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Home My WebLink AboutResolutions - 2022.02.03 - 35246i BOARD OF COMMISSIONERS February 3, 2022 XHSCELLANEOUS RESOLUTION #22-3.1 Sponsored By: Penny Luebs IN RE: Sheriff's Office - Budget Amendment Appropriating Funding for a Contract fvith Wellpath LLC to Provide Nledical Services at the Oakland County Jail Chairperson and Members of the Board: WHEREAS the current contract Nvith Wellpath LLC to provide medical services at the Oakland County Jail expires on February 28, 2022; and WHEREAS the Oakland County Sheriff s Office (OCSO) presented a notice of intent to enter into a contract for services for the Jail Health Clinic — Innnate Health Program to the Finance Committee on October 6. 2021: and N17HEREAS a request for proposal Nvas placed on the Michigan Inter -governmental Trade Network (MITN) resulting in two bid responses; and WHEREAS the bids were evaluated based on the following categories: health management system. medical/clinical staff management, corporate history and experience, contract administration, and pricing: and WHEREAS only one bid response, NVellpath LLC. included a complete turnkey health program for the jail: and \VHEREAS the Oakland County Sheriff s Office reconunends awarding the jail medical services contract to tiVellpath LLC for S20.205,364 covering a three -pear period, March 1. 2022 through February 28, 2025. (Year 1 S6,537.049, Year 2 S6.733,160 and Year 3 $6,935.155); and �VIIEREAS approximately 7% of the increased cost in Year I is attributed to staffing and the need to offer competitive wages in order to maintain a skilled medical staff. Recruitment and retention are increasingly difficult as seen in medical facilities around the country; and WHEREAS the annual increase to the jail medical services contract has historically been 3%, and WHEREAS the Sheriff s Office Contracted Services budget (Account 730373) does not have sufficient funding to cover the new contract costs and OCSO is requesting to increase the FY2022 budget by S548.195. increase the FY2023 budget by S744,306 and increase the FY 2024 by S946.301 to support medical services at the Oakland County Jail. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authotizes an appropriation of additional funding to the FY 2022 - 2024 Sheriff s Office Contracted Services Account (4730373) for the purposes of entering into a contract with SVellpath LLC for services for the Jail Health Clinic - Inmate Health Program. BE IT FURTHER RESOLVED that the 3-year contract forjail medical services will be awarded, pending a separate Board of Commissioners' resolution; to Wellpath LLC beginning March 1. 2022 in the amount of $20,205,364. BE IT FURTHER RESOLVED that the FY 2022 - 2024 budget shall be amended as reflected in the attached Schedule A - Budget Amendment. Chairperson, the following Connnissioners are sponsoring the foregoing Resolution: Penny Luebs. Q7d��U Date: February 07, 2022 David Woodward, Commissioner WY►w Date: February 11, 2022 Hilarie Chambers, Deputy County Executive II ( f l� Date: February 11, 2022 Lisa Brown, County Clerk / Register of Deeds COMMITTEE TRACKING 203?-01-25 Public Health & Safety - Recommend and Forward to Finance 2022-01-26 Finance - Recommend to Board 2022-02-03 Full Board VOTE TRACKING Motioned by Conunissioner Penny Luebs seconded by Coimnissioner Michael Gingell to adopt the attached Budget Amendment: Appropriating Funding for a Contract with Wellpath LLC to Provide Medical Services at the Oakland County Jail. Yes: David Woodward. Ntichael Gingell, Michael Spisz. Karen Joiiat. Kristen Nelson, Eileen Kowall. Christine Lone, Philip Weipert, Gwen Markham. Angela Powell, Thomas Kuhn, Cluck Moss. Marcia Gershenson, William Miller III, Yolanda Smith Charles, Penny Luebs, Janet Jackson, Gary- McGillivray. Robert Hoffman (19) No: Charles Cavell (1) Abstain: None (0) Absent: (0) The Motion Passed. ATTACHMENTS 1. Jail Medical Services - yy%ellpath - Schedule A 2. MemoProfSeivices Jail Health Services 3. Wellpath Part 1 d. Wellpath Part 2 3. Wellpath Pail 3 STATE OF MICHIGAN) COUNTY OF OAKLANfl) I. Lisa Bro«qz, Clerk- of the County of Oakland. do hereby certify- that the foregoing resolution is a trite and accurate copy of a resolution adopted by the Oakland County Board of Conunissioners on February 3, 2022, with the original record thereof now remaining in my office. In Testimonv R"hereof, I have hereunto set my hand and affixed the seal of the Circnit Court at Pontiac. Nlicliigan on Thursday. February 3, 2022. Liso Brown, Oak-kmd Comav Clerk/ Reg vey- of Deeds q01.AKLAND?=F COUNTY MICHIGAN BOARD OF COMMISSIONERS AMENDMENT IN RE: Amendment #1 WHEREAS the current contract with Wellpath LLC to provide medical services at the Oakland County Jail expires on February 28, 2022: and WHEREAS the Oakland County Sheriff s Office (OCSO) presented a notice of intent to enter into a contract for services for the Jail Health Clinic — hunate Health Program to the Finance Committee on October 6, 2021; and WHEREAS a request for proposal was placed on the Michigan Inter -governmental Trade Network (MITN) resulting in two bid responses; and WHEREAS the bids were evaluated based on the following categories: health management system, medical/clinical staff management, corporate history and experience, contract administration, and pricing; and WHEREAS only one bid response, Wellpath LLC, included a complete turnkey health program for the jail: and WHEREAS the Oakland Comity Sheriff s Office recommends awarding the jail medical services contract to Wellpath LLC for S20,205,364 covering a tluee-year period. March 1. 2022 through February 28, 2025. (Year S6,537.049, Year 2 $6,733,160 and Year 3 $6,931,155)-, and WHEREAS approximately 7110 of the increased cost in Year I is attributed to staffing and the need to offer competitive wages in order to maintain a skilled medical staff. Recruitment and retention are increasingly difficult as seen in medical facilities around the country; and WHEREAS the annual increase to the jail medical services contract has historically been 3° o and WHEREAS the Sheriffs Office Contracted Services budget (Account 730373) does not have sufficient funding to cover the new contract costs and OCSO is requesting to increase the FY2022 budget by $54& 195. increase the FY2023 budget by $744,306 and increase the FY2024 by S946,301 to support medical services at the Oakland County Jail. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authorizes an appropriation of additional funding to the FY 2022 - 2024 Sheriffs Office Contracted Services Account (#730373) for the purposes of entering into a contract,,vith Wellpath LLC for services for the Jail Health Clinic - Inmate Health Program. BE IT FtTRTHER RESOLVED that the 3-year contract for jail medical services will be awarded, pending a separate Board of Commissioners' resolution, to `Vellpath LLC beginning March 1, 2022 in the amount of $20,205,364. BE IT FURTHER RESOLVED that the Board requests the county administration, working a} ith the Sheriffs Office, to contract with an independent 3rd path' to conduct a market analysis and cost analysis, on services currently outsourced. The objective of the analysis is to provide verification of lvbether the current services should continue to be outsourced In whole or in part. The report should be provided to the BOC by July 31, 2022. BE IT FURTHER RESOLVED that the FY 2022 - 2024 budget shall be amended as reflected in the attached Schedule A - Budget Amendment. VOTE TRACKING - Board of Commissioners 'Motioned by: Counnissioner Charles Cavell Seconded by: Commissioner Yolanda Smith Charles Yes: David Woodward, Kristen Nelson, Gwen Markham, Angela Powell, Marcia Gershenson, William Miller III, Charles Cavell, Penny Luebs. Janet Jackson (9) No: Michael Gingell, Michael Spisz, Karen Joliat. Eileen Kowall. Christine Long, Philip Weipert. Thomas Kuhn, Chuck Moss, Yolanda Smith Charles. Gary McGillivray, Robert Hoffman (11) Abstain: None (0) Absent: Adam Kochenderfer (1) The Motion Failed. AT THE OARLAND COUNTY JAIL Oakland CovntY. ppl<pi9an FS CONTRACT WCfUy,IELLPATR LLC FOR MEDICAL SERNCi1 rxhedule "A" DETWL 1 Anal Pto ¢d# ActWit n Fund 8ud9et pmeet p jude Reference Unit OVW aUn9 Fund' I" udn%P am#'Account#I Un0. 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OAKLAND COUNTY '��-M—t''ICHIGAN MEMORANDUM DATE: October 1, 2021 TO: Commissioner Gwen Markham, Chairperson, Finance Committee Members of the Finance Committee FROM: Mike McCabe, Undersheriff RE: Notice of intent to enter into contract for services for Jail Health Clinic— Inmate Health Program Pursuant to the Professional Services Contract Authorization Policy, please accept this memorandum as notification that the Sheriffs Office intends to enter into a contract for professional services for the provision of a turnkey Inmate Health Program utilizing unobligated funds appropriated in 10100-4030301- 112630-730373. Purpose: Contract 4989 for Jail Inmate Health Services is expiring on 2/28/2022. The current contractor is Wellpath LLC, and the current contract period is lapsing following a five-year term. This is a recurring expense to address an ongoing need to provide medical and dental care to inmates. Bid Process Overview: Competitively Bid (Event #005301) Bid Solicitation Open Date: 09/01/2021 Bid Solicitation Close Date: 09/24/2021 Number of Bids received: 2 Current Status: Bid evaluation: The evaluation team is comprised of subject matter experts working in the Oakland County Jail (Major, Captain, and Executive Lieutenant) as well as Sheriff's Administration (Supervisor Sheriff Contracts & Accounts, Accountant II and Accounting Specialist). The scoring matrix follows the requested material included in the Scope of Work. There was an opportunity for interested bidders to take part in a walk through of the jail clinic, a pre -bid conference call to allow potential bidders an opportunity to ask questions as well as a 16-day window for potential bidders to make written requests for clarification. List of notable changes to Scope of Work: 1) Added language in the Medication Management/Medical Supplies section: MAT -A Medication Assisted Treatment (MAT) program for opioid use will be administered by the contractor's health care personnel to continue care for any inmate entering the jail currently on MAT. If the county develops a MAT program during the contract period which encompasses opioid dependent individuals who are incarcerated and not currently on MAT, the contractor's health care personnel will be responsible for administering the medication. 2) Added language to Staffing section: The contractor must provide a detailed contingency plan for loss of staffing addressing situations similar to the COVID-19 pandemic or other unforeseen circumstances that could potentially cause a loss of staff in both the short (a couple weeks) and long-term (potentially months to years). 3) Added language to New Hires section: The employee chosen by the contractor to fill the Health Services Administrator or equivalent lead managerial position responsible for overseeing the jail health clinic will need to be approved by the Oakland County jail administration staff. Please list the qualifications and experience of the individual you plan to place in this position. 4) Added a "Pandemic" section. The contractor will manage, treat, test and track for any pandemic (including COVID). The contractor will work in coordination with local, state, or federal health officials as well as jail staff on any new and immediate policy, protocols or procedures put in place as a result of a pandemic. Contractor will have an emergency staffing plan that addresses and ensures coverage in the case of temporary or long-term staffing shortages as a result of a pandemic or quarantine. S) Added Information for IT Review: An Oakland County Information Technology (IT) review will be required of the awarded contractor's electronic medical record and retention system. The contractor's database(s) must integrate with the county's jail management system, both current and new. The contractor must work with both Oakland County IT and the jail management system contractor to ensure systems are working properly. In the event that either the server, jail management system or contractor's system have a failure, all parties will work together to bring the systems back up to full functionality. Any system incident that causes a delay in the jail's critical operations needs to be escalated to the highest priority. Awarded contractor will be responsible for all costs incurred for IT system transition/updates 6) Clarified some areas where requests by inmates used to be made on paper (requests for medical service, grievances/kites), now done through the Smart tablets. Example: Inmates will have the opportunity to request health care services 24-hours a day. All inmate health service requests will be through an electronic system that notifies clinic staff of the request and must be answered based on NCCHC requirements and OCSO department policy. If the electronic system is down the contractor will respond to the inmate health service requests through an alternate process determined by the jail. The contractor must submit a plan that illustrates how health care personnel will triage the requests and determine the appropriate course of action to be taken. The plan must include immediate intervention, scheduling for nursing sick call, or a provider evaluation. This plan must include triage to occur at least once daily. 7) For past RFPs we have provided the previous year's inmate population information, but for this RFP we had to provide pre-COVID data and current data so they have a better picture of what our numbers would be like in the absence of a pandemic. Same issue for the health services statistical data (provided 2 years instead of 1). Estimated Annual Expenditures: $5,600,000 Conclusion: The annual amount was included in our FY 2022 - FY 2024 Recommended Budget based on current contract amounts. We anticipate cost increases based on additional requirements added to the Scope of Work, primarily the addition of a comprehensive Medication Assisted Treatment (MAT) program for opioid use and a new Pandemic section. _ L a^ » a«<!