Missouri Department of Corrections, Division of Offender Rehabilitative Services (hereinafter referred to as the state agency), as well as offenders transferred under the Interstate Compact Agreement (5 217.535), in accordance with the provisions and requirement stated herein. Unless otherwise stated herein, all references to ?correctional facilities? shall include both the correctional facilities and the community release centers. 3. As stated in the Notice of Award, the contractor shall provide all primary medical care services or mental health care services or both, personnel, equipment (except as otherwise identi?ed herein) and supplies, as well as i all on?site specialists, transportation services for emergency hospitalization (pursuant to and other E. secondary care. The contractor shall provide specialty clinics and coordinate hospitalization and offsite care, as medically necessary. Additionally, the contractor shall be responsible for the utilization review and management of all care rendered on-site and off-site. b. A copy of the contract utilized for Interstate Compact agreements is provided as Attachment 28. On average there are forty-five (45) in-state offenders and forty-?ve (45) out-of-state offenders at any given time. 1) The contractor shall recoup funds in those cases where the sending state is responsible for medical care services, mental health care services, or both. The contractor may work with the state agency Interstate Compact . of?ce to coordinate reimbursement of medical care services or mental health care services. In all instances, the contractor shall provide services to offenders in transit betsveen correctional facilities and throughout the State of Missouri while under supervision of the state agency. This includes, but is not limited to, services to offenders being transported to and from a correctional facility or offenders who are on work reiease. 1) The contractor shall not provide services for offenders housed overnight or longer at any correctional Corizon?s Response to General Requirements Corizon has reviewed and complied with this RFP requirement. Corizon has 34 years of experience providing medical and mental healthcare services in correctional systems; we have worked in partnership with prisons and jails since 1979 to provide integrated, cost- effective medical and mental health services. Today, we provide healthcare services to more than 400,000 offenders in 13 DOC systems across the US. We are extremely excited about the potential opportunity to expand upon our MDOC medical contract to provide an integrated program including mental health and have taken the Opportunity, through this proposal, to clearly outline flown truly integrated program will bene?t MDOCfrom a quality and cost perspective. Co rizon has continuously provided medical, dental and pharmacy services to the State of Missouri and MDOC since December 1, 1992 to present. From July 1, 2001 through June 30, 2007, Corizon provided either directly or indirectly Contractual Requirements - 1 Proven A a Partnership Mental Health Services to include, Mental Health Staff, Staff and Sex Offender Therapy services. Corizon understands that the vendor is] awarded the contract will be expected to provide all primary medical care services or mental health care services or both, personnel, equipment (except as otherwise identi?ed within the RFP) and supplies, as well as all onsite specialists, transportation services for emergency h05pitalization (pursuant to and other secondary care. As described in detail in our proposal, Corizon will provide specialty clinics and coordinate hospitalization and offsite care, as medically necessary. We will be responsible for the utilization review and management of all care rendered onsite and offsite as described in the section of this proposal titled ?Utilization Management Progromf State Agency interstate Compact Of?ce Corizon will work with the State Agency interstate Compact Office to coordinate reimbursement of medical care services or mental health care services. We will provide services to offenders in transit between correctional facilities and throughout the State of Missouri while under supervision of the MDOC. This includes, but is not limited to, services to offenders being transported to and from a correctional facility or offenders who are on work release. Corizon understands and will not provide services for offenders housed overnight or longer at any correctional facility not operated by the DOC. Corizon has 21 years of providing this type of services for interstate compact offenders in and out of the State of Missouri. The contractor shall provide services in accordance with all current and future court ordered mandates, as Corizon understands and will provide services in accordance with all current and future court ordered mandates, as applicable. 2-1-3 v_ t?w. The contractor shall comply with all statutes, rules, regulations or court orders adopted after the contract effective 1 date, which affect the required services. If the State of Missouri determines that the contractor is entitled to . additional compensation or decreased compensation as a result of such changes, a contract amendment shall be I processed by the Of?ce of Administration, Division of Purchasing and Materials Management to re?ect the i contract changes and increased or decreased compensation. The decision as to whether the provision of this i paragraph shall be utilized shall be vested solely with the State of Missouri and such decision shall be without Corizon understands and will comply with all statutes, rules, regulations or court orders adopted after the contract effective date, which affect the required services. Contractual Requirements - 2 Partnership . 2.1.4 Compliance with Missouri State Statutes observe and comply with all applicable Missouri State Statutes, rules, regulations, guidelines, internal management policy and procedures, and general orders of the state agency that are applicable, current, or hereafter adopted, 5 regarding operations and activities in and about all state agency property. i a. The contractor shall comply with and implement the requirements of all relevant federal and state laws and policies which pertain to the medical care services or mental health care services, or both, provided by the contractor. b. The institutional services policies and procedures of the state agency that are available for public review that i may have impact on the comprehensive healthcare services, and not already specifically referenced elsewhere herein, are included as Attachments 80 through 175; Attachments 80 through 169 applies to the medical care i services and Attachments 170 through 175 applies to the mental health care services. This list is not meant to limit applicability of policies and procedures, but to provide a guideline to the contractor. After issuance of the Notice . L- of Award by the Division of Purchasing and Materials Management, if requested by the contractor, the state agencywill provide the policies and procedures that are not available for public review. Corizon has reviewed and complied with this RFP requirement. We understand that our personnel, and others acting under our personnel, will at all times observe and Comply with all applicable Missouri State Statutes, rules, regulations, guidelines, internal management policy and procedures, and general orders of the state agency that are applicable, current, or hereafter adopted, regarding operations and activities in and about all state agency property. . Corizon will comply with and implement the requirements of all relevant federal and state laws and policies whiCh pertain to the medical care services or mental health care services, or both, provided by Corizon. We understand that the institutional services policies and procedures of the state agency that are available for public review that may have impact on the comprehensive healthcare services, and not already speci?cally referenced elsewhere herein, are included as Attachments 80 through 175; Attachments 80 through 169 applies to the medical care services and Attachments 170 through 175 applies to the mental healthcare services. We understand that after issuance of the Notice of Award by the Division of PUrchasing and Materials Management, if requested by Corizon, the state agency will provide the policies and procedures that are not available for public review. 2.1.5 General Requirements any provision or requirement contained in the contract is held to be unenforceable, the contract shall be construed as if such provision or requirement did not exist, and the enforceability of such provision or requirement to Lender??thir of the contract unenforceable. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands that if any provision or requirement contained in the contract is held to be unenforceable, the contract will be construed as if such provision or requirement did not exist, and the enforceability of such provision or requirement shall not be held to render any other provision or requirement of the contract unenforceable. Contractual Requirements - 3 we WW . In the event an offender escapes or attempts to escape from any correctional facility, the contractor shall provide medical care services or mental health care services, whichever is (are) applicable, to the offender if the state i agency is legally responsible for the offender's care. If the state agency determines that the state agency bears no 5 legal responsibility to care for the offender, the contractor shall not assume the cost of care. i I. applicable, to an offender in escape status when the offender is returned to custody of the state agency or is I included in the state agency's daily offender count, or both. The state agency shall communicate such information i to the contractor. 3 a. The centractor shall provide medical care services or mental health care services, whichever is (are) i Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will assume healthcare for offenders on escape status, when the offender is in the custody of MDOC, and/or is returned to a MDOC Correctional Center. Corizon anticipates the MDOC notifying us soon as possible the status of such offenders should the offender not be physically located within the MDOC Correctional Center. If MDOC has no legal responsibility for the offender's health care then Corizon understands we will have no responsibility as well and assumes no cost. if the offender is injured away from a MDOC Correctional Center and upon request, Corizon will send appropriate nursing and medical staff to accompany custody staff and safely bring the offender back to MDOC facility. Corizon has done this in the past and will continue to support MDOC should the need arise. Contractual Requirements - 4 Praven Ea Partnership 2.1.7 General Reggirements - Parolee The contractor shall not be responsible for services provided to parolees until such time as custody of the parolee 1 i is resumed bV the state agency, or the individual is returned to the correctional facility, and is added to the daily W51 51 offender count. Corizon has reviewed and will comply with this requirement. Corizon understands we will have no financial responsibility for Parolees until such time as MDOC resumes custody of the parolee or the individual is returned to the correctional center and is added to the daily offender count. Corizon will also Provide collaboration to custody traveling and returning a parolee back to Missouri for any medical or mental health issues that could occur. The letter within the inset has been provided as an example of our history working with the MDOC to ensure ca re for parole violators from out of state(I. for!" [Awhile]; Im a} t. Imam? II . {rt :1 r' \11 11:" i I?m-??lms Dry-fem? a a 9. We ?is? . Aden!? - . a?l??aq New?) 9000mm; 2 Jerks: farm" 3w- 0 Moist-low Den" Snap: I a 0 "$ka {a m' I I-: Vol}: n, i; ?1 B?roi ?lial sfori a ?bi-o? 5 J?'r rm! 0 I In?? mm (It at Veto! ?mi: ire r?i?mim to? ?Wear i . ?rt W19 nq?, I c: I. ?04 Oh will} MM ?imp; L, i pm my,? F, wary r: can in a on 2% 1:135]st 30fo MW (in ?h 0M [him be! wk! ?0 Eng (3 U) ajirll?q- Oef?p ?rm if] 101! .. mom mm e?Crls. ?my? mum "Nu. rim"alka Hm. yr!? Wu? 0""?fo 9} Wires 1 ?pron the o. m? who ?T?W'Nonr I, of Flow, rm - ?rs?15f . Q: @9133? 6th; ?Wk! 5 lm Ci? Contractual Requirements - 5 Proven wa Partnership ?he?contractor shawliwtitili?z; the state agency's current offender classi?cation system as stipidated in the initial Classi?cation Manual and Reclassi?cation Manual, Attachment 293, Attachment amend Attachment 29c. . W. awng?w . 2.1.8 Offender Classi?cation System . Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand and will utilize the state agency's current offender classi?cation system as stipulated in the Initial Classification Manual and Reclassi?cation Manual, Attachment 29a, Attachment 29b, and Attachment 29c. a .1 The contractor shall accommodate and provide services to offenders who are blind, hearing impaired, illiterate, intellectually de?cient, or do not use English as their ?rst language, whichever applies. i a. The contractor shall ensure that interpretive services are available for all on-site and off-site services I pursuant to the Enforcement of Title Vi of the Civil rights Act of 1964 - National Origin Discrimination Against m. Corizon has reviewed and will comply with the performance standards as written in this requirement. interpretive Services Corizon will continue to provide services to and accommodate offenders who are blind, hearing impaired, illiterate, intellectually deficient, andfor mm.- 1 {Rims-l me- do not use English as their first language. We will provide all interpretive services in accordance with Title Vi of the Civil Rights Act of 1964 (National The fgnowing anguages are 3 Origin Discrimination Against Persons with Limited English Pro?ciency). sampling of those available for interpretation by Optimal Phone interpreters?: Corizon?s Ability to Satisfy the Needs of a Diverse Albanian Population Japanese Croatian The correctional environment, over the years, has evolved into one that Portuguese must readily address the needs of a very diverse population including Czech disabled persons, offenders with mental health problems, deaf, blind, or Romaman perhaps do not Speak English. To address the needs of this evolving 322?; population, Corizon has integrated the following services into our (airman healthcare approach. Taiwanese ltallan Turkish Optimal Phone Interpreters Vietnamese Because effective communication is essential during patient assessment, it is fundamental that healthca re personnel have access to la nguage interpretation services to assist in the treatment of offenders whose command of English impedes . Contractual Requirements - 6 Proven wa Partnership genuine two-way communication. Although our goal is always to have bilingual staff onsite, when that is not possible, we employ the services of Optimal Phone interpreters, for our interpreting needs. The interpretation capabilities allow Corizon staff members to effectively communicate with, diagnose, and treat offenders regardless of their native language. Deaf Way Interpreting Services To ensure that MDOC offenders with impaired hearing or total hearing loss have unimpeded access to both medical and behavioral health services, Corizon utilizes the services of Deaf Way Interpreting Services. Throughout our professional relationship with Deaf Way, we have found their interpreters qualified to interpret in any situation for any deaf individual regardless of their language preference. Corizon?s contract with Deaf Way includes 24 hour service allowing our care of the hearing impaired offender to be facilitated by a qualified interpreter 24 hours a day, seven days a week. Partnering with Deaf Way, Corizon?s healthcare staff can communicate with MDOC hearing-impaired offenders utilizing a variety of language modes including American Sign Language, Pidgin Signed English, Conceptually Accurate Signed English, Signed Exact English, and Oral Interpreting. 3.4.10 Hemmer ResismLQEE Ms The contractOr must maintain a regional administrative of?ce in Jefferson City, Missouri for the contractor's i 3 management personnel to offer direction and supervision of all of the contractor's assigned personnel. The i' contractor's regional administrative office must not be located on the site of any correctional facility or the state agency central office. a. The contractor shall provide all equipment, furniture, supplies, utilities, etc. for the regional i administrative office. At the end of the contract term, all equipment, furniture, supplies, utilities, etc. for the Qe?i?gd?inistrative office shall remain the of the contractor. w_.J Corizon has reviewed and will comply with the performance standards as written in this requirement. Since December 1, 1992, Corizon has maintained a regional office within the City limits of Jefferson City, Missouri to support the medical units of all MDOC Correctional Centers. Corizon has actually been at the same address since the inception of the contract and as needed has modified the regional office to accommodate the needs of MDOC and the medical units across the State of Missouri. MDOC, as well as other ContraCtors, including the Mental Health Contractor have used our of?ce?s conference room for meetings throughout the years. Corizon, as a partner to the State of Missouri and MDOC are willing to assist in any way we can in the delivery of services for the o??ender population. Should Co rizon receive the award of both the medical and mental health component of services, Corizon will either expand our current of?ces to accommodate Mental Health Services, use existing sites or consider new locations within Jefferson City to support the MDOC contract and Correctional Centers across the state of Missouri. Corizon understands our responsibility to provide all equipment, furniture, supplies, utilities, etc. for our regional office(s) as necessary for the function and support of the sites, MDDC, collaboration with other contractors and understand at the end of the contract term all items will remain the preperty of Corizon. Contractual Requirements - 7 . i to the contract. Proven Partnership 2.1.11 Glossar_y, Attachment 30 The contractor shall agree and understand that the de?nitions provided in the Glossary, Attachment 30, shall apply mi Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands and agrees that that the definitions provided in the Glossary, Attachment 30, will apply to the central"ww? Corizon has reviewed and will comply with the performance standards as written in this requirement. We will provide all services to the sole satisfaction of the state agency. The contractor shall not be relieved theprovisions and requirements speci?ed herein due to the contractor?s failure to prudently inspect the correctional facilitylies) during the on-site inspection of the Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that we will not be relieved of performance of the provisions and requirements specified within the RFP due to failure to prudently inspect the correctional facilities during the onsite inspections. We participated in all site tours as part of this procurement and are very familiar with the sites through our existing contract. _Uti?tiss Unless otherwise speci?ed herein, the state agency will be responsible for all necessary utilities, including telephone service, with the exception that the contractor shall pay for its long distance telephone communications, including modems and faxes used by the contractor at each correctional facility, for the contractor?s entire operation. Additionally, the contractor shall be responsible for photocopying services an I . Corizon has reviewed and will comply with the performance standards as written in this requirement. We are cognizant that unless otherwise specified herein, the state agency will be responsible for all necessary utilities, including telephone service, with the exception that the Corizon shall pay for its long distance telephone communications, including modems and faxes used by Corizon at each correctional facility, for Corizon?s entire operation. Corizon will be reSponsible for the photocopying services and postage. Contractual Requirements - 8 Proven a Partnership . 2.1.15 General Materials, Equiprnegi and Supplies Requirements Unless otherwise Specified herein, including but not limited to, the General Materials, Equipment and Supplies i Requirements and the State Agency Provided Equipment requirements stated herein, the contractor shall furnish i all material, labor, facilities, equipment, and supplies necessary to perform the services required herein. i Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that unless otherwise specified herein, including but not limited to, the General Materials, Equipment and Supplies Requirements and the State Agency Provided Equipment requirements stated herein, Corizon will furnish all material, labor, facilities, equipment, and supplies necessary to perform the services required herein. 2.2 Implementation of Services or to @3941? *0 Pac?? Di 5 The contractor must be fully operational and begin providing comprehensive health care services on July 1, 2014. I The contractor shall complete all start-up activities identi?ed below no later than June 30, 2014. i a. Start?up activities shall include, but are not limited to: 1) Purchasing any necessary equipment and supplies; 2) Submitting resumes prior to assignment for personnel proposed for management, supervisory, physician, and dentist positions; 3) Training employees; . 4] implementing communication efforts with the state agency; and 5) Establishing a central administrative office in Jefferson City. b. The contractor must provide the contractor?s facility administratorslsupervisors with a copy of the contractor's orientation materials concerning the requirements of the contract. The state agency must approve all orientation materials prior to use. 1? i c. The contractor's administratorslsupervisors shall provide orientation/training concerning the 2014 Contract Transition Continuity of Clinical and Administrative Management Services Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon, as the current partner, will not require the same level of contract transition support from the MDOC as a new provider inevitably would. A continued partnership with Corizon will not only ensure seamless continuity of clinical and administrative management services and responsiveness throughout the duration of the 2014 contract transition, but will also allow our MDOC Regional Management team to focus immediately on beginning the implementation ofeodr new program enhancements are have proposed for 2014-2021. The following step-by?step transition plan is provided as an example of the typical activities that need to be completed to facilitate an orderly transition of services from one provider to the other. We have included all required transition activities although you will note, as the current provider of medical Contractual Requirements 9 Proven A Partnership services for the MDOC, the large majority of these services are already in place and will not require any transition activity if Corizon is once again selected as the medical contractor. We have then provided a separate transition plan for a? of the new initiatives we have proposed for the 2014-2021 contract. Finally, to ensure the reader is well informed regarding our planned mental health program transition and our CRC implementation, we have provided separate matrices on the pages that follow. Contractual Requirements - 10 Proven . Partnership . Corizon/MDOC Transition Goals Goal Objective and Key Deliverables Timeframe Responsible purchasing Objective: Corizon will provide all medical, pharmaceutical, COMPLETE Clinical Program laboratory and radiology supplies as required by contract. ream Necessary Equipment and Key Deliverables . w/ Conduct inventory of existing supplies, medications and Jessica Lee I Supphes equipment. Make arrangements to purchase existing supplies in Vice President of accordance with final contract terms and purchase new supplies, Nursing as needed v? Assess need and order any needed office supplies Rhonda Moore, r? Coordinate delivery of supplies and equipment with vendors and RN, Cr?im'cof schedule delivery with facility management Program v? Review maintenance agreements on existing equipment and Manager renew or replace as needed i Identify equipment needs and submit Capital Expenditure Requests in accordance with contract terms v? Obtain property tags and tag each piece of Corizon equipment Test pager and fax operation by sending text pages and faxes Contractual Requirements 11 Prove II A . cPannership Corizon/MDOC Transition Goals Goal Objective and Key Deliverables Timeframe Responsible submitting Objective: To ensure the MDOC has had ample time to review and COMPLETE Human Resonrce authorize the proposed Regional Management team, and all Team Resumes to MDOC providers (physicians, and dentists) (Regional Management, Chris Heeg' PhVSidansr Key Deliverables Senior Manager and Dentin? v" Recruit for all open positions that resulted from the transition of of HR the contract to an incoming vendor v? Full physician credentialing process for each new candidate Nancy Roesler, v? Presentation of new physician staff to MDOC for authorization Senior Talent Manager Terry Mocalody, Sr. DirectOr Compensation, and Payroll Trail-Ii}; Objective: Provide detailed orientation to current and new COMPLETE Human Resource employees regarding theirjob duties, Corizon policies and Team orientation 01: procedures and the correctional environment. Tailor all Corizon ew Te 3 policies and procedures to re?ect MDOC policies and procedures. Chris Heeg, Members Continue regularly scheduled in?service training on an on-going basis Senior Manager after contract start. of HR Key Deliverables Identify who will be involved in orientation prior to startaup (HR, Clinical Services, UM, etc.) v? Arrange orientation for loadership positions {Regional Directors, Health Service Administrators, and Directors of Nursing) v? Arrange orientation for the Regional Medical Directors and facility Medical Directors 5 Orient nursing personnel utilizing orientation check list, nursingmw Nancy Roesler, Senior Talent Manager Contractual Requirements - 12 Goal Proven 6 Partnership Corizon/MDOC Transition Goals Objective and Key Deliverables exam, and incorporating any client requirements as appropriate Coordinate facility orientation for new Corizon staff Explain payroll procedures at time of orientation Orient staff to UM procedures . Orient staff to using Daily Operating indicators, Reporting of Events and associated forms Orient staff to the time keeping system to be utilized Orient contract leadership to Corizon and client public relations, media communication and release of information policies Implement and coordinate on-going in~service training program implementing Communication Efforts with MDOC Oblective: To facilitate the?development of several-formal modes of communication; meetings, update calls, teleconferences. Key Deliverabies: To Establish the Following: v? v? i/ Monday Morning Meetings Weekly ?Cross Over? Meeting Clinical Executive Committee - Medical and Mental Health Meeting infection Control Meeting Medical Administrative Committee Meetings Corizon/MDOC - Regional Meeting Morbidity and Mortality Meetings Quarterly Peer Mortality Meeting Quarterly Pharmacy and Therapeutics Committee Quarterly infection Control Meeting Timeframe ReSponsible COMPLETE Regional Office Staff Group Vice President, Ralf Salke Regional Director of Nursing, Tara Taylor Regional Medical Directon Dr. Thomas Bredeman Contractual Requirements 13 Proven A games . Corizon/MDOC Transition Goals Goal Objective and Key Deliverables Timeframe Responsible Establishing A Objective: To establish a regional office in Missouri to ensure COMPLETE Corizon, Facilities Missouri-based operational support for the MDOC contra ct from day Management Regional Office one, Marty Reagan Key deliverables Manager Of?ce space found and rented Administrative Phone system installed Services v? PC connectivity and Corizon network installed Recruitment Objective: Recruit and Retain MDOC Employees COMPLETE Human Resource Key dellverables Team Current Employees v? Receive approval to contact current employees Chris Heeg, 1/ Obtain list of current employees Senior Manager v? Send communication to current employees providing recruiting of HR department contact information v? Introduce E-Recruiting on-iine application process and log in and Nancy Roesler, password for employees to complete the application process Senior Talent v? Provide information regarding dates and times for visits to Manager facilities for transition meetings Conduct meetings at each facility with all current staff to Terry Macalady, introduce Corizon, present bene?t enrollment information, Sr. Director conduct question and answer sessions and provide any Compensation, assistance regarding the on line application process HRIS, and Payroll v? Update credentials as necessary v? Conduct hiring interviews Execute offers and provide new hire information packets New Employees v? Post all opportunities on company website and all other recruiting resources for_vacant_ positiOns or positions not filled by Contractual Requirements 14 Prevail i Partnership Corizon/MDOC Transition Goals Objective and Key Deliverables Timeframe Responsible transitioning current staff v? Screen candidates and coordinate interviews with operational leadership if Conduct interviews, drug screens and background checks as required Verify licenses and credentials v" Execute offers Network Team will review existing contracts and negotiate new contracts as COMPLETE Development Healthcare and needed with a wide variety of healthcare providers of specialty care Team specialty services. Therese PrOWders Key Deliverables Brumfield, Vice v" Coordinate with each hospital, securing contractual President of arrangements, to ensure seamless transition for the existing Provider offsite provider network Operations v? incorporate MDOC sites into existing onsite laboratory contracts Incorporate MDOC sites into existing onsite radiology contracts Contract with current onsite optometry providers and/or incorporate MDOC sites into the existing optometry provider contract v? Contract with current orthotics and prosthetics provider and/or incorporate MDOC sites into the existing contract 4' Contract as needed with multi-specialty groups for onsite medical services Contractual Requirements - 15 Proven artnership Corizon/MDDC Transition Goals Timeframe v, Pharmacy Services Objective: Transition pharmacy services to PharmaCorr. Objective and Key Deliverables Contract with established nursing and allied health registry providers and/or incorporate MDOC sites into existing agreements Key Deliverables PharmaCorr meetings with the Health Service Administrator at each facility to obtain all pertinent information required for a seamless transition of services Complete a new facility information tool for each MDOC facility identify necessary forms for ordering medication and revise if needed Review condition of equipment for medication storage and order transmission and order new equipment if needed DevelOp a facility fact sheet detailing the information needed to service each facility Review current shipping vendor and schedules for delivery to each facility Review current emergency backup pharmacy contracts and revise as needed Schedule orientation for staff on any changes to existing pharmacy procedures Review medication orders to ensure no interruption of medications during contract transition Medication carts and fax machines arrive, if needed, at facilities Complete inventory of supplies and medications on hand at the contract start date Responsible COMPLETE Pharmacy Team Chuck Jones, President and 00, Ph ormoCorr Contractual Requirements - 16 Proven Wg Partnership Corizon/MDOC Transition Goals Objective and Key Deliverables Timeframe Responsible Identi?cation, Objective: under the leadership of the Corizon Regional Medical COMPLETE Medical/UM Director, Corizon identify and evaluate all pending Specialty Team Evaluation and cases with the goal to ensure continuity of care during the transition Resolution of Period- Pm?mna It Dr. Rene. -y Key Deliverables Fallhowe, Vice cases Receive and evaluate the logs of pending offsite specialty President, consultations ordered prior to Corizon assuming contract Medical A?airs responsibility v' An RN in our UM Department will be available on a full?time Pablo Viteri, Vice basis to triage and facilitate pending consultations ordered prior President of to Corizon assuming contract responsibility Utilization v? Corizon Network Development will work rapidly to identify Management additional providers willing to provide onsite clinics to reduce previously submitted and pending offsite specialty consults Dr. Thomas Each offender with a request for specialty consultation will be Bredemon, evaluated by a clinician to determine the on-going need for the Regional Medical requested consultation Director v? Each request will be evaluated against existing Corizon UM criteria to determine disposition v? 100% of specialty consults ordered prior to Corizon assuming contract responsibility that meet medical necessity will be completed and scheduled in less than 90 days from the start of the contract Contractual Requirements - 17 Prone? . a Partnership Corizon/MDOC Transition Goals Goal Objective and Key Deliverables Timeframe Responsible Information Objective: Corizon will provide the computer equipment required to IT Team conduct health service operations at each facility if sufficient TEChnology computers are not currently available. Corizon Service Desk will provide support 24 hours per day, 365 days per year for all hardware Brion Holman, and software solutions. . Vice President of information Key Dellverables Technology Project planning infrastructure Software licensing analysis Business rules analysis System configuration Customization and integration System testing Training Deployment Telehealth 'o Timekeeping and scheduling system - PeopleSoft/People Site/Staffing and payroll components COMPLETE Contractual Requirements - 18 Proven . Partnership . Corizon/MDOC Transition Goals Goal Objective and Key Deliverables Timeframe Responsible Medical Records Objective: Corizon will provide and manage medical records in COMPLETE Clinical Services accordance with contractual requirements and standards. Corizon Team management will maintain medical records in accordance with prevailing regulations for confidentiality, retention and access. Qualified medical records personnel, responsible for assuring the system and Jessica Lee Vice contractual needs are met, will oversee the system. President of Nursing Key Deliverables v? Prepare for ACA and NCCHA audits in 2014 Rhonda Moore, v" Determine backlog for filing and scanning RN, Clinical v? Incorporate strategy to assure current filing and pending Program consults are up to date with offsite appointment schedules Manager Contractual Requirements - 19 Prayen aPartnership . . w. w. wm?mm. ?whoa?H.? WW Visionary Healthcare Program for 2014-2021 Implementation Timeline Goal Objective and Iggy Deliverables Timeframe Resp?gnsible program Innovation Objective: Establish mobile tablets to assist in delivery Wi_Fi Tab'et Pilot Program of care for medical, mental health and infirmary services. Key Deliverables 1- Identify through Wi-Fi February, 2015 David Burton, Senior IT Proposal Analyst 2. Identify types of tablets to be used March, 2015 Regional Office Team, DORS 3' Conduct training and beta testing May, 2015 Representation, Corizon Information Technology Representatives 4. Go Live June, 2015 Cindy Schupp, Regional Director, John Meisel, Manager Systems and Support, Dayid Burton, Senior IT Proposal AEMLW ?u .m Contractual Requirements - 20 "we" Partnership FPrograrn Innovation HCS Electronic Medication Administration Record Visionary Healthcare Program for 2014-2021 Implementation Timeline m. *J?m??emm Objective: Enhance Medication Administration Process through EMAR system Key Deliverables 1 Order equipment September, 2014 David Burton, Senior lT Proposal Analyst John Meisel, Manager 2. install equipment ?Stems and support 3 Train staff November, 2014 David Burton, Senior IT Proposal Analyst John Meisel, Manager 4 Go ?ve Systems and Support December, 2015 John Meisel, Manager Systems and Support 2015 for initial sites Corizon HSA Team, Mark Movers, then roll~out Regional Pharmacist statewide through Contractual Requirements - 21 Proven A aPartnership . 5% Visionary Healthcare Program for 2014-2021 Implementation Timeline we? Goal Objective and Key Dellverables 7 Tlmeframe Responsible program Innovation Objective: To assist MDOC in providing a new, safe and efficient medical, dental and mental health unit for the New Medical Facility for Offenders at MC. - ACC Key Deliverables 1. Coordinate with on which unit they desire December, 2014 DORS Representatives, Ralf Salke, Grout: Vice President 2. Obtain necessary Office of Administration, Design/ Construction Approvai January, 2015 MDOC Representation 3. Order March, 2015 Ralf Salke, Group Vice President 4. Install, rel 0 en eqmp a June, 2015 Ralf Salke, Group Vice President .mmwm Le meme We.? meme program Innovation Objective: To provide additional (2-3 beds for and . . MH scores up to 5 at Missouri Eastern Correctional Addition of In?rmary Beds Center (MECQ Within the MECC Medical Unit Key Deliverables I . . 1. Begin build out/remodel of existing unit 59mg 2015 MDOC Representa?om MECC Representation 2. Modify procedures/ hire staff Mail: 2015 MECC/Medical Unit Representation 3. Train staff June, 2015 . MECC/Medical Unit Representation Contractual Requirements - 22 Proven . Partnership m" Visionary Healthcare Program for 2014-2021 Implementation Timeline Goal, to We. Objectiveend Kev Deliverables. Limefteme 4 uip unit, open Juli], 2015 Medical Unit Representation program Innovation Objective: Implement eight re?entry enhancements to the current re-entry rogram in place at MDOC. lie-entry Program Enhancements Key Dellverables 1. Work with MDOC and Probation and Parole to introduce and begin immementing Corizonis November, 2014 Leon Vickers, Regional Director, Re- planned re-entry program enhancements entry semces 2 Present ?nal enhancements to for December, 2014 Leon Vickers, Regional DirectOr, Re? appmval entry Services 3 Train sites regiowwide on enhancements December, 2014 Leon Vickers, Regional Director, Re~ entry Services 4. Go live with enhancements January, 2015 Leon Vrckers, Regional Director, Re- entry Services, Corizon?s Mentai Health Re?entry Coordinator Corizon Health Services Administrators Mental Heaith Chiefs Program Innovation Objective: Implement Eight re-entry website enhancements to the current 5 stem. Enhancements To The Corizon MDOC Re?entrv Key Deliverables HF Contractual Requirements 23 Provon A Implementation Timeline 5 a V'sr'onary Healthcare Program for 2014-2021 MML .1 website 1. Work with MDOC, Probation and Parole to with new Begin after 2014 Leon Vickers, Regional Director, Re- initiatives contract award entry Services 2. Present final enhancements to for September, 2014 Leon Vickers, Regional Director, Re- approval entry Services 3. Train sites region-wide on enhancements October, 2014 Leon Vickers, Regional Director, Re- entry Services 4. Go live with enhancements October, 2014 Mental Health Re-entry Coordinator Corizon Health Services Administrators Mental Health Chiefs Program Innovation Objective: To enhance credentialing tracking on all licensed roviders. MD-Staff Solution cradentianng Key Dellverables 1_ Begin upgrades to existing system After contract award Carlton-Human Resources Professionals 2. Orientate Central Of?ce Staff and BHS staff 20? Corim Human Resources 3. inform DORS on new system enhancements for meess'onals credentialing. June, 2014 Group Vice President, Ralf Saike July 2014 Regional Behavioral Health Director, 4. lm lament new rocess Dr. Mariann Atwell We.? WM Program Innovation Objective: Improve employee commitment, engagement, and success for the MDOC contract. wwmm_ w? Contractual Requirements - 24 Proven . Partnership .7 a Visionary Healthcare Program for 2014-2021 Implementation Timeline so Obiective and Kev Deliverables 352193: Implementation of the . Key Deliverables coma" E'mployee Corizon Regional Directors and Expectations Program 1, Modify current plan accordingly June, 2014 Regional Administrators 2. Obtain approval for plan June, 2014 Group Vice President, Ralf Salke Regional Behavioral Health Director, 3. Train all medical and mental health staff July, 2014 Dr- Marian" Atwell 4. implement the program on a statewide basis August, 2014 Corizon Health SerVices Administrators .me.mm.wv program Innovation Objective: improve for birth midical and Behavioral Health Services wit trac ing and Enhancements to Corizon quartew Current cor Program Key Deliverables Regional Director of Nursing, Tara 1. Present program to DORS June, 2014 Taylor and Regional Behavioral Health Director, Dr. Mariann Atwell 2. Obtain approval for medical, BHS to include MOSOP June, 2014 Regional Director of Nursing, Tara Taylor and Regional Behavioral Health Director, Dr. Mariano Atwell 3. inform Staff/sites July, 2014 Regional Director of Nursing, Tara Taylor and Regional Behavioral Health 4. Gather data and present and quarterly Director, or. Mariano Atwell beginning in July 2014 jggional Coordinator and Clinical Contractual Requirements - 25 Proven a Partnership a Visionary Healthcare Program for 2014-2021 Implementation Timeline Goal I Objective and Key Deliirerables Timeframe A Responsible Educator, Dana Meyer, Regional Director of Nursing, Tara Taylor Site CQI leadership, Regional CQI Coordinator and Clinical Educator, Program Innovation Objective: Update Benefits at a glance for BHS services . to assist in reducin com laints rievances Addition of Mental Health to Corizon?s Key Deliverable; "Bene?ts at A Glance." 1. Make suggested changes to current bene?ts chart . July, 2014 Conzon Medical and BHS staff 2. DORS to approve final product August, 2014 Group Vice Presrdent, Ralf Salke 3. Obtain 800 laminated posters from or BehaV?O?a' Heam? D?rem? Thinkpatented September, 2014 Dr. Mariann Atweii, Robyn Brown, Office Manager, Missouri Regional 4. Distribute to UN to be passed out to replace Of?ce . October, 2014 Group Vice PreSIdent, Ralf Salke existing posters Regional Behaworal Health Director, Dr. Mariann Atweli, Regional Behavioral Health Director program nnovation #11; Objective: Enhance the Dental Services Program at . . MDOC sites by placing Hygienists to assist Dentists with Addition of Four Dental meanings and exams. Hygienists to Our Dental Program Key Deiiverabies I Wu .mmw? Contractual Requirements - 25 Proven A . Partnership i a Visionary Healthcare Program for 2014-2021 Implementation Timeline I Goal a WW Objective and Key Deliverables Timeframe Responsijgle 1. Identify Hygienists for each region June, 2014 Corizon HSAs, Corizon?s Dental Directors 2. Provide training and lay out schedule for all sites June?ulv. 2014 Corizon HSAs, Corizon?s Dental Directors 3. Begin services throughout their assigned regions Juiv. 2014 Corizon HSAs, Corizon?s Dental Directors Program Innovation Objective: Enhance MOCIS 50 it will be able to receivemw . x-ra downloads within the stem. Radiology Records/M005 Linkage Key Deliverables 1? identify probiems July, 2014 Corizon iT Department and MDOC iT Department 2. Assign programmers with MDOC approva? July, 2014 German IT Department and MDOC iT Department 3 Implement new protocois September, 2014 Corizon IT Department 4 Go live? with downloading info December, 2014 or Corizon?s Providers sooner Program [nnovation #13: Objective: Enhance Orthotic/Prosthetic clinics . throu hout live clinics or via telehealth as we now do at Onsite arthritic/Prosthetic mm 8 Clinic - Key Deliverable: 1. Identify local vendors and at what sites will have 2 1 Leon Vickirs? Direcmr' Re- services, obtain dearances June, 0 4 entry Sew ces, Conzon HSAs, $4 Contractual Requirements 27 Proven A @Partnership .1 ?7 "anions ar?ey Deliverables 6 Visionary Healthcare Program for 2014?2021 Implementation Timeline Tlmeframe 2. Identify telehealth clinics 3. Begin services as needed at sites Program Innovation #14: Ebjective: optometry services to sites with no equipment and/or visual fields testing to sites with no Onslte Mobile Optometry equipment through Optometry Van. Clinic Key Deliverables 1. Identify potential vendors 2. identify what sites, frequency to visit 3. Obtain MDOC clearance/approval for van to enter site 4. Begin services June, 2014 July, 2014 Telehealth Coordinator July, 2014 August, 2014 November, 2014 December, 2014 Objective: To provide additional review of complex or complicated cases by RMD. This could be for cases as well with the Director of Program Innovation #15: Regional Medical Director Responsible Leon Vickers, Regional Director, Re- entry Services, Corizon HSAs, Telehealth Coordinator Leon Vickers, Regional Director, Re- entry Services, Corizon HSAs, Telehealth Coordinator Group Vice President, Ralf Salke Leon Vickers, Regional Director, Re- entry Services, Corizon?s team of Regional Directors Corizon's team of Regional Directors Corizon?s at each site Contractual Requirements - 28 Proven Wig Partnership [Telehealth Clinic Key Deliverahies 1. Inform each sites of the new RMD Clinic 2. Support each site as they prepare lists of "beans 55d July, 2014 July and or 55 Visionary Healthcare Program for 2014?2021 Implementation Timeline Responsible? Corizon's Telehealth Coordinator Site HSAs and/0r Mental Health Chiefs Journaiing complicated caseis) for the RMD 35? ?eed?id 3. Have ready the patient on date/time for RMD to conduct telehealth clinic Corizon nursing staff 4. Document findings in EHR for Patient . i As requned Corizon's nursing staff program [nnovation #15; Objective: To improve the delivery of Services - at the MDOC centers. Innovative Hospice Programming/Patient and Key Denverables valunteer Journaling 1 Modify Hospice Procedures June, 2014 Leon Vickers, Regional Director, Re- . entry Services, Telehealth Coordinator 2. inform MDOC and obtain approval June' 2014 . Leon Vickers, Regional Director, Re- 3 Education of Corizon medical and BHS staff July, 2014 entry Services, Telehealth Coordinator 4. Educate Ho i Offenders Vol nt Sp ears on As needed Corizon HSAs, Mental Health Chiefs Objective: Provide enhanced, in?house services for Program innovation #17: Juveniles at FCC in accordance With HB 215. Contractual Requirements - 29 A @Paitnership a Visionary Healthcare Program for 2014-2021 Implementation Timeline Goal Objective and Key Deliverables Timeframe Responsible Treatment Program I it re Enhancement for Juveniles Key 0" ?e 1. Install teiehealth and other medical/3H5 equipment July, 2014 Corizon Telehealth Coordinator and within the Juvenile Housing Unit at FCC Corizon IT 2. Arrange for medical and BH services onsite as well July, 2014 as Juvenile substance abuse and Juvenile Sex Corizon?s HSAs, Regional Directors, and Offender services (as needed} MH Chiefs 3. Use FCC for patient care encounters either in person July, 2014 or via teiehealth Corizon?s HSA and MH Chief 4. Obtain reviews from outside consultants/ July, 2014 experts such as Dr. Bumby, Gateway, and Scott Group Vice President, Ralf Salke Huntington for Sex Offender Services, Substance Regional Behavioral Health Director, Abuse Services Dr. Mariann Atwell, Regional Mental Health Director ?B?rogI-am mnovatibn #13; ?Objectivet-Zfo focus onhoffenders vvho are veterans and PTSD Treatment for may have PTSD, TBI or other conditions which may cause recidivism in corrections. Incarcerated Veterans Key Deliverables Mental Health Chiefs, Regional Directors, Regional Behavioral Health July, 2014 Director, Dr. Mariann Atwell, Regional Mental Health Director 1, Identify Veteran Offenders at each site 2. ldenti thosewillin to artici atein mu July, 2014 Mental Health Chiefs, Regional Contractual Requirements 3O Proven A . a PartneI'Ship 5; Visionary Healthcare Program for 2014-2021 Implementation Timeline em T. Goal at 3. Determine groups weekly at sites with the Directors, Regional Behavioral Health established curriculum. August, 2014 Director, Dr. Mariann Atwell, Regional Mental Health Director 4. Follow up through CQI and re?entry activities for Quarterly MH Chiefs, Regional Behavioral Health effectiveness Director, Dr. Mariann Atwell, Regional Mental Health Director Regional Behavioral Health Director, Dr. Mariano Atwell, Regional, Corizon ?Mme-.5 Program Innovation Objective: To address provide female offenders with programming involving Enhancements to Gender victim and perpetrators of sexual violence Responsive Programming Key Dellverables Regional Behavioral Health Director, 1. Assist MDOC with Policies and Procedures regarding My? 2014 Dr' ??nann PREA and compnance Coor inators, la 5 an Corizon HSAs July, 2014 Regional Behavioral Health Director, 2. identify female offenders that would benefit in this type of programming Dr. Mariano Atwell 3. Receive prior approval on established curriculum June' 2014 MH Chiefs? others as needed from DORS Staff. 4' Impiement programming and provide cm as August, 2014 MH Chiefs, others as needed Contractual Requirements 31 Proven A . a Partnership a Visionary Healthcare Program for 2014-2021 Implementation Timeline Goal Obiective ee?rsv Deliverableim .Jimeframe Program Innovation #20; Objective: To provide payment for autopsies of . unknown diagnosis Corlzon Payment for Autopsies - Key Deliverable-s Group Vice President, Ralf Salke 1. identify current examiners in Kansas City, St. Louis June? 2014 3333?? Beh?wor?l Health D?rector? and Columbia r? ?an? we 2. Finalize agreements with agreed upon examiner?s June? 2014 6m?? Vlce Pre?ident? Ralf same Regional BehaVioral Health Director, for MDOC . Dr. Mariann Atwell 3. Ens re auto 5 re arts are delivered direct! to June, 2014 Group Vice President, Ralf Saike Regional Behavioral Health Director, 4. implement for July 1, 2014 delivery for all unknown I 201 Dr? manann Ame? diagnosis at time of offender?s death. 1? 