<«f■.» «<¥» /-g wellp T mdGm. \=1 Oakland County, Michigan Waterford, Michigan Solicitation Event ID: 005301 Jail Health Clinic Technical and Cost Proposal Friday, September 24, 2021 2 pm Eastern Time llp To hope and healing. Respectfully Submitted to: Joseph Dahl, Buyer Oakland County Purchasing Executive Office Building 41W — Lower Level 2100 Pontiac Lake Road Waterford, MI 48328 248-858-0514 Submitted by: W E LLPATH ° 1283 Murfreesboro Road, Suite 500 Nashville, TN 37217 800-592-2974 Tax ID# 32-0092573 Points of Contact: Renee Negri, CCHP Director, Partner Services 724-787-6698 rnegri@well path. us Kip Hallman President 858-283-8619 kip.hallman@wellpath.us This submission includes the following required copies: Technical and Cost Proposal —1 Electronic Copy 0 WELLPATH is a registered trademark of Wellpath Holdings Inc. All Rights Reserved. Solicitation Event ID: 005301 Jail Health Clinic September 24, 2021 Dear Sheriff Bouchard, Major Childs, Lieutenant Vida, Ms. Piir, Members of the Oakland County Sheriff's Office and Representatives of Oakland County Purchasing: Wellpath appreciates the opportunity to submit our proposal in response to Oakland County's Solicitation Event ID 005301 for Jail Health Clinic and the provision of a comprehensive turnkey Inmate Health Program for the Oakland County Sheriff's Office (OCSO) Correctional Facilities. We are proud to be the current healthcare services provider for the OCSO, and we possess unmatched knowledge of the intricacies of caring for the patient population incarcerated in the Main Jail Correctional Facility and the East Annex Correctional Facility. 'Wellpath Regional Diroctur of Operations, Mark Morrissey, € sW, RN, CCHP, voas a member of the Oakland Crsun.y Sheriff's Office for 14 years, .<erving as Carrectio€,s Nogran: Chief, Nursing Supervisor and Public Health €?urse, Our Health Services Administrator, Vicki -Lyn Warren, BSly, RN, CC!#P is in her 37th year of providing administrathic and nursing care for the OCSO. We look forward to continuing our inmate healthcare services program, which respects the rights of the patients in Oakland County while also demonstrating cost -efficiency, transparency, and accountability to the Sheriff's Office and the County. As a public health company, we do not just focus on treating sick patients. We understand that the goal of public health is to promote healthy behaviors that prevent people from becoming ill or injured in the first place. We know our corrections business is a very diverse public health setting where promoting wellness among the inmate population is a critical component of increasing the health of the entire community. In most cases, when an inmate leaves an OCSO facility, he or she remains in Oakland County. The OCSO has an obligation to the community to ensure inmates are released in the best possible health, and Wellpath is dedicated to continuing to help meet this obligation. We are proud of the strong relationship that we have built over the past nine years with the OCSO and the correctional facility administration and staff who assist us in completing our public health mission of treating patients "as if they are members of our family." Through our approach of collaborating with the OCSO, we continue to raise the quality of patient care for our patients in your facilities. We look forward to discussing how our proposed enhancements to the existing program can increase our on -site capabilities. Since Oakland County made the decision to entrust its inmate healthcare program to Wellpath's legacy company (CCS), the Oakland County Sheriff's Office has worked with us to improve the inmate healthcare program. Some of those enhancements include: COVID-19 Response: Wellpath and the OCSO have teamed to provide a dedicated — and evolving — response to COVID-19 and the Delta Variant. As of August 31, 2021, Wellpath has administered 12,635 COVID swabs with 196 testing positive. There have been only two emergency department visits related to COVID. e 'J� Solicitation Event ID: 005301 Jail Health Clinic Accreditation Success: Wellpath and Oakland County have worked together to maintain accreditation with NCCHC over the past nine years. Our last survey was October 2019. Our annual inspection record with the Michigan Department of Corrections (MDOC) can be summed up by its report comment on an audit of 50 inmate health records this month (September 2021): ' iWui?pc,M hogs (lone an excetfent job and didn't rr J_s crrc 34 day health apprar"su.?." Technological Solutions: Since beginning our partnership with Oakland County in 2012, Wellpath has committed to implementing technological solutions that streamline workflows, provide enhanced reporting capabilities, and augment our ability to provide patient care to those housed in the OCSO Correctional Facilities. Our solutions include: o Employing our Electronic Records Management Applications (ERMA) along with our Point of Care Companion (POCC). o Implementing the Wellpath Client Portal for reporting transparency. o The Wellpath Cloud, a suite of technology -enabled, remote healthcare services and tools designed to enable the delivery of the best care, to the most patients, in the shortest amount of time. o Working with the Michigan Department of Health & Human Services on the integration of the OCSO Correctional Facilities with CareConnect360, a Health Information Exchange. Increasing Services while Reducing Cost: Wellpath has operated the inmate medical program for Oakland County since 2012. In those 9-plus years Wellpath has been able to operate a health services program that delivers enhance patient care under budget. tr6'e have provided budgeted savings to Oakland County of more than $793,000 since March 1, 2017. In addition to staying below budget, Wellpath has a team dedicated to ensuring we consistently enroll patients in Medicaid correctly to ensure proper and timely payment. Since 2017 and Fh,rousgh September 1.0, r"_021, we have successfully `'Hied 587 approved inpatient enrollments covering a total of 2,617 inpatient days, saving the County an esthriated 1-6,677,500 in in patient charges. Medication Assisted Treatment Program (MAT): Wellpath will continue to offer a MAT program for OCSO patients, ensuring that those entering the Correctional Facilities who are already working with a community MAT provider continue their treatment and helping those who wish to start on a MAT program while incarcerated connect to community resources for continued treatment upon release. Frank Knasiak Memorial Golf Outing: Wellpath is a proud event sponsor of this event supporting community groups such as food banks and domestic violence shelters. Knasiak was a member of the OCSO when he died unexpectedly while jogging in 1983. Community Outreach: Each year Wellpath's clinical staff at the OCSO Correctional Facilities holds a Christmas collection to benefit a local organization. In 2020, a book drive was held for an early intervention outreach program, Oakland Family Services. We also work with the Oakland County Animal Shelter. In this proposal, we outline our current and proposed program strengths to demonstrate our ability to meet and exceed the program objectives stated in your Solicitation Event. We also describe some of the successes that the OCSO and Wellpath partnership have already created. Our past success combined Solicitation Event ID: 005301 Jail Health Clinic with our enhanced programming establish a strong platform for an even more successful future together. Wellpath is the Only Company that Offers Oakland County ZERO Transition Risk? As the provider of healthcare services for the OCSO Correctional Facilities since 2012, we have a full appreciation of the mission and objectives of Oakland County's healthcare program. Our record of delivering thoughtful, cost-effective solutions to meet the healthcare needs of the Main Jail and East Annex has been established. For all other bidders, there will be a significant learning curve for the first several months of operations. Selecting Wellpath eliminates the need to transition, and therefore removes the inevitable challenges that any new contractor would experience. All specialty care provider and hospital contracts are in place. All services are being provided to meet or exceed your expectations. By retaining Wellpath as your health care services provider, the OCSO can feel confident there will only be enhancements to the high -quality service and support that you currently receive from a well - established team. We are the most experienced company providing healthcare services in correctional facilities. We work harder than any other company in the industry to retain our clients by exceeding their expectations. With Wellpath as your continued provider, there will be no interruption of services, and you can expect full continuity of your well -run healthcare program. The program will continue to be delivered through a team of competent, credentialed team members and supported by our experienced corporate organization. Change under any circumstance is a challenge, and in this case, it is unnecessary. As your long-term Inmate healthcare provider, we are proud of the efforts of the OCSO and Correctional Facilities administration working with Wellpath to provide healthcare services to the patients housed in Oakland County. We value our partnership, and we welcome the opportunity to continue that partnership. We thank you for your consideration and look forward to discussing our proposed program in more detail with you. Throughout this proposal, you will notice the blue icon to the right of this paragraph. This icon is a way for us to highlight innovative solutions and other differentiators that are unittEse io a partnership with Wellpath. You will also encounter the green icon to the right of this paragraph, which clearly identifies areas within our proposal where cost savings advantages are to be gained by continuing to 0. partnering with Wellpath. 0 Sincerely, Ky` Kip Hallman President 858-283-8619 kip. hall man @wel I path. us Renee Negri, CCHP Director, Partner Services 724-787-6698 rnegri@welIpath.us well-[ : ;..b V i. fflrsli 1 1 Solicitation Form...................................................................................... 2 Health Management System.................................................................... 2.1 On -Site Medical Services................................................................... 2.1.1 Intake Screening......................................................................... 2.1.2 Health Appraisal......................................................................... 2.1.3 Inmate Requests for Health Care Services ................................... 2.1.4 Assessment Protocols................................................................. 2. 1.5 Segregation Rounds/Infirmary .................................................. 2.1.6 Women's Preventative Health Care... .......................................... 2.1.7Infectious Disease....................................................................... 2.1.8 Chronic Illness and Special Needs Inmates .................................. 2.1.9 Emergency Services.................................................................... 2.1.10 Emergency Response Plan ......................................................... 2.1.11 Pandemics — COVID.................................................................. 2.1.12 Medication Management/Medical Supplies ............................ 2.1.13 Laboratory Services................................................................... 2.1.14 Radiological Services................................................................. 2.1.15 Mental Health Services............................................................. 2.1.16 Health Records Management.................................................... Confidentiality of Medical Records ...................................................... Access to Medical Records................................................................... Transfer of Medical Information.......................................................... Ownership of Records......................................................................... Release of Medical Information.......................................................... LostRecords....................................................................................... RecordsRetention.............................................................................. 2.1.17 Nutritional Services.................................................................. 2.1.18 Inmate Complaint/Grievance Procedure ................................. Resolutionand Review....................................................................... 2.1.19 Inmate Co -Payment Processing Procedures .............................. 2.1.20 Dental Care.............................................................................. 2.2 Off -Site Referrals to Preferred Providers .......................................... 2.3 Pre -Book Hospitalization and Evidentiary Blood Draws .................... 3 Medical Clinical Staff Management........................................................ 3.1 New Hires........................................................................................ 3.1.1 Credentialing and Privileging..................................................... 3.1.2 Background Screening............................................................... 3.1.3 Health Services Administrator (HSA).......................................... 3.1.4 Personnel Compliance................................................................ 3.1.5 BLS -CPR Training....................................................................... Solicitation Event ID: 005301 Jail Health Clinic ................8 .............. 23 .............. 24 ............. 24 ............. 39 ............. 43 ............. 43 .............. 46 .............. 49 ............. 53 .............. 58 .............. 65 .............. 68 .......... I... 69 .............. 72 .............. 87 .............. 88 .............. 89 .............. 89 .............. 91 .............. 91 .............. 91 ...... I....... 91 ....... I...... 91 ..... I........ 91 .............. 91 ............106 ............106 ............107 .......I....109 ............109 ............111 ............126 ............128 ............136 ............137 ............139 ............140 ............140 ............140 3.2 New Employee Orientations ...................................... 3.3 Ongoing In -Service Training ........................................ 3.3.1 Continuing Education ........................................... 3.3.2 In -Service Training ............................................... 3.3.3 Health Training for Correctional Officers .............. 3.4 Position Descriptions ................................................. 3.5 Performance Appraisals ............................................. 3.6 Administrative Procedures ......................................... 3.7 Staffing...................................................................... 3.7.1 Nursing Shortage Strategy ................................... 3.8 Security...................................................................... 3.9 Hazardous Waste Management ................................. 4 Contractor Requirements.................................................. 4.1 Corporate Experience ................................................ 4.2 Accreditation............................................................. 4.3 On -Site Medical Services Staff .................................... 4.4 Contract Administration ............................................. 4.4.1 Program Support ................................................. 4.4.2 Reporting and Accountability ............................... 4.4.3 Wellpath Client Portal .......................................... 4.5 Staffing Plan............................................................... 4.5.1 Administrative Services ........................................ Collaboration with Security Staff .................................. The Wellpath Whiteboard Method ............................... 4.5.2 Clinical Practitioner Services ................................ 4.5.3 Nursing Services .................................................. 4.5.4 Dental Services .................................................... 4.5.5 Support Services .................................................. 4.5.6 On -Call Services ................................................... 4.5.75taffing Plan Matrix ............................................. 4.6 Off -Site Preferred Provider Network .......................... 4.7 Quality Monitoring and Improvement ........................ Medical Administration Committee .............................. Review of Processes, Systems, and Care ....................... High -Risk Items............................................................ 5 Contractor History............................................................ 5.1 Service History........................................................... 5.1.1 Michigan Experience ............................................ 5.1.2 Current Clients ..................................................... 5.1.3 Former Clients ..................................................... 5.1.4 References........................................................... 5.1.5 Berrien County, Michigan ..................................... Solicitation Event ID: 005301 Jail Health Clinic ..................140 ..................144 ..................144 ..................145 ..................148 ..................149 ..................149 ..................150 ..................150 ..... I ...... I ..... 151 ..................152 ..................153 ..................154 ..................154 ..................158 ..................162 ..................162 ..................162 ..................164 ..................167 ..................169 ..................169 ..................169 ..................170 ..................171 ..................173 ..................174 ..................175 .............I....175 ..................176 ..................177 ..................178 ..................182 ..................182 ..................183 ..................187 ..................188 ..................188 I .... I ............ 190 ........ I .... I .... 190 .............I....190 ..................197 Solicitation Event ID:00S301 Jail Health Clinic 5.2 Litigation and Claims History.....................................................................................................199 5.3 Transition Planning...................................................................................................................200 5.4 Fee Structure............................................................................................................................201 5.4.1 Cost Plus Management Fee Model...................................................................................... 201 5.4.2 Three-year Pricing.............................................................................................................. 206 5.4.3 Budget Breakdown for Each ADP Level................................................................................ 207 5.4.4 Pricing Assumptions............................................................................................................209 5.4.5 Legal Exceptions................................................................................................................. 209 Tabbed Attachments Wellpath Clinical Decision Support Monograph for Alcohol and Benzodiazepine Medications * ...............A Sample Treatment Protocols*................................................................................................................. B EmergencyChecklists *........................................................................................................................... C Lettersof Intent*....................................................................................................................................D Formulary Policies and Procedures *....................................................................................................... E IT Technical & Architectural Requirements Response Table *.................................................................. F Request for Consultation Form *.............................................................................................................G New Employee Orientation (NEO) Curriculum*.......................................................................................H Welcome to Wellpath Video (Hyperlink)*................................................................................................I Patient Escort Policy and Procedure*.......................................................................................................i AccreditedFacilities*.............................................................................................................................. K ProviderNetwork*................................................................................................................................. L Environmental/Safety Inspection Checklist*..........................................................................................M CurrentClients*......................................................................................................................................N FormerClients*......................................................................................................................................0 LitigationHistory *.................................................................................................................................. P SampleReports *................................................................................................................................... Q PandemicPlan*....................................................................................................................................... R *CONFIDENTIAL AND PROPRIETARY ATTACHMENTS In accordance with State of Michigan Uniform Trade Secrets Law concerning trade secret protection and confidential commercial information protection, Wellpath respectfully requests that the attachments labeled CONFIDENTIAL be redacted from any distribution of this proposal pursuant to requests under the Michigan Freedom of Information Act, or for any other reason. In accordance with the RFP, this proposal remains valid for 120 days following the proposal due date. Solicitation Event ID: 005301 Jail Health Clinic 9/112021 SolicitallonForm0053011n1ml Solicitation Event ID: 005301 Jail Health Clinic ®AKtil V c a u NTY M I CHI G AN OAKLAND COUNTY EXECUTIVE DAVID COULTER COMPLIANCE OFFICE Compliance Office I Purchasing PURCHASING (248) 858-0511 1 purchasing@oakgovcom SOLICITATION FORM M SEALED BIDlRFP ❑ NONSEALED BID/RFP 92 ONLINE ONLY 0 Hard Copy Required 19 Online (Online AND additional Hard Copies (SEE GENERAL SUBMISSION INFORMAT CONTACT INFORMATION Oakland County Purchasing Division Building 41 West - Lower Level 2100 Pontiac Lake Road Waterford, MI 48328 Solicitation Event ID 005301 Event Title Jail Health Clinic FOR DIRECTIONS ON HOW TO SUBMITTHE ABOVE CHECKED BID/RFP TYPE) Buyer Dahl, Joseph Phone (248)858-0514 Email dahij@oakgov.com Response Due 9/24/2021 2:00 PM Eastern Time Category Codes 95828, 95220, 95856, 94874, 94872, 94864, 91878 Oakland County Purchasing is issuing a BidlRequest for Proposal (RFP) seeking bidders/respondents to provide services or goods as detailed in Attachment (B). Index Solicitation Form (This Form- BiddertResponder Information and Signature Page) Attachment (A) — Mailing Label Attachment (B) — Solicitation Specifications fi ll/CNseWdahllyDownlmds/Solic,tallonFonn005301.html 1112 0 Solicitation Event ID: 005301 Jail Health Clinic 911=1 WWt0W FWmocam.Wd BIDDERIRESPONDERS INFORMATION Legal Maine Wei Ipat h LLC gtraet Address 1233 Murfreesboro Road, Suite 500 CRY Nashville statelzip Tennessee 37217 Corporate I.D. orTaxpayer 32-0092573 I.D. # BiddorstRaspondera Renee Negri -Director, Partner Services Contact MGM Contact Phone 724-787-669S ContactEmall rnegrigwellpath.us This ENTIRE Solicitation packet (ALL Pages) must be included and returned signed with your WWII response. I have reviewed the TERMS AND CONDITIONS and Insurance requirements stated prior to submitting this bid/RFP solicitation. Vendors Authorized Signature Anent Printed Name Kip Hallman Title President Phone 858-283-8619 Date September 24, 2021 Email kip.hallman®wellpath.us neJxC:iusersWeal,Uownbada6dwMatlmFarmaQG90t.MlN Date 9/24/2021 ant 10 r i b,,'.: t Solicitation Event ID: 005301 rod Jail Health Clinic 9l1R021 SoliptehonPom00530t.hfml *To be filled out and used when mailing or dropping off a hard copy CUT BELOW THE DOTTED LINE AND AFFIX LABEL TO EXTERIOR OF MAILING ENVELOPE OR PACKAGE ®®®_.......®®..®..,._......®®..®.®...___.®...._.._®_®.-...®®..®....._........-.__.. From Company Name Wellpath LLC City, State and Zip Nashville, TN 37217 Contact Person Renee Negri Phone Number 724-787-6698 Email rnegri@wellpath.us Solicitation Event ID 005301 Event Title Jail Health Clinic Due Date and Time 9124/2021 2:00 PM Eastern Time Buyer Dahl, Joseph DELIVER HARD COPIES TO: (if aR li I ), OAKLAND COUNTY PURCHASING EXECUTIVE OFFICE BUILDING 41W - LOWER LEVEL 2100 PONTIAC LAKE ROAD WATERFORD MI 48328 "Verify your company Information above file///C:fUwmfdahilyDmnloads/Sofioi(ehonFmm W 5301.html 3112 11 it t , �`'f. 9112021 SolicftfianFo m 05301.hrml GENERAL SUBMISSION INFORMATION: Solicitation Event ID: 005301 Jail Health Clinic E2 SEALED BID/RFP 0 ONLINE RESPONSE ❑ HARD COPY RESPONSE: Online Response: It is the bidder'strespondent's responsibility that the responses are entered/uploaded into the MITN system - LA w.mltn Info, prior to the due date and time specified. Hard Copy Response: It is the bidder's/respondent's responsibility to insure that hard copy responses are received In Purchasing prior to the due date and time specified. Purchasing's address, due date and time are listed on the first page of this proposal farm. The responsibility rests entirely with the biddedrespondent, including delays resulting from postal handling or for any other reasons. The official time dock shall be the date/time stamp machine located at Purchasing's main office located at the address listed above. NO LATE BIDS/RFPS VAL.]. BE ACCEPTED - Hard Copy responses are accepted at Oakland County Purchasing and are to be delivered to that office. • Deliver bid/RFP responses to: Oakland County Purchasing Building 41 West —Lower Level 2100 Pontiac Lake Road Waterford, M148328 e BidlRFP responses through courier services shall be accepted at Oakland County Purchasing any time during the normal course of business only; said hours being 8:30 A.M. to 5:00 P.M. Eastern Time, Monday through Friday, excluding County holidays. All questions regarding this solicitation should be submitted by email to the buyer listed on page one of the proposal form. Subject line needs to include the solicitation event numberlisted on page one of the proposal form- 0 NON SEALED BID/RFP E2 ONLINE RESPONSE Q HARD COPY RESPONSE: This solicitation event can be accessed at the Michigan Inter -governmental Trade Network (MITN) website: uvarw.mlm.info Online Response: It is the bidder's/respondent's responsibility that the responses are entered/uploaded into the MITN system - w4vw mitn.info, prior to the due date and time specified. Hard Copy Response: it Is the bidder'sfrespondenfa responsibility to insure that hard copy responses are received in Purchasing prior to the due date and time specified. Purchasing's address, due date and time are listed on the first page of this proposal forth. The responsibility rests entirely with the bidder/respondent, including delays resulting from postal handling or for any other reasons. The official time clock shall be the date(time stamp machine located at Purchasing's main office located at the address listed above. NO LATE BIDS/RFPS WILL BE ACCEPTED - Hard Copy responses may be emailed or delivered through courier services unless otherwise stated in the specifications. a Email bld/RFP solicitation responses to; &�i g@Egkg<w.corl Subject line should state: Oakland County Solicitation Event It: • Deliver bld/RFP responses to: rile///C./U amfdahfjNo.nbods/Solkltd.o Fo.005301.htm1 Oakland County Purchasing Building 41 West —Lower Level 4112 12 w Ile y3 Tc.I r i6'i:._3/:. 911/2021 Sa1icltaSonForm005301.htm1 Solicitation Event ID: 005301 Jail Health Clinic 2100 Pontiac Lake Road Waterford, MI 40320 • Bid/RFP responses through courier services shall be accepted at Oakland County Purchasing any time during the normal course of business only; said hours being 0:30 A.M. to 5:00 P.M. Eastern Time, Monday through Friday, excluding County holidays. All questions regarding this solicitation should be submitted by email to the buyer listed on page one of the proposal form. Subject line needs to Include the solicitation event numberlisted on page one of the proposal form. Submissions: • This proposal form must be signed by a person authorized to bind and commit the company to provide such goods and/or services offered to the County should their bid/RFP be accepted by the County. Public Disclosure: • The bidder/respondent acknowledges that the County is a public entity and therefore is subject to all public disclosure laws. • Any information contained in the bid/RFP response, including, but not limited to, trade secrets, commercial information, financial information, or copyrighted material, is considered public information and not exempt from disclosure under the Michigan Freedom of Information Act (FOIA). • Bidder/Respondent should not Include any information in a response that bidder/respondent does not want disclosed by the County in response to a FOIA request. • Eldder/Respondent shall not bring any claim or action against Oakland County, including its employees, agents, or officials, to prevent the County from disclosing any information in the bid/RFP response to a third party in response to a FOIA request or for damages related to such disclosure. Modifications: • Prior to opening the solicitations, clarifications, modifications, or amendments maybe made to the solicitation at the discretion of Oakland County Purchasing. Should any such changes be made, an addendum will be Issued and posted on the Michigan Inter -governmental Trade Network (MITN) website:ww mitn imfa. • It is the responsibility of the biddedrespondent to check the MITN website for addendums. Withdrawal: Responses may be withdrawn prior to the bid/RFP dosing date and time by providing written notice to Purchasing. Award Information: • The successful bidder/respondent may be requested to submit a completed, signed Federal W-9 form prior to an award of a contract or purchase order. • BIDDER/RESPONDENT MUST PROVIDE DOCUMENTATION OF REQUIRED INSURANCE UPON AWARD flelOC.