4 I Group Vice Presrdent, Ralf Salke Regional Behavioral Health Director, Dr. Mariann AtWell Program mnovation #21; Objective: Ensure treatment modalities are Enhancememts to Mosop that based on current research based practices promote alignment with Key Deliverah'es contemportary resarch and PraC?C-es 1. Meet with thestate agency to discuss current May, 2014 Dr. Greg Markway, Regional Mental treatment modalities bein utilized with all 3 Health Director, Dr. Mariann Atwell 2. Present state agency with suggested program ?mg??nj?g??wg??w May, 2014 Dr. Greg Markway, Regional Mental mm . m. Contractual Requirements - 32 e; Proven WA (a Partnership ?0 if? Visionary Healthcare Program for 2014-2021 Implementation Time-line appropriate staff on offender healthcare and BHS issues Goal Objective and Key Deliverables Timeframg Responsible Health Director, Dr. Mariann Atwell 3. Order state approved testing materials and June, 2014 curriculums for all 4. Identify staff to be trained on enhancements to the June, 2014 Regional Mental Health Director, Dr. Mariann Atwell, Dr. Kurt Bumby 5. Provide training to necessary staff on testing material, curriculums and overall enhancements to July, 2014 Regional Mental Health Director, Dr. the Mariann Atweli, Dr. Kurt Bumby program nnovation #22; Objective: improve upon objective reviews of offenders Addition of a Part Time Physician care and provide expert reviews to the Missouri General Assembly as needed as well as other entities and for Increased Monlto?ns Key Dellverables 1. Provide funding for a 19 hours/week Medical I 2 1 _d If Director and 19 hoursfweek Director y? 0 4 Group Presi ent? Ra salke 2. Once has hired staff, provide the Medical and Director with orientation on I A 014 I ff Corizon and EHR, protocols, labs, referral criteria, ?gust? 2 ?so: 2 egg": ta as medicationsCollaborate as needed and at weekly updates with . Weekly, ongoing Contract Staff as needed! identified Contractual Requirements 33 Prawn _t . Implementation Timeline and KEY Deliverables Timeframe Respo?s?ible Program Innovation #23: Objective: To provide additional infirmary beds at Additi0n of In?rmary Beds Moberly Correctional Center. to MCC Key Deliverabies Spring, 2015 MDOC Representation, MCC 1. Begin build out/remodel of existing unit Representation 2. Modify procedures/hire staff May, 2015 MCC/Medical Unit Representation 3. Train staff June, 2015 MCC/Medical Unit Representation 4. Equip unit, open July, 2015 Medical Unit Representation Contractual Requirements - 34 Proven A . Partnership . Transition and Implementation Plan Qbisstixe Rasponsible Begin 24 hour, 7 day a week Objective: Work with MDOC and each CRC to ensure coverage at both CRCS by July a smooth start up for 24-hour healthcare operations 2014 Key Deliverables 1. identify space to be used at each site with MDOC May, 2014 M000 Warden, Regional Director, Regional Administrator 2. identify existing staff to staff such as ire-entry or contract employees from Probation and Parole May, 2014 Group Vice President, Ralf for MH services Salke, Regional Behavioral Health Director, Mariann Atwell, Regional Director, 3. Identify new staff to be hired June, 2014 Regional Administrator Regional Director, Regional 4. Identify staff to be trained either at other sites June, 2014 Administrator and onsite at CRCS Regional Director, Regional Administrator 5. Identify contracts such as lab, may and others onsite. Work with local providers for Emergency June, 2014 Corizon Network Department and Hospital as well. Development Department 6. Move into identified Spaces at CRC and bring July, 2014 Corizon Network equipment, supplies, software/hardware. Development Department, Corizon IT Department, Charge Nurse 7. Install telehealth equipment and train staff on equipment for medical and mental health. July, 2014 Corizon IT Department Contractual Requirements 35 Proven i aPartnership . Transition and Implementation Plan Responsible? w?Objective and Key Deliverables Timeframe Charge RN and Mental 8. Work with wardens to ensure that they all know June, 2014 Health Chief exactly what services will be provided and how they will be delivered. Contractual Requirements - 36 Proven A we Partnership Transition and Implementation Plan Goal mu Objective and Key Deliverables w'I'imeframe Responsible Begin 24 hour, 7 day a week Objective: Work with Mooc and each cec to ensure a smooth coverage a both by July start up for 24 hour healthcare operations 2014 Key Dellverables 1. Identify space to be used at each site with MDOC. . May, 2014 MDOC Warden, Regional Director, Regional Administrator 2. Identify existing staff to staff such as re?entrv or contract 0 4 V. ,d 1k employees from Probation and Parole for mental health avservices. Regional Behaworal Health Director, Mariann AtWell, Regional Director, Regional Administrator 3. identify new staff to be hired June, 2014 . . Regional Administrator, Regional Director 4. identify staff to be trained for other sites and onsite at CRCs. I June, 2014 Regional Administrator, Regional Director 5. identify contracts such as lab, may and others on?site. Work 20 . I with local providers for ER and Hospital as well. une' 14 em? Dave opment Department 6. Move into identified spaces at CRC and bring, equipment, supplies, software/hardware. July, 2014 Corizon Network Development, Corizon IT Department, Charge Nurse 7. install Telehealth equipment and train staff on equipment for medical and mental health. July, 2014 Charge RN and Mental Health Chief was Contractual Requirements - 37 raven Partnership Transition and Implementation Plan Goal Objective and Key Del?iverables Timeframe Responsible 8. Work with Wardens to ensure all know exactly what services will be provided and how they will be delivered. June, 2014 convert Objective: Ensure ausmooth transition from the current mental health vendor to Corizon in areas of MH, Special Units and Behavioral Health Staff from current Mental Key De?vmbm Health Contractor to 1. Develop list of all positions to convert or add to existing May, 2014 Regional Behavioral Health conzon staffing matrix. Director, Mariann Atwell 2. identify management conversions ?rst for all leadership May, 2014 Regional Behavioral Health positions at the regional and site level both clinically and Director, Mariann Atwell, Regional operationally. Administrators 3. Send advance letter of information to all staff informing them of meeting times and what to expect. No one will go May, 2014 Corizon?s Human Resources back and for PTO, gg?zon will recognizg up to 9 gear; 9f Department service which is th aximu allowable. 4. Arrange for MDOC to approve list of hiring all employees June, 2014 Regional Behavioral Health from existing MH contractor. Director, Mariann Atwell 5. Meet with Staff, arrange for offer letters, letters of welcome and/ or agreements. Work with current MH contractor and June, 2014 Regional Behavioral Health MDOC on when and how this will be completed. 7 Director, Mariann Atweli 6. identify additional positions not covered by existing employees. Recruit internal and external via email, e-recruit, May, 2014 Regional Behavioral Health newspapers, professional magazines, ext. Director, Mariann Atwell, Corizon?s Human Resources Department 7. Identify security clearances so Cq_r_i__zon may ?provide onboard Contractual Requirements - 33 Proven W5 Partnership Transition and Implementation Plan Goal Objective and Key Deliverables Timeframe ReSponsible training ahead of July start date with permission of MDOC June, 2014 Regional Behavioral Health and current MH contractor or provide afterhours/ Director, Mariann Atwell, Corizon weekends. Human Resources Department, I Regional Administrators 8. Provide training for specialized units, MOSOP, RDUs, Policy and Procedures. June, 2014 Regional Behavioral Health Director Atwell, Dr. Kurt Bumby, Scott 9. Work with existing MH provider for training and health Huntington, records to be transferred. At very least a copy provided to June, 2014 the employee so they can provide to Corizon. Regional Behavioral Health Director Mariann Atwell 10. Ensure ALL management staff are aware of new programs, June, 2014 reporting dates and what is required on those reports. Regional Behavioral Health Director Atwell, Regional Administrators, 11. Order and train on testing materials and curriculums for June, 2014 Dr. Kurt Bumby, Scott Huntington MalefFemale and Juvenile offenders. Group Vice President, Ralf Salke, 12. Order and install teleheaith equipment for all sites in the June/July, 2014 Corizon Information Technology area of BHS services to include the CRCs and Juvenile unit. Department, Regional Behavioral Health Director Mariann Atwell 13. Train all staff on Telehealth equipment. July, 2014 SKC Telehealth, Corizon?s 14. Arrange for adequate coverage for Psy nurses throughout Information Technology sites and special units July, 2014 Department 15. identify services to be completed via telehealth with Regional Behavioral Health Director prior approval. June, 2014 Atwell Atwell, HSAS, Mental Health Chiefs, Regional Administrators 16. Begin BHS services July 1, 2014 Regional Behavioral Health Director Atwell, HSAS, Mental Health Chiefs, Regional Administrators Contractual Requirements - 39 ?i Proven A @Partnership Orientation Materials Corizon will provide each facility administrator with a copy of our proposed orientation materials. We understand that the state agency must approve all orientation materials prior to their use. In addition, we will provide orientation and training that encompasses pertinent requirements of the contract to all Corizon personnel. z?g?t?et?wet??- Mew After issuance of the Notice of Award, the state agency will designate a representativeis) [hereinafter referred to i as state agency liaison) authorized to act on behalf of the state agency in regard to the contractor's provision of contrmial?services. Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that after issuance of the Notice of Award, the state agency will designate a representativels) authorized to act on behalf of the state agency in regard to the MDOC/Corizon contract. 2.2.3 Written Notification Within seven calendar days after issuance of the Notice of Award, the contractor shall provide written] Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon?s current Group Vice President, Rob?Solke, will serve as liaison for our contract with the M006. We will, in accordance with the directives of the RFP, provide written notification to the state agency within seven (7) calendar days after issuance of the Notice of Award regarding Mr. Salke?s representation of Corizon. 2.3 Facilities, Locations of Service, and Schedule for the Delivery of Service 52953595 ?0 3? wanders 3? i? 1' . Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon?s proposed medical and mental health services program for the MDOC will encompass each facility as noted within Attachment 1. Contractual Requirements 40 Proven ai?artnership anew-Jam 2.3.2 Contractor Services if requested by the state agency, the contractor shall provide the services required herein for all additional, expanded, consolidated, relocated, regionalized or separated facilities including, but not limited to, current and planned correctional facilities. a. The following would require the contractor and the state agency to provide services at one or more additional correctional facilities or locations: 1) Consolidation; 2) Relocation; 3) Regionalization; and 4) Separation of facilities. b. The contractor shall cooperate with the state agency in: 1] Adding; 2] Redirecting [reallocating); 3) Realigning; and 4) Relocating contractor personnel, materials and services necessary to meet the needs of the offender population. I c. In the event a correctional facility develops other housing units at a correctional facility, the contractor shall consult with the state agency to meet speci?c needs of the offenders. d. The state agency shall not assume any ?nancial obligations of the contractor associated with such change, nor shall the state agency be responsible for displacement expenses or loss of salary that may be incurred by the contractor's personnel, associates and subcontractors. e. Currently, the Central Missouri Correctional Center (CMCC) is closed. At this time, there are no plans to re-open the however, it may re-open at some point in the future and personnel requirements will be the same as prior to closing as identi?ed in Attachment 31. The anticipated population for CMCC is unknown at this timethe events mentioned above occur, a contract amendment shali be procest by the Of?ce of Administration, Division of Purchasing and Materials Management. The ?rm, ?xed price per diem, per offender, quoted on the Pricing Page, shall remain the same, and the contractor shall not receive any additional compensation. Responsibility to Provide Services Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands that if requested by the state agency, we will be expected to provide the services required within the RFP for all additional, expanded, consolidated, relocated, regionalized or separated facilities including, but not limited to, current and planned correctional facilities. Corizon will cooperate with the state agency in adding, redirecting (reallocating), realigning and relocating contractor personnel, materials and services necessary to meet the needs of the offender population. Contractual Requirements - 41 a i Proven A Partnership Corizon understands that the state agency will not assume any ?nancial obligations of Corizon?s associated with such change, nor will the state agency be responsible for displacement expenses or loss of salary that may be incurred by Corizon's personnel, associates and subcontractors. We understand that the Central Missouri Correctional Center (CMCC) is currently closed and that there are no plans to re-open the CMCC, however, in the event that CMCC re-opens the personnel requirements will be adjusted based on the mission of the facility. Corizon understands staffing prior to closing is identified in Attachment 31. Finally, we are cognizant that if any or all of the events mentioned above occur, a contract amendment will be processed by the Office of Administration, DPMM. We understand that the firm, ?xed price per diem, per offender, quoted on the Pricing Page, will remain the same, and Corizon will not receive any additional compensation. Delivery 9599599. w. . . The contractor shall schedule the delivery of services at the correctional facilities in coordination with the 1 operating schedule of each correctional facility. In the event of con?ict between the contractor?s schedule and the 2 schedule of each correctional facility, the decision of the state agency regarding scheduling shall control and prevail. I a. For informational purposes, there is not a speci?c daily operating schedule for each correctional facility. However, it is important that the operation of services not con?ict with the safety and security of the correctional i facility. Corizon has reviewed and will comply with the performance standards as written in this requirement. As we have stated throughout this proposal, Corizon is cognizant that our MDOC program will succeed only if provided in coordination with the MDOC. We will continue to schedule the delivery of services at each facility in coordination with the operating schedule of each facility. Corizon fully understands that there is not a specific daily operating schedule for each facility. However, we will continue to ensure the MDOC that our healthcare services program does not impede or con?ict with the security or safety of the facility. 2.4 Prison Rape Elimination Act (PREA) The contractor shall assist the state agency in complying with bot?hv'thed?state agency? the contractor?s: l_ Baas ?llets?!? Act 0? . Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will comply with the Prison Rape Elimination Act of 2012 and will follow and enforce the 01-813 O?ender SexuolAbuse and Harassment policy with the assurance that access to medical and behavioral health care will be provided immediately, upon report or discovery, to victims of sexual misconduct. Contractual Requirements - 42 a Partnership Corizon?s medical and behavioral health care staff will contribute to a coordinated response to all allegations of sexual abuse by relaying, to the designated MDOC administrative staff, information pertinent to the well-being of the offender(s) or for investigative purposes. Offenders who report sexual assault will be treated for immediate stabilizing healthcare needs onsite and then transferred to an offsite hOSpital emergency provider for forensic evaluation and treatment. Co?zan has contracts and access through HealthLink for accessing providers. Appropriate follow-up for prophylactic treatment and referral to mental health staff will be completed upon return from the crisis center. Corizon?s Experience with PREA PREA ?5 requirements apply to all detention facilities, including federal and state prisons, jails, police lock?ups, private facilities, and immigration detention centers. As one of the nationthe prowsron of correctional ("Wm Blacklist healthcare, Corizon?s experience enforcing 6??.M?hw the guidelines enacted by PREA is um unmatched. For our partnership with the mamth ,atr; ornam- 1., ?Vila MDOC, Corizon will implement a program based on the best practices we have implemented in the following statewide DOC . contracts: . muf?n; Arkansas Department of Correction mm Minnesota Department of Corrections Wyoming Department of Correction m. A manna Ida ho Department of Correction :uHcEJmm than it. oh a him no coma"; dun ll'oildhm-w? ?b Sh: Indiana Department of Correction bumbym?.m New Mexico Corrections Department . Alabama Department of Corrections Michigan Department of Corrections Fla Tennessee Department of Correction "new?" 1" Eli-raw: This program will encompass the development of an offender education program designed to provide the offender population with information regarding the parameters of the Prison Rape Elimination Act (PREA.) This program will be developed with?the goal of both deterring prison rape and informing offenders of the newly developed standards for detection, prevention, reduction, and punishment of prison rape. Contractual Requirements - 43 Pa rtnershiP Staff training for our healthcare professionals, nursing, and mental health staff will be held on an annual basis and as needed to include: . Orientation information at intake . Written materials (pamphlets, posters, etc.) . Gender-speci?c education . institutional policy and correSponding sanctions (including site commitment addressing sexual assault) . Awareness of sexual violence, including ?red flags? for potential victimization and offender preventiony?protection strategies such as boundaries, coping skills, and the grooming and coercion process - The health and safety risks of consensual sexual relations . Staff readiness to assist offenders and avenues for reporting both fears and incidents . The inVestigation process (including timeliness and evidence preservation) . SanctiOns for false reporting Warnings to predatory and sexually aggressive offenders . Availability of counseling and other treatment services Corizon will comply with any standards adopted by the Attorney General of the United States in conjunction with the Prison Rape Elimination Act (PREA). Copies of Corizon?s written policies and procedures governing compliance with PREA, training material resources, and our Patient Information Fact Sheet regarding PREA are provided as Appendix C. Intake and Receiving Screening and Health Assessment History forms will play a central role in supporting our compliance with PREA guidelines. Corizon will utilize the Intake and Receiving Screening (M0931-3757) and Health Assessment History forms which require that the following questions are posed to each offender: . Do you have a history of violent behavior? - Do you have a history of victimization? Do you have a history of sex offenses? if an offender answers yes to any or all of these questions, a referral for a mental health evaluation is generated. These questions are repeated during the history portion of the Health Assessment to better ensure consistent and accurate information. Collection and dissemination of information will be reported to the correctional authority when a potential risk is identified through the evaluation process. Training Regarding PREA Corizon will provide Specialized medical and mental health training on an annual basis to all Corizon staff. Corizon will continue to update training materials to reflect changes in standards and policies. All training will be approved by the MDOC Training Academy and will be sent in the approved MDOC Contractual Requirements 44 (a Partnership . format. New employee?s will receive the PREA Basic Training while at MDOC Basic Training and will receive the additional specialized training within 30 days of hire. A PREA Training Manual will be maintained at each site which will contain documentation of required training for easy access to PREA auditors. Documentation of training will also be maintained at the Corizon Regional Of?ce. Corizon will assist in officer and non?custody training as requested. Assisting with training will help to develop a working relationship between medical and non-medical staff and bring awareness to medical?s role in a PREA event. Corizon has established protocols in place at MDOC to assist our staff with PREA associated events. 2.4.2 Zero Tolerance The state agency has a zero tolerance policy for any form of sexual misconduct, to include I staff/contractor/volunteer on offender, or offender an offender sexual harassment, sexual assault, sexual abuse I and consensual sex. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon acknowledges that MDOC has a zero tolerance policy for any form of sexual misconduct, to include staff/contractor/volunteer on offender, or offender on offender sexual harassment, sexual assault, sexual abuse and consensual sex. Likewise, Corizon has a zero tolerance for this type of behavior and as such, will terminate employees for this behavior; if they are licensed, they will be reported to their appropriate board of discipline. 3.4.3 Contractor ilyi_li_tnessww& In the event the contractor witnesses any form of sexual misconduct, the contractor must immediately report such 3 conduct in writing to the correctional facility?s warden. If the contractor fails to report or knowingly condones sexual harassment or sexual contact between the contractor?s personnel with or between offenders, the contract 1 may be canceiled or, at the sole discretion of the state agency, require the contractor to remove the contractor?s providing service?iltger the contract. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands that in the event our staff witness any form of sexual misconduct, we will immediately report such conduct in writing to the correctional facility?s wardenfdesignee and copy the DORS Assistant Division Directors of Medical! Mental Health Services. If Corizon fails to report or knowingly condones sexual harassment or sexual contact between our personnel with or between offenders, the contract may be cancelled or, at the sole discretion of the state agency, require Corizon to remove its personnel from providing services under the contract. Contractual Requirements - 45 Proven QB ?Partnership 2.4.4 Abuse by Contractor The contractor shall understand and agree that any of the contractor?s personnel who engage in sexual abuse shall i be prohibited from entering the correctional facility and shall be reported by the state agency to law enforcement Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands and agrees that any of our personnel who engage in sexual abuse will be prohibited from entering the correctional facility and will be reported by the state agency to law enforcement agencies and licensing bodies, as appropriate. w. ii The state agency shall have the right to review actions and documentation of actions taken by the contractor 3 related to the contractor's personnel identi?ed by the contractor as either not meeting the requirements of the contract related to PREA or violating the state agency?s policies and procedures related to PREA, or both. 5 If a. The contractor shall be responsible for the actions or inactions, whichever is applicable, of all personnel providing services under the contract. b. The contractor shall immediately report any violation of professional practice to the appropriate licensing/certification board. immediately thereafter, the contractor must provide documentation of the report to i the state agency. c. Within twenty-four [24) hours of disciplinary action taken against any of the contractor's personnel 3 providing service under the contract, the contractor shall inform the state agency of the personnel disciplinary action, including counseling and legal action. In this context, the personnel shall include clinical and non-clinical personnel. If requested by the state agency, the contractor shall provide documentation of the incident leading to Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon acknowledges the state agency has the right to review actions and documentation of actions taken by Corizon related to its personnel identi?ed by Corizon as either not meeting the requirements of the contract related to PREA or violating the state agency?s policies and procedures related to PREA, or both. Corizon will be responsible for the actions or inactions, whichever is applicable, of all personnel providing services under the contract. Co rizon will immediately report any violation of professional practice to the appropriate licensing/certification board. Immediately thereafter, Corizon will provide documentation of the report to the MDOC. Within two nty-four (24) hours of disciplinary action taken against any of Corizon?s personnel providing service under the contract, Corizon will inform the state agency of the personnel?s disciplinary action, including counseling and legal action. In this context, the personnel will include clinical and non?clinical Contractual Requirements - 46 P- Proven Partnership . personnel. If requested by the MDOC, Corizon will provide documentation of the incident leading to the disciplinary action. 2.5 Missouri Rte-entry Process Process .W 5 The contractor shall collaborate with the Missouri Re-entry process to contribute to the offender?s successful release. The contractor shall initiate discharge planning for offenders with serious treatment needs as re?ected in Standard If there is a separate contractor for medical care services and mental health care services, the medical care services contractor and mental heaith care services contractor shall work together to maintain Corizon's Re-entry Program for MDOC Corizon has reviewed and will comply with the performance standards as written in this requirement. As of September 30, 2013 there were 31,555 people behind the walls in MDOC correctional centers and community release centers and, according to the Missouri Annual Probation and Parole report for 2012, there were an additional 73,693 people under some form of community supervision. Missouri statistics estimate that approximately 97% of those offenders will be returning to the cammunity, with 90% of them returning to the community where they committed their crimes. . Statistics indicate that approximately 20,000 MDOC offenders are released back into the community annually. Reconnecting these offenders with famin and friends and assisting in their growth as productive, tax-paying citizens can be a challenge; but, one that Corizon is excited to accept in partnership with MDOC. Experience has shown that in order for incarcerated individuals to be successful, they must have the support of family, friends, work release centers, probation and parole and a large network of community?based organizations. An effective re?entry program begins on the day of reception at the MDOC Reception Centers, continues throughout incarceration and follows the offender into the community. Corizon believes that an interdisciplinary team approach, coupled with a robust and dynamic re-entry program that utilizes an innovative mix of partnerships, face?to-face intervention for growth and multi-media to bring together all of the diverse segments of re~entry gives the most likely chance of success for the offenders. Contractual Requirements 47 @Partnership Working Together with the MDOC ..In 2013, Corizon developed and released an Offender Education Re?entry Video. This video was filmed at the Moberly Correctionai Center (MCCJ and incorporated both medical (Corizon) and MDOC's re-entry processes with the objective of enhancing offender education about the benefits of fully seeking re-entry support and using the resources we have worked to put in place. Missouri Strategic Initiative Offender Re-entry Corizon?s Goals For Re-entry: To serve as an active partner in the Missouri Re-entry Process and to expand ed ucatiOn, training and services available post?release for patients with chrOnic medical or mental health Conditions/diagnoses as well as partner with facility and MDOC Central Office Division of Re?entry, Division of Adult institutions, Case Management, Probation and Parole and other individuals or groups involved in the successful re?entry of offenders into the community. Strategic Statement: A comprehensive health services re?entry program beginning upon reception including staff education, offender education and improved knowledgefaccess to services in the community to maintain a released persons health and wellness and assists him/her to sustain a productive role in the community must necessarily include other non-medical MDOC and community partnerships to better assure success. Objectives of Corizon?s Re-entry Program: . To facilitate healthcare services involvement in the MDOC re-entry program at all levels to assist in identi?cation of areas within the process that Corizon can provide/modify services to improve outcomes of released offenders. - To educate and increase general understanding by healthcare staff regarding objectives, services and staff roles and responsibilities not only of health care providers but other members of the re? entry team. - To improve continuity of care for medically complex patients released from the MDOC with a multi? faceted approach: v? Developing and implementing health services re?entry planning education materials to assist the offender on understanding how, where, when and why to access medical care post- release. v? To Continue to deveIOp the web-based program for providing a single location for all persons or groups involved in the re-entry process to access identi?ed services in the community as well as a resource for offenders and their families who have unanticipated concerns post- release. This website can also be a resource to famin members, whose main familial source of income is incarcerated, assisting them to locate low or no-cost resources in their partner?s absence. In partnership with MDOC and Probation and Parole staff, deveIOp and implement outcome measures fer offenders returning into MDOC with ongoing chronic/complex care issues to identify methods to improve effectiveness of and compliance with medical care post-release. I Contractual Requirements - 48 - To continue existing routine statistical monitors and develop additional monitoring methods to collect and document health care services provided to offenders pertaining to re?entry activities and efforts. For further understanding of our approach to re?entry programs, please refer to Modernized and Integrated Approach to Medical lie-entry,? an article written by Co rizon?s Group Vice President Ralf Salke and Dr. Mark Fleming. Provided as Appendix D, this article shares the recent Corizon re-entry program innovations implemented in partnership with MDOC. Identi?ed Professional Leadership and Re-Entry Personnel We understand that the Offices of the Governor, Legislature and MDOC at all levels have made a commitment to reduce recidivism by the development and implementation, through the National Institute of Corrections, of the 2002 Transition from Prison to the Community Model, now renamed to the Missouri lie-entry Process. I Corizon?s Regional Of?ce Re-Entry Director Leon Vickers provides oversight of the Corizon re?entry program for MDOC. Mr. Vickers acts as a resource for site level re-entry personnel. Our site level re- entry personnel will act as liaisons for Corizon, MDOC and the programs in the community at-large. While we will provide targeted, individualized re?entry plans for the intellectually disabled 0r cognitively impaired, the medically complex or seriously handicapped, geriatric, and severely mentally ill, and sex offenders, we do not believe that we can separate ourselves completely from the other issues that may impact the offender?s ability to be successful. Responsibilities of Corizon?s Re-Entry Coordinators Duties and responsibilities of the identi?ed Facility Re-Entry Coordinators (These duties will be a joint responsibility of the physical and mental health providers depending on the identi?ed needs ofthe offender). - Act as the facility level contact person for all issues related to the re-entry process whether MDOC, contract or community partner, acting as a participating co-operating member of an interdisciplinary team. . Assist the site leadership with identifying, documenting and processing offenders who may be eligible for Medical Parole and assist MDOC with all aspects of post?release planning needs. . Assist MDOC with identifying offenders who need special assistance before, during and after release. - Assist in the completion and submission of required Medicaid, mental health assistance or other applications required to link the offender with necessary community services. Complete application and coordinate the search for nursing home placement for offenders requiring assistedflong term living arrangements. Work closely with the other institutional re?entry staff and probation and parole in the completion of each offender?s ?Home Plan?. Contractual Requirements - 49 Proven apartnership Assure that the offender receives a thirty (30) day supply of release medications for control of chronic medical andfor mental health conditions. Assure that the patient receives sufficient c0pies of his records to assure adequate continuity of care in the community. Assure that the patient is offered a current copy of the pamphlet, "Healthcare - From Corrections to the Community?. Maintain a complete record of all offender contacts or other actions related to the re?entry process made by the designated Re?Entry Coordinator and document the contacts in the current electronic record in the location and format required by MDOC. Will work in partnership with Probation and Parole, Public Health Departments and other Community Based Organizations to track and assist: Offender patients designated as medically complex patients or nursing home placements, a minimum of 30 days and a maximum of 90 days post?release, depending on the individual case. A case will be considered and reported as closed when the patient arrives at and is accepted by their nursing home; they complete their ?rst appointments with their designated provider, or they successfully receive their first refill of chronic care medications, whichever occurs ?rst. Offender patients being released on prophylactic treatment for Tuberculosis who have been referred to their local Health Department for follow-up. Post?release follow-up will consist of contact with the relevant health department concerning continuity of their treatment, successful re?ll of prescriptions prior to completion ofthe thirty (30) day release supply and any other concerns identi?ed by the health department. A case will be considered as closed once it has been determined that the patient has either been lost to follow-up or has successfully been engaged with a provider at the health department to continue their care. Offender patients who are classi?ed as MH4 or MHS for whom release planning and follow- up have been arranged by the mental health staff at the facilities. Cases will be closed when it has been determined that the patients have been either successfully linked with services in the community or lost to follow-up by the community provider. These parameters may change as necessary to coincide with the parameters of the existing MH4 project. Participate in the development of a statewide/regional network of agencies, community organizations and healthcare providers with Corizon Regional staff and the MDOC Re-Entry Program staff in each facility?s designated catchment areals), by: Developing a network of medical, dental and mental health providers to serve as re-entry partners. Developing a list of community resources for continuance of medications post-release. Identify local medical, mental health or other centers willing to serve as re?entry centers of assistance. Maintain and periodically submit data related to re?entry as may be required by Corizon and our MDOC partners. Provide sufficient facility cross-training to assure that there will always be adequate personnel to maintain the re~entry planning process at all times. Contractual Requirements 50 "i 4 i Proven a Partnership . . Provide MDOC Re?entry Website utilization reporting and analytics to the MDOC using our lnGauge system as addressed in the section of this proposal titled ?Analytics, Missouri fie-entry Dashboard?. a Visionary Healthcare Program for 2014-2021 Re-entry Best Practices to be Implemented at MDOC Corizon currently provides re-entry programming for the following eight state DOC systems: a combined population #1631320 state prison a?enders. It is from these contracts that we will identify best practices to present to the MDOC for possible inclusion into our MDOC re?entry program. . Arizona Department of Corrections . Arkansas Department of Correction . Idaho Department of Correction . Indiana Department of Correction . Missouri Department of Corrections . New Mexico Corrections Department . Virginia Department of Corrections . . Wyoming Department of Corrections Corizon will not only continue the current processes in place at each MDOC facility; but, with the authorization and participation of the MDOC, will implement the following program enhancements for our re-entry program throughout Missouri. . The development of a Mufti-disciplinary Discharge/Release Planning Task Force comprised of MDOC personnel, Mental Health, Pharmacy, Dental, Medical, and community representatives. The DischargeIRe-entry Planning Task Force will identify and address the challenges of transitioning follow-up care requirements back to the community and will develop an appropriate action plan to address the ?ndings. . Inclusion of a medical re-entry subject matter expert on the Missouri Re-entry Process (MRP) Steering Team. . The further improvement and updating of the Discharge Reference Guide "From Corrections to the Community? given to each offender being discharged that includes information and preparatory materials and forms discussing how to get medication ordered by a physician, how to make and prepare for a physician?s appointment, instructions on preventive care, emergency room care and walk?in urgent care, etc. . Inclusion and participation in the many Community Resource Partnerships statewide. . Attend Probation and Parole regional and district administrator meetings to stay abreast of newer developments in re-entry resources and efforts to transfer this information into the re?entry website. . Participation in the facility level re-entry process as needed. Contractual Requirements 51 @Partnership . Encourage and participate in the development of facility level multidisciplinary re-entry teams who meet on a regular basis with the frequency determined by the facilities re?entry data. . The further growth and development of the Corizon Offender Re-entry Website that can be utilized by all persons invmved in the offender re?entry process with updates and data validity checks performed annually. . A robust "cross-training? program to ensure that all staff are aware of current needs as well as any Changes that may occur as the programis) develop. Re-Entry Planning Task Force Co rizon pro poses the development of a Mufti-disciplinary lie-Entry Planning Task Force comprised of facility and regional office level Mental Health, Pharmacy, Dental, Medical, and community representatives, if indicated. The facility level members will be from those facilities that have, on average, the highest number of releases. The Task Force will identify and address the challenges/barriers to transitioning follow-up care requirements back to the community and will develop an appropriate action plan to deal with the findings. The Discharge Planning Task Force will meet at least quarterly and address the following topics, at a minimum: . All nursing facility placements and complex cases released into the community in the previous quarter from the perspective of: Effectiveness of the release efforts x/ Housing in the community Healthcare benefits if lncomefFinancialsupport Transportation 1? Ongoing mental health/substance abuse care On processes speci?c to re-entry to monitor the effectiveness of our re?entry planning efforts Use of existing technology video-conferencing) to facilitate coordination of services 1 Reiease medications Transition assistance needs Beginning the re-entry planning process at intake ProviSiOn of medication and medical records to offenders at the time of their release Other issues discussed in the MRP Steering Team and other meetings that could assist the Task Force in improving the re-entry process or those brought forward by the individual team members. Contractual Requirements - 52 Proven Missouri Re-entry Process Steering Team Inclusion Corizon/ Medical Re-entry Subject Matter Expert With permission and support of MDOC, Corizon proposes that a medical re-entry subject matter eXpert be allowed to become a regular and active member of the existing Missouri lie-entry Process Steering Team. This medical professional would identify and address the challengeslbarriers to successful transitioning and follow~up requirements back to the community. As a part of the steering team, the subject matter expert would also be able to assure that the content of the re?entry website is up to date and would assist the team in meeting their defined goals. Corizon will work closely with the MDOC, Federally Qualified Health Centers, community providers, community agencies, community substance abuse treatment centers, and probation and court personnel to establish policies, procedures, and relationships appropriate to each release planning situatio n. Cross training of DOC staff and clinical treatment personnel will be pursued early and extensively in Con?zon's program in an effort to maximize synergy and minimize disruption and waste. Facility/Staff Resource Guides/Electronic Format As an enhancement to the current re-entry process, Corizon will work with the MDOC to place the current staff resource guides, now available for use by every facility, in electronic format and made available on the MDOC shared access drive and the reventry website. We propose that various guides be continued andlor developed to improve the chances of overall re-entry success. These guides would include, but would not be limited to: . Discharge Reference Guide ?Healthcore - From Corrections to the Community? - Re-entry Quick Reference Guide Designed to provide the healthcare staff with general information related to medical re?entry resources - Re?entry Resource Guide - Designed to provide actual medical resource information Medicaid and SSDI Disability Criteria Designed to provide a better understanding of the speci?c information that should be furnished with a Social Security Disability application and/or a Medicaid application in preparation as offender?s transition from confinement to release. Con'zon?s ultimate goal will be to replace the existing hardcopy guides with the electronic copies. We believe that this will enhance the ability to keep the information current and available to all levels of re- entry personnel. These guides will continue to include local community providers and other free/reduced cost medical providers. The providers that will be highlighted in this resource will include, but will not be limited to: . State Health Department - Local Health Departments . Local Mental Health Clinics . Local Free Clinics Contractual Requirements - 53 . .. :13? Proven A ?3 Partnership . Area Hospitals Services - Dialysis Units . Nursing Homes . Temporary Housing . Employment Services Faith Based Social Services . State and County Social Service Agencies - Food Banks - Substance Abuse Treatment Programs - Other Miscellaneous Programs Corizon?s Current Re-entry Website for MDOC Corizon first worked with the MDOC to develop and begin maintaining a re?entry website for the MDOC in 2012. The home page of this website is provided within the inset. This website is fully functional and can be viewed at: MISSOURI Contractual Requirements - 54 . Each area on the homepage designated by an individual icon serves as a link to a depth of resources. For example, when the user clicks the ?Medical Care and Services? icon they are linked to a page that allows them to click the Missouri County in which they are interested. Once the user's county has been chosen, a map appears that highlights each resource available in that county. in this case, we have chosen Cole County, site of the Missouri State Capital. There will appear to the left of the page, an alphabetical listing of available resources. Center screen, there will be a map of the locations of the resources, each of the blue icons representing a single resource. Clicking on an icon will produce contact information for that resource. It is important to note that resources provided on the re-entry website will only be those who have been vetted as providers with an interest in accommodating low-income and anderserved individuals. Corizon will continue to work closely with the MDOC re?entry, Probation and Parole and steering team staff and members to ensure that the website fully encompasses the re-entry resources available by geographic area. We will rely on the expertise of the re-entry staff, Probation and Parole and other resource professionals to ensure that our enhanced a?ering addresses identi?ed needs of released offenders available in every community. Medical Care: Community Health Center at Central no . 3933*? Mary Mm I'Jty NO 65101 Contractual Requirements - 55 Proven A @Partnership a Visionary Healthcare Program for 2014-2021 Enhancements to Our MDOC Reentry Website For our 2014 contract, Corizon proposes thefoliowing eight enhancemants to our MDOC Re-entry website. 1. 2. Site Map: We will add a site map on the opening screen. Topic Expansion: We will expand the number of website topic areas that offer the county search capability. Opening Video Replacement: Replace the opening video with one that features the current Regional Director of Re?Entry Services, a MDOC representative and some offender attestations about the website. For the latter, we would work closely with Probation and Parole to choose success stories in different areas of re-entry, notjust medical services. Proximity Searches: We will add the capability for proximity searches. The existing ability to utilize county searches will remain intact. Additionally, the user will be given the option of placing an address into the respective area of concern. The system will then generate a listing of services available within a set radius of the address. We are currently considering expanding the coverage area 25 miles in each direction. Screen Optimization Capability: We will institute screen optimization capability; this will make the site more user friendly with newer smart phones and other handheld device technology. Enhanced Printing: We will enhance the print capabilities of the website, both in the areas that will eventually contain the electronic versions of the current hardcopy guides with forms and the lists of services identified during the search process. Improved Accessibility to Phone Numbers: We will expand the blue bullet content to include the contact telephone numbers when applicable. Potential of Additional Enhancements: We will consider other enhancements based on feedback from the statewide medical re?entry committee and our MDOC/Probation and Parole partners. Contractual Requirements - 56 a Partnership Corizon will continue to forward and provide metrics of the website to MDOC and Probation and Parole. The information is useful to show how people are accessing the data inquiries, who is using it, where usage is coming from, how they are accessing it whether it be by computer, tablet or smart phone and other more detailed reporting. The data will assist us in making renovations to the website to become even more ef?cient for MDOC, the offenders, and their families in the Re-entry operations. A sample of the tracking data we currently provide to the MDOC is included in the Appendix titled "Anaiytics, Missouri Re-entry Dashboard?, provided as Appendix BB. Re?entry Coordination - Cross Training of Staff Corizon recognizes that successful re?entry and release programs require a number of essential elements Supported by a team of professionals skilled in intervention and the core components necessary to assist offenders as they return to the community. Toward that end, Corizon hos proposed the inclusion of a medical re-entry subject matter expert on the existing Missouri lie-entry Process Steering Team. With comprehensive cross-training, qualified Corizon staff will be prepared to fully support enhancements to the current re?entry program by assuring timely statewide training programs as each pregram is introduced. in addition to the education surrounding the newer programs, we suggest cross-training: - To educate and increase the understanding of the medical team regarding the objectives, services and the responsibility of the healthcare team in the re-entry planning process. . To develop and maintain current community resource details for each facility and provide staff education on services and resources available to provide mental health, medical, pharmaceutical services, housing, vocational services and other services deemed necessary by MDOC and the MRP Steering Team. . To develop a training program to assist designated members of the medical team to determine offender eligibility for Medicaid disability benefits and the process to facilitate application for the offender. . Beginning during the intake process into the MDOC, to develop and implement a needs assessment process for identification and management of medical and mental health conditions likely to require ongoing care throughout the duration of the incarceration period and upon return to the community. . To identify and expand available resources to meet medical, mental health and other critical needs of offenders upon release. . To work with onsite staff to identify gaps in community service availability and identify strategies and initiatives for improving access and options to obtain services. . To explore opportunities in utilizing telehealth and other technology in coordinating re-entry programming and aftercare services. . To redesign the written Discharge Reference Guide From Corrections to the Community for each offender being discharged that includes but is not limited to contact names and phone numbers, appointment dates and locations, how to get medication ordered by a physician, instructions on preventive care, emergency room care and walk-in urgent care, etc. Contractual Requirements - 57 Proven @partnership Should the physical and mental health potions of the RFP be awarded to separate vendors, Corizon will . always assure that there is collaboration and inclusion of all vendors in these development processes. Working to our Re-entry Program Manuals and implementation of the current lie-entry Website began as a coordinated effort between MDOC and Corizon in 2011. We look forward to continuing our partnership with the MDOC and further developing and improving upon our current re-entry program and Re-entry Website for Missouri. Health The contractor must provide the offender information on how to receive electronic medical/?mentai health records after release. Paper copies shall be provided upon request. The discharge planning process shall include, at a minimum, the following: a. Thirty [30) calendar day supply of current medications; b. Assistance from the state agency in completing Medicaid and Social Security determinations for offenders who meet eligibility criteria; Perform physicals for offenders in the Missouri Re?entry Program in the correctional facility; Formal linkages between community-based organizations; . e. Lists of community health professionals; f. Discussions with the offender that emphasize the importance of appropriate follow-up and aftercare; . 