[U emtdehfjlDownloads/SolkltetlonFmm005301 html 5112 13 ,17 well -pa;' Solicitation Event ID: 005301 -f. »; -I,^ Jail Health Clinic 9/12021 SollcltabonPo�05301.htrnl PURCHASE TYPE (ONLY THE CHECKED BOXES APPLY TO THIS SOLICITATION), t2 SERVICE CONTRACT ❑ BLANKET CONTRACT (PRODUCTS OVER SPECIFIED PERIOD OF TIME) l7 PURCHASE ORDER (PO) (A ONE TIME PRODUCT PURCHASE) t5l SERVICE CONTRACT REQUIREMENTS: " A copy of the Countys Contract boilerplate is included in this bid/RFP package or at ht:ns:/Avww.oaknov.cx>m/nurchaslneiPaoestfamt anolicatinn/Defauit.asnx. Bidders/Respondents are encouraged to review the contract boilerplate with the proposed terms and conditions. Exhibits checked below will be applicable for the bid/RFP. t2 Exhibit I: Contractor Insurance Requirements 12 Exhibit It: Business Associate Agreement (Health Insurance Portability and Accountability Act Requirements) • Exhibit III: Requirements for Contractors with Access to County PH (Personally Identifiable Information) Ci Exhibit IV: Requirements for Contractors with Access to Criminal Justice Information J Exhibit v: Federally Funded Contract Requirements G Exhibit VI: Software Licenses) D Exhibit VII: License for Use of County Servicemark O Exhibit Vlll: Acknowledgement of Independent Employment Status V Exhibit IX: Scope of Contractor Deliverables/Financial Obligations (Generally listed in attachment B of the bid/RFP) Review the Primary insurance requirements in Exhibit I listed below. Checicboxes in Exhibit I marked with an °X" in Supplemental Coverages will be in addition to the Primary coverage. • Failure to maintain the Insurance requirements will be considered a breach of contract. OR A copy of the County's Professional Services Contract boilerplate can be viewed on the Oakland County Purchasing website: h_ttus'tiwtru.aakgpv ccaml ub rchasing/Pag cj#nrrn_gppiicationlCefauir as,,& Bidders/Respondents are encouraged to review the Standard Contract Boilerplate with the proposed terms and conditions. Review the Exhibit I Contractor Insurance Requirements starting on page 21 and the f.le>//C.fU emIdshIyDownloads/SoIIcite0onFormW5301.htmt e/12 14 Solicitation Event ID:005301 Jail Health Clinic 9112021 Solipta6anFOrm005301.h 1 General Insurance Conditions on page 23. The successful bidder/respondent will be required to comply with same. Awarded bidder/respondent shall provide required insurance documentation upon notice of award- 1-1 BIANKET CONTRACT • A copy of the County's Blanket contract terms and conditions Is located on the website: f�ttps:1ut44w.caYnnv rnm/nl irrhas(nglPagesfforrtt apn€isation/Default.asr..x Bidders/Respondents are encouraged to review the terns and conditions. [J PURCHASE ORDER REQUIREMENTS: • A copy of the County+s Blanket contract terms and conditions Is located on the website: https_Ilwyuw.oakgav comr'purchasinglPagesiform application/Cetauit.asnx Bidders/Respondents are encouraged to review the terms and conditions. Bid/RFP Specifications for Scope of Contractor Deliverables and Financial Obligations: • The specification requirements, defined in Attachment B, must be submitted with signed proposal forms. • Failure to include all required information in the bidder's/respondent's submittal maybe cause for rejection of the entire response. TERMS AND CONDITIONS: The bidder/respondent shall be responsible for all costs incurred in the development and submission of this response. Each response should be prepared simply and economically, providing a straightforward concise description of the bidder'slrespondent's approach and ability to meet the County's needs, as stated in this solicitation. Submission of a response is a confirmation that the bidder/respondent Is familiar with the solicitation, contractual requirements, and specifications. The bidder/respondent understands and agrees to abide by each, and all of the stipulations and requirements contained within this document. To best serve the County's interest, Oakland County reserves the right to accept or reject any or all responses and to waive any irregularities and/or formalities. This includes the right to award the contract to respondents other than the lowest priced response. The County reserves the right to split or abstract any or all bidderstrespondents and award multiple contracts from the same solicitation based on price, availability, and services when in its judgment best serves the County. Oakland County assumes no contractual obligation as a result of the issuance of this solicitation, the preparation or submission of a response by a bidder's/respondent's, the evaluation of an accepted response, or the selection of finalists. Oakland County shall not be contractually bound until the successful bidder(s)/respondent(s) has an executed written contract or Purchase Order. All prices shall be quoted in U.S. dollars. In case of error In the extension of prices in the response, the unit prices shall govern. Unless notated in the specifications, all quoted prices will be firm for 120 days after the solicitation due date. Default payment terms are Net 30. Discount payment terms may be offered for earlier payment than 30 days. file'///C:Ncars/dahlllDm.loods/SolkitehonFo.=301.himl 7112 15 Solicitation Event ID: 005301 Jail Health Clinic 9/12021 Shcdtd.nFora 05301.html Shipping terms must be "FOB DESTINATION" The County reserves the right to request any additional information necessary after the submission of the response. The County reserves the right to conduct interviews, reference checks, and perform any other due diligence necessary to select the vendor(s). Pursuant to Michigan law, (the Iran Economic Sanctions Act, 2012 PA 517, MCL 129.311 of seq.), before accepting any bid or proposal, or entering into any contract for goods or services with any prospective Vendor, the Vendor must first certify that it is not an "IRAN LINKED BUSINESS", as defined by law. This signed document, with: 1) full knowledge of all of Vendors business activities, 2) full knowledge of the requirements and possible penalties under the law MCL 129.311 at seq. and 3) the full and complete authority to make this certification on behalf of the Vendor, by his/her signature, certifies that: the Vendor is NOT an "IRAN LINKED BUSINESS" as required by MCL 129.311 at seq., and as such that Vendor is legally eligible to submit a bid/RFP and be considered for a possible contract to supply goods and/or services to the County of Oakland. E-Verity — Prior to contract award aft County Contractors are required to comply with Miscellaneous Resolution No.09116 (Board of Commissioners Minutes, July 30, 2009, pp 37,38), unless otherwise exempted, all service contractors and/or vendors who wish to contract with the County to provide services must first certify they have registered with, will participate In, and continue utilize, once registered, the E-Verify Program (or any successor program implemented by the federal government or Its departments or agencies) to verify the work authorization status of ag newly hired employees employed by the contractors and/or vendors. Breach of this term or conditions Is considered a material breach of a contract Contractors/Vendors submitting bidIRFP responses agree that the contractorlvendor will registered with, and will participate in, and will continue utilize once registered and throughout the term of contract, ffone is offered, the E-Verify Program (or any successor program Implemented by the federal government or its departments or agencies) to verify the work authorization status of all newly hired employees employed by the contractors and/or vendors. All County Contractors are required to comply with all Federal, State, or Local laws. The County reserves Ole right to cancel the contract for services if the contractor has not done so. Failure to comply with all Federal, State, or Local laws either currently or historically Is a consideration in the bid/RFP evaluation process as well. Such compliance shall include, but not be limited to, the contractor and Its subcontractors shall not discriminate against an employee or an applicant for employment in hiring, any terms and conditions of employment or matters related to employment regardless of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, genetic information, height, weight, disability, veteran status, familial status, marital status or any other reason, that is unrelated to the persons ability to perform the duties of a particular)ob or position, in accordance with applicable federal and state laws; prohibition of use of any copyrighted software contrary to the provisions of any applicable Software license agreement or State or Federal law; compliance with all applicable grant requirements if any part of a Contract is supported or paid for with any State or Federal funds granted to the County; compliance with the Immigration Reform and Control Act (IRCA) and 1-9 employment verification requirements. Any and all future Federal, State, or Local laws must also be compiled with while the contractor is providing services/products to the County. Vendors that have been found guilty or held civilly liable for violation of any federal or state law, or have been barred and/or declared ineligible from consideration in receiving any federal, state or municipal contract, must provide Information as part of their proposal on all such violations / banings i Ineligibilities. 1 el//C:Nsen:/dahl},Dnxnloads/SoliciWtonFoim005301.html e/12 T 9/12021 SoliGfeGonFomi00.9301.hbnl Solicitation Event ID: 005301 Jail Health Clinic Pursuant to Act 167 of the Public Acts or 1933, the County of Oakland, A Michigan Constitutional Corporation, Is exempt from the sales tax provisions of this Act. In addition, the Michigan Department of Treasury has promulgated General and Specific Sales and Use Tax Rules which provide that the County of Oakland is not required to have a sales tax exemption number. (R205.79; Rule 29) For reporting purposes— County of Oakland Tax 1.0 # 36-5004876 filet/IC:fUm Wdohljnmnloads/SolbitgonFomOD5301.h"I 9112 17 911/2021 SolicitatlonFonOD5.30t.hlnl Solicitation Event ID: 005301 Jail Health Clinic Q THE FOLLOWING INSURANCE EXHIBIT APPLIES TO THIS EVENT IF CHECKED THE FOLLOWING INSURANCE IS THE COUNTY S STANDARD REQUIREMENTS, ALONG WITH ADDITIONAL OPTIONS WHERE CHECKED Exhibit I CONTRACT INSURANCE REQUIREMENTS During this Contract, the Contmctorshall provide and maintain, at their own expense, all insurance as set forth and marked below, protecting the County against any Claims, as defined in this Contract. The insurance shall be written for not less than any minimum coverage herein specified. Limits of Insurance required in no way limit the liability of the Contractor. Primery Coverages Commercial General Liability Occurrence Form including: (a) Premises and Operations; (b) Products and Completed Operations (including On and Off Premises Coverage); (c) Personal and Advertising Injury; (d) Broad Form Property Damage; (a) Broad Form Contractual including coverage for obligations assumed in this Contract; $1,000,000—Each Occurrence Limit $1,000,000 — Personal & Advertising Injury $2,000,000 — Products & Completed Operations Aggregate Limit $2,000,000 —General Aggregate Limit $ 100,000 — Damage to Premises Rented to You (formally known as Fire Legal Liability) Workers' Compensation Insurance with limits statutorily required by any applicable Federal or State Law and Employers Liability insurance with limits of no less than $500,000 each accident, $500,000 disease each employee, and $500,000 disease policy limit by a fully Insured or State approved self -insurer. 1. Sole Proprietors only must submit a signed Sole Proprietor form if they do not have a Workers' Compensation Policy. 2. Exempt entitles such as Partnerships, LLCs, etc., must submit a State of Michigan form WC-337 Certificate of Exemption If they do not have a Workers' Compensation Policy. Commercial Automobile Liability Insurance covering bodily injury or property damage arising out of the use of any owned, hired, or non -owned automobile with a combined single limit of $1,000,000 each accident. This requirement Is waived If them are no company owned, hired or non -owned automobiles utilized In the performance of this Contract. Commercial Umbrella/Excess Liability Insurance with minimum limits of $2,000,000 each occurrence. Umbrella or Excess Liability coverage shall be no less than following form of primary coverages or broader. This Umbrella/Excess requirement may be met by increasing the primary Commercial General Liability limits to meet the combined limit requirement. ^agpniemental Coverages - As Needed f lel#C,/Userstdahlybownloeds/SoliciWonFomODS.101.hM1 10112 18 t 111 f-r i Solicitation Event ID: 005301 �'� hop, "" d il-=`:'"'L Jail Health Clinic 9/112021 Soliotdmo nr005301.html 1. UProfessional LiabilitylErrors $ Omissions Insurance (i.e., Consultants, Technology Vendors, Architects, Engineers, Real Estate Agents, Insurance Agents, Attorneys, etc.) with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when the Contractor provides professional services that the County relies upon. 2. OCyber Liability Insurance with minimum limits of $1,000,000 per daim and $1,000,000 aggregate shall be required when the Contractor has access to County IT systems and/or stores County data electronically. 3. OCommercial Property Insurance. The Contractor shall be responsible for obtaining and maintaining Insurance covering their equipment and personal property against all physical damage- 4- i_-ILiquor Legal Liability Insurance with a limit of $1,000,000 each occurrence shall be required when liquor is served and/or provided by Contractor. 5. OPollution Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when storage, transportation and/or cleanup B debris removal of pollutants are part of the services utilized. 6. UMedical Malpractice Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when medically related services are provided. 7. OGarage Keepers Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when County owned vehicles and/or equipment are stored and/orserviced at the Contractors facilities. 8. t2Other insurance Coverages as may be dictated by the provided productlservice and deemed appropdate by the County Risk Management Department. f lel/M.:/Userstdehlj/Downloads/Solklt0onFotm00.5301.html vtlz 19 9/1/2021 _General Insurance Condifions ao11cltaSonFomi005a01.html Solicitation Event ID: 005301 Jail Health Clinic The aforementioned insurance shall be endorsed, as applicable, and shall contain the following terms, conditions, and/or endorsements. All certificates of Insurance shall provide evidence of compliance with all required terms, conditions and/or endorsements. 1. All policies of insurance shall be on a primary, non-contributory basis with any other Insurance or self- insurance carried by the County; 2- The insurance company(s) issuing the policy(s) shall have no recourse against the County for subrogation (policy endorsed written waiver), premiums, deductibles, or assessments under any form. All policies shall be endorsed to provide a written waiver of subrogation in favor of the County; 3. Any and all deductibles or self -insured retentions shall be assumed by and be at the sole risk of the Contractor; 4. Contractors shall be responsible for their own property insurance for all equipment and personal property used and(orstored on County property; 5. The Commercial General Liability and Commercial Automobile Liability, policies along with any required supplemental coverages shall be endorsed to name the County of Oakland and it officers, directors, employees, appointees and commissioners as additional insured where permitted by law and policy form; 6. If the Contractor's insurance policies have higher limits than the minimum coverage requirements stated in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the Contractor under contract. 7. The Contractor shall require its contractors or sub -contractors, not protected under the Contractor's Insurance policies, to procure and maintain Insurance with coverages, limits, provisions, and/or clauses equal to those required in this Contract; 6. Certificates of insurance must be provided no less than ten (10) Business Days prior to the County's execution of the Contract and must bear evidence of all required terms, conditions and endorsements; and provide 30 days' notice of cancellation/material change endorsement. 9. All insurance carders must be licensed and approved to do business in the State of Michigan along with the Contractor's state of domicile and shall have and maintain a minimum A.M. Best's rating of A- unless otherwise approved by the County Risk Management Department. f!Wl//C:Nson:/dahlyDownloatldaalicifabonFmm005WI.html 12112 20 Solicitation Event ID: 005301 Jail Health Clinic l GD I DATEUawD01YYlo AC"R CERTIFICATE OF LIABILITY INSURANCE 917)2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED, the pollcyges) most have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, Certain policies may require an andorsemeld. A statement on this cartlgcate does not confer rights ED the CertMcate holder In lieu of such endomement(s). PRODUCER CONTA= Chicago, IL -Hub International Midwest West PR ONE • FAX 55 East Jackson Boulevard M eo, eat): 312-922-MOO VCD. Not, 312-922-5368 Suite 141h Floor An.NEgs:_ csuchicago®hubintematlonal.com _ Chicago IL W004 INSUREFIRDAFWRDING covERAGE NAIC9 LIcBONSN;-t03D@e1@ INSURERA: Zurich Amerl_canlnsurdnce Compam, 16535 -_ INSURED WELLPAID01 INSURER a: American Zurich lnsumnce Company 40142 Wellpath Holdings, Inc. msuasac: Texas Insurance Company 1650.3 1283 Murfreesboro Road I Suite 500 INSURER n: _ Nashville TN 37217 I INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 291233538 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED PROVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WBp Auu.5U9R POUR EEE lIMR4 TYPEnFINbURANCE INBp uvn POLICYNUMBER +M... 'NVEEEYYM� C X I COMMERCwLDENERpi LIABlLm BUQSTftTTN013100-0500m-01 311512021 311512022 EACHOCCURRENCE '$3,00g000 X� CIAIMSMADE E OCCUR PREM SES IFao2w1099W) $100,ODD . MEDEXPW,.neP ) $5,000� GEML AGGRCGATE UWTA PUFS PER X POUCY PRO- -Lot —' OTHER. AMTOMMUIIJABILm Y Y BAP5252136-06 X ANYNUTO OWNED 'SCHEDULED HIRED NLY AONIO X HIRED X''ACTOW ONLY AUTOS ONLY ACTOR ONLY UMBRELIADAS _ OCCUR E1.CE6r6 Lw9 CIAIMSl.IADE DEDf 'RE(E.."ONE WORNENSCONPENSA90N 'AND EMPtAYER6'LwBILm YIN ANTPNDPWEfMNARTNERIIXECUTIVE I NI NIA: OFFICETVMEMBERE%cLUOED� LJ taarlJnioryln NH) DESC IPTRe OFO OESCRIPTIONOF OPERATIONS bebW MFDICAI. PROFLNBIUIY (C(AIMB MADE) as CERTIFICATE HOLDER Oakland County Michigan Attn: Purchasing Division PENSONALSAOV IBITE $6'aw.0000 GENBRALAGGPEGATE $6,000,000 ,PRODUCTS-COMPIOPAGG 61ngBded $ 1011=20 10/1m, L •CO U.C.$1NGLEUMII $2,00,000 J BODILY INJURY teal pesan) $ BODILY INJURY LPar—Bun I $ 0wPROaPc6ce) GE '$ W135252134-06(AM) 1011AW20 101112021 WCSn2135-0S(WD 1011f= 1onn021 SUMTRTTN013100-050001-01 3115,2021 311W2022 EACHOCCURRENCE AGGREGATE .'t_ jtPilnE ER EL EACH ACCIDENT E1,000.0no I EI. N$FIU56. FA EMPLOYEE' $t,000,000 E.LOISEASE.POLICYUMIT S1000.000 PERLOSSEVENP $3,ono000 l AGGREGATE $6,oneo C s are Tncfuded as additional Insured with respect to work performed by conimctor and Autarnobue Liability where required by wottan contract. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2100 Ponflac Lake Rd Bldg 41 W ruoRUEnREPSEssxnnvE Waterford MI 48328 0119t888-2015 ACORD CORPORATION. All rights reserved. ACORD 25 {201ID03) The ACORD name and logo are registered marks of ACORD THIS CER'i IFICATE SUPERSEDES PHEVIOUSLY ISSUED CERTIFICATE 21 ell ACC AGENCY HUB international Midwest Limited Paucrxu4eER AGENCY CUSTOMER ID: LOG ik. ADDITIONAL REMARKS SCHEDULE NAC GORE j eFFEcrrvE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE' CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL NAMED INSUREDS INCLUDE. • CCS-CMGC Parent Holdings, LP • CCS-CMGC Intermedlate Holdivi Inc • CCS-CMGClntermendte HNdhgs,Inc. • CCS-CI Holdings, inc, • Welipath Gmup Holding, LLC • Corned Care Soluliona GmuP Holdings, LLC • Welipath CFMG, inc • CFMG Holdings Com. • WeliPalh Management, he • Conectional Mediml Gmup Companies, Inc • California Forensic Maement nagGroup,Inc. a Southwest Cmredional Madiral Gmup,Inc. • Width, LLC Hoal• Cormct Cam Sphtions,LLC • Comm(ost Holdings. LLC • CoineCo. Ho, Se LLC Wdlpa• Correct Recovery SDlullrma, LLC • Coned Care, LLC • Correct Care ACbmadMadliFSDali Cly, Ltd,llC • Loome Care Al Conapm, Ltd(Aushalle) • League MadW Concepts, LLC • League n. 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Forensic Medical Group, Inc, • Colorado Correctional Medical Gmant,PLLC • Southeast Cenedidi al Medical Group, LLC • Soulpath Hospital digs Coal"ny, U-LLG • Wdlpat 1 Hospital Holdings Caoi h Fin LLC • Cal '15imer cdm Waft Palm Beath Florida Behavioral HNallh Hospital IX • Wettomia Cemmodity Cate rstra, of • WClipath Commudty Card Centers of Win Ca, ino • Bowede Community Care a le.sof Nodh Carolina, P.C. • BoynbR Beath Florid BetuvloralHNoaprlet • Wellpath Community Care of VCenters of nLL Virginia, C • Wellapth Community Care Centers of Indiana, P.C. Solicitation Event ID: 005301 Jail Health Clinic ACORD 101 (2008101) 0 2008 ACORD CORPORATION. All rights reserved. The ACORD name and Ingo are registered marks otACORD 22 L Solicitation Event ID: 005301 Jail Health Clinic Wellpath will continue to provide a healthcare delivery system specifically tailored to the Oakland County Sheriff's Office's requirements under the leadership of Health Services Administrator Vicki -Lyn Warren, BSN, RN, CCHP and Site Medical Director Jo Ann Mitchell, DO. Our managed care system promotes efficiency and reduces cost by eliminating unnecessary services and encouraging preventive health measures at the OCSO Correctional Facilities. Wellpath staff are responsible for identifying patient healthcare needs and scheduling appropriate treatment, as well as coordinating emergency and nonemergency on -site and off -site medical services. The Wellpath Healthcare Delivery Process Emergent sClinical &urgent ., NursingTrtage "'Pathways eni`I+Yealth' ,. Medical Ce e > s M ' [. 1giital Care;`- ,. Special Needs Treatment Plans Medications Diet Exercise Therapy Modalities Health Monitoring Written Healthcare Plan Wellpath has in place a written healthcare plan with clear objectives and site -specific policies and procedures for the OCSO Correctional Facilities. Our ongoing goal is to reduce risk for the OCSO, avoid unnecessary transportation and security costs for off -site care, and lower litigation claims and 23 Solicitation Event ID: 005301 -� ,;r € c.-,4 , Jail Health Clinic grievances while improving patient care. Our significant experience in these areas at the OCSO Correctional Facilities and in facilities nationwide helps us achieve these benchmarks in Oakland County. REEMENIM Wellpath performs its obligations in compliance with all applicable local, State of Michigan, and federal laws, rules, regulations, and orders. Our pro gram foi the OCSO vvilI ccjntinuc to meet or exceed °:c.r.inn..,nity stan&rds of care, as we3l 25 standards e,taizlished by 0e M?'flet'ial f orrfrnis5i,_,rt on Cot rectional Health Care (€iiCCH"'). We operate all of our programs at an appropriate level of care consistent with national standards for correctional healthcare. Our internal quality improvement programs guarantee that all Wellpath clients meet or exceed these standards. Wellpath will continue to work with the Oakland County Jail Booking and Classification Staff to address urgent intake medical concerns. Receiving screenings emphasize identifying, referring, and treating individuals with acute and chronic healthcare conditions, behavioral health disorders, suicide risk, withdrawal risk, and dental issues. We assess the need for medication, isolation, or close observation. This receiving screening sets the course for the patient's medical care throughout confinement. Early identification of problems using a systematic intake evaluation prevents more serious and costly problems from developing later. Wellpath understands the importance of a timely and proper booking and admission screening process to promote individual and facility well-being. We allocate properly trained and authorized healthcare staff to conduct receiving screenings 24 hours a day, seven days a week, including holidays. We provide adequate staffing to ensure timely evaluation of intake orders, stabilize patients with health issues as quickly as possible, and initiate needed medications. Wellpatri receiving screenings at the OCSO Correctional Facilities meet NXCHC and Michigan Department of Correcd nzs (MDOC, standards and minimally include: Direct visual observation: Abnormal appearance (e.g., sweating, tremors, anxiety, disheveled, signs of trauma or abuse) a Restricted or compromised movement (e.g., body deformities, physical abnormality, unsteady gait, cast or splint) n Abnormal breathing or persistent cough Skin conditions, including obvious lesions or wounds, lice, jaundice, rash, bruises, edema, scars, tattoos, and needle marks Characteristics of being at risk for victimization (e.g., age, small build, femininity, first-time offender, passive or timid appearance) Clinical screening for current illnesses. health problems, and conditions: o Illnesses and special health needs, including allergies * Current medications * History of hospitalization 24 Solicitation Event ID: 005301 Jail Health Clinic Dental conditions or complaints History of tuberculosis or other infectious diseases (or symptoms such as persistent cough, shortness of breath, loss of appetite, fatigue, coughing up blood, night sweats, or unexplained weight loss) Medical dietary needs Drug and alcohol use, including types, methods, date and time of last use, problems associated with ceasing use, and history of treatment for substance use Tobacco use For women, current or recent pregnancy, birth control use, date of last menstrual cycle, current gynecological problems, and methadone use Current pain Notation of personal physician and known medical risks Testing and initial assessments: Record of vital signs Oral screening Initial mental health screening STD testing for syphilis, gonorrhea, chlamydia, and HIV as indicated Pregnancy testing as indicated Mental health screening: History of or present suicidal and/or self-destructive behavior or thoughts Mental health problems, including suicidal ideation and psychosis Current psychotropic medications History of hospitalization and/or outpatient mental health treatment Current mental health status Information sharing and education: Explain right to healthcare How to access medical, dental, and mental health services verbally and in writing in a language the individual understands Oral health and hygiene education PREA screening and education regarding sexual assault Explain grievance process Document informed consent Verification and referrals: Examine medications brought into the facility Verify current medications; a clinician may be notified to assess the need for non -formulary medications, which may be provided for up to 30 days until an expedited physical exam can be completed Verify medically necessary special diets Ask about current health insurance 25 ttv ,... 7 f^ pla „? �`- Solicitation Event ID: 005301 T^ ' << 'rie.;tin,. Jail Health Clinic N Refer for mental health evaluation as indicated Refer for emergency, specialty, or dental care as indicated Refer for placement/housing (e.g., general population, medical observation, mental health observation, suicide watch, etc.) Refer disabled individuals to the physician to determine treatment Wellpath notifies correctional staff of patients needing special oversight, treatment, or management of those with critical conditions, including but not limited to: Need of emergency room referral s Urgent need for medication Suicidal thoughts or behavior Potential for withdrawal Diabetes Heart condition Seizures New or recent injuries Mental conditions or personality disorders (potential for violence) 4 Contagious illness or disease considered an immediate threat to the patient population or correctional staff Any other urgent or emergent concerns "'. ♦ �;r, Wellpath's standardized, physician -approved receiving screening form in ERMA guides the assessment, treatment, and referral of individuals admitted with healthcare needs. Wellpath nurses use the screening results to determine the appropriate intervention. Healthcare staff are trained by the responsible physician or designee in the early recognition of medical or mental health conditions requiring clinical attention. Training includes how to complete the receiving screening form and when to contact medical staff to determine disposition. ERMA interfaces with the OCSO Jail Management System (JMS) Intellitech (MACS by pulling demographic data when a new patient is booked, giving medical staff timely access to information. Re- admitted patients with previous medical or mental health history are immediately identified, providing critical information to the intake nurse and the physician from an authorized computer connected to the internet. Data is also immediately available on readmitted patients. am Sample Receiving Screening in ERMA ��r.r�,n.rnrmtr,�lad�n.r�ry ;�; 1kI Bulk print@II11 illYlil�il�llii�iIIWI�iYIYJ��II�� ; - Umnr<care i ❑N fw.