8 Speci?c appointments arranged at the time of release, if possible; and and update the Missouri Reentry websitp; Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon agrees to provide the releasing offender with all items and services noted within section 2.5.2. As addressed in the section of this proposal titled ?Enhancements to Our MDOC Re-entry Website?, improvements to our website will be jointly provided by all contracted vendors and will allow for updates to the website on a regular basis and a review annually for completeness and accuracy. This will be done by the Regional Director of Re?entry Services. Processes and procedures for further enhancements to our current Re-Entry Program are addressed in the section of this proposal titled "Enhancements to Our Current fie-entry Program". The information necessary for all complex cases will be on the following standard two-page format and distributed as indicated: Contractual Requirements - 58 @Partnership Medical Release Planning Discharge Information/Instructions Please review the following information with the offender prior to release: Offender Name: Offender DOC ii: Anticipated Date of Release (or Mandatory Release date): Home Plan Release Area: Reason for Referral: Follow up Referrals: (Name/contact info) In case you do not have or know of a doctor to care for your ongoing medical care, we have supplied some names, addresses and phone numbers for doctors and/or clinics in your area that provide care for the uninsured andfor Under insured. If you have a doctor that you prefer to use, please feel free to follow up with them. It is important that you schedule an initial appointment with a doctor in the next few weeks after your release. Additional information: We have also provided information on services available through the public health department that serves your release area. Additional recommendations for patient: When you go to your ?rst appointment, please make sure that you take the copy of your medical records that were given to you when you were released. Your application for Medicaid was submitted to 055 (Department of Social Services) prior to your reiease from the facility. At that time, you provided information on your home address after release. That address will be where any paperwork regarding the application will be sent. if you do not receive paperwork within a few days of release, we recommend that you contact the local 055 through the Division of Family Services to check on the status of your application. The local office information for your release area is as follow: Also, as a reminder, if you do qualify for Medicaid you should always ask the doctorfclinic that you are scheduling an appointment if they are a Medicaid provider. This will insure that they accept that type of insurance and payment for your care will be eligible if provided by them. Additional Also, it is important that you continue to take the medicine that the doctor has ordered for you. You are being sent home with a 30 day supply of your prescription medicine. But it is important that you see a doctor in the next week so you have enough time to get a new prescription from your doctor and for you to get to the pharmacy to get the prescription filled. This way you will not run out of your medicine. Continue to follow instructions given to you by the nurse and/or doctor prior to your release. Continue to take any ordered medications that were provided to you at the time of your release. 0 Make sure you make an appointment with a doctor to continue to receive healthcare for your Contractual Requirements - 59 Proven ?3 Partnership medical diagnosis. . NOTE: Additional copies of Medical Records after release from the facility may be obtained. Please note that requests received from a health care provider are free HOWEVER, copies requested by the patient will be subject to a monetary charge as per the Department of Rehabilitation Services policy. Requests should be sent by mail or fax to the following: Division of Offender Rehabilitation 2729 Plaza Drive Jefferson City, MO 65109 FAX Attn: DORS 573-526?8156 Copies provided to: Offender?s site case manager Institutional MH chief Health service department file Contractual Requirements - 60 administration must be maintained. The contractor must develop a system for offender medication pro?les. c. Deleted by Addendum 1 d. A Pharmacy and Therapeutics Committee whose function is to review, change and update the ?i prescribed appropriately as indicated in the most current edition of Drug Facts and Com parisons'. ?5 Partnership 2.6 Pharmaceuticals 2.6.1 Prescription Medication a Committee shall meet at least quarterly. 2) 5 agency?s Assistant Director of Mental Health Services or designee and other administrative representatives, to The medical care contractor and mental health care contractor shall be responsible for the cost of all prescription and over-the-counter medications that are speci?c to the contractor?s respective discipline. Each contractor shall be responsible for the medications ordered by the contractor's personnel. 3. The medical care contractor shall invoice the mental health care contractor for the actual costs of all pharmaceuticals dispensed as requested by the mental health contractor. All medications must be prescribed or countersigned by the prescribing authority and records of medications contained in the formulary will be formed by the state agency. The Pharmacy and Therapeutics 1) The contractor shall provide personnel deemed necessary by mutual agreement between the contractor and the state agency to co-chair and serve on the Pharmacy and Therapeutics Committee. i The state agency shall provide the state agency?s Assistant Director of Health Services or designee, the state serve on the Pharmacy and Therapeutics Committee. 5 e. The contractor shall establish and maintain a drug formulary. The drug formulary and any changes thereto, shall be subject to ?nal review and joint approval of the state agency, the contractor providing medical care services and the contractor providing mental health care services. 1] The contractor shall provide suf?cient controls over both subcontracted and employed prescribing I authority to ensure strict adherence to the contractor's drug formulary. Additionally, all medications shall be Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that the chosen medical care provider and the chosen mental healthcare provider will be responsible for the cost of all prescription and over?the?counter medications that are speci?c to the provider?s respective discipline. Each provider (medical and mental health) will be responsible for the medications ordered by the contractor?s personnel. We understand that the chosen medical care provider will be responsible for invoicing the mental healthca re provider for the actual costs of all pharmaceuticals dispensed as requested by the mental health contractor. Contractual Requirements - 61 Proven A @Partnership Medications Prescribed and Countersigned All medications must be prescribed or countersigned by the prescribing authority and records of administration must be maintained. Corizon has a system for offender medication profiles in place at MDOC that has been approved by the MDOC. Medications Filled and Delivered Pha rmaCorr will fill and deliver medications overnight delivery services from a commercial carrier. CorizonIPharmaCorr will ensure that new medication orders received by the deadline of 4pm Monday through Friday and 12 noon on Saturday will be shipped the same day. Medication orders received after the deadline will be shipped the next day. Corizon utilizes a network of back-up pharmacies to fill emergency prescriptions as described on the pages that follow. Missouri Back-up Pharmacy Network - Employer Health Options (EHO) PharmaCorr has a national agreement with Employer Health Options (EHO) to provide back-up pharmacy services to our clients. EHO is a national pharmacy bene?t management company with a network of over 1,800 retail pharmacies in Missouri. This agreement will continue to ensure that a qualified back-up pharmacy is in close proximity to each MDOC facility. Back-Up Pharmacy Network in Missouri MDOC Carrectional Center Name Closest Back?up Pharmacies Algoa Correctional Center (Minimum) Primary: Wal-Mart 401 Supercenter Dr. Jefferson City, MO Secondary: Walgreens 2002 Missouri Blvd. Jefferson City, MO Primary: Secondary: Boonville Correctional Center (Minimum) gzdazli:$ Boonville, MO Boonville, MO Primary: Secondary: Chillicothe Correctional Center (Minimum, HyVee Wal-Mart Medium, Maximum) 1210 Washington St. 1000 Graves St. Chillicothe, MO Chillicothe, MO Primary: Secondary: Cremer Therapeutic Community Center Redsggazttag?acy l??iirj? Fulton, M0 Fulton, MO Contractual Requirements 62 Primary: Secondary: Crossroads Correctional Center (Maximum, The Drug Store Wal-Mart Medium) 610 N. Walnut 2000 N. Walnut Cameron, MO Cameron, MO . . . . Primary: Secondary: Eastern Reception, Diagnostic and Correctional Medicate Long Term Care Walgreens Center (Minimum, Medium, Maximum, Diagnostic) 312 E. Karsch Blvd. Farmington, MO 600 W. Karsch Blvd. Farmington, M0 Farmington Correctional Center (Medium, Primary: Medicate Long Term Care Secondary: Walgreens Minimum) 312 E. Karsch Blvd. 600 W. Karsch Blvd. Farmington, M0 Farmington, M0 Primary: Secondary: Fulton Reception and Diagnostic Center Red Cross Pharmacy Walgreens (Minimum, Diagnostic) 600 Court St. 1410 N. BlufiF Fulton, M0 Fulton, M0 Primary: Secondary: Jefferson City Correctional Center (Maximum, Walgreen Walgreens Medium) 900 Eastland 2002 Missouri Blvd. Jefferson City, MO Jefferson City, MO Primary: Secondary: . . HyVee Walgreens Treatment Center (Minimum) 1217 S. Main St. 1114 S. Main St- Maryville, MO Maryville, MO Primary: Secondary: Missouri Eastern Correctional Center (Medium, Medicine Shoppe Wail-Mart Minimum) 305 Hoven St. 131 Eureka Towne Center Dr. Paci?c, MO Eureka, M0 Primary: Secondary: Moberly Correctional Center (Medium, Sam's Drug Store Walgreens Minimum) 300 N. Morley St. 222 E. Broadway Moberly, M0 Columbia, MO Primary: Secondary: Northeast Correctional Center (Medium, Best Buy Bowling Green Pharmacy Minimum) Hwy 61 8 N. Court Bowling Green, M0 Bowling Green, MO Primary: Secondary: . . . Seymour Pharmacy Downtown Pharmacy Ozark Correctional Center (Minimum) 214 S. Main St. 122 w. Washington St. Seymour, MO Seymour, M0 Primary: Secondary: Potosi Correctional Center (Minimum, Medium, Medicate Long Term Care Walgreens Maximum) 314 E. Karsch Blvd. 600 W. Karsch Blvd. Farmington, M0 Farmington, MO Primary: Secondary: South Central Correctional Center (Minimum, Siskaercy Walgreens Medium, Maximum) 101 N. Main 101 N. Grand - Licking, M0 Houston, M0 Southeast Correctional Center (Minimum, . anan?: secondary: Medium Maximum) Discount Pharmacy Walgreens 405 S. Main 299 N. Main Contractual Requirements - 63 A Partnership Charleston, M0 Sikeston, M0 Primary: Secondary: . . . . St. Mary?s Walgreens Tipton Correctional Center (Minimum) 875 Hwy 5 South 2002 Missouri Blvd. Tipton, MO Jefferson City, MO Primary: Secondary: Western Missouri Correctional Center (Medium, The Drug Store Wal-Mart Minimum) 610 N. Walnut 2000 N. Walnut Cameron, MO Cameron, MO Primary: Secondary: Western Reception, Diagnostic and Correctional Medicine Center Walgreens Center (Minimum, Diagnostic) 3601 Faraon St. Joseph, MO 3645 Frederick Ave. St. Joseph, MO Women's Eastern Reception, Diagnostic and Correctional Center (Minimum, Medium, Maximum, Diagnostic) Primary: Vandalia Drug Co. 112 N. Main Street Secondary: Wal-Mart 3 Town Center Dr. St. Louis Community Release Center Vandalia, MO Bowling Green, MO Primary: Secondary: Walgreens Walgreens 1530 Lafayette Ave. Saint Louis, MO 63104 1400 Grand Blvd. Saint Louis, MO 63106 Kansas City Community Release Center Primary: Walgreens 2301 Holmes Kansas City, MO 64108 Secondary: 24-Hour Pharmacnyaigreens 3845 Broadway St. Kansas City, MO 64111 Pharmacy and Therapeutics Meetings Corizon has established a statewide pharmacy and therapeutics committee that meets on a quarterly basis. As CorizoanharmaCorr's Regional Pharmacist for the MDOC contract, Mr. Mark Moyers plays a pivotal role in the planning and agenda setting for the meeting. Corizon?s Regional Medical Director, Dr. Thomas Bredeman serves as the Chair of the comiittee. Per current MDOC policy, the following team omprises the MDOC committee: Corizon Regional Medical Director, Dr. Thomas Bredeman, Committee Chair Corizon Group Vice President, Ralf Saike, RN, BSN, CCHP-A CorizonXPharmaCorr Regional Pharmacist, Mr. Mark Moyers, Corizon Regional Director of Nursing, Tara Taylor, RN, CCHP Corizon Regional Re-entry Director, Leon Vickers, RN, CCHP Assistant Director, MDOC DORS, Ms. Deloise Williams, RN, BSN MDOC Assistant Director of Mental Health, Greg Markway, Mental Health Vendor?s Director of Shirley Eyman, Psy.D Mental Health Vendor?s Pharmacist, Gregg Puffenberger, Contractual Requirements 64 Proven ripartnership This multidisciplinary Pharmacy and Therapeutics Committee meets to discuss formulary and non? formulary usage, provider prescribing practices, drug utilization review, educational information, drug costs and other relevant topics to pharmacy operations. Through this committee, it is the combined objective of PharmaCorr, Corizon, and the mental health vendor to evaluate drug products based on four main principles: 0 Safety - Efficacy 0 Therapeutic appropriateness - Cost-effectiveness CorizoanharmaCorr ensures the availability ofour Regional Pharmacist, Mr. Mark Moyers, for all 8: committee meetings. Mr. Moyers serves as a pharmacotherapy content expert when matters of comparative effectiveness emerge and require analysis. PharmaCorr recognizes that providing a competitive drug price is only one aspect to furnishing cost?effective pharmacy services. Tracking drug utilization patterns, managing the drug formulary, and understanding complex pharmacotherapy positions are essential to providing the most clinically sound and cost?effective outcomes for MDOC facilities. Mr. Moyers will continue to utilize as resources in support of our MDOC contact, our clinical pharmacy experts including HIV Specialist, Dr. Tiffany Sarrell. In addition, our web?based drug utilization reporting system will give MDOC medical and administrative staff access to pertinent data for all facilities combined, individual facilities, as well as practitioner and patient-speci?c reports. We understand the importance of having access to pharmacy data in an organized and efficient manner to make the best clinical choices and manage drug costs. Our ability to provide this data in a web?based, easy to use format is unparalleled in the correctional pharmacy industry and will provide MDOC with information to maximize ef?ciency. Drug Formulary Maintenance Throughout the duration of our contract with the MDOC, Corizon will continue to utilize our proven MDOC formulary. This formulary, developed in coordination with the MDOC and based upon Corizon and PharmaCorr?s extraordinary purchasing power, has proven both quality-driven and cost e?'ective. Our current formulary has been developed to provide ninety to ninety-?ve percent of all medication dispensing required by offender population. In the event a non?formulary medication is ordered, it can be easily obtained by a one-step level peer review by Regional Medical Director Dr. Thomas Bredema n, or his designee. This one-step review does not delay the dispensing a! the medication. Corizon will continue to provide suf?cient controls over both subcontracted and employed prescribing physicians to ensure strict adherence to the current formulary. Corizon will continue to maintain a list of authorized practitioners permitted to approve non-formulary requests as Dr. Contractual Requirements - 65 Proven to! anrtnership Bredeman deems appropriate. All medications will be prescribed appropriately as indicated in the most current edition of Drug Facts and Comparisons?. A copy of the current MDOC/Corizon formulary is provided for the reader?s review as Appendix E. This formularv will be modified, as necessary, to meet the evolving needs of the MDOC healthcare program. PharmaCorr agrees to provide prescriptions consistent with the available formulary or approved non- formulary requests. in addition, we will bring to the MDOC our unmatched and proven ability to manage correctional formularies and the documented cost savings that directly result! PharmaCorr - Proven Ability to Contain Costs In order to manage our clients? drug utilization as efficiently as possible, the medical, mental health, and pharmacy leadership teams must have a comprehensive understanding of the safety and efficacy comparisons between drugs and classes of drugs. PharmaCorr will communicate these decisions and the background analyses to the team of healthcare providers supporting the MDOCI'Corizon contract. This communication takes many forms with PharmaCorr: memo from the Committee, a written and referenced review of the topic, a didactic PowerPoint presentation at or regional provider meetings. We communicate the message in the manner that most increases the chance of successful implementation. PharmaCorr?s philosophy is that the mastery of clinical information will promote improved healthcare with a cost?efficient strategy. PharmaCorr also understands that it is essential that we establish trust with the medical providers based on our content knowledge, our willingness to promote what is best for the patient regardless of cost, and our ability to occasionally say, "Let as assist you by researching and finding an evidence-based answer for your question.? This content expertise also allows PharmaCorr to initiate contracting options with manufacturers, as we understand their and weaknesses in comparison to their competition. In addition, the client and provider relationships discussed above allow for successful pharmacy initiatives that commonly drive significant market share to one manufacturer. This, in turn, allows PharmaCorr to negotiate maximum rebates and discounts on the part ofour clients. Corizon/PharmaCorr Support for Medical Providers PharmaCorr understands that it is essential that we establish trust with the medical providers based on our content knowledge, our willingness to promote what is best for the patient regardless of cost, and our ability to occasionally say, "Let us assist you by researching and finding an evidence- based answer for your question." PharmaCorr has significant expertise and experience in evaluating client utilization to find clinically acceptable alternatives to lower pharmacy costs. Our experience and expertise will provide the MDOC with affordable drug therapy at a time when cost management is of the utmost importance. The case studies below will display our efforts to achieve notable and documented savings for our contracted facilities. Contractual Requirements a 66 .J Proven Partnership Respiratory Cost Management at MDOC PharmaCorr and Corizon worked together to decrease respiratory cost for our MDOC contract while, in tandem, improving clinical care and ensuring MDOC offenders received appropriate medical care. The initiative was implemented to ensure the patient received the appropriate medication in relation to an appropriate diagnosis. The chart below illustrates the decrease in costs for respiratory medications with no increase in respiratory emergencies or negative clinical impact to the patient. Reductions in Respiratory Medication Costs for MDOC $400,000 $200,000 $100,000 09?; Through this initiative, Corizon learned that better communication with the MDOC site wardens and the MDOC offender population was needed. While the results are impressive, Corizon identi?ed several training and educational needs through the implementation of this initiative allowing us to develop better strategies with future initiatives for the MDOC. Diabetes Cost Management at MDOC PharmaCorr and Corizon also worked together following a recent large price increase by the manufacturers of glyburide, a diabetes medication. Glipizide is a very similar medication that is used to treat the same conditions with almost identical pharmacotherapy profiles. Corizon worked with our providers in Missouri to change the glyburide to glipizide when clinicain The chart below shows the cost savings. to Glipizde Conversion at MDOC $5,000 $4,000 $3,000 $2,000 51,000 2?59 :3 30? 29 Contractual Requirements - 6? @Partnership Insulin Analog Cost Management Reductions in Insulin Analog Spend PharmaCorr has demonstrated signi?cant savings in management of insulin analogs for the management of diabetes. in an attempt to achieve pricing advantages for our clients that would exceed the standard group purchasing organization contracts, PharmaCorr approached Novo Pharmaceuticals regarding a PharmaCorr?specific contract for Levemire (insulin Determer) in 2011. During the negotiations, the PharmaCorr clinical team did exhaustive research regarding the comparative clinical and safety data for Levemir?, Lantus??, and Humulin With this review and with specialist consultation, PharmaCorr and the national Committee were convinced that there was no safety or efficacy disadvantage for Levemir?. To outline our analysis, we produced a provider informational summary to help explain and promote our conversion to Levemir??. With the implementation, signi?cant reductions in insulin analog spend was achieved. Our negotiated contract was clearly superior to the standard pricing available through multiple group purchasing organizations and wholesalers. Our conversion effort saved our clients over $1 million over a one year period. Lantu 5 Total teremir Net Total Arming Total $900,000 ?hmF ?fl 5506.060 506,000 $306,000 $200,000 5 100,000 I . . . 2011-111 2011-112 2011413 zou-ua zen-cu 2012-02 2012413 Lantus? to Levemir?D conversion Formulary Reductions in Utilization Using Both Clinical Expertise and Provider Education When trying to manage a client?s formulary, PharmaCorr understands the complexity of drug choice in behavioral health and we go weil beyond a recommendation to "choose the cheapest atypical in our analyses and discussions with providers. We first identify potential problem medications for the client's system. These medications are commonly sedating and are known to most corrections departments Seroquel, Sinequan, Wellbutrin, Neutrontin). Because these medications are typically Direct Observation Therapy (DOT), they increase nursing medication time substantially. Overuse or misuse also adds significant expense. In addition to helping to identify ?target? medications through analysis, PharmaCorr actively participates in behavioral health client meetings and has been effective in several systems with detailed, didactic Contractual Requirements - 68 Proven A @Partnership . reviews and analyses of and other behavioral health literature comparing first and second generation PharmaCorr Seroquel Spend Managment $1,000,000 $900,000 $800,000 $700,000 $600,000 $500,000 $400,000 $300,000 $200,000 $100,000 . Summary of Findings The graph on the following page demonstrates PharmaCorr?s notable experience managing utilization in several correctional systems serviced by PharmaCorr. As the figure below illustrates, PhannoCorr?s experience managing utilization has resulted in sgg' ni?con; Ewing: for PhonnoCorr clients. If chosen as the mental health partner as a result of this procurement, we are con?dent that we can put the infrastructure in place to ensure that we exceed the outcomes ofthe current mental health provider. Contractual Requirements - 69 Contractual Requirements - 70 $5.00 53 00 $7.00 $19 00 $17 00 $15.Jan-08 Mar?08 May?08 4? Jul-08 - a Sen-08 Nov-08 - Jan-09 - Mar-09 - May-09 Jul-09 - Sap-09 - Nov-09 - Jan-10 - Mar-10 - May-10 - Jul-10 Sap-10+ Nov-10 - Jan-11 Mar-11 - May?11 Jul-11 - Sen-11 Nov-11 Jan-12 - Mar-12 - May-12 - .Iui-12 - Sap-12 - Nov-12 - Jan-13 - PharmaCorr Spending Management f" a Partnership F, . Pro ven A fa PartnershiP PharmaCorr Cost Containment Step Therapy Pathways and Protocols Corizon will utilize clinical pathways for certain disease states that will incorporate step therapies that ensure the most appropriate care is given to the patient. Step therapies are tools that are used in the medical communities in the private and public sector. Step therapies promote appropriate care based on safety, efficacy, and cost. Clinical step therapies require that a patient?s therapy follows steps with input provided by the patient?s physician using clinical judgment. The steps are developed from evidence-based therapies. Step therapies provide cost effective, clinically appropriate treatment for the patient?s disease state. Some therapies to be included are multiple sclerosis, disease-modifying anti-rheumatic drugs (DMARDS), and other disease states to be determined. Release Medications As part of the Missouri Re-entry Program, Corizon will provide a thirty?day supply of medication to offenders upon release to facilitate continuity of care during the transition to community?based treatment. All release medications will be provided in child proof/resistant containers. First follow-up appointment referrals will be scheduled for offenders. In the unlike y event that Corizon cannot provide an offender his or her medication upon release, discharge. or transfer to a community release center, Corizon will overnight via UPS the medication to the required address. Stock medication or medication from a back up pharmacy can also be used when needed. Stock Medications Maximum Inventory Level (MIL) PharmaCorr and Corizon work together to maintain optimal inventories at each MDOC facility to meet site pharmaceutical needs. PharmaCorr will continue to ensure that we have a stock supply of commonly utilized medications (OTCs, legend and controlled substances} for administration to offenders prior to receipt of their actual offender specific preseription. While ensuring the maintenance of adequate stock levels is of the utmost importance, we are also aware that it is necessary to have apprOpriate inventory control processes in place to ensure that excess or unnecessary drugs are not kept at the facilities. Pha rm aCo rr addresses this issue through our Maximum Inventory Level Program (MIL). By using actual quarterly utilization numbers, PharmaCorr works with each MDOC facility to establish appropriate MIL quantities to meet the needs of the patients. it is PharmaCorr?s standard practice to r' Maximum Inventory Level PharmaCorr has customized stock lists specifically for each MDOCfocility to ensure that each facility is utilizing the most cost-effective medications and maintaining optimal inventories. Contractual Requirements - 71 9 Proven A I: Partnership stock a two-week supply of each stock drug. PharmaCorr will, of course, adjust MIL quantities if utilization changes. The MIL process also serves as a guide for the medical personnel responsible for ordering stock drugs at each facility. Stock Medication Utilization Reporting PharmaCorr will provide the MDOC with separate utilization reports of stock medications. Stock utilization reports will be provided on a basis. Through our committee at MDOC, we review medications currently available in emergency drug boxes, starter packs, or stock supply at each MDOC facility. We will prepare and submit to MDOC administrators our written policies and procedures that ensure medications are purchased from back?up pharmacies only when appropriate. Finally, PharmaCorr has developed standardized stock forms for facilities to easily order stock medications, develop par levels, and conduct efficient and accurate inventories. Stock medication will be used in response to orders, newly ordered medication for an offender that has not yet received hisfher patient speci?c drugs, or in other cases as agreed between the state agency and the contractor. Use of stock medicatiOn will require documentation on the stock card that includes the time, date, route and initials of the nursing staff or physician administering the medication. The Corizon nursing staff will document, in the medication administration record, all medication as ordered by the physician, and the note accompanying such documentation will reflect the date, time and name of the person actually administering the medication. 2.7 Medication Assisted Treatment (MAT) 2.7.1 MAT i contractor shall collaborate and provide necessary services for screeningfevaluation, required laboratory testing I and administration of required medication. This includes any necessary healthcare monitoring, as required. a. The contractor providing medical care services shall conduct a medical screeningprocess to determine if 1 that offender is medically eligible to participate in the MAT program. Screening shall include: i 1) Raview medical records for contraindications to medicaticms; 2) Laboratory testing; 3) Review of medical risks and bene?ts of the medication and its administration; and 4) Obtain informed consent for inclusion in the MAT program. a If the offender signs the consent form to participate in the MAT program, the contractor shall schedule and administer the Vivitrol injection and monitor the 'offender as indicated in the contractor's internal procedure. b. The contractor providing mental health care services shall provide a evaluation upon request by the medical care services contractor or by the state agency?s substance abuse treatment staff. 1) The mental health contractor?s personnel shalt consult with medical care service contractor?s personnel staff as needed to ensure continuity of care. Contractual Requirements T2 a partnership Medication Assisted Treatment (MAT) Corizon has reviewed and will comply with the performance standards as written in this requirement. Working with the Department of Mental Health, Allkermes and 2012, Corizon assisted in Medical Assisted Treatment at OCC and CT CC to prescribe and administer Vivitrol to offenders being released to the St. Louis area with prior alcohol convictions and addictions. These injections were administered by Corizon staff within 72-96 hours of being released. Corizon also provided lab draws and reviews at no additional costs. As a partner in the Medication Assisted Treatment (MA Corizon will incorporate a medically based protocol that has established prooedares which are in accordance to Section 2.7.1 of the RFP. These medically based protocols and procedures will ensure that a comprehensive medical evaluation and assessment is conducted to assess the eligibility of the MDOC offender to participate in the MAT program. The MAT program for the use of Vivitrol will target offenders who are identified as having an opioid dependence andfor alcohol dependence along with being abstinent for a minimum of? days prior to first injection of Vivitrol. Corizon is already working in collaboration with MDOC, Alkermes and Gateway on this program at facilities to include; OCC, CT CC, MTC and NECC. Corizon has received a letter of reCommendation from Gateway that addresses our collaborative efforts; this letter is provided as Appendix W. Screening Tools MDOC offenders will be administered a comprehensive assessment that addresses the individuals Substance use history, family history of substance use, mental health history, prior treatment, medication history, suicidality history, and general medical conditions. The goal of the assessment is to determine substance use diagnosis (per the severity of the substance use, and selection of level of care. In conjunction with the comprehensive assessment the use of the American Society of Addiction Medicine Patient Placement Criteria (ASAM PFC-2R) along with using the Clinical Opiate Withdrawal Scale (COWS). Complete History and Physical Examination All offenders participating in the MAT will undergo a complete history and physical examination, inciuding blood work. The examination will also include a screening for Hepatitis A 8: B. The physical examination will be comprehensive and speci?c for signs of addiction. - Corizon will conduct drug screen panels and obtain blood work regularly before any administration of Vivitrol. Drug screen panels will speci?cally screen for opioid use and any other substance use. - Corizon will obtain all relevant medical records for the physician to review to ensure that there are no contraindications in medication. Contractual Requirements - 73 Proven aPartnei-ship FaCtors That Will Exclude Offenders from Participation in the MAT Vivitrol PrOgram The following factors will prohibit the participation of MDOC offenders in the MAT program. An offender receiving opioid analgesics An offender with current physiologic opioid dependence An offender in acute opioid withdrawal An offender who failed the naloxone challenge test or who has a positive urine screen for opioids An offender who has exhibited hypersensitivity to naltrexone, polylactide?co-glycolide (PLG), or any other components of the diluents Warning and Precautions - Vivitrol Each participating offender will be given an informed consent that provides information covering the risk factors of Vivitrol to include the following: Vulnerability to Opioid Overdose: Because Vivitrol blocks the effects of exogenous opioids for approximately 28 days after administration, patients are likely to have a reduced tolerance to opioids after opioid detoxi?cation. As the blockade dissipates, use of previously tolerated doses of opioids could result in potentially life?threatening opioid intoxication (reSpiratory compromise or arrest, circulatory collapse, etc). Cases of opioid overdose with fatal outcomes have been reported in patients who used opioids at the end of a closing interval, after missing a scheduled dose, or after discontinuing treatment. Patients and caregivers should be told of this increased sensitivity to opioids and the risk of overdose. Injection Site Reactions: Vivitrol injections may be followed by pain, tenderness, induration, swelling, erythema, bruising, or pruritus; however, in some cases injection site reactions may be very severe. Injection site reactions not improving may require prompt medical attention, including, in some cases, surgical intervention. inadvertent subcutaneousg'adipose layer injection of VIVITROL may increase the likelihood of severe injection site reactions. Select proper needle size for patient body habitus, and use only the needles provided in the carton. Patients should be informed that any concerning injection site reactions should be brought to the attention of their healthcare provider. Precipitation of Opioid Withdrawal: Withdrawal precipitated by administration of Vivitrol may be severe. Some cases of withdrawal have been severe enough to require hospitalization and management in the ICU. To prevent precipitated withdrawal, patients, including those being treated for alcohol dependence: v" Should be opioid-free (including Tramadol) for a minimum of 7?10 days before starting Vivitrol. v? Patients transitioning from Buprenorphine or Methadone may be vulnerable to precipitated withdrawal for as IOng as two weeks. Patients should be made aware of the risk associated with precipitated withdrawal and be encouraged to give an accurate account of last opioid use. Hepatotoxicity: Cases of hepatitis and clinically significant liver dysfunction have been observed in association with Vivitrol. Curizon healthcare providers will warn patients of the risk of hepatic injury; Contractual Requirements 74 Proven {its} A @Partnership advise them to seek help if experiencing of acute hepatitis. Discontinue use of Vivitrol in patients who exhibit acute hepatitis - Depression and Suicidality: Alcohol and opioid?dependent patients ta king Vivitrol should be monitored for depression or suicidal thoughts. - Eosinophilic Pneumonia: Cases of eosinophilic pneumonia requiring hospitalization have been reported. Corizon healthcare providers will warn patients of the risk of eosinophilic pneumonia and to seek medical attention if they develop of pneumonia. - Hypersensitivity Reactions: Patients wiil be warned of the risk of hypersensitivity reactions, including anaphylaxis. Intramuscular Injections UM): As with any IM injection, Vivitrol should be administered with caution to patients with thrombocytopenia or any coagulation disorder. Considerations for Special Populations 0 Pregnancy: Vivitrol is classified as a Pregnancy Category drug per the FDA and there are no suf?cient controlled studies on Vivitrol that demonstrate minimal risk factors. - Labor and Delivery: The potential effects and risk factors on labor and delivery are unknown. - Pediatric Use: The efficacy and safety of the use of Vivitrol has not been established for individuals under the age of 18 years old. - Geriatric Use: Vivitrol has not been tested and evaluated with individuals over the age of 65 years old. Once the offender is provided the informed consent and they sign the waiver of consent, Corizon will enroll the offender into the MAT program. Upon enrollment the offender will be scheduled and administered the Vivitrol injection along with being monitored through the established procedures stated above. 2.8 Substance Abuse Treatment Programs 2.8.1 Substance Abuse Treatment i The medical care services contractor and mental health care services contractor shall work cooperatively with the state agency?s substance abuse programs as needed. For example, the mental health care services contractor may need to help substance abuse treatment staff place offenders appropriately in special needs programming, participate in multidisciplinary treatment planning. help determine if an offender is capable of completing treatment if the offender has serious medical or mental illness, etc. Substance Abuse Treatment Corizon has reviewed and will comply with the performance standards as written in this requirement. In the past two years, Corizon has demonstrated that we are A, willing to partner and assist the State of Missouri and MDOC in the area of Vivitrol. We have worked with the Department of Mental Health (DMH), Division of Adult institutions (DAI), - Corrections Foundation Division of Offender Rehabilitative Services (DORS) and the Assisted Recovery Centers of America (ARCA) from the St. Louis area to promote this program. emf/r, Contractual Requirements 75 Proven a Partnership Corizon provided counseling, testing (to include, drug screens, HCV Panels, etc) at our cost for offenders at CTCC and OCC. Recently, Corizon agreed to work with Gateway and endorsed them with a letter of reference for RFP SDA 420113001 for continuation of this or a similar program in Corrections. A copy of this letter is provided as Appendix W. Together with MDOC and DM H, we have trained staff at CTCC and OCC thoroughly regarding the Vivitrol project. Corizon is committed to programs such as these which benefits the State of Missouri and MDOC and will continue to provide any assistance the MDOC needs in achieving their goals and continued reduction of recidivism within Corrections. Corizon welcomes any opportunity to collaborate with MDOC and outside entities to achieve MDOC initiatives for the offender population. 2.9 Laboratory and EKG Services 2.9.}WLaboratory and EKG When an EKG is necessary, the medical care services contractor must perform and interpret the EKG results, 3 regardless 0f Who ordered the EKG. if the EKG is ordered by the mental health care services contractor, the medical care services Cantu-actor must communicate the results to the mental health care services contractor. a. Laboratory testing expense shall be the responsibility of the orderin?g?ldiscipline. Corizon?s Laboratory and EKG Services Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands our responsibility to perform and interpret EKGs regardless of the ordering provider. Should Corizon be awarded the medical component but not be awarded the mental health component as a result of this procurement, we will ask that the ordering provider submit an order or requisition to have the Corizon staff complete this procedure. Corizon has on EKG Protocol already established and in place. The site EKG machines are self- interpreting and are also read by a Corizon licensed physician. If there is any question or concern on the EKG, Corizon veri?es the results through a licensed Cardiologist and the findings are documented in the EHR for the offender. Corizon will bear the costs of the EKG and the interpretation of the procedure. Corizon understands laboratory costs will be the responsibility of the ordering discipline. If the mental health provider is separate from the medical provider, Corizon will work with the other vendor to establish a procedure for ensuring the tests are completed timely and documented accordingly. As an example of our willingness to work and collaborate with another venderfprovider, Corizon currently draws the laboratory tasts for the mental health provider and forwards it to our lab provider. Corizon also batches the results and downloads the information into the EHR on a daily basis (Monday thru Friday). The mental health provider is financially responsible for the cost of the medications. This type of arrangement has been in place for over 6 years within the MDOC. Contractual Requirements - 76 I A a partnership 2.10 General Personnel Requirements 2.10.1 Security Coverage The state agency will provide for the security of the contractor's personnel while in the correctional facility. The 1 level of security provided will be consistent and according to the same standards of security afforded to state 3 agency personnel. a. The state agency will provide for adequate security coverage in the event in?rmary services are available on site. i b. The state agency assigns one correctional of?cer to the medical unit. The number of correctional of?cers assigned and the hours assigned varies based on the needs of the correctional facility. The correctional of?cer only .- escorts Administrative Segregation offenders and Protective Custody offenders and, in these cases, remains during treatment. 5 Corizon The state agency will provide for the security of the contractor's personnel while in the correctional facility. The level of security provided will be consistent and according to the same standards of security afforded to state agency personnel. The state agency will provide for the security of the contractor's personnel while in the correctional facility. The level of security provided will be consistent and according to the same standards of security afforded to state agency personnel. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands that the state will provide for the security of our personnel while in the correctional facility. The level of security provided will be consistent and according to the same standards of security afforded to state agency personnel. We will work with the MDOC to ensure there is adequate security coverage in the event in?rmary services are available onsite. As the current partner, we are aware that the state assigns one correctional officer to the medical unit and that the number of correctional officers assigned and the hours assigned varies based on the needs of the correctional facility. Finally, we understand that MDOC correctional officers only escorts Administrative Segregation offenders and Protective Custody offenders and, in these cases, remains during treatment. 2.10.2 Minimum Staf?ng Requirements Mag 00.00 J?a W0 #00 z. ?31? l0 The contractor must employ suf?cient personnel staf?ng and utilize appropriate resources to achieve contractual i compliance. The contractor's personnel resources must be adequate to achieve outcomes in all functional areas 5 within the contractor?s organization. Adequacy shall be evaluated based on outcomes and compliance with contractual and the state agency's departmental policy requirements. a. The contractor shall agree and understand that certain situations necessitate that particular fuil time equivalent employee positionls) [refer to the Attachment 30 for a de?nition of FT 5) not be vacated for a i given period of time. Determinations of such situations shall be made by the state agency and shall be ?nal and without recourse. If I 1) As a result, the state agency shall deduct a payback amount from the contractor?s payment by one hundred fifty percent (150%) of the average hourly pay rate of the contractor?s rate for the respective position's de?cient hours. Payback shall apply for the positions identi?ed with a double asterisk on Attachment 33, Minimum Staf?ng Requirements - Medical Care and for the positions identi?ed with an asterisk on Attachment 34, Minimum Staf?ng Requirements - Mental Health Care. I - The contractor shall understand that the deduction described herein shall not be construed as a penalty. Contractual Requirements - 77 - The contractor shall agree and understand that all assessments of any reduction shall be within the i discretion of the State of Missouri and shall be in addition to, not in lieu of, the rights of the State of Missouri to pursue other appropriate remedies. - The payback applies to de?cient hours of positions as outlined in and accepted as a binding contractual requirement. 0 The payback amount shall be calculated for respective position's de?cient hours at each correctional facility. 1 0 The amount of time spent for training and quality improvement are not subject to payback. i i 2] On a biannual-basis (July 1 and January the contractor shall provide the state agency hourly pay rates for each position to be used for the payback deduction. b. in the event the state agency is dissatisfied with either the scope of medical care or mental health care i services delivered, the contractor shall mutually agree to provide appropriate staf?ng levels to address the issuels) the state agency identi?es. If the contractor does not achieve or does not correct the state agency's identi?ed issuefsl, or fails to maintain compliance with contractual obligations, additional monitoring and regulatory action may be employed by the state agency. i c. Any change to the minimum staf?ng requirements must be made through a contract amendment I proceSSEd by the Of?ce of Administration, Division of Purchasing and Materials Management. I d. Except as speci?ed elsewhere herein, the contractor shall not substitute hours worked at locations other than the state agency's correctional facilities or the contractor's central administrative office to ful?ll the on-site Personnel requirements outlined in the minimum staf?ng requirements. In the event the contractor?s personnel provide services at more than one correctional facility, the hours worked at a particular correctional. facility shall or?? apply toward services to that correctional facility. 1) For purposes of the medical care services contractor only, with prior approval from the state agency, the medical care services contractor may utilize telemedicine at correctional facilities where the contractor's physician hours are de?cient. Payback shall not apply when the state agency has given prior approval for telemedlcine to be lieu of deficient ph_ysig:a_n_and nurse practitioner hours. i i Corizon has reviewed and will comply with the performance standards as written in this requirement. Analysis, Review and Development of Our Proposed Staffing Plans Corizon assembled a multidisciplinary team consisting of clinical, operational, human resources and administrative staff from corporate, regional and field correctional health care programs to focus on analysis, review and development of our proposed staffing plans for the MDOC's health care program. This process included: Identification and review of key clinical processes pertaining to the health care program - Development of generally accepted workflows for the key health care processes . Breakdown of specific tasks associated with the workflows Contractual Requirements 78 f: 35: 5 Proven A QPaI-tnership . Determination of minimum clinical and/or non-clinical skill sets by task including answering the questions Does the task require clinical judgment or assessment? Does the task require specific licensure, training or certification? How and who completes the task in other health care sectors? . Minimum requirements for clinical and non-clinicallnon-Iicensed staff . Availability of human resources within the State of Missouri by licensure type . Validation of staffing recommendations using current contracts, known scope of services and volumes. Focus of Corizon?s Staf?ng Methodology The focus of our staffing methodology includes the use of the licensed clinician in those tasks that have direct impact on the outcomes of the patient versus tasks associated with patient care such as scheduling, medical record management, pharmacy and supply ordering, tracking, etc. Then, these principles are coupled with understanding specifics related to the required healthcare program including: . Physical layout and custody level of the facility - Scope of health care services provided and required at the facility . Acuity of type of patients housed at the facility based on their Medical and Mental health scores; . Volume of services provided - Where services are provided (centralized medical unit, decentralized units located in individual housing areas, combination) Duplicate the community standard of care to deliver the optimal level of clinician services to meet the needs of the patient While these guidelines form the basis for proposed staf?ng, additionally Corizon performs a thorough review of state licensure and practice acts verifying speci?c skills, training, certi?cationllicensure and clinical/required supervision. Therefore, if the identified minimum position does not exist in Missouri or the minimum requirements/skills sets are not part of the training/licensure with the state, an acceptable position alternative is used. Then, the desired positions and optimum staffing levels are cross referenced against available human resources to determine if adequate resources are available in each speci?c location to enable recruitment of adequate staff. This detailed review allows Corizon to develop guidelines and recommendations for quali?ed staf?ng mixes, using licensed and non-licensed staff, to provide a quality, cost ef?cient healthcare program. This has allowed us to develop staffing plans that address the challenges of current market resource limitations without impacting the overall quality of the health care services delivered for our MDOC contract. Contractual Requirements - 79 Proven apaltnership Facility Staf?ng Plans and Rationale In developing our staffing plans for MDOC, Corizon leveraged the in-depth knowledge we have gained . staf?ng our current program at MDOC for 21 years. It is our goal, through staffing, to ensure that we provide the right resources to achieve the various tasks required. First, the non?direct patient care roles and responsibilities are directed to other non?clinical/professional staff. This frees the direct patient care providers to focus on the patient care assessments, treatment plans and improvement of healthcare status. We also reviewed the number of professional needed by facility?s mission, population and physical structure and the data provided within the RFP Attachment. in accordance with the directives of the RFP, we have completed and provided an Exhibit for every job noted on our staffing plan. Corizon understands that certain FTE positions cannot be vacated for a given period of time. We also understand that, as a result, the state agency will deduct a payback amount from Corizon?s payment by one hundred fifty percent (150%) of the average hourly pay rate of our rate for the respective position?s de?cient hours. Payback will apply for the positions identi?ed with a double asterisk on Attachment 33, Minimum Staffing Requirements Medical Care and for the positions identified with an asterisk 0n Attachment 34, Minimum Staf?ng Requirements Mental Health Care. Our proposal includes a detailed rationale for our proposed staf?ng at each MDOC facility in the section of this proposal titled "Corizon?s Staffing Rationale?. Our detailed staf?ng plans for the Corizon Regional Office and facilities are provided as Appendix F. Human Capital Management (HCM) and Kronos? Workforce Central Systems . Working With 2011, Corizon implemented our new time and attendance system, Kronos'9. Today, following system upgrades, we utilize state-of-the-art PeopIeSoft Human Capital Management and Kronos?i? Workforce Central systems to support our MDOC contract. Our integrated systems help Corizon?s management team at each facility effectively oversee assigned facilities by ensuring contract needs are men-while at the same time minimizing overtime pay, special pay and agency usage. Using these systems to manage HR, Payroll, Benefits, and Labor Management processes in an integrated manner, Corizon: 0 Highlights critical staffing and recruiting needs - Ensures timely and accurate payroll processing co?znn if; our - Reduces overtime hours and "special pay? a Reduces/eliminates the need for agency usage . Contractual Requirements - 80 Proven A Partnership I Enhances management of benefits including paid time off for eligible personnel 0 Improves analysis of wages to determine competitiveness with local market Corizon fully understands the need for transparency in our partnerships as well as our client?s need for real-time labor reporting to clearly demonstrate that they are receiving the services for which we are being paid. In the rapidly changing and cost conscious correctional environment, Corizon believes it is critical to provide clear, concise, accurate and timely reporting to our clients. Corizon has the ability to optimize workforce management through real-time data collection of Time and Attendance with Kronos, integration with PeopleSoft for Staffing and Position Management and the use of labor Key Performance Indicators (KPI). The ability to see changes as they happen enables Corizon to make critical adjustments and record the changes so there is transparency and accountability. Corizon?s Labor Management and Reporting provides the following bene?ts to the MDOC: - To ensure Corizon is providing the appropriate level of staf?ng, these tools utilize the following: v? PeopleSite: Integrated tool which allows site management of HR, Payroll, Bene?ts, and Labor Management functions and operational reporting if PeopleSCD: Automated linkage of expected contracted and non-contracted full-time equivalent positions from Corizon?s Position Management System License validation and certification expiration reporting to ensure that licenses, renewals and recertification are completed prior to expiration thus preventing gaps in services requiring speci?c credentials, licensure, certification and registration 0 Real time reporting, by site, employee, and task, comparing actual hours worked to contract requirements 0 On-line client access to laborfstaf?ng reports by service delivery area or individual sites 0 Fully Integrated with InGauge Business Intelligence for KPi?s and advanced analysis Early in 2011, Corizon began installing biometric clocks to support labor management at each of our client sites. Biometric clocks are currently in place to support our MDOC contract. Biometric clocks serve as a control point because the clock requires employees and contractors to use their ?ngerprint as a unique identi?er. The use of biometric clocks requires that the employee swipe in and out in coordination with their designated PIN number. This level of security eliminates potential ?buddy swipes?, time fraud, and the need for badges. Eliminating the need for badges greatly reduces time adjustments due to lost or forgotten badges. Corizon understands that if the state agency is dissatis?ed with the scope of medical care or mental health care delivery of services, appropriate staffing levels will be provided to address the issuels). If the issuels) are not corrected or contract compliance maintained, additional monitoring and regulatory action may be employed. Corizon expects that through our use of an in-House Sta?ing Agency and through expansions to our telehealth program we will ensure contract required staf?ng levels for our MDOC contract. Corizon?s in?house agency program is effective in filling vacancies with higher compensation and reduced bene?ts. Contractual Requirements - 81 Partnership Changes to Minimum Staf?ng Requirements . Corizon understands that any change to the minimum staffing requirements will be made through a contract amendment. Unless otherwise speci?ed, only staff hours worked at MDOC correctional facilities will apply toward staffing requirements at that particular facility. Corizon understands that with prior approval from the state agency, medical care services may utilize telehealth for hours of de?ciency in physician and nurse practitioner hours. Payback will not apply when prior approval has been given, i 4420 #00! icoL 2.10:3. i? (5?33 ID a. The contractor personnel assigned to the contract must be approved by the st}; agency in order to provide services. b. The contractor shall provide the state agency with current vita information and evidence of Iicensure or certi?cation. or both, of the contractor?s personnel prior to the assignment of the person for on-site delivery of services Accordingly. the contractor must obtain the approval of the state agency prior to the assignment of any personnei to provide services. .1 c. At a minimum, the contractor?s personnel assigned to provide services under the contract must be . twenty-one (21) Years of age. The contractor must maintain a copy of the employees? birth certi?cate or driver?s 3 license in the personneI 3. d. The contradOr?s personnel shall not be or shall not have been under the supervision of any federal, state, . 0f aUthOI?itV Within the past two years. The contractor?s personnel shall not be currently supervised by a municipal correctional agency for a conviction of moral turpitude, or have been under such supervision within the past two (2) years. e. The contractor shall understand and agree that offenders under active federal or state felony or miSdemeanor supervision must receive written state agency approval prior to becoming an employee of the i contractor for the services provided herein. The contractor?s personnel with prior felony convictions and not 3 under active supervision must receive written state agency approval prior to providing services. f. The contractor shall strive to employ diversi?ed personnel who re?ect the ethnicin and cultural diversity Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon?s Quali?ed Personnel A Proven infrastructure in Place All healthcare organizations are facing increasing needs and heightened competition for healthcare professionals. in spite of this trend, Corizon has been extremely successful in recruiting quality staff to fulfill the neods of the MDOC healthcare services program. We know that the quality of our program relies heavily on the quality of our staff. Each potential Corizon employee undergoes the Corizon Credentialing Process prior to hire. Routine maintenance updates and ongoing monitoring are also performed to ensure continued compliance. We ask the reader to refer to . Contractual Requirements - 82 f. Proven a Partnership the section of this proposal titled ?Credentialing Process? for a detailed overview of Corizon?s approach to credentialing. Carlzon will continue to employ only those persons maintaining the proper training, licenses, and registrations necessary to provide services for the MDOC healthcare services program. Job Descriptions and Curriculum Vitae Information Corizon will continue to ensure the MDOC that the qualifications of our personnel meet and/or exceed the qualifications outlined in ourjob descriptions. We have provided each job description within Exhibits and as required by the RFP. If requested, Corizon will provide the state agency with current vita information and evidence of licensure or certification, or both, of our EMPIOYW 0! personnel prior to the assignment of the person for onsite delivery of What Team ?5 services. Accordingly, we will obtain the approval of the state agency prior 591""? -- to the assignment of any personnel to provide services. ?The corporate support is As the current partner, we are aware that our personnel must be oumtandin?r If at am time twenty-one (21) years of age and that we are required to maintain a copy there is a" issue: know that I of each employee's birth certi?cate or driver's license in their personnel can feat? my managemem me, with a simple phone call or email?. No member of the Corizon staff will currently be or formerly be under the supervision of any federal, state, or county authority within the past two years. Our personnel will not be currently supervised by a municipal FCC correctional agency for a conviction of moral turpitude, or have been Since 2001 under such supervision within the past two (2) years. a a We understand and agree that offenders under active federal or state felony or misdemeanor supervision must receive written state agency approval prior to becoming an employee of Corizon?s for the services provided within the RFP and contract. Our personnel with prior felony convictions and not under active supervision must receive written state agency approval prior to providing services. Corizon?s Dedication to Cultural Diversity Among Our Workforce It is within our company?s policies and procedures as well as our company culture to foster equal opportunity for all Corizon employees and to promote principles of diversity management that will enhance the level of effectiveness and efficiency of our healthcare programs America" ?ndian/AIBSka Native across the United States. It is Corizon?s "it/Latino objective to foster a workplace environment Blafkmf?can'??merica" where the contributions of all employees are Wh'te recognized and valued. As'an Not Contractual Requirements - 83 Proven A @Partnership Our ultimate goal is to develop a high?achieving, diverse workforce based on mutual acceptance and trust. It is Corizon?s company policy to select the best qualified applicant for the job, regardless of race, national origin, gender, age, disability, religion, sexual orientation, or any other non-merit factor. Corizon?s management team, from Executive Leadership to onsite leadership takes a structured approach to ensuring continued progress toward reaching our diversity management goals, promoting a discrimination?free work environment, and providing opportunities for all employees to use their diverse talents to support our mission of quality correctional healthcare for the offenders we serve. Corizon?s Vendor Diversity Program Corizon has a company?wide commitment to promote the growth and development ofquali?ed minority, womenaowned and/or small businesses (MIWBE). With a 34-year history of working with local and small businesses and as the largest private provider of correctional healthcare services nationwide, Corizon had an annual spend of over $55 million with minority and small businesses across the country in 2012. Corizon?s Vendor Diversity Program was developed to promote and foster Employer OfChOIif-?e diversity and economic development, as well as provide on- What our Team ?5 going evaluation to ensure that businesses are provided equal saying -- opportunities in Contracting and procurement activities. Our efforts are designed to create and increase business opportunities for all by promoting job deVeIOpment, neighborhood stabilization, and economic growth in the geographical areas where Corizon conducts business. ?Corizon values the diversity and integrity of their employees. They provide a working environment that encourages growth and development?. As Corizon strives to conduct business in a fair and equitable manner, we follow local and State laws and adhere to regulations of the states in which we operate. Corizon is dedicated to providing diverse businesses the opportunity to participate in all areas of procurement, including vendor, provider and supplier activities. ?Brendo Burlbaw RNZDON, FCC Employee since 2007 Corizon ensures that all employees and leadership are trained and informed of Carlton?s Vendor Diversity Program and policies. Ro utine i monitoring of compliance occurs on a basis with senior leadership of the company to ensure consistency and adherence throughout Corizon. Co rizo n?s program applies to all firms orinstitutions regardless of the business owner's race, color, religion, gender, gender identity or expression, sexual orientation, national origin, disability, age, or status as a special disabled veteran or other veteran. We comply with all applicable federal, state and local laws, including those dealing with the use of women-owned and minority-owned businesses. The Corizon Provider Operations Department leads this effort by: . Managing the program, providing direction and serving as an advocate. . identifying and qualifying suppliers and expanding opportunities whenever possible. . Participating and networking in local, regional and national groups. - Establishing goals and tracking participation levels. Contractual Requirements - 84 Proven Key performance measurements of the program include: a Current certification of SUppliers. - Tracking and reporting of purchases, and the percentage of total purchases. Proper racial, ethnic categorization of business types. . Tracking dollars spent in each product or service category. is Diverse supplier base percentage by servicelgood category, and minority classi?cation. Corizon prides itself on creatively working with smaller MIWBE companies to establish and grow these businesses. Prepaying for services and providing cash deposits up front are two examples of how Corizon has assisted MMBE with effectively operating cash flows. For our 2014 MDOC partnership, we will partner with Jackson Institutional Dental Services (MBE), Progressive Home Care Solutions, Jewel Healthcare Solutions, and EMED Medical Company. We have provided both an ExhibitJ and an Exhibit for each and attest that each provider meets each of the RFP directives as written in RFP 5.8.4. Con'zon is pleased that we are able to meet MeState?s goals ofa minimum 13le MBE and 5% WE participation in our proposed MDOC contract. Client Diversity Tracking Report Corizon uses a Client Diversity Tracking Report, which features a component that interfaces with company ?nancial systems to track supplier credentials, purchasing volumes, and MXWBE participation levels. When a new supplier is added, forms are submitted from the Provider Operations Department to the Finance Department for system input. Activity reports are generated to monitor performance and participation levels. 2.10.4 Securitlg?og?f I Prior to?ptbviding service, each of the contractor's personnel must have security clearance approved in advance by}. i in. the state agency. 3. Prior to the provision of services, and prior to the assignment of any new personnel to provide services under the contract, each of the contractor's personnel must submit to and pass a background investigation conducted by the state agency or its designers in order to be eligible to provide services in any correctional facility. Such investigations shall be equivalent to investigations required of all state agency employees. The state agency i shall be responsible for the cost of background investigations. 1) For informational purposes only, background investigations typically take up to forty-eight (48) hours for completion. 2) During the birth month of each of the contractor?s personnel providing services, the contractor shall Egg the state agency__c?nduct an meal check. Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 85 a Partnership We understand the importance of security within a correctional institution and will work with MDOC security personnel to provide health services in the most secure environment possible. in additiOn to regular visits to each MDOC facility and meetings with DORS management (at a minimum of weekly), Group Vice President Ralf Salke, Regional Medical Director Dr. Thomas Bredeman and our team of Regional Directors are always available to address any security concerns that may arise. Prior to the provision of services, and prior to the assignment of any new Corizon personnel, each member of the Corizon team will be required to submit to and pass a background investigation conducted by the state agency or its designee in order to be eligible to provide services in any correctional facility. Such investigations will be equivalent to investigations required of all state agency employees. We understand that the state agency will be responsible for the cost of background investigations. i Prior to providing services, each of the contractor?s personnel must submit to and pass a preemployment testing i conducted by the state agency and, thereafter, random drug testing pursuant to state agency policy and WNW Corizon?s Commitment to Ensuring a Drug-Free Workplace at MDOC Corizon has reviewed and will comply with the performance standards as written in this requirement. We recognize the use and abuse of drugs can seriously impair an employee?s ability to perform required job duties in a safe and efficient manner. We are cognizant that drug use and abuse not only jeopardizes offender and co-worker safety, it undermines our clients? and the public?s confidence in Corizon. Prior to providing services, each Corizon employee must submit to and pass a pre-employment testing conducted by the state agency and, thereafter, random drug testing pursuant to state agency policy and procedures on drug testing. In addition, as a result of our commitment to safeguard the health ofour employees, clients, and patients, Corizon has established a for cause substance abuse screening policy. Under this policy, it is a condition of employment for all Corizon employees to refrain from reporting to work or working after the use, or under the influence, of drugs and/?or alcohol. All Corizon employees are expected to report to work free of illegal drugs and to otherwise comply with all laws regarding illegal drugs. All Corizon employees are also expected to not misuse or abuse any prescription or nonprescription medications. Corizon looks to all its employees to support this policy to ensure quality care and to better the overall safety, health, productivity, and welfare of Corizon employees. Corizon tests for the following illegal drugs when implementing our for cause policy: . Amphetamine Propoxphene . Barbiturates Methadone Tramadol Contractual Requirements 86 Proven A @Partnership . Cocaine Metabolite . Meperidine . Marijuana . Oxycodone . Opiates . Fenta . PCP ln coordination with the contract that results from this procurement, Corizon will provide a drug free workplace by: . Publishing a statement for the purpose of notifying employees that the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance, including cannabis, is prohibited in Corizon's workplace; specifying the actions that will be taken against employees for violations of such prohibition; and notifying the employee that, as a condition of employment on such contract, the employee will abide by the terms of the statement and notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. . Establishing a drug free awareness program. . Providing a copy of the statement required by subparagraph to each employee engaged in the performance of the contract and to post the statement in a prominent location in the workplace. . Imposing a sanction on, or requiring the satisfactory participation in drug abuse assistance or rehabilitation program by, any employee who is so convicted, as required by Section 5 of the Drug Free Workplace Act (Public Law 100?690; 15 U.S.C. Section 5110). Assisting employees in selecting a course of action in the event drug counseling, treatment, and rehabilitation is required and indicating that a trained referral team is in place. - Making a good faith effort to continue to maintain a drug free workplace through the implementation of the Drug Free Workplace Act (Public Law 100-690; 15 U.S.C. Section 5110). zg?wMissouri Licensure/Certi?cation Upon renewal of license or certi?cation, or both, of personnel and for any newly hired personnel, the contractor shall provide state agency personnel with current Missouri licensure or oerti?cation, or both, as required by the person?s speci?ed position. a. The contractor shall comply with applicable state licensure regulations and requirements regarding performance of services pursuant to all applicable Revised Missouri Statutes and Code of State Regulations that address the provisions of professional services in the State of Missouri. Any and all lioensure held by the contractor's personnel must be current and not restricted by the issuing Board. b. The contractor shall be responsible for the licensing supervision of the contractor's personnel who, because of professional standard or statutory regulation, require the supervision of a Missouri licensed professional. The contractor shall only provide individuals requiring such supervision upon the state agency's prior approval. Contractual Requirements 87 Proven a Partnership c. if it is determined that a licensed health professional violates ethical standards of practice, the contractor i shall report the incident to the licensing board and provide documentation to the state agency?s . Assistant Director of Health Services and the state agency's Assistant Director of Mental Health Services, as i Corizon has reviewed and will comply with the performance standards as written in this requirement. All healthcare organizations are facing increasing needs and heightened competition for healthcare professionals. in Spite of this trend, Corizon has been extremely successful in recruiting quality staff to fulfill the needs of the MDOC healthcare services program as demonstrated by the fact that our program has been staffed, on average, at 97%, since 2009. Early in our history with the MDOC, Corizon implemented a rigorous credentialing process for our MDOC contract designed to ensure that only highly qualified and experienced staff support the MDOC program (described in detail on the pages that follow}. We know that the quality of Mr program relies heavily on the quality of our staff. Each potential Corizon employee undergoes the CorizOn Credentialing Process prior to hire. Routine maintenance updates and ongoing monitoring are also performed to ensure continued compliance. Corizon will continue to employ only those persons maintaining the proper training, licenses, and registrations necessary to provide services for the MDOC healthcare services program. Compliance with All Applicable Regulations Corizon will comply with all applicable state licensure regulations and requirements regarding performance of services pursuant to all applicable Revised Missouri Statutes and Code of State . Regulations that address the provisions of professional services in the State of Missouri. Corizon understands that any and all licensure held by our personnel must be current and not restricted by the issuing Board. Licensing Supervision Corizon will be reSponsible for the "licensing supervision? of our personnel who, because of a professional standard or statutory regulation, require the supervision of a Missouri Licensed Professional. We will only provide individuals requiring such supervision with the State?s prior approval. Licensing supervision will apply to both nurse practitioners and provisionally licensed Current Vitae Information If requested by the State, Corizon will provide the MDOC with current vitae information and evidence of licensure and! or certification of our personnel prior to the assignment of the person for onsite delivery of services. Accordingly, we understand that the State has the right of approval prior to the assignment of any persoonel to the provision of contract services. Contractual Requirements 88 pmven 2.10.7 Credentialing Process rm i To the sole satisfaction of the state agency, the contractor shall establish a credentialing process for all of the i contractor's licensed and certi?ed personnel. i 5 a. For each such personnel, the contractor shall provide the state agency with copies of the following, if applicable: 1) Completed contractor's application form; 2i Applicable National Practitioner Data Bank Report; 3) Current Bureau of Narcotics and Dangerous Drugs License; 5 4) Current Missouri License; 5) Current Drug Enforcement Agency (DEA) License; and 6) Current resume or curriculum vitae. b. The credentialing process shall provide full and complete disclosure of any and all restrictions, probations, sanctions, and impairments which are not necessarily limited to the personnel's current licensure. c. The contractor shall maintain documentation on the credentialing of the contractor?s personnel in the health services unit of .each correctional facility, which must be made available to the state agency upon request. The state agency shall maintain the con?dentiality of such documentation and shall not make any part of such documentation available to the public without the prior written consent of the contractor, unless such information is required to be disclosed pursuant to federal or state law. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon?s Credentialing Process at MDOC Co rizo n?s Credentialing Department supports our MDOC contract utilizing the credentialinng practices that have resulted from Corizon?s experience credentialing physicians for our Missouri contract for over 21 years. For our proposed 2014 program, we propose the addition of both Fast-track Credentialing and Tracking and Reporting of Credentialed and Licensed Staff through PeopleSoft and Corlzon?s newly added Solution. For our current contract with MDOC, Corizon employs only those persons who have appropriate full and unrestricted Missouri licensure or certi?cation in good standing and who have provided documentation of past healthcare experience to Corizon Credentialing professionals. Corizon's recruiting and credentialing employees perform an initial credentialing process prior to hire, and routine maintenance updates and ongoing monitoring are performed to ensure continued compliance. Corizon will employ only those persons maintaining the proper training, licenses, and registrations necessary to provide services in Missouri to staff our program. All Corizon physicians (medical doctors, dentists) must satisfy certain threshold indicators to be considered for hire. Our team approach to credentialing ensures a thorough review of each applicant. A Corizon Senior Credential Coordinator is responsible for reporting, compiling, and maintaining the credential information. The Corizon Regional Medical Director will be responsible for con?rming the provider? 5 credential suitability and the provider?s eligibility for employment. Contractual Requirements - 89 Proven a Partnership Initial Credential Requirements All physicians hired to provide clinical services at any facility under contract with Corizon must satisfy the threshold indicators below. Corizon must receive all applicable documentation. After these documents are obtained, the Regional Medical Director attests to the physician?s suitability by signing and submitting a Corizon ?Credential Approval Document?. Threshold indicators for our contract with the Department will include: Completed application form; Applicable National Practitioner Data Bank Report; Current Bureau of Narcotics and Dangerous Drugs (BNDD) License; Current Missouri License; Current Drug Enforcement Agency (DEA) License; Current resume or curriculum vitae; Copy of veri?ed Missouri license to practice medicine; Cepy of application for initial or renewal registration; Evidence of malpractice insurance with claims and/or lawsuits pending or closed during past ten years veri?ed by physician?s insurance carrier; Copies of verified medical education documentation including medical school, internship, residency and fellowship programs; For foreign medical school graduates, query of the American Medical Association foreign medical graduate veri?cation service; American Board of Medical Specialties (ABMS) board certi?cation, or evidence to support board eligibility defined by the ABMS criteria; Current BCLSICPR certification; Ten year employment history, present and past, where physician has practiced and reasons for change; Evidence of reasonable inquiry into employment history with emphasis on assessment of clinical skills; Signed release of information form; and, Information regarding any criminal proceedings. After these credentials are obtained, the Senior Credential Coordinator obtains ?Primary Source Verification? and queries hospitals in which the independent contractor has had active staff privileges in the past five years. Then, the Senior Credentialing Coordinator ensures that the provider has current certification in Basic Life Support/CPR or agrees to obtain it within six months. The provider obtains a self-query of the National Practitioner Data Bank (NPDB). This report must be submitted within 45 days of start date. Contractual Requirements - 90 Proven A gPartnership Physicians will not be hired to perform services by Corizon if any of the following conditions exist: A previous felony conviction . History of any criminal or civil penalty for the following offenses: Violent crime, sexual offense, or crime involving the use ofa weapon v" A crime involving the distribution, sale, or misuse/abuse of narcotics or controlled substances - History within the last two years (applicant will be free of any offense listed for 731 days before starting clinical activities) of any of the following: v? Any crime other than those listed above (excludes summary offenses and minor traffic violations) Substance abuse or addiction Alcohol abuse or addiction inability to practice medicine Loss of medical license or voluntary surrender under threat of suspension, revocation, or restriction 1? Limitation of medical license if involuntary surrender of clinical privileges v? inability to obtain professional liability insurance Visionary Healthcare Program for 2014-2021 Fast Track Credentialing Because of the nature of correctional medicine, it is frequently not possible to make other arrangements in the event a provider resigns or is otherwise unavailable. Offenders patients cannot go elsewhere for care, as would be possible for members of a healthcare plan outside of the facility. Therefore, it is necessary and important for Corizon to provide a rapid method of temporary approval for services by selected applicants. Providers with clean records are eligible for Fast Track credentiah'ng and may be approved for interim privileges for up to 60 days. Providers can only be considered for Fast Track credentialing when applying for the first time. To receive provisional credentials, a provider must present the following documentation: - Completed, dated and signed Application for Corizon Affiliation; - Completed Healthcare Practitioner Request for Privileges form; - Copy of Missouri license to practice; - Copy of DEA and state controlled substance license if required; a Copy of current PM or malpractice insurance certificate; - Copy of BLS certification; and, a Original signed and dated application for Professional Liability Insurance. Contractual Requirements - 91 ti Proven who . . A ?Partnership The Credentialing Coordinator will perform the following veri?cations: . Perform telephone or internet verification of the license and determine if there are any sanctions; - Determine if a physician?s malpractice insurance is current and meets Corizon/ policy limits; Forward the Corizon employee malpractice insurance application to Corizon?s Legal Department; - Verify that the DEA and State controlled substance license are current; - Verify that the certificate is current and meets state contract requirements; and, Obtain an NPDB report. it is important to note that this prover: Corizon process will not be used to support our contract with the M006 without the authorization of the Department. a Visionary Healthcare Program for 2014-2021 I Credentialing Technology Corizon takes a two-pronged approach to tracking and reporting on credentialed and licensed staff. Currently all of our employed nursing staff?s certifications, credentials and licensing are stored in our PeopleSoft system. This system allows the Directors of Nursing (DON) and our Health Services Administrators (HSA) direct access to their individual employee?s certi?cations, credentials and licensing dates and documentation. Corizon?s and work from within 3 PeopleSoft daily and receive alerts regarding employees whose credentials are close to expiration. This allows our sta?r to take a proactive approach to credentialing at the facility level. New to Corizon in 2013 was the addition of the solution. The MD?Staff solution will allow Corizon to track and report on the credentialing status of our physicians, and dentists. The addition ofthis system will allow Corizon to better track and report data regarding our physicians in the ?eld; we believe this technical addition will serve as a needed adjunct to the skills of our corporate human resources staff. MD-Staff is a comprehensive credentialing system that includes all of the modules needed to streamline and automate the credentialing process for Corizon and our employed physician population. The foundation for MD-Staff is an extensive, highly relational database that stores nearly every data element relating to a provider. All of the modules in MD-Staff are built upon this single powerful database, thus allowing them to work seamlessly with each other. The web-based version of MD-Staff is a feature rich enterprise level credentialing system, yet is still very user friendly and intuitive. it is based on a highly successful Windows version of MD?Staff, the web- based version takes usability to a new level by utilizing the most advanced web-based technologies to Contractual Requirements - 92 Proven . A Partnership make the application fast, responsive and easy to understand. Along with being easy to use, MD~Staff also automates many tedious credentialing processes, thus drastically reducing workloads while increasing accuracy. MD-Staff interfaces with numerous online verification sources in order to streamline many ofthe verification processes. Veri?cation can be conducted by Corizon directly from MD-Staff for a single provider or for a group of providers, drastically reducing the amount of time spent on verifying provider information; allowing for a faster and more comprehensive hiring process. The system features the following: a Comprehensive Credentialing; - Drag-and-Drop Privileging; . Extensive Reporting; - Web-Based, always available; - Built in Online Veri?cation to include: 4' License Verification; v? DEA Veri?cation; v? Verification; I National Provider identifier) Veri?cation; and, v/ Board Certification Veri?cations. - NPDB (National Practitioner Database) Integration; and, - Workflow Alarms. Both PeopleSof?t and the MD-Staff software will also allow Corizon to track and report on numerous other specialty certifications and provider specific training including ?rst aid and CPR certi?cations to name a few. Active alerts are configured for these employee credentials as well to ensure the greatest coverage and alerting system for our providers in MDOC facilities. 2.10.8 Staf?ng Guidelines Per Standards Il In addition to the personnel and staffing provisions outlined herein, the contractor must comply with ali current i personnel and staf?ng guidelines (standards) of the National Commission on Correctional Health Care The contractor shall provide professionally quali?ed licensed or certi?ed personnel at levels that assure all offenders equal access and the continuity of care which is maintained in accordance with all standards while providing services that commensurate with the offender's needs in an ef?cient, effective and timely manner. i 3. Staf?ng patterns must take into consideration changes in the scope of services deiivered and additional services added; therefore, the contractor shall ensure that the health care delivery system has sufficient numbers and types of health care staff to care for the offender population to prevent delay in health care. Factors to - consider, but not to be limited to, include the following: i 1) Size of correctional facility; 2) Acuity of offenders; 3} Types (cg, medical nursing, dental, optometry, mental health) and scope of health services delivered; 4} Needs of the offender population; and 5) Organiziional structure hours of service, use of assistants, scheduling}. Contractual Requirements - 93 "mm b. The contractor shall consider labor-intensive activities when developing a staffing plan and adjust the staf?ng plan to suit the needs of each correctional facility while ensuring the needs of the offender are met. ml Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon knows that the ability to provide a quality onsite healthcare program is directly related to maintaining quality, professional staff at levels designed to meet the specific needs of each facility. Appropriate staffing levels and the right mix of staff, including, administrative, clinical, ancillary and support staff is critical to the effective, efficient delivery of quality healthcare. When developing staffing patterns for each MDOC facility, Corizon considered the current success of our healthcare program at each facility and how we have learned best, over the last 21 years, to ensure the efficacy ofour healthcare program. Integral to Our staf?ng analysis is the consideration of the following: . The custody levells) of the MDOC facility - The medical and mental health scores of the offenders Specialty medical and mental health services provided onsite - Physical plant and layout of facilities, and associated complexityflimitations of offender movement - Achieving and maintaining accreditation, contractual and professional licensure standards - Scope of services, required frequency of services and associated anticipated volume of services - Coordination of onsite, offsite and telehealth specialty services Organizational Structure of the facility (hours of service, use of assistants, scheduling) - Non?clinical related requirements including reporting, accreditation maintenance, training Oversight and maintenance of quality improvement, process and program initiatives Corizon has developed a complete Staf?ng Rationale for every facility included in our staf?ng plan. We ask that the reader refer to the section of this proposal titled ?Corizon Sta?ing Rationale? to review each rationale. The?state agency has policiesTuhich have an impact on the contractor's hiring of personnel. This list is not meant] to limit applicability of policies, but to provide a guideline to the contractor. a BIZ-7.8 Tuberculosis Testing for Employees 0241.3 Nepotism and Fraternization c. Tobacco Use Limitations i d. DZ-11.10 Staff Conduct 02-1 1.11 Staff Drug Testing (Drug screens are conducted by the state agency] 02-1112 Staff Alcohol Testing 5st swerve; .. Corizon has reviEWEd and Will comply with the performance standards as written in this requirement. As the MDOC's current healthcare partner, each of the aforementioned MDOC Policies and Procedures has been incorporated into Corizon?s current hiring policies and procedures for our MDOC contract. Contractual Requirements 94 I 2.10.10 Orientation and Training 1 The contractor shall cooperate with the state agency regarding orientation and training efforts as required herein. The contractor shall work with the state agency to mutually agree for orientation and training schedules of all personnel. The contractor understands and agrees that all expenses incurred on behalf of its personnel, including, but not necessarily limited to, meals, mileage and lodging, shall be the responsibility of the contractor. in general, 3 orientation and training shall include the following: I As soon as possible but no later than implementation of services, the contractor?s personnel, with the exception of physicians, nurse practitioners, physician assistants, and dentists, who provide services . within the correctional facility for more than thirty (30) hours per week, must complete the Contracted Staff Basic i Training. I: a. 2 1) The Contracted Staff Basic Training is provided at three locations: 1 Central Region Training Center - 1717 Industrial Drive, Jefferson City, M0 9 Eastern Region Training Center 901 Progress Drive, Ste. 100 Farmington, M0 i 0 Western Region Training Center - 902 Edmond, Ste. 300, St. Joseph, MO 5 2) In the event any of the contractor's personnel have previously attended the Contracted Staff Basic Training, the contractor may submit a request to the state agency, along with proof of completion of the. Contracted Staff Basic Training, for the training requirement to be waived. The state agency will make the ?nal decision to determine if training may be waived on a case-by?case basis. 'i b. Training to complete host facility orientation as required by the state agency as soon as possible prior to or after 1. initiation of services. c. The contractor shall develop and provide a speci?c corrections-oriented training program for physicians, i nurse practitioners, physician assistants, and dentists. The program must be approved by the state agency chief of staff prior to implementation. i d. The contractor shall require all program personnel to participate in cross-training with state agency personnel as mutually agreed upon by the contractor and the state agency. ensure successful Compliance with the contract. f. Attendance at the Annual Core Curriculum training is recommended for all the contractor's correctional facility personnel, with the exception of physicians, nurse practitioners, physician assistants, and I dentists. 3. Attachment 32 provides information regarding the state agency's Training Academy New Staff Training courses. 1 h. The contractor shall understand and agree that the state agency?s current electronic health record system training is on~the?job training. 1 i i. On an annual basis, the contractor shall provide and make available to the contractor's nursing personnel ?head to toe" assessment training in accordance with Standard P-E-M. j. The state agency shall consider the time spent by the contractor's personnel attending state agency i required trainings, orientations, meetings, and off-site promoting quality improvement, as time worked for the purposes of the contractor's compliance with the minimum staf?ng requirements provided on Attachment 33, Contractual Requirements - 95 The contractor shall require all personnel who are not required to complete the Contracted Staff Basic e. The contractor shall agree to participate in additional training as deemed necessary by the state agency to I Proven a Partnership Minimum Staf?ng Requirements - Medical Care and Attachment 34, Minimum Staf?ng Requirements Mental 5 Health Care, or the staf?ng plan included with the contractor's awarded proposal, whichever minimum staffing plan?contains the higher number of personnel. . Corizon has reviewed and will comply with the performance standards as written in this requirement. Staff Basic Training Corizon will require that all personnel, with the exception of physicians, nurse practitioners, physician assistants, and dentists, who provide services within the correctional facility for mom than thirty (30) hours per week, complete the Contracted Staff Basic Training. In addition, all physicians will continue to be assigned to the Regional Office for a one-day orientation Employer of Choice that includes; legal aspects of providing healthcare in the correctional What Our Team is environment, case management, protocols, and MARS training. Saying .. All Corizon physicians will be required to complete the Practitioner On? ?Audits are performed boarding Program provided by Corizon. Corizon also assigns each continuously to ?nd physician supporting our Missouri contract a mentor, and in many weaknesses and train staff situations, newly contracted physicians visit a similar site prior to their appropriately. We recently ?rst day to work alongside a seasoned correctional physician. This level initiated mandatory meetings of training and orientation is also provided to each dentist. Dr. Jackson for nursing staff that involve oversees the orientation of each dentist at the onset of their speci?c medical topics and relationship with JIDS and Corizon. case studies followed by a test. This is a very valuable . As the incumbent provider at MDOC, numerous members of our educational opportunity for healthca re services team have previously attended Basic Training. We our staff?. understand that our employees who have previously completed this training may submit a request to the State, along with proof of ?-Todd Renshaw completion of Basic Training, for the training requirement to be waived. ADON, ERDCC Employee since 2009 We will require all personnel who are not required to complete the Contracted Staff Basic Training to complete host facility orientation as 0 0 0 required by the state agency as soon as possible prior to or after initiation of services. Corrections-Oriented Training Program Corizon?s Practitioner On-boarding Program Co rizon has a proven corrections-oriented training program for physicians, nurse practitioners, physician assistants, and dentists in place in support of our MDOC contract. Corizon?s Practitioner On-boarding Program is specific for a number of physician leadership positions (medical, dental, and mental health) as well as full-time and part-time physicians, and physician extenders. The goals of Con?zon?s Orr-boarding program are in accordance with the Centers for Medicaid and Medicare innovation?s mission of: . Contractual Requirements - 96 Proven al?artnership . Better healthcare by improving all aspects . of patient care, Gideon team. including Safety, rmimnem?yg M3 game Effectiveness, Patient? ?9120?