+..A ev.;gorlil rre l,riV aaaar � crone Gmnrtlm ;i _ oc.lnl Pau+M Oueetldnnahi, (eapinlna8ynsnnawenl -kh°ldkq`n .hdr IYa:arul.e.e or r"rd 1uffhly hard treYeo oar a 9Nnm urtell: z'.re a lard, . me.may fny,mf dzo:Jv''110... d h''0 a ad'e ,dr. at'd'n9 rvl=oldsr a-nidne, d.eaze% ' c Inlakezar landar 2111— ,-urtra11,lnmp BealcdUer a. Or-, nest nt Inak, ryrcllern net n.. .=y_ .... rt'�i LsId eW4e + ndrsrrro «amed n el „m fBh,rt ✓nnle..e , s psrar rrammnte ^r..er zd Gao-.de9vq i,,a Pr:ylen . ireernrm,PavrJa 3 All ,an carten4} Ilk nd all a'. chin' plascnts] b I-- N, a 11'Ill` S A,, a11ercafoa-:^red-t-11da I- ha.a and ofhar ald,1e5" elc I. In'. rr.. + FHa da. been a=.p Wlid b, a Fh. o a, erp.}mralnsG o G, 1Tv are ...... I pan al d -1-d ad, crlhnId comp:a n, ]. Ya. cu Mzn d,.d II beend:eynos:d anh Hepamh."-dalof sanell/ PansmiHH41—,a llm,ans n dry inner wham d,x 1 E 9a.z Yhu era. had a dale a IF s+m led Eden s psed!e TB er Intl ua8nwed 119 181 Admission DCOM-rYols Admission to the OCSO Correctional Facilities requires clearance for serious, urgent, or emergent injuries or medical problems. Intake staff may identify arrestees whose clinical status requires urgent or emergent health services not available on site. In this case, the intake nurse refers the arrestee to a local emergency room or approved hospital. The arrestee's subsequent admission requires written medical clearance from the hospital. Reasons for admission deferrals include: I, Trauma/injury upon arrest u Excessive bleeding Chest pain Is Unconscious, semiconscious, or severe confusion 6 Active convulsions a Respiratory distress Active labor Solicitation Event ID: 005301 Jail Health Clinic e:. N' Yes Nn > rt.r,w Fatrlenl A,Mlcal Glearonw� ^� grten,lan Hucplul SlaX lTnrndr✓rJd Hanp,1.11 dlneu andaInvfmrergcirryd taa..rreslLu iaclh 1aPan ncnpl of TJiW leelsrte aM da[umentaLnn reP.ecivg ll,al Ipis ,lavndn i Aalm:en.lnyx+n heer..rlrnr�mmmeam me IdPern rnmrwun Pw �.."raal. Mill.,. „a- .. Ilml cal, d,au,amrle hrt lips re: Imalau M rra In—, far our rears, Ala b pmWe"'run,, c hex henry ."P.land: 11Ia r.,a.11Y. Ne 1.'ln Fnlonemmll III— III, unr'.. r", Mine Turf' K E ONN Sneer. Parent 1.1Y S"L 1.1,s, i-5t "Ida" 'a It,alldn Ind" olad,""ard" An I ins, end"'nnna re„ dne M I1"1 rnNe rdrenlrlrefxMp'l—ad Id lelwn lc loony InlaMn p'—h, radial I it11 laka-111 learttl Il"hu M duuryn'rl f ela.:re a, redid, P""La, Ii—I... oelenn,r All tall ...h....ad'It rile rel-k1l "I m. lou'dil ,Aratual Al I'durall ,.:at, Housing Wellpath provides assessment for housing placement in conjunction with Booking and Classification staff. This includes: 27 Solicitation Event ID: 005301 Jail Health Clinic Placement in the general inmate population; Placement in the general inmate population and referral to the appropriate health care services at the Correctional Facility; Immediate referral to a physician or physician's assistant when indicated; Referral to an appropriate off -site preferred provider/facility for emergency treatment. BITTRINIM Intake staff advise arrestees of their right to access care and the process for requesting healthcare services. We communicate this information verbally and in writing in a language the arrestee understands. We will continue to ensure that arrestees who do not speak English understand how to obtain healthcare. Medication Verification Intake staff ask arrestees about recent medical, dental, or mental health treatment before arrest. They also obtain information regarding the arrestee's medical provider(s) in the community. Intake staff contact the providers to ask about current treatment and verify prescribed medications to facilitate continuity of care. We ask individuals who report medication use at intake to complete a Release of Information (RCI) form, allowing the medication verification process to begin. A prescribing clinician (physician or mid -level provider) reviews verified medications and continues them as clinically indicated. We expedite medications for life -threatening or serious chronic diseases from our local backup pharmacies, Walgreens and CVS. Wellpath bridges non -formulary medications for up to 30 days to prevent a break in the continuity of care. Given the nature of jails as short -stay facilities, we typically continue verified medications (formulary or not) throughout a patient's stay, unless the patient reports side effects, poor response to the regimen, or a different medication is deemed more clinically appropriate. To continue a non -formulary medication beyond the initial bridge order, the prescribing clinician will request continuation of the medication using the Wellpath Non -Formulary Medication Request process. Continuation of the medication requires clinical rationale. 92 "i�' �BL�rTw*4E i �� Wellpath adheres to applicable informed consent regulations and standards of the local jurisdiction regarding patient examinations, treatments, and procedures. Initial documentation of informed consent takes place during the receiving screening. Wellpath obtains informed consent and places it in the patient's health record before performing procedures and treatment. We document refusal of health evaluation, treatment, or medication with an explanation and the patient's signature. For invasive procedures or treatment where there is a risk to the patient, we document informed consent using a written form containing the signatures of the patient and a healthcare staff witness. The informed consent process includes informing Solicitation Event ID: 005301 Jail Health Clinic wrowneo coxsEur the patient of the benefits and risks of the procedure. Concerns regarding the patient's decision -making capability will be referred to the appropriate provider. Transfer Screening Wellpath screens patients transferring between facilities for acute or chronic conditions and communicable diseases. We assess their mental health status and record their current medications and include the findings in the patient's medical record. If a transfer sheet is not sent over from the previous facility's medical unit, Wellpath staff request one from the facility. Wellpath conducts a transfer screening for patients transferring to another facility within 24 hours of receiving the name and inmate number. A medical transfer form containing the information required for the continuation of treatment accompanies the patient. Wellpath only sends medications when the receiving facility does not have them available per the physician's order. Wellpath obtains written authorization from patients before transferring their medical records or other health information outside the correctional system unless otherwise provided for by law. We communicate pertinent health information to local specialty providers upon referral. Withdrawal Management Wellpath will provide medically supervised on -site withdrawal management services in accordance with applicable standards of treatment. Patients will undergo medical stabilization for withdrawal management to minimize the risk of adverse symptoms and the need for off -site treatment. Wellpath will train healthcare and correctional staff to recognize the signs and symptoms of withdrawal and safely manage patients experiencing them. 29 We will also provide correctional staff with Quick Facts for Intoxication and Withdrawal to help them quickly decide if medical intervention is needed. The Wellpath Withdrawal Management Program and Policies incorporate the following: Recciv;i�g t:crcening... Identifying of those at risk e Ob.RtSrva9 inn and rnoniif,,63%-- Monitoring and assessment tools to ensure the necessary treatment as quickly as possible Tre A.men? -.Following American Society of Addiction Medicine (ASAM) national practice guidelines Receiving Screening Solicitation Event ID: 005301 Jail Health Clinic .: W� _-_C LACTt II 11{TOYJ[FnONANO W[fHORAWAI1 :mail QUICK FACTS lrvrodKAnorvallowllHOXawa1 • •" � o�s�w,.nY.v�xi. ».n�,:.IX•«nftneXa'n xyamea:A.� Many individuals arrive at intake under the influence of drugs or alcohol requiring some degree of withdrawal. The Wellpath receiving screening will probe types of substances used, time of last usage, frequency and amount of usage, length of time using, and side effects experienced during past withdrawals. Our standardized form evaluates all arrestees for signs and symptoms of withdrawal or serious intoxication, including: Anxiety and agitation Disorientation Visual and auditory disturbances Nausea and headache ® Tremors Paroxysmal sweats Elevated pulse, respiratory rate, and blood pressure Individuals who report alcohol and/or drug dependence or identified as being at risk for withdrawal will receive a more in-depth assessment. Wellpath staff will complete this assessment using the Addiction Research Foundation Clinical Institute Withdrawal Assessment for Alcohol - Revised (CIWA-Ar) and/or the Clinical Opioid Withdrawal Scale (COWS). --- 30 Aln44 Solicitation Event ID: 005301 Jail Health Clinic These evidence -based tools help nursing staff assess the severity of withdrawal symptoms based on the patient's behavior or responses to questions. Medical providers also use the CIWA-Ar/COWS tools to gauge how patients respond to medications administered to stabilize withdrawal symptoms. Arrestees who have the potential of withdrawal from alcohol based on frequency, duration of drinking and history, or current experience of symptoms will be started on CIWA protocol and receive their first dose of Librium within four hours. If an individual is receiving medication -assisted treatment (MAT) in the community, healthcare staff will verify treatment and contact the MAT provider for orders. Arrestees who show signs of opioid withdrawal will be started on COWS protocol. Observation and Monitoring When a patient is considered a high risk for withdrawal, the nurse will contact the physician/mid-level provider on duty or on call to determine whether placement in observation is indicated. Healthcare staff will monitor patients at risk for withdrawal throughout the medical stabilization process. Healthcare staff will monitor patients experiencing withdrawal from alcohol, opiates, or benzodiazepines for at least five days, or longer if deemed necessary by the provider. They will assess patients undergoing withdrawal monitoring three times daily and when requested by facility staff. Assessments will include CIWA/COWS checks to determine the level of withdrawal. Scores will be calculated at each assessment to determine appropriate patient intervention, as well as the success of treatment provided. The assessment also includes a short mental health screen for thoughts of suicidality, hopelessness, or recent bad news. If a patient gives positive answers to any of these questions, healthcare staff will notify mental health staff immediately and place the patient on suicide watch. Wellpath takes this proactive approach since withdrawal is a risk factor for suicide and suicide attempts. Electronic CIWA/COWS Checks 6ubganc W�Ntlrewel _E�nm iwm Wellpath staff can complete and document CIWA/COWS checks in ERMA using the Wellpath Point of Care Companion (POCC), described in Section 2.1.12. The POCC allows healthcare staff to complete and document medication passes and "treatment passes" at the point of care. Since implementing e;ectronic CIWA/COIitS protoccis, we have reduced withdrawal -related critical rare events by 50%. Wellpath staff can add an order for CIWA or COWS protocol in the patient profile in ERMA, automatically adding the required assessment schedule to the patient's orders. It also creates a Treatment Administration Record (TAR) for documenting each ordered check or treatment. 31 Solicitation Event ID: 005301 Jail Health Clinic During medication pass with the POCC, nursing staff can administer an initial CIWA/COWS assessment or a subsequent CIWA/COWS check. A screen with a med pass summary and treatment pass summary shows medications and protocols that must be administered at a specified date and time. Medication Pass and Treatment Pass Summaries in POCC iLA The nurse can complete and document ordered protocol assessments at the point of care and administration of required medications during the treatment pass. The POCC will automatically calculate the patient's CIWA/COWS score and identify further actions needed. CIWA/COWS Scores and Action Items in POCC Cows Protocol ..., ... �. ,,,.. smith, J. 24 Aim.e.....ar..:' i P1-raoni La r E.m.n,-... ,n.,.,-e:::.... .,0o:,.. , ,.� 8 CIWA Protocol - - - - -- . n..n fllfttPa ww: iNu.e ]t.gOgarm. ..... aaa.n e... v.. ..an..v.., r...........,..:oro -0 fl r„ 8- „: ,,..,,„,,,, „„- v 1—, U k o c lone dl-m @ ic-n•.cpcs hxOon,WIwS 32 Solicitation Event ID: 005301 Jail Health Clinic After the nurse returns to the medical unit, the medication pass data automatically synchronizes with ERMA and the completed protocol is added to the patient's TAR. ERMA also shows the patient's score trend from all CIWA/COWS checks. Patient CIWA Score Trends sue& 0 15 rt k'Y'.Y, Ia! t'.t 'J :'c.e'ttei6e.!.e .