- Centeredness, bonny?) Timeliness, Efficiency, ?gem,? of, a? a cc, and Equity (the ?mm? mm domains of quality in patient care as defined by the Institute of Medicine). . Better health by encouraging healthier lifestyles in the entire pOpulation, including increased physical activity, better nutritiOn, avoidance of behavioral risks, and wider use of preventive care. - Lower costs through improvement by promoting preventive medicine, improved coordination of healthcare services, and . by reducing waste and inefficiencies. These efforts will reduce the national cost of healthcare and lower out?of-pocket expenses for all Medicare, Medicaid, and Children?s Health Insurance Program (CHIP) beneficiaries. The following six goals are addressed in Corizon?s Practitioner tin-boarding Program: Recruiting Shaping the practice of Correctional Medicine Retention 1 2 3 4. Patient safety 5 The provision of quality care 6 The merits of expanding the practitioner pool Through the Practitioner On-boarding Program, Corizon aspires to develop staff into advocates for Correctional Medicine. Everyone becomes a mentor; but the practitioner cannot become a mentor until they have been mentored themselves. Our plan is to establish a well-codi?ed network for mentoring, support and coaching within the 2014 Missouri DOC contract. The three phases of our on-boarding program for practitioners supporting the Missouri contract will begin with recruiting and will carry forward for the first 90 days of employment with Corizon. Contractual Requirements - 9? . Proven I: ?if? @Partnership - Phase I takes place prior to employment and includes a screening tool, completed by the recruiter during discussions with the candidate, which is then forwarded to the hiring manager and/or regional office as part of the candidate review process. . Phase II takes place after a candidate is hired, and is a balance of self?study and face?to-face encounters with Subject Matter Experts. The syllabus is clinical role centric while addressing some essential correctional specific ?need to knows? for all roles. It is the intention that Phase 1 Practitioner On?boarding for new practitioners can be completed in four to eight hours, depending on the individual?s background and experience may be completed prior to "hands on encounters? with offender patients. . Phase Ill is an expansion of Phase I, spanning over 30 to 90 days depending on the level of service the practitioner is providing to the site. Material includes an in-depth review of the Corizon Medical Management Model, as well as aims and methods for achieving and consistently delivering safe, effective and efficient care. Cross Training with State Agency Personnel As is current practice, Corizon?s personnel will participate in cross?training with state agency personnel as mutually agreed upon by Corizon and the MDOC. We will participate in additional training as deemed necessary by the state agency to ensure successful compliance with the MDOC/Corizon contract. Annual Core Curriculum Training Corizon understands that attendance at the Annual Core Curriculum training is recommended for all Corizon correctional facility personnel, with the exception of physicians, nurse practitioners, physician assistants, and dentists. On-The-Job Training/Electronic Health Record System Corizon?s healthcare staff will support and participate in all on-the-job electronic health record system training. I Head-to-Toe Assessment Training Corizon provides Head-to-Toe Assessment Training for all Corizon nursing personnel on an annual basis. Corizon will continue to provide this training throughout the duration of the contract that results from this procurement. It has been our intention to convey throughout this proposal the importance Corizon places on staf?ng our programs with qualified, experienced, and credentialed healthcare professionals. Corizon?s detailed approach to recruiting and retention, orientation and training, and provider credentialing are all con?rmation of the importance we place on hiring and retaining quali?ed surf. Contractual Requirements - 98 Proven - A ?3 Partnership Corizon is cognizant that providing quality healthcare within a correctional setting, while simultaneously maintaining a secure environment, is a signi?cant challenge to those who choose to make correctional healthcare their vocation. To address this challenge, Corizon provides an onsite orientation program at each MDOC facility that highlights correctional healthcare. This ensures each new Corizon healthcore employee is productive from the first days on the job. Our New Employee Orientation program, as detailed on the pages that follow, has proven successful in our MDOC contract, and others similar DOC contracts throughout the country, and is utilized to prepare our employees for performing in the correctional environment. We are dedicated to providing our employees the opportunity to enhance and improve their skills by taking part in mandatory, as well as optional, in-service training sessions. Our in-service training sessions, also addressed on the pages that follow, have been developed sped?colly toful?il the needs of the correctional professional with the goal of constantly improving and adding to the clinical and administrative skill sets of our employees. Corizon's Dedication to Orientation and Training Proven Success at MDOC At the onset of their employment with Corizon, all new personnel receive a written plan for orientation and staff development/training customized to their position and scope of practice. Each Corizon employee is tracked through our Human Resources Information System (HRIS) to govern compliance with completing orientation programs and annual obligations of training. Corizon also tracks and reports completion of employee participation in in-service and training events. Evidence of the successful completion of competency training is accessible in the credentialing files of all licensed personnel and of all personnel working under the license of professional personnel. A variety of sources are used to guide the identi?cation and development of our training materials. They include but are not limited to: . Direction from Corizon?s Director of Organization and Talent Development based on the company?s Mission/VisionXValues and Goals for each year. a Direct requests from field operations leaders and staff members. - input from course evaluations. - Review of site assessments providing information regarding systemnwide training needs. a New Hire Surveys with company staff. - Subjects identi?ed from trade and professional journals. Our training and development team for the MDOC contract include: . Lorie White, Corizon?s Vice President of Talent Management 8: Organization Development. Contractual Requirements - 99 - '1 Proven a Partnership . Constance Thran, RN, CCHP, Vice President of Clinical Programs and Applications. - Nancy Roesler, Director, Organization Talent Development. . Claire Flowers, Training Specialist. . Tyra Austell?jones, Technical Training Specialist. - Tr? O?Brien, Clinical Education and Training Specialist. - Corizon?s Correctional Nurse Specialist Team (working in coordination with Regional Director of Nursing, Tara Taylor). Specialized Training for Corizon?s Mental Health Personnel In addition to staff identi?ed above, the Corizon Behavioral Health Clinical Education Council (BHCEC), made up of corporate and ?eld-based behavioral health experts, facilitates the development of all Corizon mental health care staff through quality clinical education programs with a corrections?based focus. This includes an innovative annual curriculum to update employee?s skills, keep them abreast of new ?ndings in the field of mental health, and assist with re-Iicensure requirements. This training program will be implemented at MDOC if Corizon is awarded the mental health component of the contract. In addition, our Corporate Behavioral Health staff facilitates, at a minimum, conference calls. Materials are released for review via electronic distribution. These materials are then discussed in virtual discussions or during conference calls. These teams recently completed the initial orientation and mental health training far over 2,000 health ca re professionals at more than forty (40) Florida Department of Corrections? facilities, representing 75,000 offenders across the state; over 800 employees at the Arizona Department of Corrections? ten (10) complexes, representing 34,000 offenders; and over 450 health care professionals at the Virginia Department of Corrections, representing 15,000 offenders throughout the state. Corizon?s New Employee Orientation (NEO and Il) Corizon?s orientation program begins with our extensive two?part New Employee Orientation (NED) program. Part one of our New Employee Orientation program (NEO I) is presented to all employees and consists of institution and human resources issues (business conduct, sexual harassment, etc), safety topics, and other critical information for successful employment within the corrections environment. Corizon requires that NED I be completed by all employees within 14 clays of their employment start date. NEO I components include: . Corizon Code of Conduct and Ethics - Confidentiality Protection and use of company property Compliance with rules, laws and regulations Emergency or unusual situations Contractual Requirements - 100 Proven Employee safety a Review of Corizon?s Policy and Procedures Manual . EMR training, if applicable . HIPAA confidentiality training Hazardous communications - Human resources policies and procedures - Drug?Free Workplace training Post?exposure prophylaxis - Timekeeping Part two of our New Employee Orientation program ll), structured for nursing and other clinical staff, and consists of modules covering a comprehensive array of clinical topics, including: . Ancillary Health Services a Mental Health Services . Chronic Illness . Clinical Communications 0 Controlled Drug Documentation and Accountability - Documentation 8: Medical Records . Emergency Care . ln?rmarv Care intake Health Screening and Transfers - Medication Administration and Documentation . Nursing Assessment protocols - Physical Exams and TB Skin Testing . Segregation and Special Housing . Sharps Safety . Sick Call - Situations Requiring Special Procedures . Substance Abuse Withdrawal . Suicide Prevention . Tool and Sharp Control . Utilization Management Contractual Requirements - 101 .. rove a Partnership For the clinical staff, there is a time limit of 30 days from the start of employment to complete their basic orientation and NEO ll training. Full completion of a site? specific, preceptor-guided orientation varies based on individual needs. There is a standard 90-day probationary period that can be extended to 150 days, if needed, to fully ensure a proper orientation I . Em 0 r0 Choice and training of each new staff member. pl I What Our Team Is . . . Saying .. Finally, all new Corizon employees are requnred to come to Corizon?s regional of?ce within the first 30 days of their employment for training by Corizon's regional staff. During this day long training, we introduce the Corizon regional team, discuss Corizon?s philosophy (mission, vision and values), Corizon?s stance on professionalism, PREA, Corizon?s Performance Improvement approach and other important topics and introductions. "Corizon has established a very thorough orientation and on-going training for their staff. From the New Employee Orientation (NEO) binders to the annual nursing training, Corizon?s staff is kept up-to-date on the latest Corizon?s Mental Health On-boarding Program in nursing care?. In addition to the New Employee Orientation (NED Parts and II), 4 ?10d? Practitioner On?boarding Program; and B.A.S.I.C Training Program, all MTG behavioral health staff will also be oriented utilizing Corizon?s Employee Since 1995 Behavioral Health Orientation Manual. The Table of Contents from this manual is provided as Appendix H. . B.A.S.I.C. Training Program for Key Leaders Corizon is committed to training and deveIOping our front line and regional operations leaders. All newly hired Regional Directors, Health Services Administrators, and Directors of Nursing at MDOC facilities will participate in our comprehensive ?r Behaviors, Accountabilities, Systems and Information for Corizon Training Program. .A This program focuses on three integral elements of the correctional If: health care management functionProviding quality patient care ?image 5 .H 2. Leading people effectively 3. Managing costs appropriately The B.A.S.I.C. Training Program provides information critical to each Corizon management team member? 5 success through a variety of curricula using a blended learning approach. Corizon?s instructors and mentors are committed to meeting the professional needs of the Corizon clinical and Operations management team by sharing their professional knowledge throughout the on?boa rding process. This comprehensive learning approach includes: Contractual Requirements - 102 apannership Prove? . Manager guidance . Mentoring Self~study . Online learning . Web Ex instruction . Instructor-led training This program focuses on three integral elements of the correctional health care management function: 1. Providing quality patient care 2. Leading people effectively 3. Managing costs appropriately Visionary Healthcare Program for 2014-2021 Employee Expectations Program Corizon believes that the most ef?cient and sustainable way to consistently meet and exceed client expectations is through development of an engaged, productive team. in order to increase employee engagement, enhance employee commitment, more closely align employee success to the company?s success, and build a stronger team, an Employee Expectations Program will be implemented at MDOC as an additional step in the orientation process for the MDOC contract. This pregram, previously deployed with excellent results in other Corizon contracts, involves gathering each new employees expectations regarding their position at the onset of his/her employment. Knowing these needs up from provides immediate opportunity for the management team to engage the new employee on an individual, personal level, address any questions or concerns the employee may have. and speak to any discrepancies between the employee?s expectations and the requirements of the job. Following this initial dialogue, additional discussions are planned and scheduled at thirty (30), sixty (60) and ninety (90) days, then quarterly throughout the em pioyee?s first year. At the end of the year, each new employee and his/her supervisor complete at year-end summary to determine and discuss any remaining concerns and ensure the employee?s continued success. Below are a few typical and representative quotes from employees and managers who have participated in the Corizon Employee Expectations Program: "The company is taking an active interest in keeping their employees happy. ?ifeel like iam a vaiued member of the heaith care team. Sofas my expectations have been exceeded.? Contractual Requirements - 103 Proven ital ?i feel important. Like have a voice.? ?When this program was introduced, i thought it was another fly by night program. Surprisingly, the employee expectations program has turned out to be a very valuable instrument. i can say that because it has made me evaluate and adjust my approach when interacting with my team. This program has been shown to result in a variety of improvements and desired outcomes in addition to the bene?ts outlined above. By implementing the Employee Expectations Program in Missouri, we expect to realize the following: . Increased MDOC con?dence in a stable Corizon workforce and higher satisfaction with service delivery - Significantly decreased overtime costs due to more engaged, team- oriented employees who are less likely to call off for their shift. Training and Education Programs Proven In the Correctional Environment Corizon employs a number of strategies designed to reach multiple disciplines in the development and implementation of a comprehensive Employer of Choice What Our Team is Saying .. "Corizon is a company that cares! I don't feel like I?m just an employee number?l know there are people who truly care about me as a person". ?.luiia Cox MTC Employee since 2010 training program. Training includes participation in continuing education programs, online training, and mentoring programs. Training and education is also a fundamental component of our Continuous Quality Improvement (CQI) pragram. Educational programs and tools are developed based on best practices identified within the CQI program as well as opportunities for improvement. This method bene?ts both the individual site as well as other sites that have similar needs or challenges. Continuing Education and Training for Our Nursing Staff at MDOC To ensure each member of our nursing staff at MDOC has the basic competencies required in a corrections environment, 11 core competencies have been identified by our nursing leadership. As a result, skills verification forms were developed by Corizon?s Clinical Education and Training Department. Annually, each RN or LPN must physically demonstrate his or her ability to appropriately carry out each of the 11 competencies and have that demonstration verified in writing by a subject matter expert (DON or designee). This documentation is maintained in the employee?s training file and is also sent to Corizon?s Clinical Education and Training team for centralized tracking. The competencies are: Contractual Requirements - 104 - Obtaining a Blood Pressure Reading . Crutch Fitting and Crutch Walking . Placement and Management of IV Infusion - Obtaining a Peak Expiratory Flow Rate Measurement Employer of Choice . Performing a Basic Respiratory Examination What Our Team ls - Obtaining and Receding a Snellen Chart for Visual Acuity 507mg . Placement of a Cervical Collar ?Corizon offers more training - Obtaining and Reporting an EKG and ?Us, at "0 Charge: to the nursing staff than any Placement and Management of Oxygen Therapy other company I have worked - Obtaining and Preparing Laboratory Samples It ?5 VEFY bene?cial to the nurses as a way to stay up?to~date on new processes and even as refreshers?. Placing and Reading a TB Skin Test In addition to initial orientation, each nurse is provided can?going educatiOnal opportunities through a program planned and coordinated by the Corizon Nursing Department in collaboration with Regional _Brenda Burlbaw Directors of Nursing from across the company. Forour Missouri contract, FCC Regional Director of Nursing Taro Taylor plays a pivotal role in spearheading these onan training opportunities for our Missouri nurses. . . Employee since 2007 Training is developed based on the current body of nursing knowledge and information gathered through our Quality Improvement and Sentinel Event Programs. It is imperative that nursing leadership at each of our contracted sites is aware of nurse performance and clinical decision?making based on a review of their work through the Corizon Quality Improvement Program. This review quickly identifies performance needs as well as areas of best practice that can be shared with others at the facility. continuing education materials are mandatory and provided for each nurse with topics focused on clinical issues commonly encountered in their daily work activities and those areas where focus is needed. Corizon?s Clinical Education Council is accredited by the California Board of Nursing as an Approved Provider of Nursing Continuing Education programs. The Corizon CE library includes training modules for the following topics . MRSA in Correctional Settings - Nursing Documentation - Corrections Nursing The Corrections Environment Improving Interdisciplinary Clinical Communications a Nursing Emergency Care . Red Flags of Neurology - Corrections Nursing?What Makes Corrections Special - Diabetes Update Contractual Requirements - 105 Proven ?Partnership . Managing Chest Pain . Nursing Ethics and Corrections - Corrections Nursing Issues a Dental Screening and Emergencies In addition, onsite nurse managers receive training materials that can be used in daily encounters with staff through planned training sessions or as a part of staff meetings. These materials on emergency response situations and patient safety topics. Each nurse is also required to complete annual training on topics such as suicide prevention, employee safety, medication administration, narcotic control, infection control, HIPAA and corporate compliance and ethics. CEU Hours No Expense to Corizon Nurses Corizon?s comprehensive continuing education program allows nursing and provider staff to accrue CE contact hours toward re-licensing requirements at no charge. All Corizon staff is able to use the program to accrUe training hours for accreditation requirements with no out ofpocket expense. The Program is tracked at the corporate level to verify participation. Corizon?s Approach to In-Service Training ln?Service Training gives us an opportunity to focus on speci?c educational requirements. This may include the development of an Annual In?Service Calendar, as well as opportunities for staff to have input on the topics offered throughout the year. Our ln?service education will be documented, including topic outlines, datesftimes of course offerings, and instructor and attendance rosters. A file will be maintained on each staff member documenting orientation, current CPR certification, and satisfactory completion of recruited annual training. Participants will receive proof of proficiency at the time a course is completed. Examples of in?service education topics will include: - Medication Administration - Interview . Mental Status Examination . Mental Health Assessment Suicide Prevention and Intervention . Disaster Plan Medical Emergencies - Recognition of Mental Illness Signs and - Infection Control - Recognition and Treatment of Chemical Dependency . Basic PrincipIES of Using Individual and Group in a Correctional Setting Contractual Requirements 105 tit": Proven f' PartnershiP - OSHA Safety and Compliance . Patient Education - Documentation Requirements . Other training as identi?ed by the MDOC The calendar that follows provides the reader with an overview of the current in-serye training approach Corizon takes at MDOC. This training calendar, typical of each of our facilities, is from Potosi Correctional Center (PCC). PCC EDUCATION CALENDAR 2013 ?Training takes place at each staff meeting unless otherwise announced? Emergency Plan 511 Policy Update "ma" 30 min 30 min 30 min Asthma; Inhalers, Lung Assessment, . . . Pulmonary Function Testing, Nebulizer [511 Policy Update. l51_1 8.1 Clinical Health Fabmaw Treatments Permits 1 hr 30 min The Sting: Anatomy of a Sll Policy Update: 1511-412 M000 C?lbersecurit?! March Setup Hunger Strike (Mandatory) 1 hr 30 min 30 min Mortality Review: Offender #1577655 April . 30 min May None Scheduled June None Scheduled Nursing Skills CompetencieSJCompe-tency COde Of condUCt 8? Eth'cs Safety DVD (LMS Module) Test 1 hr 1 hr 3 ln? rmary . . . Head to Toe Assessment Nursmg Protocols Module} Rewew 1 hr 1 hr 1 hr Medication Administration Controlled Substance PREA July (LMS Module} Accountability 1 hr 1 hr 30 min Time and Attendance MDOC Professionalism SOAP Charting Forced 8: Involuntary Troponin I Heat Warning GUIdelInes . 1 hr 30 min Meds Pl Mortality Review: Offender mergenqy an #28136 Acknowledgement Sheets 30 min 30 min Mortaiity Review: Offender Corizon CE Module (Self #507229 . . Study): Cardiac Assessment 30 min Communication 1 hr August 1 hr Corizon CEU Module (Self Study): GI Corizon CEU Module (Self Study): Assessment TraumaIMusculoskeletal Assessment 1 hr 1 hr ember Flu Update Corizon CEU Module (Self Corizon CEU Moduie (Self 30 min Study}: Emergency Response Study}: Asthma: Clinical Contractual Requirements - 107 Proven A (?Partnership 1 hr Pathway and NET 1 hr Hazardous Communication: . . . Zoll AED Training Rule of 1005 Campaign 2013 Updates . . 30 min 30 min 30 min Corizon CEU Module (Self Study): Diabetes: Clinical Corizon CEU Module (Self Study}: Suicide Prevention Corizon CEU Module (Self Stu dy): Critical Thinking October MDOC: Discrimination, Harassment, 8: Retaliation MDOC: Cybersecurity HIPPA (LMS Module) (Mandatory) Pending Release) 1 hr 1 hr Corizon CEU Module (Self comm CEU (sen: Study): Developmentally . . Study): Nursmg . Tea November DelayedepeCIal Needs . Documentation 1 hr 30 mm 1 hr (Pending Module Release) Corizon CEU Module (Self Operational Plan Review Teambuiiding Study): Delegation and 1 hr 30 min Supervision 1 hr Mandatory LMS Courses Completed by Employees: Bloodborne Pathogen BIDOdbome Pathogen 53 my Fall Prevention Part 1: Risk December . Part 2: Exposure Controls 8; Review Assessment PPE . 1 hr . 30 min 30 min Fall Prevention Part 2: Preventative Strategies Products 30 min Fall Prevention Part 3: A Comprehensive Fall Prevention Program 30 min Preventing Needlestick Injuries 30 min COMPLETED PER REQUIREMENTS PLANNED EDUCATION HOURS: 43 Corizon Behavioral Health Continuing Education Committee (BHCEC) Continuing Education and Training For Mental Health Professionals The Corizon BHCEC works in partnership with our site personnel to identify the speci?c behavioral health education and training needs of our correctional behavioral health staff. As a rule, information is reviewed during the fourth quarter of the year for the coming year?s program. This information is shared with the members of the BHCEC and a clinical training program is developed. Differentiation is made between development of in?service education programs and continuing education programs. Once the material has been approved by the Chief Mental Health Officer, the article is released to the company for distribution. The following topics are included in our 2013 CEU Schedule: Contractual Requirements - 108 Proven A gPartnership Clinical Management of Difficult Behaviors (updated annually) Suicide Prevention - Our Aging Population and the Behavioral Health Implications - Developmentally Delayed and Other Special Needs Offenders: Treatment Considerations - Discharge Planning and Re- entry for the Mentally Ill Offender - Diagnosis Treatment Using the ln~service education programs, as a rule, are documented and tracked at the site level. Completion is recorded in the employee training file. Some in- service education is released with the speci?c purpose of providing system-wide exposure to the training topic. We ask the reader to refer to Appendices X, Y, Z, and AA to review several examples of behavioral health Continuing Education Topics utilized by Corizon. Crisis Intervention 8: Training Training in Suicide Prevention and Mental Illness is a particularly important component of an effective and ef?cient mental health program. Accordingly, the Corizon Training and Education Department makes available a comprehensive training program for security staff and facility supervisors as well as the medical staff in pertinent areas of mental illness, suicide prevention and crisis intervention. Corizon?s mental health professionals are committed to applying preventive approaches; however, they are also trained in the application of crisis intervention techniques required during emergencies. Appropriate identification and management of emergencies requires an array of clinical expertise that provides the MDOC with appropriate, expeditious and quality mental health servnces. Contractual Requirements - 109 aPartnership Corizon understands that the expert clinical skills of the Mental Health professionals in the management of crisis situations offer the offender quality mental health services and access to assessment and treatment. Corizon Mental Health professionals are trained in de-escalation strategies in an effort to prevent harm to self or others during a potential crisis. The Corizon LMS (Learning Management System) Corizon supports our onsite programs with a speci?cally designed and customized Learning Management System (LMS), available for all staff at (screenshot below). The Corizon LMS ensures all staff members have complete 24/7 access to the latest material necessary to be successful on the job. With over 500 total courses available, our onsite managers and ?eld staff across the country have instant access to our New Employee Orientation i Program, numerous software and proprietary applications training courses, and Continuing Education (CE) Continuing Medical Education (CM E) courses (over 150). These on~line courses are all accredited by nationally recognized organizations for Credit. The program is provided at no cost to the staff and allows them to perform the course, complete their testing and print their certi?cate of completion on any Internet-capable computer. This program also has a tracking capability, accessible to site management, that allows them to track completion of courses by their staff. 4- mum - v, m. as.? we?: nun-coxkn? who: ?Em macros 1? 2?43 IWWB: IMO YOU KNOW: WIHUS: I 1UMJ up in. "rm: . n: H. .ui? saw:- an?, anal-NM. as mu. elm win-1m? mag-how scrim? mun. \uo 'muum-?Imxru 1 sanp amt-t i-ng An industry ?rst for private correctional health ca re providers, the Corizon LMS allows us to leverage the power of the Internet to deliver comprehensive professional development instruction to our management and field employees throughout the country. Utilizing LMS technology, Corizon can connect, inform, and educate our geographically -- 1- -- -- - - - dispersed workforce using a single, integrated on?line training and communication platform. Through a partnership with leading e~learning provider, Oracle and their Learn Cloud Service, Corizon is able to provide a wealth of course material on a large variety of professional development topics. Contractual Requirements - 110 i Proven a Partnership Customized LMS Curriculum This unique learning solution enables Corizon subject and instructional experts to create customized content unique to the correctional health care ?eld and proprietary company technologies. Such tepics have included our Code of Conduct and Ethics, and HIPAA. Our instructional designers continually monitor the evolving educational needs of our diverse workforce and will develop future study modules to best address these professional development areas. . . . Employer ofChoice All course content featured in this Interactive lea system IS What Our Team ls designed to measure ability within four key areas: saying-mm"- 1. Leadership and Influence "Mommy training and the 2 b, - P, . LMS are great assets for em 0 an anmng education and continuity of 3. Relationship Skills Care - ?Brenda Shim 4. Process and Outcome Mana ement Corizon LMS users may take the courses at their own pace and at a Emplwee Since 2007 time that is most convenient for them. Students are tested on their comprehension of many subjects, thus identifying precise and areas for improvement. Managers can then track the completion and comprehension rates of learners and use such data to aid in the development of future training programs. The Corizon LMS curriculum and customizable Learning Plans are designed to empower employees to take charge of their personal training programs. Each course is self?paced and can take from 30?120 minutes to complete. Students may start and stop the courses at any time, saving their place in the process. Employees can chart their progress in the system and view a record of courses completed, along with any applicable test scores. Through our orientation programs, focused management, clinical curriculum and access to ongoing training/development, Corizon clearly demonstrates its commitment to providing employees with a work environment conducive to growth, development and well-being. Missouri Employees Lead the Way Since the incaption of the LMS, Corizon employees supporting our MDOC contract have consistently completed more courses than any other contract in the company. In fact, the 7,926 total LMS course completions by Missouri employees since January 2009 represent 25% of the total courses completed by all Corizon employees in that time; 45% (3,599) of those courses were completed for CE credit. Contractual Requirements - 111 Proven A rjpannemhip BY no later than SEVEN calendar days prior to the ?rst day of the weekly work schedule but no sooner than one month prior to the ?rst day of the weekly work schedule, the contractor must provide the state agency with the weekly work schedule for each correctional facility. The weekly work schedule must identify the personnel assigned to the correctional facility and each person?s days and hours of work for the week. The work schedule must certify that a" the contractor's personnel listed are appropriately licensed and quali?ed under all federal and statejtatutes and guidelines may be applicable. wm?r? ?wag?"W?m Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands and will provide the state agency with the weekly work schedule f0r each correctional facility by no later than seven (7) calendar days prior to the first day of the weekly work schedule but no sooner than one (1) month prior to the first day of the weekly work schedule. Corizon understands and will identify the personnel assigned to the correctional facility and each person?s days and hours of work for the Week. We will certify that each member of our healthcare team is licensed and qualified under all federal and state statutes and guidelines as may be applicable. 2-10-12 Yaon?ss . - -. The contractor must make a good faith effort to fill all vacancies with quali?ed personnel as soon as possit?l .1 the vacancy of a position. The contractor shall understand and agree that a position shall be considered vacant if staffed by an individual from a temporary staf?ng agency, consistent use of overtime hours are necessary I EwneertenesressfEsseeseea- Corizon's Approach to Vacancies Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will make a good faith effort to ?ll all vacancies with qualified personnel as soon as possible following the vacancy of any position. As we have referenced throughout this proposal, Corizon?s filled staffing ratio? has averaged 97% Since 2009, With actual paid hours inclusive of part?time, PRN and overtime 98-100 percent. Corizon has a proven track record of filling staff openings at MDOC as they occur. Once Corizon identifies a position as ?open?, a Corizon recruiter is assigned to work with the site staff to fill the vacancy utilizing e?ecruit, professional journals, local/state} national mailings, and job fairs. Corizon also allows provider sign on bonuses for referrals and signing bonuses for selected staff. in addition, Corizon has made a multitude of market adjustments for our MDOC contract to ensure that we stay competitive with the local labor market for various positions to include Administrator, DON, RN, LPN, Dentist, and Corizon has a history of increasing shift differentials at selected sitels), as well as implementing I'D-house agency programs to augment our staffing efforts. Due to the fact that we have been faithfully providing services to MDOC since 1992, we have the hands on experience needed to ensure our programs are staffed. Corizon knows the market rates required for various professional positions and what it takes to recruit and keep candidates for those positions in the Contractual Requirements - 112 Proven Partnership Missouri market. Corizon knows and understands what it takes to operate a contract the magnitude of . the MDOC and We stand by our proposed staffing plan provided as Appendix F. Corizon has continually increased staffing levels at MDOC to ensure we meet the needs of the increased offender population numbers and higher acuity levels of the offender population over the last ?ve years. 2.10.13 Supervision of Personnel The contractor shall supervise contractor-assigned personnel to provide services. The unique nature of working within the state agency, including safety and security issues, requires the state agency to carefully monitor the 3 contractor's empIOyees when the employees are working at a correctional facility. l, a. The contractor shall be responsible for the conditions of employment, work environment, and employee I: fights 0f the contractor's personnel. The contractor shall not be reSponsible for supervision of state agency personnel or the supervision of the staff not employed by the contractor. However, if the contractor becomes I aware of a work environment problem, the contractor must notify the state agency in writing of such and shall i work with the state agency for a solution to the problem. The contractor must provide a means and orient personnel to web means of resolving complaints or problems regarding any of the personnel's work at a i correctional facility, b. Because of the unique nature of work, close copperation between the contractor's personnel and state agency Personnel shall be required. However, the contractor must ensure the contractor's personnel work the ll correct hours, receive correct pay, have the tools required to perform assigned duties, receive additional job i training as needEd, and have adequate supervision. 1) Adequate supervision includes access to supervisory personnel for personnel problems including, but not . if limited to, complaints about working conditions, harassment, discrimination or any other matters. The contractor shall provide written communication to the state agency regarding the personnel action i c. {taken based on the complaintls) or problemls) regarding any of the personnel's work. Corizon?s Supervision Approach Corizon has reviewed and will comply with the performance standards as written in this requirement. The Corizon management team, under the direction of Group Vice President, Ralf Salke, is comprised of numerous healthca re professionals with signi?cant tenures with the State. Contractual Requirements - 113 Proven A @Paltnership We will continue to provide the MDOC with clinical and management expertise, while at all times maintaining accountability to MDOC administration. - We understand our responsibility for the conditions of employment, work environment, and employee rights of our personnel. We understand that we are not responsible for the supervision of state agency personnel or the supervision of the physical plant outside of the area where we provide services. Although employees may never need a formalized complaint mechanism, Corizon has created an environment that ensures our employees know that complaints will be received and considered without fear of retaliation. Corizon does however ask each employee to first discuss employee problems with their supervisor. We have found that an open and honest dialogue of concerns will clear up most misunderstandings and resolve a majority of employee issues. We make it known to our employees that the next level of management addresses issues that are not resolved to an employee?s satisfaction or that cannot be discussed with the supervisor. If the employee still does not receive satisfaction on his or her issue, he or she may then contact a representative from our Human Resources Department. The ?nal step available to Corizon employees is interaction with the Vice President of Human Resources. Even though the chain of command is recommended in assisting with employee issues, they may at any time contact any individual listed above without re prisal or retaliation. Corizan will continue to provide written communication to the State regarding any action requested of the State based on a carapioint from Corizan personnel. Corizon Lines of Authority Corizon has developed clear lines of authority throughout our organization to ensure that each employee has both adequate supervision and immediate access to a supervisor when needed. We have provided our organizational chart in the section of this proposal titled ?Organizational Chart? to provide the reader with not only the structure of our organization, but also the names of each professional that will continue with the MDOC/Corizon program. 3: 10-14 i The state agency shall have the right to review actions and documentation of actions taken by the contractor?- i related to personnel who are identi?ed as not meeting the obligations of the contract or violating the state agency's policies and procedures, or both. a. The contractor shall be responsible for the actions and inactions of all the contractor?s personnel providing services under the contract. a b. The contractor shall immediately report any violation of professional practice to the appropriate Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that the state agency has the right to review actions and documentation of actions taken related to personnel who are identified as not meeting the obligations of the contract or violating the state agency?s policies and procedures, or both. Corizon understands and will be responsible for the Contractual Requirements - 114 actions and inactions of all personnel providing services under the contract. Corizon understands and will immediately report any violation of professional practice to the appropriate licensingfcertification board and shall provide documentation of the report to the state agency. 2.10.15 Disciplirgry Action The contractor shall inform the appropriate state agency Assistant Division Director of all disciplinary actions]E 5 within twenty-four [24) hours of the action, including counseling and legal action, taken against any of the contractor?s personnel providing any services required under the contract. In this context, personnel speci?cally include clinical personnel and non-clinical personnel. The contractor shall provide any documentation of the incident as requested by the state agency?s Assistant Division Director. Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand and will inform the appropriate state agency Assistant Division Director of all disciplinary actions, within twenty?four (24) hours of the action, including counseling and legal action, taken against any personnel providing any services required under the contract. Corizon will provide any documentation of the incident as requested by the state agency?s Assistant Division Director. 3:19.16 State Agncy Dissatisfaction I If the state agency is dissatis?ed with any of the contractor's personnel, the contractor must resolve the problem to the State Stile satisfaction. if circumstances exist whim prevent resolution to the satisfaction of the . State agency, the contractor shall immediately replace the person with appropriate part-time 0f overtime personnel untiL?ull?time replacement meeting the state agency?s approval can be assigned. _j Corizon has reviewed and will comply with the performance standards as written in this requirement. Co nnel rlzon understands that we must resolve any and all Per-?30 problems when brought to our attention by the State. If circumstances exist which prevent resolution to the satisfaction of the State, Corizon will immediately replace the person with appropriate part-time or overtime personnel until a full-time replacement meeting the M9005 approval can be assigned. In all cases, Corizon will maintain the number of FTEs in the staffing plan as required by the contract. What Our Team is Saying .. ?Safety and security is maintained. The teamwork between medical and custody is unbelievably good. Great mesh between medical section heads Over the duration of our current contract, Corizon has demonstrated our and 1'10? from the desire to work with the MDOC and has replaced both employees and depanmenr' independent contractors, at the request of the MDOC, in an expeditious . . -Todd Renshaw manner. Conzon will not place the burden ofa Comon employee ADON ERDCC and/or independent contractor removal on the MDOC and we will not Employee'since 2009 convey to the removed party that the change has been made at the fewest. We are cognizant that the removal of our employee?s . . . is our responsibility alone and we will not involve the MDOC in our terminations. Contractual Requirements 115 Proven a Partnership 2.10.17 Substitution of Personnel The contractor agrees and understands that the State of Missouri?s agreement to the contract is predicated in part . on the utilization of the speci?c key individualls) and personnel quali?cations identi?ed in the proposal. Therefore, a! the contractor agrees that no substitution of such speci?c key individualis) and personnel quali?cations shall be 3' made without the prior written approval of the state agency. The contractor further agrees that any substitution l: made pursuant to this paragraph must be equal or better than originally proposed and that the state agency's approval of a substitution shall not be construed as an acceptance of the substitution's performance potential. The Svtategfjl?i?ssouriwagreesthat an approval of a substitution will not be unreasonably withheld. I, Substitution of Personnel Corizon has reviewed and will comply with the performance standards as written in this requirement. As our proposal illustrates, the Corizon Management team currently serving the MDOC contract is one with many years of dedicated MDOC service to their credit. Unlike our competitors, we can assure the MDOC that each member of our proposed key personnel knows the rigorous demands that will be required of his Or her position. We do not anticipate changes in our key staff as Group Vice President Ralf Salke has ?shaped? a team for the MDOC program that is dedicated to seeing each ofour 2014 program goals to completion. However, should unforeseen changes in key personnel occur, we understand that the State of Missouri's agreement with Corizon is predicated in part on the utilization of the specific individualls) and/or personnel quali?cations identified in our proposal. We agree that no substitution of such speci?c individuaifs) and/or persona of quali?cations will be made without the prior written approval of the state agency. . Further, we agree that any substitution made pursuant to this paragraph must be equal or better than originally proposed and that the state agency's approval of a substitution will not be construed as an acceptance of the substitution's performance potential. 2-1948 livestrisjcign of Employment i The contractor shall not bind any of the contractor?s personnel, including regional of?ce personnel, to an i agreement which would inhibit, impede, prohibit, restrain, or in any manner restrict the contractor's personnel in I or from accepting employment with any subsequent health care provider or mental health care provider for the $9339! wisest-1'39 Shallnot applv toes Corizon has reviewed and will comply with the performance standards as written in this requirement. We will not bind any member of our MDOCiCorizon staff to an agreement that would inhibit, impede, prohibit, restrain, or in any manner restrict their ability to accept employment with any subsequent medical andior mental healthcare provider for the State of Missouri. This includes site and regional office staff. Contractual Requirements - 116 a PartnershiP 2.10.19 Prorpgtion of Health Care Careers The contractor may partner with the state agency at statewide job fairs or other events to promote correctional 1 health care careers. Corizon has reviewed and will comply with the performance standards as written in this requirement. We will continue to partner with the MDOC at statewide job fairs or other events to promote correctional healthcare careers. Corizon actively participates in conferences to facilitate recruitment efforts through the following: Missouri Nurses Association (MONA) - Missouri State Association of Licensed Practical Nurses (MOSALPN) - Missouri Student Nurses Association (MOSNA) 0 Missouri Association of Osteopathic Physicians (MAOPS) - American Dental Association (ADA) - American Association (APA) . National Commission on Correctional Health Care - American Correctional Association (ACA) a Career MD . Kansas City Southeast Clinical Society . M0 Society of the American College of Osteopathic Family Physicians 2.10.20 Introduction of Contractor Personnel i?W?W?m?m . . i For the positions of full-time physicians, dentists, nurse practitioners, and managerial personnel, the cantractor must introduce potential personnel to the correctional facility's warden. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon?s Group Vice President Ralf Salke and Regional Medical Director Thomas Bredeman take a leadership role in ensuring that all full?time physicians, dentists, nurse practitioners, and managerial personnel are introduced to the applicable facility?s warden. i The contractor shall maintain, and operate in accordance with, written personnel policies that shall be available to 3 all personnel and accessible to the personnel at each of the personnei?s work sites. a. The written personnel policies should contain standards for all personnel. b. The written personnel policies should address issues such as hiring practices for diverse personnel, 1 retention, recruitment, promotions, grievance procedures, staff development, training, performance appraisals, i bene?ts, disciplinary procedures and terminations. c. The contractor?s written policies shall de?ne ethical and professional relationships that shall be 1 maintained between the contractor?s personnel and offenders. Contractual Requirements - 117 I d. The contractor and the contractor?s personnel agree to comply with the state agency's guidelines, policy agency as deemed necessary. Copies of state agency policies and procedures will be made available to the on sexual misconduct and harassment, and conduct of the personnel, incorporating such into the contractor's written policies. The contractor further understands and agrees that investigations will be conducted by the state contractor upon issuance of the Notice of Award. The contractor shall understand and agree that the contractor's personnel shall abide by the state agency?s policy and procedures. 1] Contractor's personnel shall not display favoritism or preferential treatment for individual offenders or groups of offenders. 2) Contractor?s personnel shall not engage in any personal or business relationship with any offender under the state agency?s jurisdiction or with an offender that has been a program participant within the last two years, or the offender's family. 3) Contractor?s personnel shall not use their of?cial positions to secure or receive advantages, gifts, money, or favors from offenders, their families, or associates. 4) Contractor's personnel shall value the human worth and dignity of all offenders by respecting the I individual, recognizing diversity and treating all offenders fairly. 5) Contractor?s personnel shall not abuse offenders verbally or physically. 6] Contractor?s personnel shall recognize the offender? 5 right to privacy and adhere to con?dentiality rules. I If) Contractor?s personnel shall report any attempt to violate these guidelines immediately to the I Corizon has reviewed and will comply with the performance standards as written in this requirement. Policy Standards As noted throughout this document, Corizon has worked closely with the MDOC since the onset ofour contract to ensure that our policies and procedures are in compliance with MDOC policies and procedures; MDOC policies and procedures always take precedent over Corizon?s policies and procedures. Our Regional Director of Nursing, Tara Taylor, has among her responsibilities, ensuring that all new MDOC policies and procedures are distributed to each Corizon site and implemented. The Corizon policies and procedures that govern our current program are fully compliant with all MDOC policies and procedures, ACA, and Federal and local standards. Our policy and procedure manual is provided to the MDOC for review and authorization upon request. Our healthcare professionals that support the MDOC contract use this manual in a number of ways, including the following: . Comprehensive staff training and orientation . individualized treatment planning Utilization management activities Contractual Requirements - 118 if? 3} Proven Inter-disciplinary coordination among our mental health team A ?3 Partnership Found below are some of the points addressed in our policies and procedures manual: 0 It is important to note that if awarded the mental health component of the contract, we will immediately begin revising the current policy and Continuous quality improvement Dental services Dialysis Emergency care manual Equipment and supply inventory control manual Health education program lnfirmary care manual Medical records management Palliative care Pharmaceuticals Radiology Risk management and mortality review Peer review i Employer of Choice What Our Team ls Saying .. ?The ?eld of healthcare changes continu0usly. Corizon updates the protocols, policies and procedures to keep up with the latest discoveries and best practices?. -lulia Cox BSNIRNIDON, MTC Employee since 2010 procedure manual to encompass the mental health component of the contract. Development of New Policies and Procedures We will continue to work with the MDOC to ensure the healthcare program at MDOC is fully supported by MDOC approved policies and will assist the MDOC in the development of new policies, procedures, and protocols for the health care unit, dental, and medical staff, in concert with the MDOC. Our Regional Director of Nursing, Tara Taylor, typically same: as a direct liaison to MDDC and will continue to take responsibility for ensuring that all policies and procedures are implemented fully across the state. Hiring Practices Corizon?s current personnel policies, provided to our employees in a manual titled "Corizon?s Employee Success Guide? address issues such as hiring practices for diverse personnel, retention, recruitment, promotions, grievance procedures, staff development, training, performance appraisals, bene?ts, disciplinary procedures and terminations. We have provided a ?le copy of this important employee tool with each hard copy of our proposal. Contractual Requirements - 119 Partnership Ethical and Professional Relationships Corizon has policies and procedures in place that govern and define the ethical and professional relationships that must be maintained between Corizon?s personnel and MDOC offenders. Sexual Misconduct and Harassment Corizon understands that our personnel must agree to comply with the state agency?s guidelines, policy on sexual misconduct and harassment, and conduct of personnel; these guidelines have been incorporated into our current policies and procedures. In addition, we understand and agree that investigations will be conducted by the state agency as deemed necessary and that copies of state agency policies and procedures will be made available to Corizon upon issuance of the Notice of Award. Corizon understands and agrees that our personnel will abide by the state agency?s policy and procedures. Favoritism Corizon?s personnel will not diSpIay favoritism or preferential treatment for individual offenders or groups of offenders. Personal or Business Relationships Corizon?s personnel will not engage in any personal or business relationship with any offender under the state agency?s jurisdiction or with an offender that has been a program participant within the last two (2) years, or the offender?s family. Gifts Corizon?s personnel will not use their of?cial positions to secure or receive advantages, gifts, money, or favors from offenders, their families, or associates. Fair Treatment COrizon?s approach to working with the MDOC to continually improve upon the healthcare we provide is a true testament to Corizon?s belief that each offender patient has value and should, at all times, be treated with the utmost dignity. The Corizon healthcare team provides essential medical, dental, and, if awarded the mental health component of the contract, will provide mental health services in a manner consistent with accepted community standards for the correctional environment. For MDOC offenders with chronic 0r acute medical conditions, Corizon has a sophisticated system of chronic care clinics to Contractual Requirements 120 r- ?i Proven A @Partnership ensure the availability of advanced care for chronic conditions such as cardiovascular disease, diabetes, and hypertension. Health promotion is emphasized through offender health education during offender encounters, education about the effects of medications, infectious disease prevention and education. Corizon?s dedication to ensuring fair treatment and quality care for MDOC offenders includes an emphasis on heart-healthy diets, nutrition education, and dietary counseling in conjunction with MDOC dietary staff. Verbal and Physical Abuse Corizon's personnel will not abuse offenders verbally or physically. Right to Privacy Corizon?s personnel will recognize the offender?s right to privacy and adhere to con?dentiality rules. Our personnel will immediately report any attempt to violate any of the guidelines as referenced in RFP 2.10.21 to facility director who will in turn report to the state agency. 2.10.22 Written Job Descriptions a The contractor shail maintain written job descriptions for all personnel. The job descriptions shall include jobji titles, minimum quali?cations, responsibilities and duties, as well as titles of the immediate supervisor. The employee's job description shall be located in the personnel file. Corizon has reviewed and will comply with the performance standards as written in this requirement. We will monitor the performance of each of our MDOC healthcare staff members in accordance with the appropriate job description. Detailed job descriptions are provided to each new Corizon emplciyee during their orientation period; a signed and dated employee verification of theirjob description will be placed in the individual?s personnel file. Each Corizon job description will encompass the following to ensure there is no uncertainty regarding our expectations for each role. a Minimum qualifications - Essential responsibilities and duties - Job speci?cations education requirements, other skills required) a Physical demands, work environment a Job summary or purpose a Title of the immediate supervisor - Signature and date section for the employee and supervisor - Physical demands statement Contractual Requirements - 121 git-3. Proven am @Partnership it is important to note that we have provided a job description for every position included on our staffing plan following Exhibit of the RFP. 2.10.23 Personnelfi?l?e The contracmr Shall maintain a personnel ?le for each of the contractor? personnel. The personnel ?le shall be i accessible to the state agenCy or its representatives for the purpose of verifying compliance with the contractual requirements. The ?le must include criminai record checks completed by the state agency, background investigations, resumes, transcripts, dates of employment, training records, performance appraisals, commendations. disciplipfm actions and other related actions. Corizon has reviewed and Will comply with the performance standards as written in this requirement. We will, as is current practice, maintain a personnel file for each member ofour staff. The personnel ?le will be accessible to the state agency or its representatives for the purpose of verifying compliance with the contractual requirements. Each file includes criminal record checks completed by the state agency, background investigations, resumes, transcripts, dates of employment, training records, performance appraisals, commendations, disciplinary actions and other related actions. 2.11 General Reporting and Records Requirements 2.11.1 Medical an?l__MentaI Health Records [Biomedical recogsgrigngental health care records areLa't?allti?mesLthemproperty of the state agency. Corizon has reviewed and will comply with the performance standards as written in this requirement. We agree that medical records and mental health care records are, at all times, the property of the state agency. . 3 The contractor shall ensure Eu health care and mental health-care, as applicable, provided is documented? appropriate? and timely in the state agency's electronic medical record system. a. The contractor shall maintain progress notesffile for each offender receiving the contractor?s services. I The Progress notes/?le Shall contain appropriate speci?c information regarding the offender's progress to assist in the development of the treatment planning and assessment report; i Medical and Mental Health Record Oversight Corizon has reviewed and will comply with the performance standards as written in this requirement. CoriZOn wil ensure that all healthcare and mental health care, as applicable, provided is documented appropriately and timely in the state agency's electronic medical record system. We will maintian a medical record for all offenders who enter into MDOC custody for the first time, maintain medical records for all MDOC offenders with existing records, and will do so for the contract term. Our healthcare staff will ensure that this medical ?le is thorough and includes all information regarding medical, dental and mental health services, as applicable, as a result of the intake screening process, or for services rendered following assignment to a housing area. We will maintain progress notes/file for each offender receiving Corizon?s services. The progress notes/file will contain appropriate speci?c Contractual Requirements - 122 Proven aPartnership information regarding the offender?s progress to assist in the deveIOpment of the treatment planning and assessment report. Corizon?s healthcare staff at MDOC will ensure that we enter all offender encounters into the EMR to include medical, mental health, aftercare counseling services, and dental procedures. The Corizon healthcare staff will keep medical records up to date at all times. ?2.9,,5124, {oatng 2.11.3 Input of Treatment Information ?i Unless otherwise mutually agreed upon between the contractor and the state agency, the contractor shall inpugr treatment information into the state agency's electronic medical record system to document the provision and *5 Performance of services. The state agency, in its own best interest, may revise or replace the state agency?s electronic medical record system as deemed appropriate. However, the duties of the contractorshall not be changed because of any revision or replacement. Accordingly, the state agency shall be responsible for the maintenance of all software, equipment, and lines associated with the state agency's electronic medical record system except as may be otherwise amended or stipulated by the state agency. a. For informational purposes, the current state agency's electronic medical record system does not have 5 the capability to interface with other automated systems providing healthcare services. The MARS system can . generate approximately seven hundred thirty (730) reports but custom reports cannot be run from MARS. i However, the contractor may write queries that pull data from MARS and OPII [the state agency?s computer i operating system). MARS does accept data ?les such as entering laboratory and x-ray results or pharmacy information. A new electronic medical record system is in the development stage. b. The state agency will grant off~site providers (such as telehealth providers] remote access to the state 1' agency? 5 electronic health record system on a case-by-case basis. The decision of the state agency on whether to grant remote access shall be ?nal. Corizon has reviewed and will comply with the performance standards as written in this requirement. We agree to input all medical information in regards to any patient care or treatment into the state agency?s electronic medical records system. In the instance of a new electronic medical record or revision of the current medical record, Corizon will continue to enter all patient care or treatment information as deemed appropriate by the state agency. Corizon will continue to provide two regional level to Support the current electronic medical record and will support any revision or replacement: of the current electronic medical record. In the instance of a revision or implementation of a new medical record, Corizon will do everything within its ability to ensure a smooth uninterrupted transition of the record. Corizon will utilize the equipment, software, and lines associated with the electronic medical record as provided by the state agency. Corizon understands any restriction or abilities of the current MARS medical record system and agrees to work within any constraints associated with generating reports or uploading data ?les into the current system. Corizon understands granting offsite providers (such as telehealth providers) remote access to the state agency?s medical record system will be at the discretion of the state agency. Contractual Requirements - 123 Proven Partnership 2.11.4 Offender Health Record The contraCtOr shall maintain physical possession, of all state agency offender health records as well as offender I ll health records prepared by the contractor. The contractor may maintain paper copies of the health records, but I must maintain electronic health records. Under the direction of the state agency, these health records shall be included in the state agency designated health record exchange. Upon expiration, termination, or cancellation of the contract, the contractor shall inventory and return all offender health records created or maintained, or both, under the contract to the state agency in an electronic format or paper copy, whichever is speci?ed by the state agency. i a. The contractor shall participate in the electronic health record exchange as directed by the state agency. The contractor shall be responsible for all necessary user fees to participate in the electronic health record exchange. b. The contractor shall obtain copies of all health records of outside specialist consults, diagnostics, and treatments for immediate placement in the offender's health record. The contractor shall attempt to obtain ll health records for health care services provided to an offender prior to the offender's incarceration if such records i are relevant to the ongoing care of the offender. If the contractor has dif?culty obtaining such records, the II contractor may request the state agency?s assistance. When practicable, the contractor shall obtain the health records in an electronic format. l, c. At the time of discharge from a hospital, the contractor shall obtain a copy of those portions of the . inpatient health records which are essential to appropriate continuity of care for immediate placement in the offender?s health record. When practicable, the contractor shall obtain the health records in an electronic format. I: d. The contractor shall not deny the state agency access to any health treatment records including for reasons of examination and copying. Requests to the contractor for health records shall be made by the state 5 agency's Assistant Director of Health Services, the state agency's Assistant Director of Mental Health Services or by counsel for the state agency. The contractor must respond to such legitimate requests for health records in a reasonable time period as determined by the state agency. e. The contractor shall direct all requests for copies of health records for the purposes of defending lawsuits I. ?led against state agency employees and of?cers to the state agency designee inclusive of the offender's full name, register number and the time span for records requested. A state agency designee shall provide the Missouri Attorney General's of?ce with the appropriate copies of health treatment records pursuant to these speci?c types of requests. f. All requests for health records for incarcerated individuals will be referred to the contractor for appropriate handling. For those individuals released from incarceration, requests for health records will be handled by the state agency. -W . Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will maintain physical possession of all offender health records as well as offender health records prepared by Curizon. We understand that we may maintain paper copies of the health records, but must maintain electronic health records. Corizon?s healthcare staff will continue to input all treatment information into the MARS system. Using this system, our staff will continue to ensure that all offender healthcare encounters are documented both accurately and in a timely manner. As part the CQI Program we currently have in place at MDOC, appropriate Corizon personnel perform medical record audits at each MDOC facility to ensure completeness of these ?les. Each onsite Medical Director and Health Services Administrator, as well as our medical records staff, are responsible for ensuring the accuracy and completeness of information found in the medical record. Contractual Requirements - 124 P?l Proven 6 Partnership The Corizon healthcare staff has been utilizing the MARS system since 1992. Many of our long-time employees currently utilize the system at the expert level and are capable of extracting Speci?c information from MARS. These types of data extractions require the end user to thoroughly understand the data relationships within the MARS system. This level of expertise on behalf of the Corizon staff has been utilized to provide information for the HEDIS studies, accreditation, and numerous special requests from the MDoc, Working and MDOC have ensured that our collective staffs are trained to effectively utilize the MARS System. Corizon considers the accurate documentation of each offender encounter integral to the success of our program. Each new Corizon employee works with an experienced user when inputting data into the MARS until the new user?s expertise level allows him or her to work independently. Health Record Exchange Under the direction of the state agency, all health records will be included in the state agency designated health record exchange. Upon expiration/termination of the contract, Corizon will inventory and return all offender health records created or maintained, or both, under the contract to the state agency in an electronic format or paper copy, whichever is speci?ed by the state agency. Corizon will be responSible for ail necessary user fees to participate in the electronic health record exchange. Maintenance of Records/Outside Consults Corizon will obtain copies of all health records of outside specialist consults, diagnostics, and treatments for immediate placement in the offender's health record. We will attempt to obtain health records for health care services provided to an offender prior to the offender's incarceration if such records are relevant to the ongoing care of the offender. In addition, at the time of discharge from a hospital, Corizon will obtain a copy of those portions of the inpatient health records which are essential to appropriate continuity of care for immediate placement in the offender?s health record. When possible, we will obtain the health records in an electronic format. Corizon will not deny the state agency access to any health treatment records including for reasons of examination and copying. Requests to Corizon for access to offender health records will be made by the state agency?s Assistant Director of Health Services, the state agency?s Assistant Director of Mental Health Services or by Counsel for the state agency. As is current practice, we will respond to such requests for health records in a reasonable time period as determined by the state agency. We will direct all requests for copies of health records for the purposes of defending lawsuits ?led against state agency employees and officers to the state agency designee inclusive of the offender's full name, register number and the time span for records requested. Contractual Requirements - 125 Proven A anrtnership All requests for health records for incarcerated individuals will be referred to Corizon for appropriate handling. We understand that for individuals released from incarceration, requests for health records will be handled by the state agency. During the term of the contract and for a reasonable period of time after expiration, termination, or cancellation of i the contract as determined by the state agency, the contractor shall have access to all records and reports related to the contractor's performance of services. The contractor shall have the right to make and retain copies of any such records or reparts as the contractor deems necessary for the performance of its contractual duties, and for i the investigation or defense of any actions or incidents related to the contractor?s performance. i . . Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that during the term of the contract and for a reasonable period of time after expiration, termination, or cancellation of the contract as determined by the state agency, Corizon will have access to all records and reports related to our performance of services. Corizon will have the right to make and retain copies of any such records or reports as we deem necessary for the performance of our contractual duties, and for the investigation or defense ofany actions or incidents related to the contractor's performance. . . Except in cases of the contractor's compliance with court order or applicable law, the contractor shall not makei i any reports or treatment records, nor utilize information, data, or other information given to, prepared by or assembled by the contractor which the state agency requests to be kept con?dential, to any individual or 5 Corizon has reviewed and will comply with the perfOrmance standards as written in this requirement. We will not make any reports or treatment records, nor utilize information, data, or other information given to, prepared by or assembled by Corizon, which the state agency requests to be kept confidential, to any individual or organization without the state agency?s prior written approval, except in cases of Corizon?s compliance with court order or applicable law. . i The contractor shall agree and understand that records created or maintained, or both, by the contractor that are not a direct requirement of the contract, and are not subject to disclosure under the terms of {1610.021 (14), nor subject Sunshine . Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand and agree that records created or maintained, or both, by Corizon that are not a direct requirement of the contract, and are not subject to disclosure under the terms of ?610.021 (14), nor protected under the scope of ?217.075, and may be subject to disclosure under the Sunshine Law. Contractual Requirements 126 Proven A ?3 Partnership 2.11.8 Medical and Mental Health Records . 5 The contractor and the contractor personnel shall assist the state agency In enforcing offender rules by reporting 1 all violations to the state agency. Furthermore, the contractor shall not obstruct the state agency or any of its designated of?cials from performing their duties in response to court orders, internal or external investigations, or in the maintenance of a secure and safe correctional environment. Corizon has reviewed and will comply with the performance standards as written in this requirement. Our personnel will assist the state agency in enforcing offender rules by reporting all violations to the state agency. Corizon understands and will not obstruct the state agency or any of its designated officials from performing their duties in response to court orders, internal or external investigations, or in the maintenance of a secure and safe correctional environment. 2.11.9 Reporting I j! The contractor shall provide, but shall not necessarily be limited to, the reports listed below. The state agency i shall determine the acceptability of all reports submitted based upon timeliness, format and content. If reports are not deemed to be acceptable or have not been submitted, the state agency shall provide written notice of such to the contractor. a. Reporting - Unless otherwise speci?ed herein or required by the state agency, the contractor l' shall submit the reports by no later than the tenth (10th) day of each month to the Contractor Monitor Of?ce located at 2715 Plaza Drive, Jefferson City, Missouri, 65109. 1) Chronic Care Report -- The contractor must provide a chronic care report that shall provide data by modality and correctional facility. A sample report is included as Attachment 35. . 2) Contracted Provider Listing Report - The contractor shall provide a contracted provider listing report that must include vendorfprovider's name, address, telephone number, primary contact person, and the description of services provided. See Attachment 36 for the mental health care listing and Attachment 75 for the medical care listing. 3) Pharmacy Report The contractor shall submit a report of medication use for the month to the Pharmacy and Therapeutics Committee. A sample report is provided in Attachment 4) Position Controi Report - The contractor must provide a position control report, formatted to the mutual satisfaction of the contractor and the state agency, which shall include the correctional facility name, person's full name, license number, and professional registry [as may be required] inclusive of expiration dates, job title, total hours worked during the month and FTE conversion. This report must also indicate and clarify all transfers, open and vacant positions, and terminations or resignations. The report should be submitted in a Microsoft Excel or compatible format, as otherwise appended. A sample report is included as Attachment 38 for medical care services and Attachment 39 for mental health care services. 5) Utilization Report - The contractor must provide a utilization report that shall include reievant correctional facility information and essential demographic data mutually agreed upon by the contractor and the state agency. A sample report for on-site clinics and service statistics is included as Attachment 40 - Listing of On- Site Clinics and Service Statistics. A sample report for medical care services is included as Attachment 41 and a i sampie report for mental health care services is included as Attachment 42. of July 1 through June 30 that shall include a summary of milestones, accomplishments, planned corrective actions, and customer satisfaction survey. The contractor shall submit the report to the state agency's Assistant Director of b. Annual Reporting - By no later than August 30, the contractor shall submit an annual report for the period Health Services and the state agency?s Assistant Director of Mental Health Services. Sample annual report I Contractuai Requirements - 127 A @Partnership Proven summaries are included as Attachment 43 for the medical report in FY12 and Attachment 44 for the mental health ,5 report for calendar year 2011 Annual Report Summary. . Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon has been accountable for the success of our MDOC contract from day one; we have, and will continue to provide MDOC with numerous mechanisms designed to allow the State to monitor the efficacy of our ongoing program. Accountability to MDOC is paramount and it is with this conviction that Corizon has developed and implemented the following program evaluation/accountability tools. These reporting tools are addressed below and throughout our proposal. Corizon Program Outcome Reporting for MDOC Corizon Reporting How it Makies our Program TranSparent to MDOC Mechanism i Timelteeplng System [Kronos') Our time keeping solution, (Kronos'), is designed to proactively address the unique challenges of our clients in the areas of labor management. Kronos helps Corizon?s site management teams effectively oversee assigned facilities by ensuring contract needs are met, while at the same time controlling costs. lnGaugeT" Corizon has deveIOped a business intelligence application, lnGauge" to support us in our efforts to aggregate disparate data sources, and quickly and accurately identify trends within our offender populations. This evidence-based process puts Corizon at the forefront in our ability to accurately assess and . report on healthcare delivery utilization, acuity levels, and pharmacy utilization for MDOC. Corizon Client Portal Corizon has a web-based collaboration tool, using Microsoft ShorePor?nt, in place in support of our MDOC contract. This system allows the sharing of informationlcontent, contact storage, calendaring of events and internal/external links. Human Resource and Labor Management Reporting . Corizon?s Proven Labor Corizon manages state?of-the?art PeopleSoft Human Capital Management Management Tools (HCM) and KronosED Workforce Central systems. Our integrated systems help Carlton?s management team at each MDOC facility to effectively oversee assigned facilities by ensuring contract needs are met, while at the some time minimizing overtime pay, special pay and agency usage. PeopleSOft HCM Hornet? Resources Using these systems to manage HR, Payroll, Benefits, and Labor 3959.55 Management processes in an integrated manner, Corizon: 31::ng - Highlights critical staffing and recruiting needs peepiesco - Ensures timely and accurate payroll processing Krona? Workforce Central - Reduces overtime hours and ?special pay? near-rims Clocks - Reduces the need for agency usage ?hpawer Contractual Requirements - 128 Proven Partnership . Enhances management of benefits including paid time off for eligible personnel . Improves analysis of wages to determine competitiveness with the local market This labor management tool is addressed in detail in the section of this proposal titled ?Human Copitoi Management (HCM) and Kronos' Workforce Central Systems?. Corizon?s Business Intelligence Application - lnGauge'" Corizon?s business intelligence application, InGauge??, is currently utilized to support our MDOC contract, and supports us in our efforts to aggregate disparate data sources, and quickly and accurately identify trends within the MDOC population. This application covers subject areas such as patient information, clinical management, medical claims, pharmacy orders, and labor and staffing statistics. lnGaugeTM provides reports detailing contract performance comparisons, labor management analysis, offsite medical trends, and pharmacy trends. In 2010, Corizon added new analytic components to lnGaugeTM which now incorporate chronic condition identi?cation and strati?cation, benchmarking, lab results, electronic medical records, and predictive modeling. Subject Areas The lnGauge data warehouse integrates information across the following key areas: a Patient information, including age, gender, eligibility and location - Clinical management, such as inpatient authorizations and outpatient referrals - Medical claims, including provider, patient, diagnosis and procedure level detail - Labor and staffing statistics, including clinical and administrative positions Business Intelligence This toolset provides us with a variety of options for data mining and reporting: - A high-performance desktop reporting and analysis application . An internet-based access center with dashboard and report hosting - User friend iy interfaces that facilitate a self service environment for accessing data . A robust security model to protect sensitive and confidential information - Scheduling and e?mail noti?cation for automated deployment of time-sensitive reports Contractual Requirements - 129 Proven A ?Partnership Standard Reporting Capabilities of Corizon?s lnGauge System In addition to the tools described above, lnGauge delivers a suite of standard reports that focus on the key drivers of healthcare utilization and cost. Many of these reports allow the user to alter a variety of parameters through simple menus and drag-and-drop features: - Contract performance comparisons Inpatient days/1000 and average length of stay Emergency department utilization Offsite referrals by Specialty Radiology by site of service and category (CT, MRI, X?ray) Lab testing . Labor management analysis Heurs worked and salaries by position, shift and pay category (regular, 0T, temp agency) v" Budgeted labor schedules for real-time evaluation of performance Turnover statistics by position and tenure - Offsite medical trend analysis claims and referral trends and year-over-year comparisons Tabular and graphical views Trends by service category (inpatient, ambulatory surgery, physician?s office, etc.) Hospital/Physician utilization and rate comparisons Trends by diagnostic category Compare lnGaugem with Centurion?s Centelligence?" Corizon?s lnGauge data mining and business intelligence system was developed by correctional healthca re experts solely for use in the correctional healthcare environment. InGauge is tested in corrections and has, over the last four years, been continually updated to reflect the needs vocalized by our DOC clients. in comparison, Centurion?s Centelligence?? Foresight business intelligence offering was developed for use in the "free?world?. The reader may note when in review of Centurion's proposal that they provide outcome data (chronic care, emergency department utilization etc.) based solely on non-correctional patient populations and that they state Centelligence?" maysupport correctional healthcare in several areas; this lack of commitment stems from the fact that they have no correctional healthcare experience and as such their system has never been tested in the correctional environment. The following screen shots highlight a sampling of the reports Corizon currently provides to the MDOC through our InGauge System. Contractual Requirements 130 Proven What?s available in lnGaugeTM? 3 -. a a1 rI?Ir ?r 23W 0. 1' an nu! 012': u: A 624% 0. Mm" vacuum -- Lean; awn ?and xur-?-u 6c? Lou?an Q. men I meow 1 . 04:5; . -.-- o' :(mtau rv-?edmm? ?fun-hay i 'abar e?d-n! sum-urea 620?de Q. ?Quantum?! Yr? :0 111mewn: Yr): Fun Yrs:- ?aw cyan-2n" 1x1? Jim-f ?var: {a Providing am wa?mn mmw': ma m-J Q-Uai'w and Reporting 5M . P?va Hi: new o?qw t? YOJF a 1? ouyrs'J-t- .camna 3W - in?, up- (-T mil)? 9mm? mm?! m? Decision Making Needs may snort: i on Lita! 9' 3H 2! 139.949 919320! I TSTWAH Mutilation-U A - a Ten n3 Unsung-v gm ?w G. 9mm 0-994 41% 5cm I 99/3 m? camzomr Contractual Requirements - 131 123% 100% 38% 50% 43% 20% 0% Nursing Fill Rale 1913?. 3923; .Cmum lust-1r: Imam .7199: 1mm: Lamb Yurtn?m Reglon A Region 8 995m: Region Region Reei onF Region Rey-3n Raglan I Regl on Rea-3n Region Eagle-n Paqelofl I 6 1 95% 952 ?061 106?; 9? HF: 1331 l: v. V: as: 95: I 97: will :00: was as: mm 95: mo: may Inn :05: 93: we: :03: mm: we: we: :00: max an: was 320: 991 sol: mo: lOiI 9a: 96: 97: 102: mm mm: LI Contractual Requirements - 132 9 Proven A ?3 Partnership Inpatient Days Region 96 to Target Actualvs. Target Actual Targe! mm 9996? ns Regions 112%_ 82 2'3 Region: 146%* 102 neg-one m? I a: 91 RegionE em? 122 136 wear 113%_ 151 126 ??50116 m? 132 I23 Rem-M I I66 205 new: Baas?I . 136 . Rea-w m? a? 63 WM 1365? ms 93 neaanL :56 #35 Contractual Requirements - 133 - A a Partnership Tu rn over Data 800% 600% 400% 200% 50005; 40.00% 3000?. 20360 1541: some: 5 35". F001- Tumover- Most Recent 18 Monms ~16. 121'. I 405511; 5121'; 5'35" a ., {1'4 450?. CleatSehctm 37m; 0? l, 2.85.. 236w mum 18?: cum am. 9.92:; 0.96:. 0962-; I I .0003bah-Idiom Mung Turnover Most Recent3 Years an Gunmen Contractual Requirements - 134 {12:3 Proven aPaI-tnership 24-Hour Client Reporting Website As part of our efforts to ensure accountability and share information with MDOC, Corizon has a client reporting portal in place for our MDOC contract to facilitate additional transparency and accountability to the MDOC. This web-based system is ., mm- developed using Microsoft ef?ng?! which ?5 a collaboration tool that provides the sharing of information} ?mme content, contact storage, m- calendaring of events and internal] external links. a Our portal for MDOC has been customized to allow for advanced functionality such as discussion groups, task assignment/ management, and other features that enhance the communications between Corizon and MDOC. Information provided through this secure electronic portal helps to keep MDOC informed of all components of our operation, and further facilitates constant communication between MDOC administration and Corizon. This reporting portal is in the process of being enhanced and in the coming months will provide access to inpatient data, telehealth data, grievance data and health services reporting. Ania-a I '3 Elm-m WWIWM - "Mm. n? mos-:3 - Departments Contractual Requirements - 135 Proven A ?apartnership Corizon?s Current Reporting Infrastructure for MDOC Corizon has been accountable for the success of our MDOC program from day one of the contract; we . have made every attempt to provide the MDOC with numerous reports designed to allow the State to monitor the ef?cacy of our ongoing progmm. Accountability to MDOC is paramount and it is with this conviction that we ensure full reporting accountability through the following weekly, and annual reports. Corimn Accountability to MDOC Reportingscirduie Posrtion Control Report [Jpen Positions Report Health Services Report Pie?Entry Report lh'heelohair Report Pregnancy Report Hepatitis Statistics Hl'u' Statistics Either Inlectious Disease Statistics TB Statistics Medical Parole Pharmacy Fleport Chronic Care - Offender Count Chronic Care Ely Site Chronic Care By Site By Clinic Chronic Care - Offender Detail Chronic Care [leer-Clue . MD Formulary Medication Audits Physical Exam Audit I Physical Er-rams Past Due Contraoted Provider Listing Annual Report I Client Report Staffing Level-s Hours Provided by Site Annualized Tusnouer by Site Medical Encounters Hunger Strikes Tole-medicine Encounters Specialty Encounters Pregnancies Community Hospital Statistics Emergency Treatment Statistics lriiuries Related to Altereations Hepatitis Mortalrttes Grievance Statistics ?udits and Inspections Client Expectations Updates Contract Compliance Quarterly Audit Infirmary Census [as Requested] Contractual Requirements 13E- 5 Procedure Manuals as such currently exist and as may be amended. a Management to re?ect the contract changes and changes to the contractor's compensation. The State of Missouri correctional facility or fail to ?le for renewal of any current or existing correctional facility accredited, the . state agency shall deduct from current obligations due the contractor an amount not to exceed the cost of I @Partnership Proven 2.12 General Quality Standards and Quality Review Requirements 4.50 is out I 001.) '2 o?i/ao 4'0 2.12.1 Services and Performance of Personnel The contractor shall provide services in accordance with standards and prevailing professional practice. i The performance of the contractor's personnel and administration must meet or exceed standards established by the as the standards currently exist and as may be amended. in addition, the contractor shall comply with all established policies of the state agency outlined in the Department and Institutional Services Policy and a. Prevailing practice shall be based on current practice as of the date of the state agency?s authorization to proceed with services. If the State of Missouri determines that a dramatic or unforeseeable material change to a current prevailing practice, or both, would result in a sustained increase in service costs to the contractor, a contract amendment shall be processed by the Of?ce of Administration, Division of Purchasing and Materials shall take into consideration any changes identi?ed by the contractor. The contractor should also document the reasons why a change to a current prevailing practice would result in a sustained increase in service costs to the contractor. - Standards and Prevailing Professional Practice Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon, as described throughout this proposal, will provide services in accordance with standards and prevailing professional practice. We will comply with all established policies of the state agency outlined in the Department and Institutional Services Policy and Procedure Manuals as such currently exist and as may be amended. Prevailing Practice We understand that prevailing practice will be based on current practice as of the date of the state agency?s authorization to proceed with services. We are cognizant that if the State of Missouri determines that a dramatic or unforeseeable material change to a current prevailing practice, or both, would result in a sustained increase in service costs to the contractor, a contract amendment will be processed by the Of?ce of Administration, Division of Purchasing and Materials Management to reflect the contract changes and changes to the contractor?s compensation. The State of Missouri will take into consideration any changes identified by Corizon. Corizon will document the reasons why a change to a current prevailing practice would result in a sustained increase in service costs to the contractor. 2.12.2 Accreditation a. The contractor shall schedule and coordinate accreditation. Themstate agency shall fully cooperate in preparing for the accreditation audits at such facilities as the contractor may schedule. 1] During the life of the contract, should the contractor fail to file for accreditation at a particular application fees and base fees inclusive of all auditing and accreditation fees in each instance. Contractual Requirements - 137 agency. ic. I b. accreditation audits of the correctional facilities. All such documentation shall become the property of the state Proven A a Partnership 2) The state agency, in its own best interest, may elect to not seek accreditation at any correctional facilin covered under the contract. 3) The contractor shall be responsible for all accreditation fees inclusive of related application maintenance, audit and continuance teas. The contractor shall maintain and keep updated such documentation as may be necessary for The correctional facilities currently accredited by the and the scheduled dates for reaccreditation surveys are provided on Attachment 45 - Accreditation Schedule. d. in the event the state agency is denied accreditation or renewal of the current accreditation due to the contractor's fault, the contractor shall assume ?nancial responsibility for reapplication and all other direct costs associated with requirements in each instance. In the event the state agency is denied accreditation or renewal of the current accreditation because of factors outside the control of the contractor, the state agency shall assume ?nancial i all other direct costs associated with requirements in each instance. Accreditation As addressed in detail in the section of this proposal titled ?Corizon?s Companywide Accreditation Success?, our success working with the MDOC to achieve accreditation for every MDOC facility since the onset of our contract is proven. In further compliance with the RFP, Corizon will schedule and coordinate accreditation in collaboration with the MDOC, DORS, Site Warden, and other vendors? onsite, etc. We understand that all entities will be expected to cooperate fully in preparing for the accreditation audits at each facility. It is important to note that since 1993, Corizon, together with MDOC, has achieved accreditations at all sites that underwent surveys. MDOC and Corizon worked together to achieve the systems ?rst two accreditations at OCC and BCC in 1993. In 2005, Corizon was honored to receive Program of the Year at WMCC. in 2010, Corizon along with MDOC and the mental health vendor continued our accreditation success by being awarded as Facility ofthe Year at TCC. Today, Missouri stands alone as having the most accredited sites in the nation according to President, Edward Harrison. Contractual Requirements - 133 ?3 Partnership Failure to File For Accreditation Corizon understands that during the life of the contract, should we fail to file for accreditation at a particular correctional facility or fail to file for renewal of any current or existing correctionai facility accreditation, the state agency will deduct from current obligations due to Corizon for an amount not to exceed the cost of application fees and base fees inclusive of ail auditing and accreditation fees in each instance. In our 34 years of experience, Corizon has never failed to achieve accreditation by the Corizon understands that we will be responsible for all accreditation fees inclusive of related application maintenance, audit and continuance fees. Corizon assumes this will be the medical contractor?s responsibility in the event that the contract is awarded to separate vendors. Corizon understands that we will be required to Western Missouri Correctional Center is awarded uccnc maintain and keep updated such 1995 ?the documentation as may be necessary for accreditation audits of the correctional facilities. Corizon understands ail such documentation will become the property of the state agency. In the event the state agency is denied accreditation or renewal of the current accreditation due to the fault of Corizon, Corizon will assume ?nancial responsibility for reapplication and all other direct costs associated with requirements in each instance. Corizon understands In the event the state agency is denied accreditation or renewal of the current accreditation because of factors outside the control of Corizon, the state agency will assume financial reSponsibility for reapplication and all other direct costs associated with requirements in each instance. Working and Corizon have attained accreditation in each MDOC facility when sought over the 21 years of our partnership. As of November 2013, 21 MDOC facilities have been accredited by making the State of Missouri #1 in the US. in terms of the number of accredited facilities. Contractual Requirements - 139 Proven a Partnership Corizon?s Role - Involvement with the Corizon has a long lasting relationship with in that several ofour employees serve on the various Boards of several are surveyors and many fulfill presentation 0in conferences by This level of involvement helps Corizon understand the arr-going changes in Standards, surveying and the overall expectations of accreditation through Corizo n's own Ralf Salke, GVP for our Missouri contract, sits on the Board of Trustees for through as well as Past Chair on the Academy of Health Care Professionals. Mr. Salke sits on this board as a board member today and has been Chair, Past Chair, and Treasurer going back to 2003. Other employees from Missouri including Mr. Salke, Tara Taylor, Regional Director of Nursing, and Patricia imbriaco, Regional Director are active surveyors for In addition, Corizon?s healthcare program is administered by several Correctional Healthcare Professionals across the state. Corizon also understands that these auditslaccreditations are more than just a healthcare survey but a facility wide audit reviewing not only healthcare services but environmental standards, housing, space, food, hygiene?a complete audit. Corizon understands this and is willing to be the point on this project by working with and coordinating all the activities from the various departments to ensure ations at the three annual CraRl I Employer of Choice What Our Team ls Saying .. "By following Corizon?s guidelines, and sometimes even being stricter, we are able to provide a foundation for quality healthcare?. "Kim Randolph HSA, PCC Employee since 2000 a a successful audit for the MDOC. 591933193: a . The state agency shall provide monitoring personnel for professional through continuous contract oversight, observation of treatment and assessment of program outcome. Upon request, the contractor shall attend all meetings with state agency monitoring personnel at the state agency in Jefferson City, Missouri. personnel. Corizon has reviewed and will comply with the performance standards as contract management assistance I 1) Currently, the state agency has four (4) medical monitoring personnel and three (3) mental health monitoring i The state agency shall conduct routine monitoring activities to include but not necessarily limited to Laidits, on-site visits, ?le review, and attendance at written in this requirement. We understand that the state agency will provide monitoring personnel for professional contract management assistance through continuous contract oversight, observation of treatment and assessment of program outcome. Upon request, Corizon will attend all meetings with state agency mOnitoring personnel at the state agency offices in Jefferson City, Missou ri. As the long-term partner, we have assisted and participated with the staff since 1992 in this area of monitoring. We know that the ?Monday Morning Meetings? are effectively used as an avenue for sharing issues, concerns and even highlights regarding the system as a whole. Ad hoc meetings are also called upon as needed. Recently, through our telehealth equipment, we have been Contractual Requirements - 140 i noti?cation will be provided to the contractor of the determination of high-risk and of any special conditions or .i The state agency reserves the right to monitor the contract throughout the effective period of the contract to Proven Partnership able to have face-to?face meetings with staff at various facilities throughout Missouri to further deveIOp dialogue with limited travel and expenses. Corizon understands the state agency will conduct routine monitoring activities to include but not necessarin limited to audits, onsite visits, file review, and attendance at routine correctional facility meetings. Corizon has participated with the monitoring staff in the reviews, report of findings, action plans, and follow-ups on a regular basis. We have also participated with DORS monitoring staff in attendance of meetings berating with various departments from the Warden on down and other vendors to ensure patient care is completed appropriately and timely. We have, and will continue to, demonstrate our commitment to w0rking quickly to resolve findings by DORS staff. a Visionary Healthcare Program for 2014-2021 Addition of a Part Time Physician and for Increased Monitoring Corizon understands the need for monitoring healthcare services to ensure the safety of the offender population and to provide credible reviews to the Missouri General Assembly when asked. MDOC and DORS, through its medical and mental health monitoring teams, works with Corizon and the current mental health contractor to ensure these reviews do occur. While most reviews are met with limited or no questions/or concerns, there has been an occasion for DORS to seek further clarifications in the areas of medical and mental health treatment. To help the State of Missouri and MDOC achieve their mission and provide objective and expanded expert reviews, Corizon is proposing the implementation of port time Physician and a part time who would become employees of the State working for sto?i but funded by Comm as part of the new contract. Corizon proposes these positions be no more than 19 hours per week. We would allow the State to reduce our revenues by $247,000 per year, divided by 24 equal deductions or $10,291.57 per payment period. Corizon would welcome medical and collaboration between our two organizations in the interest of objective monitoring and process improvements. Areas of review would include; medication management, infirmary care, special unit review, referrals, and teleheath to name a few. Corizon is excited about assisting the state with this initiative and if the State does not desire this, Corizon is agreeable to reducing our price accordingly without this initiative. 2.12.4 Contract Monitoring ensure ?nancial and contractual compliance. If the state agency determines the contractor to be at high?risk for non-compliance, the state agency shall have the right to impose special conditions or restrictions. Written restrictions to be impoSEd. The special conditions or restrictions may include, but not limited to, those conditions speci?ed below: a. Requiring additional, more detailed ?nancial reports or other documentation; Contractual Requirements - 141 Proven A apartnership l?M" i Requmng the contractor to obtain technical or management assistance; and d. Establishing additionalmprior approvals from the state agency. Corizon has reviewed and will comply with the performance standards as written in this requirement. We acknowledge that the state agency reserves the right to monitor the contract throughout the effective period of the contract to ensure ?nancial and contractual compliance. if the state agency determines Corizon to be at high-risk for non?compliance, the state agency will have the right to impose special conditions or restrictions. Written notification will be provided to Corizon of the determination of high-risk and ofany special conditions or restrictions to be imposed. The special conditions or restrictions may include, but not limited to, those conditions specified below: Requiring additional, more detailed ?nancial reports or other documentation Additional contract monitoring Requiring the contractor to obtain technical or management assistance Establishing additional prior approvals from the state agency esp-s? Corizon has always partnered with the MDOC to quickly resolve issues that the staff may have. We have provided additional staff when needed to ensure the needs of the offender pepulation at MDOC are met. MDOC is fully aware of Corizon?s cooperation and commitment to patient care over the past 21 years and the steps we have taken to assure success for all. 2.1.2.5 Independent Audit i Throughout the duration and term of the contract, and at the contractor's expense, the contractor shall obtain an 2 annual independent compliance and performance audit of the speci?c services provided. The state agency must i approve the independent auditing team as well as the specific indicators to be audited. The contractor shall provide the state agency with all reports concerning any review of services and action plans to address any 3 identified de?ciencies to the state agency Contract Monitoring Of?ce within a timeframe approved by the state 3 Corizon ls Committed To External Evaluation Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon has received commitments, with approval, for outside, independent audits to include The University of Central Missouri, Center for Effective Public Policy including Dr. Kurt Bumby, and former Director of Corrections Gary Kempker to name a few. We have used all of these organizations in the past for reviews in the area of Tobacco Cessation, Sexual Offender Services, and Re-entry Reviews. Corizon will also continue HEDIS reviews at our expense through the University of Central Missouri upon approval. We will not use students in this process but rather associate and full professor status nurses to continue with review and recommendations of data within MDOC. Corizon will also seek additional audits/reviews for other programs or for speci?c case reviews as needed. Corizon will also seek independent laboratory reviews from Tarka Techinicoi Consulting with Bonnie Ta rka. As a former State of Missouri CLIA inspector, Ms. Tarka will review sites with laboratory services to include Troponin to ensure compliance, recommend lab improvements and will provide an annual report to the MDOC regarding compliance on Corizon?s behalf. We acknowledge that throughout the duration and term of the contract, and at our expense, we will obtain an annual independent compliance and performance audit of the Specific services provided. The state agency must approve the independent auditing team as well as the Specific indicators to be Contractual Requirements - 142 audited. Corizon will provide the state agency with all reports concerning any review of services and action plans to address any identi?ed deficiencies to the state agency Contract Monitoring Of?ce within a timeframe approved by the state agency. 