—�__ ._. _ —_. iCB iTE HiE<il .:gmrei � ii ;r2J'v::5'liffV .'dri'a I Treatment Wellpath has developed an order set for clinicians to use when managing and treating withdrawal symptoms. The order set is based on best practices for determining the medication to be used, starting dose, and dosing frequency. It establishes the minimum amount of medication needed to treat patients going through withdrawal, allowing for real-time use for most patients. If a patient does not respond as expected to the medication, the clinician will develop an individualized treatment plan. Alcohol and Benzodiozepine Clinical Decision Support Tools An individualized treatment plan for individuals at risk for alcohol or benzodiazepine withdrawal will be based on the physician's assessment of the patient's condition and may include pharmaceutical therapy. The Regional Medical Director will orient clinicians on effective management of care based on specific criteria. We have provided an example of the Wellpath Clinical Decision Support Monograph for Alcohol and Benzodiazepine Medications in Tabbed Attachment A. Please note that this information is confidential and proprietary. Opioid Use Disorder Clinical Decision Support Tools Patients who are at risk for opioid withdrawal are typically identified during the receiving screening. Opioid withdrawal has significant clinical implications that can lead to an unstable clinical condition for many patients, including those who are pregnant, aged, have multiple co -morbidities, or are otherwise fragile. We will place all patients at risk of opioid withdrawal on COWS protocol and will monitor them three times daily for a minimum of five days. 33 .Cwel F <<a ;. Solicitation Event ID: 005301 Jail Health Clinic Opioid-dependent pregnant patients receiving medication -assisted treatment (MAT) in the community will have their medications continued. Wellpath encourages pregnant patients to continue MAT already in progress, as opioid withdrawal can have an adverse impact on the fetus. Opioid-dependent pregnant patients will never be required to go through withdrawal. All opioid-dependent pregnant patients will be offered either methadone (through a community provider) or buprenorphine and will be monitored and cared for closely, regardless of weeks of gestation. For additional information regarding the management of opioid-dependent pregnant patients, please see Section 2.1.6. If a patient is opiate -dependent (and not pregnant), withdrawal management will be based on clinical stabilization, which may require the use of symptom management medications such as acetaminophen, ibuprofen, and loperamide hydrochloride (Imodium). Some patients may also benefit from the use of a mu-opioid agonist, such as buprenorphine, for better symptom control. When allowed by the facility, Wellpath supports the use of a minimum five-day buprenorphine taper (typically within 24-72 hours of admittance depending on drug of use/addiction). When a patient reaches a COWS score of 8 or greater, this indicates mild withdrawal symptoms; healthcare staff will notify a DEA-X waivered Wellpath provider, who may orderthe buprenorphine taper. This low dosage of medication helps control symptoms and prevent withdrawal. Other benefits to buprenorphine include a reduction of poor outcomes, enhancement of patient cooperation, reduction of other sick call complaints, and decrease of suicide rates. The buprenorphine taper can be used to accomplish medical stabilization, but can also be used as a bridge to a maintenance dose for facilities offering MAT. Wellpath has developed and codified an update to our clinical decision support tools for the management of opioid use disorder (OUD), including but not limited to: 11 Patient education material Monographs Algorithms Screening/interview tools Consents Narcan Agreements M Practitioner orders Chronic care exam forms Post medical stabilization daily checks Nursing training tools Wellpath stocks Narcan (naloxone) in emergency response kits at our client facilities as allowed by state law. We train our nurses to administer Narcan when a patient is suspected of having an opioid overdose. It is our policy that patients found unresponsive with unknown cause, or pulseless or apneic, should be given Narcan as part of the resuscitative process. Wellpath empowers nurses to use Narcan to save lives. Since we started using Narcan in 2015, our staff have saved dearly 1,000 patients from overdosing. Those lives are honored on the Saved Lives wall in our Home Office. Medication -Assisted Treatment (MAT) Wellpath aims to provide a consistent, reliable continuum of care for patients suffering from substance use disorder (SUD) throughout their incarceration experience and beyond. We strive for a world where fewer lives are lost, addiction is treated as a disease rather than a criminal activity, and access to successful treatment is available to the millions of Americans whose lives are affected by addiction. 34 Solicitation Event ID: 005301 T, i:<. pe: ncd h• [ii;::;. Jail Health Clinic Wellpath works to meet this goal by working with our correctional partners to allow us to continue medication -assisted treatment (MAT) for patients who were receiving treatment in the community before their arrest. We also aspire to induct new patients into treatment while they are incarcerated. We know if we can stabilize someone's addiction while they are incarcerated, the likelihood of community follow-up increases and the risk of overdose death following release decreases. MAT includes the use of FDA -approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders as a medical disorder. There are three FDA -approved chronic care medications used to treat OUD: methadone, buprenorphine, and naltrexone. NIAT Therapies wrap counseling, behavioral health, and other services around medication regimens designed to tight physical symptoms and cravings. - "Full agonist' upaid with Side effects Including • Tuning agomsr- binds preferentially to the 8 overdose potential opioid receptors of the burin to relieve cravings w Satisfies cravings big does not create euphona and withdrawal symetoms or mtoxicatwn Exhibitsa -veryphorc, to Primary indicators of methadone treatment are enough toefferoCcbecome consume enough m became euptonc, rmo»tcateq or in opioid wertlose high ask of resuming iitiatmeg use or need for A P dairy moniumer of patient Gaidng momentum as the primary option for ov treatment among both providers and patents E Som2-often prescribed (combr a clam with alone unn cambinaton with naloxone alone Orin • Admmisteed oniv trough a licensed Opind DATA2000-waivered providers vim a DEA'X" Treatment Program oTP) which are regulated license. MDs, NPs, and Pecs can prescribe with o - at the state and federal level awaiver d New regulations have expanded to include nurse midwives and anesthetists (CNMICRNA) until 2023 Blocks opioidsfrom naivating receptors, neurrommg than effect Does not treat cravings or symptoms of withdrawal, although patents on 28Aay numerable Ventral has been shown to reduce aanrgs Not an opioid, thus norraddctve and non- meaccahng Generally prescnbed as injectable for patents with strong social support structure Any provider With ability to prescribe drugs -no speciaiwarmis or treatment centers required as ins not a controlled substance Maras:.�,^:p�s2;°�:'""�,�,-,14"�2n•..��•:-�,,.:K�:.:k..3��'a.`�„�:+, �'Yt (a:.�i.L..Slas�b_._- fit' - �' Wellpath's MAT Experience Wellpath is a leader in MAT programs for addiction treatment and recovery within correctional facilities. We have been assisting our local government and our state clients with MAT since 2016. Wellpath currently provides MAT in more than 70 correctional facilities, including the OCSO Correctional Facilities, with many more programs in development. Our team of 250 somatic physlciatts and mid -level providers with DEA-X waivers includes our Oakland IV Kan? Mcavoy and we will soon add Dr. Mitchell and NP Cara Deutchman. Wellpath also has more than a dozen Board Certified Addition Specialists, many of whom have presented nationally on MAT. Wellpath is passionate about the benefits of MAT. The following graphic summarizes our current MAT programs within our Local Government Healthcare Division: 35 Solicitation Event ID: 005301 Jail Health Clinic Of the 70 MAT programs Wellpath currently manages, two are fully licensed jail -based Opioid Treatment Programs (OTPs) which dispense methadone on site: in Alameda County, California and Essex County, Massachusetts. Each program meets industry standards in addition to federal (Drug Enforcement Administration), state, and local laws and regulations. Cu! OTP for Ala€neda County is act:rerlitc.c, by the rdc.rvPiC. Wellpath's MAT Program Wellpath's MAT program provides a safe and controlled level of medication to overcome the use of abused substances. The ultimate goal of MAT is full recovery, including the ability to live a self -directed life. The primary goal of Wellpath's MAT program is to remove any stumbling blocks to recovery while an individual is incarcerated. Wellpath has a multidisciplinary MAT implementation team to work with our client partners wishing to offer MAT services in some form, including full MAT programs. 0 Wellpath's dedicated MAT program for local detention facilities is led by National Director of MAT Programs, Stephanie Ruckman, DNP, FNP-BC, MBA, CCHP. Dr. Ruckman and a multidisciplinary MAT Implementation Team help clients understand the challenges associated with operating a MAT program and educate them on various available options based on their clinical workflows, staffing, counseling capabilities, costs, and other considerations. With our exnerierme and dedicated team of suhjerl matter experts, c,Avu are collaborating with the OCSO and local comr'<tun ty provider Sacred Heart to design € :v lit" progt"arn tailored to your needs. CUSTOMIZED SUPPORTED CONNECTED VVellpath creates programs that fit site needs and site capacity. Wellpath provides education and training to onsite staff and providers. Wellpath ensures continuum of care as patients transition out of custody. Continuation of Care The first step in a MAT program is to ensure that patients entering OCSO Correctional Facilities who were participating in a MAT program in the community are allowed to continue treatment. Our nurses ask all incoming patients if they are currently involved in a treatment program for OUD. If the patient reports they were receiving MAT in the community prior to their arrest, the nurse will collect a release 36 f t-"Y.'s = Solicitation Event ID: 005301 '•� h�>„ and I;<,,',,.+ Jail Health Clinic of information to verify current treatment. The nurse will also conduct a urine drug screen and contact a provider, who will see the patient to discuss continuing treatment. If the patient has been receiving methadone from a community Opioid Treatment Program (OTP), we will work with the OTP to provide this medication. If a patient entering the correctional facility was receiving buprenorphine (Subutex, Suboxone, Sublocade) or naltrexone (Vivitrol), a Wellpath provider will manage these medications on site and the patient will not have to be sent off site. All MAT continuation patients are placed on COWS protocol for evaluation and to monitor for withdrawal from any other substances. These patients will be scheduled to be seen by mental health staff to arrange treatment and by a medical provider for chronic care monitoring. Patients will be placed on the chronic care schedule every 30, 60, or 90 days based on condition stability, or more frequently at patient request. Diversion All participants in our MAT treatment programs sign consents for participation and are educated on participation expectations with mental health staff, as well as behavior expected with medication pass. Wellpath works to provide a very structured medication pass to ensure a safe, diversion -free medication pass. This requires teamwork of both medical and correctional staff. We understand when these medications are not properly handled and controlled, diversion issues can happen in a facility. Based on our expertise and time in the industry, we have developed an effective plan for medication pass. We encourage all of our sites to have MAT medication pass occur separately from other medication passes in the medical area or in another secure location away from the eyes of the general population. All participants will have a mouth check prior to receiving medication, a swish, and swallow of water. A buprenorphine tablet is then crushed and placed under the tongue. The patient must remain observed for 10 minutes while the medication dissolves. The patient will then drink a larger glass of water, have another mouth check, and return to housing unit. Wellpath recommends the use of buprenorphine tablets because they are harder to divert and they are more cost effective. However, if the OCSO prefers to use Suboxone strips, we will support this process using the same methods of observation while the medication dissolves. We realize our patient population is very smart and creative and we continually adapt our practices to meet new challenges. We have also found in our facilities where MAT is readily available through medical and patients who need treatment are receiving treatment, diversion attempts go down. This has been the case in our statewide MAT program for the Maine DOC, whose program has grown to the point that they are able to offer MAT to anyone who is eligible and interested. With diversion literally non-existent, they are now able to pass medications in the routine medication line without extra observation time or security. Discharge Planning and Community Connectivity Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the goal of sustained abstinence and recovery of their lives. Attempting to navigate free world demands while also attempting to maintain sobriety in the absence of community treatment resources is not likely to be 37 4-7 i6-., - --�- Solicitation Event ID: 005301 Jail Health Clinic successful. Community connectivity is therefore an integral component to Wellpath's SUD programming. We believe discharge planning begins when we start discussing treatment options with a patient. We must ensure patients begin a treatment they can sustain. When patients are pending release, Wellpath coordinates with local providers such as Sacred Heart to arrange post -release treatment to enhance continuity of care and reduce recidivism. Wellpath Community Care Centers Wellpath is on the forefront of substance use disorder (SUD) "i ll J treatment, not only within our client facilities, but in the community at large. We recognize that many patients seeking treatment for SUD also struggle with a serious mental illness. In concert with our comprehensive jail -based medication -assisted treatment (MAT) programs, 4He'.tpa Ah s OnamunitV Ut,m Cf rt rs create a seamless transition to the community for individuals with SUD Wellpath Community Care Centers offer evidence -based MAT programs for individuals struggling with opioid or other substance use. They provide comprehensive services to help individuals struggling with substance use and/or mental health issues by using an integrated, multidisciplinary method to improve each patient's qualify of life. Our holisi it approach to recovery promotes resilience and positive change in a patient's behavioral, physical, social, spiritual, intellectual, environmental, and vocational wellness. We have determined that this is a critical aspect of continuity of care for our patients. We opened our first two Community Care Centers in California in late 2020 and another in North Carolina in April 2021. In the coming months, we will be opening additional centers in Charlotte, NC, Indianapolis, IN, and Newport News, VA. It is our intent fo c ppn one or more Community Care ConrEers In Oakls,nd Ceu€2ty in order to impiove'the iikehhood that individuals, released from; custo.fy can tnnsitlon successfully:, Improving tive; and reducing 'recidivis€ . 