2.12.6HUtilization Management Program The contractor shall make determinations of necessity, ef?ciency and appropriateness of services and treatment I plans in accordance with nationally recognized criteria. Such utilization management program must demonstrate, through actual practice, evidence of prospective case review, concurrent case management and retrospective reviews of records. a. The state agency, along with the state agency's monitoring team or a quality review agency, or both, shall randomly select and review cases for medical necessity, appropriateness of care (level of care), length of stay for scheduled hospital admissions, emergency hospital admissions, medical, surgical and other and mental . health care services speci?ed herein. b. The contractor shall identify the clinical criteria utilized to determine necessity for care and treatment criteria, the contractor must identify the components utilized and according to what protocols. The criteria utilized shall be subject to the approval of the statejgency. Corizon will maintain clinical oversight and utilization review services for all inpatient/outpatient hoSpitalization services. Corizon will obtain routine outpatient/inpatient hospitalization services from healthcare providers who meet the health care requirements of the offender. When offsite hospitalization, andf'or specialty hospital services for an offender is required, Corizon will be responsible for the arrangement and timely payment of all hospital care and related health care expenses. Corizon will provide for the facilitation of offsite hospital care for the MDOC. To ensure that the duration of the hospitalization is no longer than medically indicated, Corizon?s Utilization Review Nurse will review the healthcare status of offenders admitted to outside h05pitals daily through our utilization management program as described, in detail, in the section of this preposal titled ?Utilization Management?. Corizon will provide each Health Services Administrator/Designee with a daily health status report of all hospitalized offenders from that facility Monday?Friday. Corizon will provide an on call nurse in the event of a weekend inpatient need. When hospitalization of an offender is required, Corizon will be responsible for the arrangement and timely access to care. Corizon?s inpatient Utilization Nurse will review with the Regional Medical Director every inpatient case daily. Quality Improvement The contractor shall provide a written Continuous Quality Improvement (CQI) program. The Cal program must clearly de?ne and describe how monitoring, anaiysis, evaluation, and improvement of the quality of health care I delivered to offenders are performed. The written description must provide recognition of pro-de?ned processes which measure the effectiveness and appropriateness of care, identi?cation of problems, and a timeline for [l implementation of quantifiable improvements on a continuous basis. The contractor shall assess quality across the entire spectrum of care required herein. a. The contractor shall appoint a quality improvement professional at each correctional facility who shall oversee the activities of each correctional facility?s CQI Committee composed of individuals representing. at a minimum, medical care services, mental health services, custody, dietary, safety, and education. An Executive C(ll Contractual Requirements - 143 (Milliman and Robertson, InterQual, internally developed or other purchased criteria]. If using a combination of a Partnership Committee shall also be established consisting of representatives from the contractor?s senior health care 3 management personnel and the state agency monitoring team. i I i b. The contractor shall institute a quality improvement program, which shall include, but not necessarily be i limited to: i It 1) Audit and chart reviews; 2} Policy and procedure compliance; i 3) Health Audit Committee - The contractor shall attend and participate in the Health Audit 1 Committee?s meetings discussing and providing information concerning the individual health unit activities. current issues affecting target populations, correctional facility operations, and senior administration concerns; and ii} PhysiCian Peer Review of all cases of offender deathfsuicide. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will continue to partner with the MDOC to provide quality health services to the offenders in Missouri. Corizon is committed to Continuous Quality improvement and Customer Satisfaction. The Missouri team that serves the MDOC has a Mission Statement on which we have built our program in Missouri: "To provide a planned, systematic and collaborative approach to designing, measuring, assessing and improving the delivery of health care services within the Missouri Department of Corrections?. Corizon?s CQI approach at MDOC encompasses the following beliefs and actions: . Consistently striving for improvement Making decisions based on fact, not assumptions, feeling or impressions Focusing on processes and systems, not individuals and tasks to identify opportunities for improvement - Examine data in the three domains of process, outcome and patient as the impact on the quality of care given - Emphasizing all levels of employee involvement . Maximizing teamwork Creating an environment of quality . Eliminating the historically punitive aspects associated with CQI . Maintaining customer focus Contractual Requirements - 144 @Partnership Corizon?s MDOC Speci?c CQI Manual Corizon?s MDOC Manual outlines our program in compliance with Standards and well as MDOC Policies and Procedures. Monitoring begins with the COJ Calendar which is developed by the Regional CCU Coordinator with feedback from the site staff, Regional Office staff and the MDOC. This calendar (as provided below) outlines audits that are to be completed each month. Release from MDOC HIVIAI BS 0 Nurse Protocol . Review I HCV Corizon has developed audit tools for our DOC contract that measure the effectiveness and appropriateness of the care we provide to MDOC offenders. These tools focus on problems identi?ed; a timeline is then initiated for implementing corrective actions and measuring improvement. CQI Team: Quality Improvement Professionals at Each Site Corizon?s CQI program for MDOC is provided under the leadership of Regional Cal Coordinator and Clinical Educatoa Dana Meyer. Ms. Meyer, Dr. Bredeman and Ralf Salke have worked together to appoint a Director of Nursing at each MDOC facility to oversee each facility?s site specific CQI program; CQI duties are integrated with their day?to-day patient care responsibilities. Contractual Requirements - 145 Proven A (a Partnership CQI Meeting The Corizon DON that oversees CQI at each facility oversees a COJ Committee. These committees include representation from all disciplines practicing at the MDOC to include, at a minimum, medical care services, mental health services, custody, dietary, safety, and education. The meeting is held to discuss and monitor the success and outcomes of the Corizon program and to facilitate communication between the disciplines integral to the implementation of our coordinated healthcare services program. Each CQI meeting is conducted with the objective of monitoring the healthcare services provided, collecting, trending, dissemination of data, and the development and monitoring of resultant corrective action plans. Site-Speci?c Cal Program All Corizon staff participates in Corizon?s facility-speci?c CQI initiatives to provide the foundation for the program. Our healthcare and behavioral healthcare staff will attend all meetings and will support the program through involvement in audits, meetings, corrective action plans, and other ongoing activities. In order to be compliant with Standards, Corizon?s Regional CQI Coordinator, Dana Meyer, assists the sites in identifying problems and developing two site-specific process and two site?specific outcome studies each year. This approach leads the committee to collaborate and discuss their individual opponunities for improvement with both their facility processes and patient care outcomes and to develop a plan of action. Co rizon fully supports regular chart reviews of all programs, including Outpatient services, inpatient unit and reception services, as a part of each institution?s program. Corizon Process Indicators Examining the Healthcare Delivery Process Diabetes Example In 2006, Corizon, Inc. began our Diabetes Disease Management Program. The goal of our Diabetes Disease Management Program is to adhere to evidence-based guidelines and improve glucose, blood pressure and cholesterol control, thereby decreasing diabetes-related complications and prolonged hospitalizations. The rationale for diabetes disease management was based on statistics published by such prestigious organizations as the Centers for Disease Control (CDC), American Heart Association (AHA), National Institute of Neurological Disorders and Stroke, and the National Institute of Diabetes and Digestive and Kidney Diseases. Those statistics stated that: - Diabetes is one of the leading causes of death and disability in the United States 0 Much of the burden of illness and cost of diabetes treatment is attributed to potentially preventable long-term complications including heart disease, blindness, kidney disease, and stroke - People with diabetes are two to four times more likely than others to die as a result of heart disease Diabetes accounts for almost 45% of new cases of kidney failure Contractual Requirements - 146 A a Partnership - Diabetic retinopathy is a leading cause of blindness, causing 12,000 to 24,000 new cases of blindness annuaHy - Every 10 millimeters of mercury reduction in systolic blood pressure in diabetics re5ults in a 12% reduction in diabetic complications improved control of cholesterol can reduce cardiovascular complications by 20% - 50% 0 Patients with diabetes who maintain near-normal HgbAlc levels gain, on average, an extra five years of life, eight years of sight, and six years of freedom from kidney disease - Medical costs for people with diabetes are more than double the medical costs of others Corizon compares outcomes to data published by the National Committee for Quality Assurance (NCQA). The latest reported NCQA outcomes for comparison orefrom the State of Health Care Quality Report 2012 and contain comparative data through 2011. An important step in managing diabetes is to monitor HgbAlc results every quarter. This blood test measures the average blood glucose control over the previous 90 days. The goal for glucose control is to maintain HgbAlc 7? for most patients with diabetes. The exception would be those who experience frequent hypoglycemic events related to such tight control. The chart below indicates the percent of patients with Diabetes in good control within Corizon Department of Corrections contracts. While NCQA results (HEDIS data) exclude patients who have not been in treatment for a period of time, Corizon includes all diabetics, including new intakes, in the outcome measurement. Corizon?s Offender Patients with Good Control All Current Corizon DOC's Alc 7 - Good Control Ou'r outcomes exceed commercial and Medicaid outcomes 100comparison, poor glucose control is defined as patients with diabetes with HgbAlc 9. This patient cohort requires more frequent monitoring through chronic care clinics, as frequently as in some cases, to adjust treatment plans until the patient reaches goal. The chart below indicates the percent of patients with Diabetes in poor control within the Corizon Department of Corrections contracts. Overall, Corizon outcomes exceed those of commercial insurance, Medicare, and Medicaid. Contractual Requirements - 147 current c??zon Doc's Cosimo Demonstrates HgbAIc 9 - Poor Control Fewer Offender Patients with Poor Control Our outcomes exceed commercial, Medicare, and Medicaid outcomes. In addition, because patients with diabetes are at risk for cardiovascular disease and compromised blood flow, it is important to keep LDL cholesterol 100. The chart below demonstrates the LDL-C control for diabetic patients in Corizon prison facilities. Corizan?s Offender Patients with Good Control Levels less than 1.00 All Current Corizon ooc's LDL-C 100 - Good Control 100% 90% Our outcomes exceed 80% Medicaid and Commercial 70% outcomes and meet Medicare outcomesassist the healthcare teams at the site level to achieve the consistently good outcomes attained in Corizon facilities, the Corizon corporate of?ce Clinical Administration Department prepares lab reperts that allow the site providers to identify, at a glance, the cohort of patients in good, fair, and poor control and then modify individual treatment plans, as for the individual patients. Contractual Requirements - 148 Proven A a partnership Parameters included in the diabetes reports are HgbAlc, HDL, LDL, Triglyceride, and GFR levels all important components of total Diabetes care. A sample report is included showing results at goal highlighted in green and those in poor control highlighted in magenta. grew" HgbAlc HDI. LDL Trig GFR 6331 33051 7/5/13 5.3 45 121 110 39 6331 72030 7/1/13 6 40 142 133 32 6331 73005 7/3/13 6.3 549 73 6333 42192 7/15/13 7 13 51 252 63 6333 64797 7/29/13 7.2 40 31 133 63 6333 26076 7/11/13 3.4 34 37 143 70 6333 67535 7/3/13 9.3 30 33 192 39 6333 54914 7/5/13 10.4 33 119 146 97 6334 34454 7/23/13 11.5 23 64 350 30 Hyperlipidemia Another component of Corizon?s chronic disease management program is management of hyperlipidemia, speci?cally high LDL cholesterol. Lipid panel is included in the lab report workbook sent to the sites each month. LDL-C 160 and Triglyceride 500 are highlighted for ease of identi?cation of those patients who require intensive management. Corizon Site Offender ID 3?32?? HDL LDI. Trig 6331 123456 7/3/13 20 SEE BELOW 393 6331 654321 7/2/13 35 31 123 6331 222222 7/1/13 59 74 53 6333 464646 7/3/13 33 SEE BELOW 516 6333 535353 7/25/13 25 SEE BELOW 399 . 6392 979797 7/3/13 43 167 153 6392 333333 7/22/13 43 200 131 6392 616161 7/30/13 33 174 391 American Heart Association statistics report that approximately 20% of Americans over the age of 20 have elevated LDL cholesterol. The goal for everyone is to decrease to 160, with parameters more stringent for those at increased risk for cardiovascular disease. Corizon lipid management is OUtStanding, as demonstrated in the chart below. Contractual Requirements - 149 Fiji Proven A Partnership All Current DOC Offenders 160 - Good Control - .2008 2009 2010 2011 2012 2013 YTD Warfarin Management Wa rfarin management is a third key clinical performance indicator for all Corizon statewide prison systems. The Warfarin management initiative was implemented in 2009. Warfarin, a blood thinning agent, is indicated for a small percentage of patients who have had a deep vein thrombosis (DVT), pulmonary embolus (PE), atrial fibrillation, and/or heart valve replacement. A study published in the Journoi of Thrombosis and Haemostosis in 2008 regarding data gathered from medical record review in private physician practices reported that, at any given time, approximately 58% of patients on Warfarin had a blood level in the therapeutic range of 2.0 to 3.5. Because Corizon includes all patients on Warfarin, including those who are new to the drug, in the cohort for outcome measurement, the Corizon range has been expanded to consider those with INR in the range of 1.8 to 3.7 as being therapeutic. Rationale for this adjustment is that clinicians will not normally make changes to drug regimen based on an isolated lab result, but rather on the patient?s trend. Corizon outcomes are demonstrated in the chart below, indicating steady improvement once Corizon processes were implemented in the Corizon prison contracts. Contractual Requirements - 150 Proven - A f2 Partnership All Current Corizon Warfarin Management 100% 80% Therapeutic 40% --?Journal of Thrombosis and Haemostasis 2008 20% 0% 1 I 1 i 2003 2009 2010 2011 2012 2013 YTD HIV Management In 2011, Corizon began including viral loads and CD4 counts in the montth lab reporting so that clinicians can identify those who require a change in drug regimen, as well as those whose CD4 counts have dropped below 500 and should be considered for antiretroviral therapy. A sample report is demonstrated in the table below. Offender Collection . Site ID Date Medication Start Date CD4 Trig GFR 2558 40729 7/22/13 ART 12/ 18/09 <20 ND 538 74 77 5114 87519 7/18/13 24728 494 119 1279 682 63 7/11/13 ART 5/9/ 12 <20 ND 661 3598 61184 7/5/13 ART 4/25/12 40 518 It is important to note that our MDOC contract will also benefit from the support of Tiffany Sarrell, PharmD., HIV Accredited Pharmacist. Ms. Sarrell?s expertise will help reduce complications of the HIV virus by consulting with our providers regarding HIV complications and severity of viral loads. Dr. John Matthews, MD., who is Board Certified in Internal Medicine and HIV Disease also provides clinical oversight of Corizons?s HIV treatment program at MDOC. in 2011, Corizon added outcomes for HIV management to the quarterly State Performance Data Report (SPDR) reports. Two indicators are reported: percent of patients on antiretroviral therapy who have a viral load, but viral load not indicative of treatment failure; percent of patients on antiretroviral therapy with undetectable viral load. The chart below demonstrates outcomes for these measures. Contractual Requirements - 151 Mental Health Speci?c Audit Tools 100% i aPartnership All Current Corizon DOC's HIV Management 80% 602011 2012 2013 YTD undetectable Corizon looks forward to the potential opportunity of being awarded the mental health component of the MDOC contract as a result of this procurement. Our established and comprehensive CQI process is complete with audit tools designed to encompass high volume, high risk, and problem-prone aspects of correctional mental healthcare as well. We will work with the MDOC to identify areas for improvement and, when necessary, implement improvement plans that include follow-up compliance monitoring. The following list encompasses Corizon?s mental health audit tools; each will be utilized to support our mental health program for the MDOC: I Therapeutic Restraints In?rmary Healthcare Record Medication Compliance Monitoring Medication Monitoring Forced ER Meds non-court ordered Intake Training Intake Offender in Segregation Intake Screening and Assessment Offender Request for MH Services Sick Call Refusal of Treatment Mental Health Treatment Plans Bipolar Disorder Contractual Requirements - 152 Proven f?partnership . Major Depression - Schizophrenia . Chart Review Suicide Prevention Program - Management of Suicidal Offender Emdamafcm What Our Team ls - Suicide Process Saying .. - Seclusion . ?The company strives for - Medication Prescribing exceuence on a regional and Medication Verification Site IBVEL 35 BVidenCEd by audits and process changes, . Medication Review Form when necessary? - Medication Monitoring dd}? Bridging Medications i. Ago? gag: . Transfers lntra-system Custody Employee since 2009 a Release Planning . . . CQI Program Requirements Reporting The leadership at each site will forward the results of the audits and minutes to Regional CQI Coordinator, Dana Meyer. Statewide data will be aggregated and analyzed. Each site will be given feetiback 0n the information submitted which will include suggestions for process improvements or support for planned actions. The data will be presented to the Executive CQI Committee on a quarterly basis. LPN Supervision Compliance with the Missouri Nurse Practice Act Corizon believes that the monitoring and supervision of LPN practice by Registered Nurses ensures the services they provide remain within their scope of practice. Corizon does this routinely in many states, including Missomi. Corizon will adapt existing CQI studies to coincide with the Missouri Nurse Practice Act and will provide the MDOC the assurance that nursing resources are being provided in accordance with Missouri State Laws and Regulations. Contractual Requirements - 153 Provider Peer Review A anrtnership A formal Peer Review will be conducted on each provider on an annual basis at a minimum as described in the section of this proposal titled "Mortality Review/Peer Review Process?. This review will includes a review of documentation as well as a review of the overall care provided. - Site Medical Directors are reviewed by the Regional Medical Director, Dr. Thomas Bredeman - Site Physicians are reviewed by their Site Medical Director - Dentists are reviewed by the Regional Dental Director, Dr. Ernest Jackson 0 Nurse Practitioners are reviewed by their collaborating physician Executive CQI Committee Corizon has an Executive CQI Committee in place in support of our MDOC partnership which includes representatives from MDOC and DORS, Corizon?s senior healthcare management team, and MHM team members. This committee meets on a quarterly basis and is currently comprised of the following: NAME Deloise Williams Adrienne Hardy Anita Clarke Jeri James Melody Grif?n Greg Markway, Michelle Hoffmeister Scott 0' Kelley Shelley Moore Karla Gier NAME Ralf Salke Kevin Bredeman, DO Cindy Schu pp Dana Meyer Deb Steinman Leon Vickers Mariann Atwell, Pat lmbriaco Tara Taylor TITLE Assistant Division Directoerealth Services DORS Medical Contract Monitor Medical Contract Monitor Medical Contract Monitor Medical Contract Monitor Assistant Division Director! Mental Health Services DORS Mental Health Contract Monitor Mental Health Contract Monitor Mental Health Contract Monitor Administrative Assistant TITLE Group Vice President Regional Medical Director Regional Director Regional COJ Training Coordinator Regional Director Director of Re-Entry Services Regional Behavior Health Director Regional Director Regional Director of Nursing Contractual Requirements - 154 Proven aPartnership Vicki Oliver Regional Infection Control Nurse . Mark Moyers Consulting Pharmacy Manager There are, in addition to this group, several members of the mental health provider?s team in attendance. Meeting Format Corizon currently uses the CRAFE format to guide our CQI meetings as follows: - ConcluSion: Conclusion arrived at from the assessment of the process being evaluated - Recommendation: Recommendations to improve the process from the team and other members evaluating the process - Action: Actions Planned - Follow-up: Follow-up to assure recommended actions are taken EvaIuation: Evaluation of the actions for effectiveness This method ensures that data is collected and analyzed and that plans for implementing actions and evaluating effectiveness for improvement are formulated. A typical CQI meeting agenda includes the following: . Previous Meeting Minutes . - Follow-up Items - Scheduled Audits - Pharmacy Inspection Sentinel Events Infection Control - Environmental 8: Safety Inspection Reports - Chart Reviews 0 Open Discussion . Adjournment in conjunction with the meetings, an Intermediate Summary is completed each July to compile the montth reports from January through June. The purpose of this summary is to identify trends, analyze actions plans that are in place and evaluate the effectiveness of the committee. In addition, an Annual Summary is completed at the end of each year to compile reports and evaluate the committee effectiveness for the previous year. Chart reviews are the basis for completing most studies. Process studies allow Corizon?s staff to determine policy and procedure compliance. The Health Audit Committee is led by the Corizon HSA to provide information concerning the individual health unit activities, current issues affecting target populations, correctional facility operations, and senior administration concerns. Contractual Requirements 155 Proven - I A @Pattnership Visionary Healthcare Program for 2014-2021 . Enhancements to Our Current Program Corizon is invested in centinuing to improve our CQI approach at MDOC and will implement the following program enhancements at MDOC in coordination with our 2014 contract. 1. We will develop standardized patient satisfaction surveys and a standardized reporting tool to enhance reporting, tracking and trending of patient comments, concerns and positive statements. 2. We will partner with a third-party to conduct a statewide review of the care provided to the patients within the MDOC. Since 2006, The University of Central Missouri conducted a statewide review of the care provided to patients at MDOC. The results were favorable and in many areas, Corizon exceeded community benchmarks in areas such a women?s health, infection control and health maintenance. 3. Corizon will fully support regular chart reviews of all programs, including outpatient services, inpatient units, and reception services, as a part of each institution?s program. Contractual Requirements - 156 2.12.8 Customer Satisfaction Survey 1 The contractor shall conduct an annual customer satisfaction survey with results submitted to the state agency?s Contract Monitoring Ojce. Proven a Partnership Corizon?s Dedication to Client Satisfaction at MDOC Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands the value and need for ensuring that our clients have an outlet and formal mode of feed back regarding the ef?cacy of our healthcare services. In 2012, Corizon developed a client satisfaction survey specifically for you, our Missouri client. We developed this survey knowing that this mode of client communication may, in some cases, allow us to identify issuesfconcerns not otherwise seen or shared with Corizon staff. Although, for the most part, Corizon was very satisfied with the results of our most recent survey (within the inset), we did identify one site in particular where additional attention was needed. This most recent survey W35 by Corizon and was approved by the Division Directors of and DORS. ??th MDOC submitted the surveys to the Wardens and collected the raw data for Corizon to review and act upon. Once we compiled the data, discussions were held and an actiOn was generated to address the ?issues? at a particular site. The other 20 sites identi?ed no significant issues and a general sense of service satisfaction was achieved. Our survey results are provided on the page that follows. Carlton commits to performing annual customer satisfaction surveys through and with the approval of All results and Subsequent follow-up will be shared with MDOC. Contractual Requirements - 157 ?Hwy Proven I gPartnership . Corizon MDOC Facility Surveys Key: 1 - Far Exceeds Expectations; 2 - Exceeds Expectations; 3 - Meets Expectations: 4 - Below Expectations; 5 - Far Below Expectations Medical Services . "22' l. rri'rj.? Mite." n1 [i t. r? r-r Ci; 5111:: Hill; l? Hun: Dental services provided for your offenders (I. 1.: lit-'Responsiveness of onsrte employees concerning health related ISSUES Staff's ability to handle emergency situations Ongoing attention to chronic health conditions such as diabetes and hypertension Responsweness of healthcare staff offender grievances Effmency which call us managed conducted Offender screening 81 testing_ Efficlency of the medication administration program ffglency In managing the volume Average: Corizon Corporate. Regional Management and Support Reparts and clinical data provided to you by Coriton management and stall Overall performance of the site . . administrator . b1. . Relra m; of Coraeon corporate management and staff Communlcation between your team and Corrzon corpmate staff . . Exten nurses are able to perform their le'Professionalism of onsite staff f?roactwe resolution of Issues and problems involving onsrte employees Staf?ng levels meet contract requirements Contractual Requirements - 158 2.12.9 Responses to Grievances i The contractor shall review and provide a written response to the state agency concerning offender grievances and offender, family and third party complaints regarding the delivery of services in accordance with the state agency Lgolicy D5-3.2, included in Attachment 46. Partnership Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon firmly believes that the best way to manage offender grievances is to prevent them in the ?rst place. By providing care in a consistent manner, offender grievances can largely be mitigated. For grievances received, the offender must be ?given the benefit of the doubt? while recognizing the potential secondary gain issues inherent in this process. Corizon believes that a formal, structured, codified grievance system is imperative for three high level reasons: 1. Problems are identified that may otherwise go unnoticed. This is an important risk management tool to avoid potential adverse outcomes associated with issues of access to care. 2. Follow through with offenders demonstrates you are serious about providing timely, effective, safe health care. 3. The Prison Reform Litigation Act (PRLA) requires that offenders ?exhaust? the grievance process prior to filin a lawsuit. This has markedly reduced the number of pro se nuisance lawsuits. Diligence is required to prevent multiple grievances which would appear to exhaust this procedure. Subsequent to local interventions, Corizon has found the face-to-face method of managing grievances and offender issues signi?cantly reduces the amount afformal grievances and lawsuits ?led against Corizon and our clients on an annual basis. The majority of offenders simply want their problem resolved and most issues can be resolved through face? to?face communication. In the rare instance when a lawsuit does develop, our philosophy toward in. offender lawsuits is one of solid defensive action rather than compliant lawsuit settlement, even during occasions when the cost of litigation may be more expensive than that of settlement. Corizon?s innovative face-to-face grievance approach ensures the MDOC that Corizon is taking a proactive apprde to offender complaints regarding health care services, thereby discouraging offender lawsuits and ultimately reducing costs. This mechanism is used to curtail unfounded offender grievances and to deepen the trust in our commitment and ability to provide quality offender health care. Corizon?s ability and commitment to continually reducing ?led offender grievances at MDOC in evidenced by the data within the inset. Corizon is encouraged that our efforts to control ?led offender grievances have resulted in positive All MDOC Facilities Corizon Grievance Tracking Contractual Requirements - 159 A @Pa?nership outcomes, however, it is our expectation to maintain that level and improve in areas where we may have Opportunities. We believe the Bene?ts at a Glance described below has facilitated our ability to keep grievances to a minimum at MDOC. Benefits at a Glance Communication with MDOC Offenders Corizon understands that communication with offenders is key to managing their expectations regarding the healthcare that they receive while incarcerated. Prior to incarceration, many offenders had their own health care insurance policies. These policies came with an explanation of benefits which informed the bearer what items were covered, deductibles, and copayments. The Benefits at a Glance resources have been enlarged and laminated for ease in reading and durability. They have been posted in each medical unit waiting area, many housing units, receiving areas, and anywhere information is posted for an offender?s perusal. Educating offenders on what to expect often keeps them from requesting inappropriate items or core 2, . 365 ?o ?6 With the Authorization of the 2012, Corizon?s Clinical Review Committee was tasked by Ralf Salke to develop a poster reflecting the offender healthcare program within MDOC. These posters were developed to post in the housing unit wings, intake areas and medical units with the objective of educating offenders regarding the types of care they are entitled to while in a MDOC facility. a? f? . Contractual Requirements - 160 . aPartnership and then becoming upset when it is not proaided. Visionary Healthcare Program for 2014-2021 Addition of Mental Health to "Benefits at a Glance? If awarded the mental health component of the contract, this offender education tool will be revised to include the mental health bene?ts that will be available to a?enders within the system. Corizon ensures these benefits will meet the MDOC's Internal Management Policy and Procedures (IMPP) and we will obtain ?nal approval for the Bene?ts at a Glance from the MDOC. Our current Bene?ts ot a Glance is provided below. Offender Communication Corizon?s Benefits at a Glance lamb-eluded rte-uncut logical Den-I my mm more mm An my condition that requrres immediate attention in order to preserve life or body hmdion. "511 43.1) Examples of conditions considered acute or emerlent include. but are not Iirmhed to: Severe Severe Henna? tm i sum diam. WI: are anaemia?! for cosmetic m. rimmed" be scheduled ?Mn auschodule allows. Wlf?tlm monument plans will be f?lm In and WIN be adjusbcd as ind-cared and may vary from what was prescribed prior to incarceration, Medications may be crushed or dispensed as watch take per orders of the prescribing pl'rvs?lcian Off site specialists are utilized wl'len determnedho he nudlcaliy indicated hm physician and will obtained new a manage! care process~ ?1 TO ER VIC. .a "Jr. -. -- Requests for copies 0* records should be submitted throw WW facillw arm Copies may be obtained at a charge at 5 15.00 plus 35 per page. Games of Hill tee! results will not be ammo while still imam-rue (lsn 1&6] Chronic Canolfendersmbeorwidedmto 1-year meow 30 donation of prescribed medication. - Speci?c appolmmanornercmwill AC. a routine vision mm can be requested em 2 year: unless change tn vision or chronic illness. Contact: - Contact: and solution are at offender's expense unless mdlcolly indicaad. Personal eyeglasses - Will not be the responsibility of medical. Delivery of personal classes/ch will he handled award-I o?ender property. ?rmted glasses can be provided follwingmessment by monitor-nettle: and rived-cal need cm?rmed. Hearing teams are performed when radically indicated. A rearing and will only be replaced when deft-cave. Hearing and batteries are obtained through medical via ll'le MSR proton. Old batteries m: be returned to medical. Prop-u fining footwear is provided by the Missouri neuronal-lat of Corrections. Madam footwear is provided following am In! the physician and mice] need confirmed. The follon issues do Melanin! need tor medical {mar Wit Feet Feel Feet Shh; On Intake alt prosthetics will he rewewed be the physician for medical need. Alf are when to com! avsecuritr are?! Personal device maintenance Is 1491 the responsibility of Missouri Department of Corrective or Canaan, Danes Braces Link Contractual Requirements - 161 @Partnership Grievance Response Quick Reference Guide . With the Authorization of the 2012, Corizon's Clinical Review Committee in Missouri developed a standardized Grievance ReSponse Quick Reference Guide. Since 2012, this tool has been widely used and has proven to drive positive outcomes in regard to curtailing the escalation of formal grievances. Co rizon knows that training is essential to teaching our management staff to handle informal issues in a manner that prevents them from escalating to more formal types of grievances. With that in mind, Corizon provides specific training for all Health Care Administrators and Directors of Nursing regarding how to solve issues at the lowest level possible. Corizon has developed a Grievance Response Quick Reference Guide containing tips on how to properly de-escalate offender concerns. Each member ofour management staff is provided a copy of this helpful reference to keep in their of?ce and use in their work of keeping offenders satis?ed with the health care they are receiving. Topics covered in the Grievance Response Quick Reference Guide include: - Policy Explanation - Prohibited Policies - Response Tips Dissatis?ed with Quality ofMedicoZ Core ReSponses Dissatisfied with Quality of Dental Core Responses Dissatis?ed with Qua!in ofiitlentotr Health Care ReSponses 4. Unfair Treatment or Rights Violation ReSponses 5. Conduct of Heoith Core StoffResponses 6. Problem with Medication Responses 7. 8. 9 905?s)?? Deioy in Health Care Provided Responses Request to be Seen Responses . Request for O?site Specialty Core Responses i 0. Other ReSponses. As the current partner, we are very familiar with grievance procedures as described in Policy D5-3.2 and have incorporated them into our current policies and procedures governing offender and grievances. In compliance with the RFP, we will ensure that offenders have the opportunity to bring issues to the attention of the medical staff informally using the facilities? Informal Resolution Request form. These informal resolution requests will be addressed by a face-to-face encounter between Corizon?s medical unit management staff and the offender as addressed in the preceding pages. If the management staff member determines that remedy is necessary to resolve the issue, the staff member will see that the remedy is implemented as soon as reasonably possible. . Contractual Requirements - 162 Proven aPaI-tnership Regardless of the resolution, the management staff member meeting with the offender will provide a . written response documenting the encounter, the issues discussed, and any suggested or agreed upon resolution. MDOC/Corizon Clinical Review Meeting Corizon has also implemented another useful mechanism to help keep focus on offender lRR?s and grievances at the Clinical Review Committee. This committee is comprised of participants from the Corizon Regional Of?ce, participants from the MDOC, and several members of the Corizon ?eld staff. The job of this committee is to meet quarterly or as needed, review grievances for any trends, and look at new ways to enhance offender satisfaction with the healthcare services provided. This committee was first developed in 2012 and some of its work resulted in the Bene?ts ata Glance and Grievance Response Quick Reference Guide described in the preceding pages. 2.13 General Materials, Equipment and Supplies Requirements Eqmpment The contractor shall understand and agree that the de?nitions of alt materials, supplies, and equipment, utilized orJ purchased. or both, by the contractor and the state agency shall be in accordance with Generally Accepted Accounting Standards and the Missouri Statewide Chart of Accounts, Expenditure Object Codes. Corizon has reviewed and will comply with the performance standards as written in this requirement. . We understand and agree that the de?nitions of all materials, supplies, and equipment, utilized or purChased. or both, by Corizon and the state agency will be in accordance with Generally Accepted Accounting Standards and the Missouri Statewide Chart of Accounts, Expenditure Object Codes. 2.3.3.2 internet Connections if requested by the contractor and approved by the state agency correctional facility warden, the contractor may 1 provide communications lines to access the internet. The contractor shall be responsible for installation, repairs, i maintenanceand fora" connections?and outlets. i Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon currently has various high speed internet circuits installed throughout the MDOC infrastructure. In coordination with our 2014 contract, Corizon will evaluate all the active circuits for upgrade possibility in the near future. We will develop a culture that is sustainable for years to come. Corizon is proposing, at a minimum, that all current DSL circuits be upgraded to MPLS T-ls and added to our current MPLS cloud serving the larger facilities throughout the state. These circuits will continue to support our healthcare WAN connectivity needs including our TeleMedical architecture. Corizon does plan to expand our TeleMedical program substantially during this contract period and will evaluate the Telel'vledical, administrative and our proposed traf?c to ensure that the necessary bandwidth is in place to previde the end user the best experience while providing care. Corizon will continue to work with the MDOC to receive approval before any work begins on the installation or upgrade of any of the Contractual Requirements - 163 Proven A 3 @Partnership circuits. We also understand that we are responsible for the installation, repair, maintenance and any costs that are incurred with these internet connections. . ?lialexs?giy Reqyire ments Unless otherwise speci?ed by the state agency, materials, equipment and supplies available at the correctional i facility shall be available and usable by the contractor. Accordingly, the state agency shall provide of?ce space, equipment and supplies, under the following conditions: a. As approved by the state agency, within the ?rst thirty (30) calendar days following the state agency authorization to proceed with services, both the contractor and the state agency shall jointly inventory all 5 materials, equipment, supplies and pharmaceuticals. b. The state agency shall distribute a consolidated inventory report which provides a listing of fixed assets 1 OWHEU bl! the state agency, itemized by item, description, object, location, purchase date and cost in accordance with Generally Accepted Accounting Principles. The report shall include a minimum of one COpy signed and retained by the correctional facility, one copy retained by the state agency, and, one copy retained by the contractor. c. The contractor shall agree and understand that the state agency shall conduct additional random audits at the_\__r_arious correctional facilities. .. 1' Corizon has reviewerl and will comply with the performance standards as written in this requirement. Unless otherwise specified by the state agency, materials, equipment and supplies available at the correctional facility will be available and usable by Corizon. Accordingly, the state agency will provide office space, equipment and supplies, under the following conditions: . . As approved by the state agency, within the ?rst thirty (30) calendar days following the state agency authorization to proceed with services, both Corizon and the state agency will jointly inventory all materials, equipment, supplies and pharmaceuticals. . The state agency will distribute a consolidated inventory report which provides a listing of fixed assets owned by the state agency, itemized by item, description, object, location, purchase date and cost in accordance with Generally Accepted Accounting Principles. The report will include a minimum of one copy signed and retained by the correctional facility, one copy retained by the state agency, and, one copy retained by Corizon. - Corizon agrees and understands that the state agency will conduct additional random inventory audits at the various correctional facilities. The contractor shall purchase all necessary of?ce equipment not signaooperwunitieach. a. The contractor shall provide a copy machine at each correctional facility for the contractor? 5 use. b. With the exception of computer equipment, the centractor shall retain ownership of any and all 5 equipment purchased by the contractor for use at a correctional facility. .. c. The contractor shall cooperate with the state agency in preparing a list of equipment needed, subject to a . i Contractual Requirements - 164 Proven aPartnership . Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon will purchase all necessary office equipment not exceeding $1,500.00 per unit/each. In addition, we will provide a copy machine at each correctional facility for use. With the exception of computer equipment, Corizon will retain ownership of any and all equipment purchased for our use at a MDOC correctional facility. We will cooperate with the state agency in preparing a list of equipment needed, subject to a regular appropriation process. ?2.13.5 State ?ency Equipment i The contractor shall purchase all necessary office equipment not exceeding $1,500.00 per univeach. i a. The contractor shall provide a copy machine at each correctional facility for the contractor?s use. b. With the exception of computer equipment, the contractor shall retain ownership of any and all equipment purchased by the contractor for use at a correctional facility. c. The contractor shall cooperate with the state agency in preparing a list of equipment needed, subject to a 5 regular appropriation process; COrizon has reviewed and will comply with the performance standards as written in this requirement. We will purchase all necessary of?ce equipment not exceeding $1,500.00 per unitfeach. We will provide 3 COPY maChlne at each correctional facility for our use. With the exception of computer equipment, . Corizon will retain ownership of any and all equipment purchased by Corizon for use at a correctional facility. Finally, We will cooperate with the state agency in preparing a list of equipment needed, subject to a regular appropriation process. 2.14 Computer Requirements 3:14.; Computerhequirements i Unless otherwise speci?ed herein, the contractor shall provide all hardware and software necessary for the Successful pfOVlSi'Dn of medical care services or mental health services, whichever is applicable, as described by the i contract. a. The contractor shall provide all printer consumables required, such as paper, toner, printer maintenance kits; Etc-i arid in such quantities to assure no interruption of medical services. b. The contractor shall provide all hardware (printers, PCs, etc.) and software. The contractor shall not be reSponsible for hardware and software for the state agency. i 1) All provided hardware and software must be approved, imaged, installed and managed by Information i Technology Services Division 0150}. i i 2) ITSD will provide detailed speci?cations for all hardware and software which shall be provided by the contractor. All hardware must include a three (3) year warranty. c. The contractor must replace any out of warranty equipment upon failure of the equipment at the i contractors? expense. Contractual Requirements - 165 Proven 5" d. The contractor shall provide any non-warranty repair at contractor?s expense. e. The contractor shall provide any and all additional hardware or software in the event additional hardware . or software is deemed appropriate by the contractor and the state agency. f. The contractor shall provide core software licensing required for a PC to participate on the state?s network. Including but not limited to Microsoft Office [when needed}, Microsoft (MS) Windows Client Access Licenses MS Exchange CALs, MS System Center Con?guration Manager (SCCM) CALs, and antivirus. I g. The contractor must provide proof of license for software installed on all PCs provided by the contractor upon request by the state agencythe contract term, computer equipment and software shall become the property of the Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon understands that it is the MDOC's desire that the medical care services and mental health services supply all of the necessary hardware and software as described in the contract including responsibility for fixing any out of warranty computers or equipment and the addition ofany new hardware that could be necessary. it is also known that the computer hardware that is currently in place is new within 6-10 months of this RFPs release. Corizon plans to begin providing replacement hardware beginning immediately upon the start of the new contract. Further, beginning in year 3 of the contract that results from this procurement, Corizon proposes replacing 25% of the computer hardware per year on a rolling annual basis to ensure the hardware is no more than 4 years old while allowing for more level budgeting. Corizon will work in coordination with the MDOC to ensure this replacement schedule meets or exceeds any expectations for hardware age that exists within the MDOC today. We will abide by the procurement standards provided us regarding the makes and modules of equipment that are approved for purchase and that the equipment will include, at a minimum, the required three (3) year warranty. We understand that we are simply purchasing the hardware and software and that the MDOC will take control of the imaging, installation and management of the computers. Corizon also presumes that with the anticipated success and adoption of Wi-Fi and tablet devices that these may be purchased as a better device for everyday healthcare in Missouri. Corizon will work in coordination with the state agency?s information Technology Services Division (ITSD) and any other identified departments to ensure the purchase and support of such devices is evaluated and approved before the replacement procedure begins. At this time, Corizon intends to purchase licensing for these computers under our corporate EA licensing agreement with Microsoft. This will allow for the core licensing of each PC and allow licensing for accessing any applications needed during the business of providing healthcare to the offender population at MDOC. If at any time MDOC or Corizon terminates the contract for medical and/or mental healthcare, Corizon will assume the EA license back to our corporate pool of licenses. The purchased computers will be reimaged, on new hard drives, a fresh copy of the original equipment manufacturers (OEM) operating system for the continued use of the MDOC and its new contractoris} and will become property of the Contractual Requirements 166 aPartnership Proven state agency. Corizon will maintain the necessary documentation for proof of legal licensure and will . produce such documentation upon request of the state agency. 2.15 Miscellaneous Requirements 2.15.1 Miscellaneous Requirements r?ww?w 2.15.1 The contractor and the state agency shall assign licensed health professionals to attend the Mortality i 5 Review Panel on a quarterly basis. Mortality Review] Peer Review Process Corizon has reviewed and will comply with the performance standards as written in this requirement. Please refer to the section of this proposal titled ?Mortality Review/Peer Review Process" for Corizon?s approach to sentinel events and mortality review. 2L1igwgt3te?g?engy Committees and Taskforces At the request of the state agency, the contractor shall serve on correctional facility or state agency committees and @Horces. Corizon has reviewed and will comply with the performance standards as written in this requirement. . Corizon commits to the MDOC our willingness to participate on committees and taskforces when asked, requested or required. During the last 21 years, Corizon has not refused an assignment of this nature. We feel honored to be healthcare partner and know it is our duty to assist MDOC in anyway necessary to maintain and improve services. Working Together ..MDOC and Corizon developed both the Transportation Committee and the Clinical Review Committee in 2012. Both of these committees played important roles, as assigned by GVP Ralf Salke, in the development of our current Offender Benefit Sheet and Provider instructions Sheet; both important in the delivery of healthcare services. These two items are discussed at length within this RFP response. Contractual Requirements - 167 Proven A Partnership 2.15.3 Missouri Attorney General The contractor shall fully cooperate with the state agency and the Missouri Attorney General's Of?ce in the i defense of any lawsuits initiated against the state agency or any of its employees. The contractor shall work with I the Attorney General's Of?ce in the preparation and execution of af?davits. The contractor shall be available to i testify in court proceedings and depositions when the Attorney General's Of?ce informs the contractor that the contractor?s testimony is needed. i a. The contractor shall not be reimbursed for expenses incurred as a result of court appearances but the I . hours will count toward ful?lling the minimum staf?ng requirements herein. The contractor shall ensure the needs of the offender populationare met.? Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand and have fully cooperated with the state agency and the Missouri Attorney General's Of?ce in the defense of any lawsuits initiated against the state agency or any of its employees. For21 years, Corizon has worked with the Attorney General '5 O?ice in the preparation and execution of af?davits and trial preparations. Corizon has been and will continue to be available to testify in court proceedings and depositions when the Attorney General's Of?ce informs us that our testimony is needed. We have done this many times on behalf of the State of Missouri and MDOC and will continue to do so as needed. Corizon understands and has never been reimbursed for expenses incurred as a result of court appearances but understands the hours will count toward fulfilling the minimum staffing requirements herein. Corizon ensure the needs of the offender population are met regardless of the circumstances. 3.15.4 Communications Except for legally privileged communications, the state agency shall have the right, at any time, to review and I approve all written communications and materials developed and used by the contractor to communicate with 5' offenders. The contractor shall provide the state agency with a copy of all correspondence developed regarding I services involvingoffenderiu v. Corizon has reviewed and will comply with the performance standards as written in this requirement. Except for legally privileged communications, the state agency will have the right, at any time, to review and approve all written communications and materials developed and used by Corizon to communicate with offenders. Corizon will provide the state agency with a cepy ofall correspondence developed regarding services involving offenders. Contractual Requirements 168 . Proven A I: Partnership . 2.15.5 Legal_and Accounting Services 1 The state agency will furnish all legal and accounting services as may be necessary for the state agency to satisfy its contractual responsibilities. The state agency shall not assume, nor shall it be liable for, legal, accounting, or i insurance counseling services as may be necessary for the contractor to satisfy its contractual obligations. Without i exception to the foregoing, the state agency is not obligated to provide legal, accounting, or insurance counseling 1 services to the contractor in connection with any litigation or threatened litigation against the contractor arising i out of the contractor's performance. Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that the agency will furnish all legal and accounting services as may be necessary for the state agency to satisfy its contractual responsibilities. We understand that the state agency will not assume: nor Will it be liable for, legal, accounting, or insurance counseling services as may be necessary for Corizon-to satisfy its contractual obligations. Without exception to the foregoing, the state agency is not obligated to provide legal, accounting, or insurance counseling services to Corizon in connection with any litigation or threatened litigation against Corizon arising out of our performance. 345.6 and Linensw The state agency will provide clean bedding and linens to support health unit operations. Corizon has reviBWed and understands this RFP section as written. We understand that the state agency will provide clean bedding and linens to support health unit operations. . gigglge?al Maintenance and Housekeeping 1 The state agency will make available, and Supervise, offenders in the performance of general maintenance and heusekeeping. I i 1 a- The state agency shall provide and make available all equipment, supplies, and other materials as may be mnecessary for and sanitation of the correctional facility. Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand the state agency will make available, and supervise, offenders in the performance of general maintenance and housekeeping. Corizon also believes it is our responsibility to assist the custody and administration staff with this endeavor. Keeping the medical and mental health units clean is a task in which we expect all members of the Corizon team to engage. Corizon understands that the contract monitors review the units for cleanliness and document accordingly. Corizon will submit work orders, discuss in MAC meetings, and work with custody to ensure the units are held to a higher standard and that the services are completed through a collaborative effort from Medical, Mental Health, Custody, Maintenance and Administrative Departments. Corizon also Understands this requirement cannot fall on just one entity to assure compliance. We are committed to being partner in this process and ensure the units are clean at all times. Corizon understands the state agency will provide and make available all equipment, supplies, and other materials as may be necessary for the upkeep and sanitation of the correctional facility. From time to time, Corizon has assisted in this process and will continue to do 50. Examples have included providing Contractual Requirements 169 F-.. in Proven A @Partnership if paper towels, cleaning supplies and even various specialty tools with the prior approval to ensure appropriate cleaning and sanitation. 2.15.8 Security The state agency will provide security and security procedures to protect the contractor's equipment as well as state agency equipment. The state agency?s security procedures will provide direction for the reasonably safe Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that the state agency will provide security and security procedures to protect Corizon?s equipment as well as state agency equipment. The state agency?s security procedures will provide direction for the reasonably safe management of pharmaceutical and healthcare supplies and equipment. Corizon will ensure that our personnel adhere to all policies and procedures regarding security, custody, and control of offenders. 245-? issouri Department Qit?setatt?aulthw i' The state agency will coordinate the contractor?s services with the services provided by the Missouri Department herein New Corizon has reviewed and will comply with the performance standards as written in this requirement. We are cognizant that the state agency will coordinate our services with the services provided by the Missouri Department of Mental Health. Health CarsEentractors [w __st_a_te\agency will coordinate the servicesof the two (@Lcontractohrs. Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that the state agency will coordinate the services of the two chosen providers if a different provider is chosen for mental health and medical care services. 2.16 Financial Requirements: -v Performance Security Deposit - The contractor must furnish a performance security deposit in the form of an original bond issued by a surety company authorized to do business in the State of Missouri (no copy or facsimile is 2 acceptable), check, cash, bank draft, or irrevocable letter of credit to the Office of Administration, Division of Purchasing and Materials Management within thirty (30) days after award of the contract and prior to performance of service under the contract. a. The performance security deposit must be made payable to the State of Missouri in an amount equal to ten percent of the total projected contract price of the initial contract year (July 1, 2014 through June 30, management of pharmaceutical and health care supplies and equipment. The contractor shall ensure that the I contractor's personneladhere to all policies and procedures regarding security, custody, and control of offenders. in the eventmof separate contractors Medical Car; Services and the-Mental Health Care Services, the] i i l. 2015). Contractual Requirements - 170 Proven aPartnership The contract number and contract period must be speci?ed on the performance security deposit. 0 *1 i c. The contractor shall maintain the validity and enforcement of the security deposit for the second year of the initial contract period, pursuant to the provisions of this paragraph, in an amount stipulated by the Division of Purchasing and Materials Management near the end of the ?rst twelve (12) -month period, not to exceed ten percent of the projected total annual contract price. The contractor shall maintain the validity and . enforcement of the sacurity deposit for the third year of the initial contract period, pursuant to the provisions of i this paragraph, in an amount stipulated by the Division of Purchasing and Materials Management near the end of the second 12-month period, not to exceed ten percent of the projected total annual contract price. d. In the event the Division of Purchasing and Materials Management exercises an option to renew the . contract for an additional period, the contractor shall maintain the validity and enforcement of the security deposit for each additional renewal option period exercised by the State of Missouri, pursuant to the provisions of this paragraph, in an amount stipulated at the time of contract renewal, not to exceed five percent (596) of the (projected total annual contract price. Corizon has reviewed and will comply with each of the performance standards as written in this requirement. We understand our responsibility to furnish a performance security deposit in the form of an original bond issued by a surety company authorized to do business in the State of Missouri in the form ofa check, cash, bank draft, or irrevocable letter of credit to the Of?ce of Administration, Division of Purchasing and Materials Management within thirty (30) days after award of the contract and prior to . performance of service under the contract. 3.16.;339992' In Application Prior to any payments becoming due under the contract, the contractor must return a completed state Vendor Application, which is downloadable from the Vendor Services Portal at: a. The contractor understands and agrees that the State of Missouri reserves the right to make contract payments through electronic funds transfer (EFT). b. The contractor must submit invoices on the contractor?s original descriptive business invoice form and must use a uniqne invoice number with each invoice submitted. The unique invoice number will be listed on the State of Missouri's addendum record to enable the contractor to properly apply the state agency? 5 payment to the invoice submitted. The contractor may obtain detailed information for payments issued for the past 24 months from the State of Missouri?s central accounting system (SAM It) on the Vendor Services Portal at: Corizon has reviewed and will comply with the performance standards as written in this requirement. We understand that prior to any payments becoming due under the contract; Corizon must return a completed state Vendor lnputhCH-EFT Application. Corizon currently receives payment via this method in Missouri. We understand and agree that the State of Missouri reserves the right to make contract payments through electronic funds transfer (EFT). Contractual Requirements - 171 Proven A (a Partnership We agree to submit invoices on our original descriptive business invoice form and will use a unique . invoice number with each invoice submitted. it??eygicina i a. Medical Care Services and Mental Health Care Services - The contractor shall not begin invoicing untilthe a contractor is fully operational and providing comprehensive health care services. 1) The contractor shall submit itemized invoices in accordance with the applicable firm, ?xed price per diem, per offender for the average population count provided by the state agency at the address listed below for service provided during the previous invoice period. In addition, the contractor shall submit an electronic copy of the itemized invoice via e-mail to the address provided by the state agency. Department of Corrections 2?29 Plaza Drive P.0. Box 236 Jefferson City, MO 65102 - The state agency will provide the contractor with the average population count on approximately the and 16th of the month. If there is a weekend, the information will be provided the next working day. Average daily population counts include offenders in transit between correctional facilities. The average daily population count does not include offenders outcounted to county or city jails. - Invoices for the period of the through the 15th of the month shall be submitted no later than the 20th of the same month. . - Invoices for the period of the 16th through the end of the month shall be submitted no later than the 5th of the next month. i A sample medical care invoice is included as Attachment 4? and a sample mental health care invoice is 3. included as Attachment 48. 2) The contractor must submit all reports and other documentation required for the month by the i 10th of the next month for reconciliation with the invoice for the end of the month. i b. Final invoices are due by no later than thirty (30) calendar days of the expiration of the contract. The if?? ase?f?ha" 599913399?fl?ff?ili??giiu Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements 172 Payments '3 a. Medical Care Services and Mental Health Care Services - The contractor shall not be paid for services until the contractor is fully Operational and providing comprehensive health care services. 1) Payments for the Period of the Though the 15th of the Month - Upon receipt of all required dowmentation and reports for the invoice period of the 1st through the 15th of the month and upon state agency approval of the services provided and the invoice, the contractor shall be paid the ?rm, ?xed price per diem, per Offender Price stated on the Pricing Page for each day of the invoice period, by the 30th of that month, based upon the average of the daily head counts of the invoice period, as determined by the state agency. 2) Pavments for the Period of the 16th Through the 30th of - the Month -Upon receipt of all required documentation and reports for the invoice period of the 16th through the end of the month and upon state agency i calendar month, based upon the average of the daily head counts of the invoice period, as determined by the state agency minus any deductions taken as a result of vacant personnel positions, any deductions for each offender transported to a healthcare provider beyond the 50-mile radius, any deductions as a result of Medicaid payment for inpatient hospital stays, and any payback deductions, if any. 3) through public or private sources, that is intended to offset a portion of health care service costs, the total obligation dine the health care contractor shall be reduced by the amount of the funding received. 5? b. Payment Withholding or Rejection - Notwithstanding any other payment provision of the contract, if the contractor fails to perform required work or services, fails to submit reports when due, or is indebted to the United '1 States, the state agency may withhold payment or reject invoices under the contract. C- No Other Payments - Other than the payments speci?ed above, no other payments or reimbursements i shall be made to the contractor for any reason whatsoever including, but not limited to taxes, travel expenses, approval of the services provided and the invoice, the contractor shall be paid the ?rm, ?xed price per diem, per I offender price stated on the Pricing Page for each day of the invoice period, by the 15th day of the following Additional Funding - in any instance when an additional source of funding is available to the contractor, Corizon has reviewed and will comply with the performance standards as written in this requirement. of Payment g_l'_R_e__imbursement :i If a request by the contractor for payment or reimbursement is denied, the state agency shall provide the contractg?rith written notice of the reasonls] for denial. Corizon has reviewed and will comply with the performance standards as written in this requirement. If a request by Corizon for payment or reimbursement is denied, the state agency will provide Corizon with written notice of the reasonls) for denial. Contractual Requirements - 173 Proven a Partnership 2.16.6 Contractor Overpayment? i If the contractor is overpaid by the state agency, upon officialwnoti?cation by the state agency, the contractor shall 5 provide the state agency with a check payable as instructed by the state agency in the amount of such overpayment at the address speci?ed by the state agency or (2) deduct the overpayment from the invoicesvas requested; by the state agency. Corizon has reviewecl and will comply with the performance standards as written in this requirement. lf Corizon is overpaid by the state agency, upon official notification by the state agency, Corizon will provide the state agency either (1) with a check payable as instructed by the state agency in the amount of such overpayment at the address specified by the state agency or (2) deduct the overpayment from the invoices as requested by the state agency. 2.17 Other Contractual Requirements: 2.17.1 Contract . i A binding contract shall consist of: the RFP, amendments thereto, and any Best and Final Offer (BAFO) With RFP changesfadditions, (2) the contractor?s proposal including any contractor BAFO response(s), (3) clari?cation of the preposai, if any, and (4) the Division of Purchasing and Materials Management?s acceptance of i the proposal by ?notiCe of award?. All Exhibits and Attachments included in the RFP shall be incorporated into the contract by reference. a. A notice of award issued by the State of Missouri does not constitute an authorization for shipment of i equipment or supplies or a directive to proceed with services. Before providing equipment, supplies and/or a services for the State of Missouri, the contractor must receive a properly authorized purchase order or other form 0f authorizatiOn given to the contractor at the discretion of the state agency. a b. The contract expresses the complete agreement of the parties and performance shall be governed solely i by the speci?cations and requirements contained therein. formal contract amendment signed and approved by and between the duly authorized representative of the I contractor and the Division of Purchasing and Materials Management prior to the effective date of such modi?cation. The contractor expressly and explicitly understands and agrees that no other method andfor no 3 other document, including correspondence, acts, and oral communications by or from any person, shall be used or iyl?construed rattan? amendment or modi?cation to the contract: i i c. Any change to the contract, whether by modi?cation andfor supplementation, must be accomplished by a I Corizon has reviewed and will comply with the performance standards as written in this requirement. 2.17.2 Contract Period i; The original contract period shall be as stated the first page of the RFP. The contract shall not bind, nor purport to i bind, the state for any contractual commitment in excess of the original contract period. The Division of 3 Purchasing and Materials Management shall have the right, at its sole option, to renew the contract for four (4) additional one-year periods, or any portion thereof. In the event the Division of Purchasing and Materials i Management exercises such right, all terms and conditions, requirements and speci?cations of the contract shall remain Missile option clause of this document- Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 174 a PartnershiP We understand that the original contract period will be as stated on the ?rst page of the RFP. The contract will not bind, nor purport to bind, the state for any contractual commitment in excess ofthe original contract period. The Division of Purchasing and Materials Management will have the right, at its sole option, to renew the contract for four (4) additional one-year periods, or any portion thereof. in the event the Division of Purchasing and Materials Management exercises such right, all terms and conditions, requirements and specifications of the contract will remain the same and apply during the renewal period, pursuant to applicable option clauses of this document. 2.17.3 Renewal Periods If the option for renewal is exercised by the Division of Purchasing and Materials Management, the contractor shall agree that the prices for the renewal period shall not exceed the maximum price for the applicable renewal period stated on the Pricing Page of the contract. a. If renewal prices are not provided, then prices during renewal periods shall be the same as during the original contract period. I b. in addition, the contractor shall understand and agree that renewal period price increases speci?ed in the contract are not automatic. At the time of contract renewal, if the state determines funding does not permit the speci?ed renewal pricing increase or even a portion thereof, the renewal pricing shall remain the same as during 2 the previous contract period. If such action is rejected by the contractor, the pantract may be terminated, and a new procurement process may be conducted. The contractor shall also understand and agree the state may 5 determine funding limitations necessitate a decrease in the contractor?s pricing for the renewal periodls). If such . action is necessary and the contractor rejects the decrease, the contract may be terminated, and a new i procurement process may be conducted. Corizon has reviewed and will comply with the performance standards as written in this requirement. 2.12.4 Termination i in the event of termination pursuant to this paragraph, all documents, data, reports, supplies, equipment, and accomplishments prepared, furnished or completed by the contractor pursuant to the terms of the contract shall, at the option of the Division of Purchasing and Materials Management, become the property of the State of I accepted by the State of Missouri pursuant to the contract prior to the effective date of termination. {g a. The Division of Purchasing and Materials Management reserves the right to terminate the contract at any 1; time, for the convenience of the State of Missouri, without penalty or recourse, by giving written notice to the contractor at least thirty (30) calendar days prior to the effective date of such termination. terminate the contract without cause upon giving the Division of Purchasing and Materials Management at least nine (9) months prior written notice. In the event of such termination, the contractor shall not be eligible to Missouri. The contractor shall be entitled to receive compensation for services andlor supplies delivered to and b. After completion of the ?rst twelve {12" months of contract services, the contractor shall have the night to 3 Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 17'5 Fr. Proven A . 2.17.5 Deficiency Notice 5 The contractor shall understand and agree that if the state agency, through its review and evaluation of contractual performance, determines that the services being performed by the contractor at any correctional facility are unacceptable, the state agency shall provide written notice which states the de?ciencies to the contractor?s authorized representative. The state agency shall ensure that all de?ciency notices contain recommended remedies as well as acceptable terms of reconciliation. i I a. Evidence of de?ciency shall exist and be recognized by the state agency as unacceptable performance I: involving the contractor?s non-compliance with any rule, regulation, policy and procedure, standard, protocol, practice, or statute, that if continued would limit andfor offset to a significant degree a desired outcome prescribed herein. b. The state agency shall deliver de?ciency notices to the contractor by certi?ed mail with a return receipt requested. The state agency shall mail the de?ciency notice to the contractor?s billing address or to such other address as the contractor provides to the state agency in writing for this purpose. c. Upon receipt of the notice of the deficiency notice, the contractor shall have seven calendar days to 3 either correct the described de?ciencylies] to the sole satisfaction of the state agency, or demonstrate good cause 5 as to why the de?ciency?es) cannot be resolved within the seven-day period. In either instance, the contractor shall implement a corrective plan of action and direct a response to the state agency within the seven-day period. i i i i d. Such provisions concerning the providing of de?ciency notices shall be in addition to the provisions contained elsewhere herein concerning notice provided to thencontr?aftor regarding issues of contractual breach. Corizon has reviewed and will comply with the performance standards as written in this requirement. i 3. Upon award of the contract, the contractor shall work with the state agency and any other organizations designated by the state agency to ensure an orderly transition of services and responsibilities under the contract and to ensure the continuity of those services required by the state agency. I b. In addition, upon expiration, termination, or cancellation of the contract, the contractor shall assist the state agency to ensure an orderly and smooth transfer of responsibility and continuity of those services required under the terms of the contract to an organization designated by the state agency. If requested by the state agency, the contractor shall provide andfor perform any or all of the following responsibilities: 1) The contractor shall deliver, FOB destination, all records, documentation, reports, data, . recommendations, or printing elements, etc., which were required to be produced under the terms of the contract to the state agency and/or to the state agency's designee within seven (7) days after receipt of the written request in a format and condition that are acceptable to the state agency. 2) The contractor shall discontinue providing services or accepting new assignments under the terms of the contract, on the date specified by the state agency, in order to ensure the completion of such service prior to the expiration of the contract. 3) If requested in writing via formal contract amendment, the contractor shali agree to continue providing any part or all of the services in accordance with the terms and conditions, requirements and speci?cations of the contract for a period not to exceed ninety [90) calendar days after the expiration, termination or cancellation date ?Lo_i?_t_he__contract for a price not toexceed those prices inmthe contract. Contractual Requirements - 176 Proven aPartnership' senrices to any offender after the termination or cancellation of the contract. The written approval must identify the speci?c offender and contain a date for the termination of service for the offender. I 1 i Ease-by-case basis at its sole discretion. Corizon has reviewed and will comply with the performance standards as written in this requirement. 2.17.7 Contractor Liability a The contractor must obtain speci?c written approval from the state agency prior to providing continuing i The decision to allow an offender to receive continuing services shall be made by the state agency on a The contractor shall be responsible for any and all personal injury (including death) or property damage as a result State of Missouri, including its agencies, employees, and assignees, from every expense, liability, or payment arising out of such negligent act. of the contractor's negligence involving any equipment or service provided under the terms and conditions, I requirements and speci?cations of the contract. In addition, the contractor assumes the obligation to save the a. The contractor also agrees to hold the State of Missouri, including its agencies, employees, and assignees, I the supervision of the contractor under the terms of the contract. b. The contractor shall not be responsible for any injury or damage occurring as a result of any negligent act or omission committed by the State of Missouri, including its agencies, employees, and assignees. c. Under no circumstances shall the contractor be liable for any of the following: (1) third party claims against the state for losses or damages (other than those listed above) or (2) economic consequential damages (including lost profits or savings) or incidental damages, even if the contractor is informed of their possibility. Corizon has reviewed and will comply with the performance standards as written in this requirement. 247.8 Insurance andfor indemnify the contractor or employees against any liability incurred or arising as a result of any activity of the contractor or any activity of the contractor's employees related to the contractor's performance under the contract. Therefore, the contractor shall maintain adequate liability inSurance in the and . suf?cient to protect the State of Missouri, its agencies, its employees, its clients, and the general public against any loss, damage, andior expense related to hisiher performance under the contract. The insurance coverage shall include, but shall not necessarily be limited to, general liability, professional liability, etc. In addition, automobile liability coverage for the operation of any motor vehicle must be maintained if the terms of the contract require any form of transportation services. The limits of liability for all types of coverage shall not be less than $2,000,000.00 per occurrence. endorsement that adds the State of Missouri as an additional insured. a. The contractor shall provide written evidence of the insurance to the state agency prior to performance under the contract. Such evidence shall include, but shall not necessarily be limited to: effective dates of coverage, harmless for any negligent act or omission committed by any subcontractor or other person employed by or under 3 s. Insurance The contractor shall understand and agree that the State of Missouri cannot save and hold harmless The general and other non-professional liability insurance shall include an limits of liability, insurer?s name, policy number, endorsement for the non-professional liability insurance naming the State of Missouri as an additional insured, endorsement by representatives of the insurance company, etc. The contract number must be identified on the evidence of insurance coverage. Evidence of self-insurance Contractual Requirements - 177 J, Proven A @Partnership coverage or of another alternate risk ?nancing mechanism may be utilized provided that such coverage is veri?able i and irrevocably reliable and the State of Missouri is protected as an additional insured. b. In the event the insurance coverage is canceled, the state agency must be notified within thirty (30) days. Corizon has reviewed and will comply with the performance standards as written in this requirement. Please refer to Appendix to review Corizon?s insurance certificates. i! a. The contractor shall not transfer any interest in the contract, whether by assignment or othenivise, without the I prior written consent of the Division of Purchasing and Materials Management. I: b. The contractor shall agree and understand that, in the event the Division of Purchasing and Materials 3 Management consents to a ?nancial assignment of the contract in whole or in part to a third party, any payments 5 made by the State of Missouri pursuant to the contract, including all of those payments assigned to the third party, i shall be contingent upon the performance of the prime contractor in accordance with all terms and conditions, 1 requirements and speci?cations of the contract. L..- . "wees?F?m Mm- .. Corizon has reviewed and will comply with the performance standards as written in this requirement. . Any subcontracts for the productsr'services described herein must include appropriate provisions and contractual obligations to ensure the successful ful?llment of all contractual obligations agreed to by the contractor and the State of Missouri and to ensure that the State of Missouri is indemni?ed, saved, and held harmless from and against any and all claims of damage, loss, and cost (including attorney fees) of any kind related to a subcontract in those matters described in the contract between the State of Missouri and the contractor. a. The contractor shall expressly understand and agree that hefshe shall assume and be solely responsible for all legal and ?nancial responsibilities related to the execution of a subcontract. b. The contractor shall agree and understand that utilization of a subcontractor to provide any of the in the contract shall in no way relieve the contractor of the responsibility for providing the products/services as described and set forth herein. c. The contractor must obtain the approval of the State of Missouri prior to establishing any new subcontracting arrangements and before changing any subcontractors. The approval shall not be arbitrarily withheld. d. Pursuant to subsection 1 of section 285.530, no contractor or subcontractor shall knowingly employ, hire for employment, or continue to employ an unauthorized alien to perform work within the state of Missouri. In accordance with sections 285.525 to 285.550, a general contractor or subcontractor of any tier shall not be liable when Such contractor or subcontractor contracts with its direct subcontractor who violates subsection 1 of section 285.530, if the contract binding the contractor and subcontractor affirmativer states that 1) The direct subcontractor is not knowingly in violation of subsection 1 of section 285.530, and shall not henceforth be in such?violation. Contractual Requirements - 178 i .I e. P. Proven A 7 Partnership 7 2] The contractor or subcontractor receives a sworn af?davit under the penalty of perjury attesting to the fact that the direct subcontractor? 5 employees are lawfully present in the United States. The contractor shall be the sole source of contact for the contract. The contractor must maintain direct oversight and coordination of all subcontracted activities. The state agency will only work directly with the i. I i_ contractor on issues involving any subcontractor. Corizon has reviewed and will comply with the performance standards as written in this requirement. 2.17.311 Participation by Other Organizations The contractor must comply with any Organization for the Blind/Sheltered Workshop, Service-Disabled Veteran meeting the Organizations for the BlindISheltered Workshop and SDVE participation levels committed to in the i contractor?s awarded proposal. The Division of Purchasing and Materials Management in conjunction with the Office of Equal Opportunity (0E0) will monitor the contractor?s compliance in meeting the MBEMBE participation levels committed to in the contractor?s awarded proposal. Business Enterprise (SDVE), and/or Minority Business Enterprisefwornen Business Enterprise participation levels committed to in the contractor?s awarded proposal. a. The cootractor shall prepare and submit to the Division of Purchasing and Materials Management a report detailing all payments made by the contractor to Organizations for the BlindISheltered Workshops, SDVEs, andfor Participating in the contract for the reporting period. The contractor must submit the report on a basis. unless otherwise determined by the Division of Purchasing and Materials Management. b. The Division of Purchasing and Materials Management will monitor the contractor?s compliance in . If the contractor?s payments to the participating entities are less than the amount committed, the state may cancel the contract and/or suspend or debar the I contractor from participating in future state procurements, or retain payments to the contractor in an amount i I for any new entities. This approval shall not be arbitrarily withheld. i I of Purchasing and Materials Management shall have sole discretion in determining if the actions taken by the I c. equal to the value of the participation commitment less actual payments made by the contractor to the 5 Participating entity. If the Division of Purchasing and Materials Management determines that the contractor becomes compliant with the commitment, any funds retained as stated above, will be released. If a participating entity fails to retain the required certi?cation or is unable to satisfactorily perfonn, the contractor must obtain other certified MBEMBES or other organizations for the workshops or other SDVEs to fulfill the participation requirements committed to in the contractor?s awarded proposal. 1) The contractor must obtain the written approval of the Division of Purchasing and Materials Management 2] If the contractor cannot obtain a replacement entity, the contractor must submit documentation to the Division of Purchasing and Materials Management detailing all efforts made to seizure a replacement. The Division contractor constitute a good faith effort to secure the required participation and whether the contract will be amended to change the contractor?s participation commitment. d. No later than thirty [30) days after the effective date of the ?rst renewal period, the contractor must .5 submit an af?davit to the Division of Purchasing and Materials Management. The af?davit must be signed by the director or manager of the participating Organizations for the BIindeheltered Workshop verifying provision of andfor services and compliance of all contractor payments made to the Organizations for the Blind/Sheltered Workshops. The contractor may use the af?davit available on the Division of Purchasing and Contractual Requirements - 179 Proven a Partnership Materials Management's website at or another af?davit providing the sanj information. Corizon has reviewed and will comply with the performance standards as written in this requirement. Corizon looks forward to continuing to build on a strong fiscal 2013 performance on our MBEIWBE commitments. As addressed in the section of this proposal titled "Our Commitment and Resources for the Missouri we have established strong working relationships with multifaceted vendors that play a pivotal role in servicing our contract to the highest possible standard, and we will continue to build on these relationships in order to ensure that we continue to consistently meet and exceed our commitments going forward. i a. The contractor shall only employ applicable federal and state laws. This includes but is not limited to the illegal Immigration Reform and immigrant I Responsibility Act and INA Section 274A. i b. If the contractor is found to be in violation of this requirement or the applicable state, federal and local laws and regulations, and if the State of Missouri has reasonable cause to believe that the contractor has knowingly employed individuals who are not eligible to work in the United States, the state shall have the right to cancel the contract immediately without penalty or recourse and Suspend or debar the contractor from doing I business with the state. The state may also withhold up to twenty-?ve percent of the total amount due to the contractor. c. The contractor shall agree to fully cooperate with any audit or investigation from federal, state, or local . law enforcement agencies. d. If the contractor meets the de?nition of a business entity as de?ned in section 285.525, pertaining to section 285.530, the contractor shall maintain enrollment and participation in the E-Verify federal work authorization program with respect to the employees hired after enrollment in the program who are proposed to 5 work in connection with the contracted services included herein. If the contractor?s business status changes 5 during the life of the contract to become a business entity as de?ned in section 285.525, pertaining to section 285.530, then the contractor shall, prior to the performance of any services as a business entity under the contract: 1) Enroll and participate in the E-Verify federal work authorization program with respect to the employees i hired after enrollment in the program who are proposed to work in connection with the services required herein; AND 2) Provide to the Division of Purchasing and Materials Management the documentation required in the exhibit titled, Business Entity Certification, Enrollment Documentation, and Af?davit of Work Authorization . af?rming said company'siindividual?s enrollment and participation in the E-Verify federal work authorization l, program; AND i 3) Submit to the Division of Purchasing and Materials Management a completed, notarized Af?davit of Work 1, Authorization provided in the exhibit titled, Business Entity Certi?cation, Enrollment Documentation, and Af?davit I of Work Authorization. i,_i_iilork Authorization annually. A valid Af?davitpf authorization is necessary to award any new contracts. Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 180 e. In accordance with subsection 2 of section 285.530, the contractor should renew their Affidavit of i 4 Proven aPaI-tnership We will only employ personnel authorized to work in the United States in accordance with applicable federal and state laws. This includes but is not limited to the Illegal Immigration Reform and immigrant Responsibility Act and INA Section 274A. We understand that if we are found to be in violation of this requirement or the applicable state, federal and local laws and regulations, and if the State of Missouri has reasonable cause to believe that Corizon has knowingly employed individuals who are not eligible to work in the United States, the state will have the right to cancel the contract immediately without penalty or recourse and suspend or debar Corizon from doing business with the state. We understand the state?s right to withhold up to twenty-?ve percent of the total amount due to Corizon. Corizon will agree to fully cooperate with any audit or investigation from federal, state, or local law enforcement agencies. E-Verify Utilization Corizon will utilize the US. Department of Homeland Security?s E-Verify system to verify employment eligibility of all persons employed during the contract term by Corizon to perform employment duties within Missouri; and all persons including subcontractors assigned by Corizon to perform work pursoant to our contract with the MDOC. This law prohibits employers (both public and private) from knowingly hiring unauthorized workers and requires employers to use E?Verify?. Corizon is 100% compliant with this Missouri law. in addition, beginning in April 2009, Corizon implemented Talx Corporation?s 1-9 Express with the E-Verify' system. This system allows Corizon to ensure compliance with Federal and State l?Q regulatory requirements for all newly hired employees. The Express solution generates and maintains forms electronically, complete with electronic Signatures. In addition, the system maintains compliance by notifying Corizon site and corporate management of any employees that require an update in employment status before work authorization expires. The E-Verify system automatically checks the work authorization of new hires with the Social Security Administration and the Department of Homeland Security databases and noti?es Corizon of any incorrect or missing data. Business Entity De?nition Corizon does meet the definition of a business entity as de?ned in section 285.525, pertaining to section 235.530, and will maintain enrollment and participation in the E-Verify federal work authorization program with respect to the employees hired after enrollment in the program who are proposed to work in connection with the contracted services included within the contract. We Will provide to the Division of Purchasing and Materials Management the documentation required in the exhibit titled, Business Entity Certification, Enrollment Documentation, and Af?davit of Work Authorization af?rming said companfsfindividual?s enrollment and participation in the E-Verify federal Contractual Requirements - 181 @Partnership work authorization program. We will also submit to the Division of Purchasing and Materials Management a completed, notarized Affidavit of Work Authorization provided in the exhibit titled, Business Entity Certification, Enrollment Documentation, and Affidavit of Work Authorization. In accordance with subsection 2 of section 285.530, Corizon will renew our Affidavit of Work Authorization annually. We understand that a valid Af?davit of Work Authorization is necessary to award any new contracts. 2-1293 The contractor is an independent contractor and shall not represent the contractor or the contractor?s employees 1' to be employees of the State of Missouri or an agency of the State of Missouri. The contractor shall assume all legal and ?nancial responsibility for salaries, taxes, FICA, employee fringe bene?ts, workers compensation, i employee insurance, minimum wage requirements, overtime, etc, and agrees to indemnify, save, and hold the 5 State of Missouri, its of?cerS. agents, and employees, harmless from and against, any and all loss; cost (including attorney fees); and damages} any kind related to such matters. Corizon has reviewed and will comply with the performance standards as written in this requirement. 2-17-14 \Eeer?inatien 5 The contractor shall fully coordinate all contract activities with those activities of the state agency. As the work of the contractor progresses, advice and information on matters covered by the contract shall be made available by the contractor to the state agency or the Division of Purchasing and Materials Management throughout the i '1 effective period of the contract. Corizon has reviewed and will comply with the performance standards as written in this requirement. The contractor shall agree and understand that all documents, data, reports, supplies, equipment, and accomplishments prepared, furnished, or completed by the contractor pursuant to the terms of the contract shall become the property of the State of Missouri. Upon expiration, termination, or cancellation of the contract, said items shall become the property of the State of Missouri, which shall include all rights and interests for present and future use or sale as deemed appropriate by the state agency. (8-2., project management software tools or training software tools, etc.) developed or acquired by the contractor that may be necessary to perform a particular service required hereunder but not required as a speci?c deliverable of the contract, shall remain the property of the contractor; however, the contractor shall be responsible for 5 ensuring such tools and materials are being used in accordance with applicable intellectual property rights and copyrights. i a. The State of Missouri understands and agrees that any ancillary software tools or pre-printed materials 1 Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 182 .3 . Proven a Partnership 2.17.16 Con?dentiality . a. The contractor shall agree and understand that all discussions with the contractor and all information i gained by the contractor as a result of the contractor's performance under the contract shall be con?dential and 3 that no reports, documentation, or material prepared as required by the contract shall be released to the public without the prior written consent of the state agency. b. If required by the state agency, the contractor and any required contractor personnel must sign speci?c documents regarding con?dentiality, security, or other similar documents upon request. Failure of the contractor arid 3'17 required personnel to sign such documents shall be considered a breach of contract and subject to the Cancellation provisions of this document. Corizon has reviewed and will comply with the performance standards as written in this requirement. 2.17.17 Fgce Majeure The contractor shall not be liable for any excess costs for delayed delivery of goods or services to the State of Missouri, if the failure to perform the contract arises out of causes beyond the control of, and without the fault or negligence of the contractor. Such causes may include, however are not restricted to: acts of God, ?res, ?oods, epidemics. quarantine restrictions, strikes, and freight embargoes. In all cases, the failure to perform must be 1 beyond the control of, and without the fault or negligence of, either the contractor or any subcontractorls]. The - contractor shall take all possible steps to recover from any such occurrences. Corizon has reviewed and will comply with the performance standards as written in this requirement. . ?nt Venture a. If the contractor?s proposal submitted in response to the RFP represented a joint venture type arrangement, the following shall apply: i, 1] The of?cial signatory for the lead entity who signed the contractor?s proposal shall serve as the of?cial signatory for any subsequent contract amendments. 2) The contractor shall be responsible for having the contractor's own joint venture in place to govern the i relationship between and among the contractor and its joint venture. 3) The contractor must function as the single point of contact for the State of Missouri, regardless of any i joint venture for all services provided herein. This shall include assuming responsibility and liabilities for all services provided. The entity whose of?cial signatory signed the proposal shall be the legal entity responsible to the State of Missouri for all sanctions under the contract and all other contractual compliance issues. 4) There shall only be one entity to which payments by the State of Missouri shall be made and that entity shall be the entity whose of?cial signatory signed the proposal. 5) The State of Missouri shall not incur any legal liability in the defending of a joint response against claims of unfair competition under the Clayton Anti?Trust Act or the Federal Trade Commission Act or any other federal or state law that applies to unfair methods of competition. Any defense of such issue shall be wholly undertaken by . the entitiesf?rms making up the joint venture. b. If the contractor anticipates entering into a joint venture with other entities at any time during the effective period of the contract, the contractor must obtain the written approval of the state agency prior to i entering into any such agreement and shall understand that the state agency shall have the sole right to refuse to 3 grant its consent to such an arrangement. . Contractual Requirements - 183 i i c. Failure of the contractor to disclose any joint venture regarding the provision of services herein shall be i grounds for termination of the contract. Corizon has reviewed and will comply with the performance standards as written in this requirement. We have not submitted our proposal to MDOC as a joint venture. 2.17.19 Assignment 3. The contractor shall not transfer any interest in the contract, whether by assignment or otherwise, i without the prior written consent of the Division of Purchasing and Materials Management. b. The contractor shall agree and understand that, in the event the Division of Purchasing and Materials Management consents to a ?nancial assignment of the contract in whole or in part to a third party, any payments I made by the State of Missouri pursuant to the contract, including all of those payments assigned to the third party, shall be contingent upon the performance of the prime contractor in accordance with all terms and conditions, Li?il?tr?f?i?ind speci?sasiart?ef the centres; Corizon has reviewed and will comply with the performance standards as written in this requirement. Contractual Requirements - 184