0 We know Wellpath patients have the choice as to where they go for care. We want to be available to the residents of the community we serve as a safe place to receive the best evidence -based care available. Our sites provide same -day admission and walk-ins are welcome. If a patient meets criteria, they may receive medications on the first day of treatment. Core outpatient and intensive outpatient programs offered: o Individual counseling o Group counseling o Family counseling o Telehealth o Treatment planning o Laboratory and pathology o Case Management services o Recovery support services 38 Solicitation Event ID: 005301 Jail Health Clinic i • Wellpath staff conduct a comprehensive health assessment, including a complete medical history and physical examination, for patients within their first 14 calendar days in custody at the OCSO Correctional Facilities. We fypicaVy target day 10 far health assessrr:ents to ensure conripliance with I3ICUAC and [tfIM'iigan Delonrtmemt of Corrections (CV DOC) standards. This also allows us to identify medical needs or conditions not disclosed by the patient during intake and initiate timely treatment. Wellpath staff document patients who refuse physicals and their reasons for refusal. A physician, a mid -level provider, or a properly trained Registered Nurse (RN) conducts the health assessment following local regulations. Before performing health assessments, RNs complete physical exam training provided or approved by the responsible physician or designee. The RN must also pass a written test and successfully demonstrate an exam for the physician, who will sign off on the RN's competency to complete assessments. The training is documented in the RN's training record and repeated annually. For additional information on nurse competency exams (and other Wellpath training initiatives), please see Section 3.3 Ongoing In -Service Training. A Wellpath physician reviews, signs, and dates assessments completed by an RN and abnormal assessments completed by a mid -level provider. A physician or mid -level provider reviews abnormal health assessment results for disposition. The comprehensive health assessment minimally includes the following: Review receiving/intake screening Record vital signs, height, and weight Review immunization history; initiate needed immunizations and therapy PPD test for tuberculosis (if not previously administered) Laboratory and/or diagnostic tests as required Vision and hearing screenings Physical examination (including breast, rectal, and testicular exams based on patient gender, age, and risk factors) 0 Pap testing for female patients as medically indicated 39 _l '@ r ia, E''.P a - E Solicitation Event ID: 005301 Jail Health Clinic s Oral screening and hygiene education Mental health assessment, including suicide potential and psychiatric screenings Review health history; gather additional data needed to complete the medical, dental, and mental health histories E Document allergies r Other tests and examinations as appropriate (e.g., diagnostic panel, urinalysis, EKG, etc.) The healthcare professional conducting the assessment records findings, which also includes the individual's title and signature, as well as the date and time of the assessment. The health assessment becomes a part of the patient's permanent medical record. -,� '-we7L`" vers��en -•- wl FeeF�mnenl nemm , .a a dwell-..:n PFv:Inl use ae �"'- �- INlSwryand _PUADavrono PhYSIcal Pssessmenf y", wIU BeFavieml Henl,i, 40 Solicitation Event ID:005301 'o rrr:"r. <t'e+ Prs .2n::. Jail Health Clinic Sample Medical History & Physical Assessment in ERMA - A_WkPnnt(D) . aeluA eY!'euYlAl1Y! armm[�,<ora<n pear sre ae'v«�.r-acanl>U, a,d P,s •, umar � PaUe'IY isiet_x LWe [al Pl<lul a'.^. P-Sax nax '-=n: c . �Inrleman History i , I — _ _- nrla,m omom<rnlanrv,arwar: • __ - - _ :L<e;.elLa.ei,C3:n :, [..t � C: �,,•re. 2y �. Sp<Oal JrturnWn,e -- �- i �_ Teealmpal4mraz �r'!5 cn 1,r r.qb = ,r-,..ttenm:Fnei.han?..r �_nE Featl+:M1C IAva:ae r . cMM.mn?r Ea'sr�kiz:�nts>ura_Izr �sJ ra F a9'-_-al +cYuvtl'F:ia .. nr!f`r•mF a9^�nl.. axle=eM1 'cePo `u - 1<'re,13VFer .. ,ac1 ,elan k le nso, olul a: t•JLem Slonlerr}<dr - ., ...ald'id 'I cf a H: pr.idgn ; hea.a M1ep i;, e='tmrn ory; a'I r� F'nh'emc.5 � - I y- ,., naren rcrrr;Pen rs,-k;nnn.tlsa darF'�; aal'm, c-i'ane.«;ear: 'r., :'n, v WeIIpath follows upon health problems identified during the physical examination or in test results. A physician reviews the follow-up for disposition and a care plan. Medical personnel see patients referred for treatment based on the physical examination the following day, unless the referring provider specifies another day, or in the case of life -threatening discoveries. 41 ... Sample Referral Form in ERMA Solicitation Event ID: 005301 Jail Health Clinic MB tFbgv .. fQemcai to;---- 'hs pa]rn: _o-rrsr.: p nos no ryags 0.efe�rat — faf�:c4av, — �tvv.rm' Ci,v c.]rt —_e ,v+h. .ceeate —l. f .,,-.,e It -v„c.z F.a.ry S,varz Rktu O, Yu.,e re ce _ +ti .ear,. ��ee n,<rf anJ>a:pan z!Ine .z l.!e].Y -z c .hR , . Periodic Health Assessment Wellpath provides health maintenance exams for patients incarcerated for prolonged periods to manage existing conditions and identify new conditions or illnesses that may have developed. This managed care approach allows us to keep down costs for medical services while improving the overall health of our patients. We conduct health maintenance exams for long-term patients on the anniversary of their incarceration. Health maintenance exams are repeated at reasonable intervals thereafter as determined by the treating physician. Determinations are based on the age, gender, and health of the patient. The specific components of the examination take into consideration the current community standard of care. Y — - �" 42 Solicitation Event ID; 005301 Jail Health Clinic Wellpath staff provide examinations and medical clearance for inmates before placing them in a work assignment. Medical clearance for work takes into consideration the individual's condition, including known or suspected illnesses or injuries observed during examination. We document this information in the patient's medical record. We typically perform examinations during the 14-day health assessment; however, examinations are also completed upon request. We medically clear food service workers before they work in the facility kitchen or as food servers, according to procedures defined by Dr. Mitchell. 2,1.3 Inmate Requests for Health Care Services Intake staff advise arrestees of their right to access care and the process for requesting healthcare services. We communicate this information verbally and in writing in a language the arrestee understands. We ensure that arrestees who do not speak English understand how to obtain healthcare. Patients have access to sick call request forms that meet all standards and guidelines. Correctional staff can also refer patients if they have concerns for their health status. We record all medical complaints, along with a recommended intervention and referral as appropriate. Patients have access to routine and emergency care regardless of their location, custody level, or status. If a patient is unable to attend a sick call session due to custody status (e.g., restricted housing) or as a result of physical condition, we conduct sick call services at the patient's cell. Qualified nurses conduct sick call triage seven days a week, including holidays. Following the collection of healthcare request forms each day, a nurse reviews and prioritizes sick call requests. Patients receive a lace -to -fence consultation at the next schedaded nurse sick call, which aiso takes ,s[ace seven days a week per NCCHC standards. ----------------- - --- -- - - - - - - r., .a. Healthcare services comply with State of Michigan and federal privacy mandates. We understand the importance of decentralized services for minimizing inmate movement, so we will continue to conduct sick call services and nursing encounters in housing units when possible. The sick call nurse assigns each sick call request a disposition of emergent, urgent, or routine. We will continue to address the patient's request within the appropriate timeframe. Requests triaged as emergent receive immediate attention. Urgent requests are scheduled for the next provider sick call clinic. Should the need arise outside the scheduled sick call, patients requiring urgent or emergent medical attention will be seen the same day. 43 ell: r, =-�" "� Solicitation Event ID: 005301 tiJ hOpc :r:d iF�2tnq Jail Health Clinic During triage, the nurse initiates referrals for patients needing consultation with the medical provider. If the patient needs to see more than one provider, we make multiple referrals. The nurse documents the referral on the request form. Professional Nursing Protocols (PNPs) Wellpath nurses at the OCSO Correctional Facilities conduct sick call using Professional Nursing Protocols. Our physicians developed the PNPs to assist nurses with treatment recommendations and promote consistent caregiving. These protocols provide a corsisient S`.rucWre fm patient care, CSLiC~1in f?' actions, ctrset G;f t4tlea`5ff-'1t f.:°tins sr,,,:Cif c to the patient's p€`-ent €ryg cond:iLlon. Their purpose is to give nurses information regarding specific health conditions or complaints so they can reach logical conclusions from their observations, then provide appropriate intervention and follow-up. In its simplest form, a Professional Nursing Protocol is a decision -tree process for nurses to follow, which also improves ease of training and optimize=- fc ;,ci:itionors' zime. All Wellpath nurses are trained to use the protocols, which cover topics such as: Abdominal pain Allergic reaction (emergent) Altered mental status Behavioral health complaint Chest pain Cold/allergy symptoms n Conditions not requiring medical treatment Dental complaints/pain M Ear complaints Eye complaints Female -specific complaints Fever Gastrointestinal complaints Headache Heat -related illness Hyperglycemia Hypertension Hypoglycemia Male -specific complaints Musculoskeletal complaints Neurological impairment Nosebleeds Pregnancy, 20 weeks or more Pregnancy less than 20 weeks Respiratory complaints Self -injurious behavior Skin problems Trauma Urinary complaints Use of force Withdrawal, alcohol and benzodiazepine Withdrawal, opiate Wounds The PNP manual is subject to approval by Major Childs or his designee. The Site Medical Director, Dr. Mitchell, reviews the manual annually and the Wellpath Nursing Department makes the necessary updates. The HSA, Ms. Warren, and/or the DON, Ms. Stamp, instruct the nursing staff on revisions, as applicable. Nurses access electronic versions of the protocols through ERMA and document findings directly in the patient's medical record. The electronic PNPs include a health education component. The nurse is prompted to educate the patient on symptoms to look for and when to notify medical staff about their symptoms. For example, a nurse seeing a patient for a headache might tell the patient to notify staff if the pain persists for more than four hours, if the patient experiences auras or visual changes, or if the patient has changes in balance/equilibrium. The education is provided verbally, or the nurse prints a -il �' Rf-x'== '- Solicitation Event ID: 005301 T:' hoj" - -,J h- 1,r"y. Jail Health Clinic handout for the pa tie nttokeep. h ,zlac'ct`trs;icilrni'c-35i.1 Uair,rltrcr':,r.:x?;:':cirB,I;I,ee:?rE:r::Er,rt;sa fiEtr&F: €o n€:ie I"ias been ihi4t 4.s"il€ilriti:?. a{SJt'- is i:isc ri ::'.iiii;'rl ir; I"t;r' t'i'ic25!,11 e fOr hIf Cl!C.. Nursing Support Tools Wellpath is dedicated to supporting our nursing teammates by enabling them to deliver excellent patient care and support improved patient outcomes. We invest in resources that are evidence -based, immediately accessible to each staff member, and support clinical decision -making. Wellpath partners with Wolters Kluwer to provide our staff with evidence -based resources, including Lippincott Procedures and Lippincott Advisor. Lippincott Procedures is an online source for instant, evidence -based procedure guidance at the point of care. With more than 1,800 procedures and skills from novice to expert and covering a wide variety of nursing specialties, it combines the most trusted clinical content with powerful online workflow functionality that saves time, standardizes care, and delivers improved patient outcomes. We encourage ancillary and support staff to access Lippincott Procedures and Lippincott Advisor to support their scope of practice. L ippieicai t` Nurses can make informed clinical decisions and perform quality skills. Procedures include step-by-step guides, simplified quick lists, information about special considerations, complications, documentation, and visual _ references, like full -color images and video clips. Staff can quickly and easily consult "Nurse Lippincott'for clinical decision Lippincott' Advisor support regarding Signs & Symptoms, Diagnostic Tests, Diseases & Conditions, Hospital -Acquired Conditions, Treatments, Care Plans, and more. Nurses can use the Health Library to access more than 30 evidence- ` based eBooks on a variety of medical topics. Lippincott Advisor O r 1iPJ scarrF Query -_ ___ ei eAv�__-nd r..rza__---V 9 Clinirni Oixgnoaia find :leatmm�i CwWRm'aml Signs and SympYouw DlaUnosfir Lxts [�''' iTm#mcnta -- conditions n," r. [are Planning --' "'Honing (are mans Pllbienl hasntuare ' - for Mcvlical Wans _ 1}iptJnMtS Potiertl P_achinq HanDudts e+ tcartamp and UgInOaM lh. (tnM1 ilnndouts ytexlcump and }z'�UpTODate Omg ....rc..�]ilandauts P,dwllt Tlllibi, N10.1Wr _ - Te"rbmg Umlh l,l FIR 1,,ldbug Concepts �ry T,,lbb 9 Doll UC Tests fd Tlo,lbb 9 "Ma U�eeasea snd F« Idiuons 45 -i_t`: e ! t.. Provider Clinics Solicitation Event ID: 005301 Jail Health Clinic Dr. Mitchell or Wellpath mid -level providers (Cara Deutchman, NP and Kari Mcavoy, NP) see referred patients during the next scheduled provider clinic. Clinics are scheduled Monday -Friday (no holidays) to meet the health needs of the patient population. A physician or mid -level provider is also on -call 24/7 for emergencies. The medical provider assesses the patient and provides the appropriate treatment and follow-up. Wellpath practitioners use evidence -based practices to make clinical decisions regarding patient treatment. We have developed clinical monographs that represent best practices our practitioners should use when treating both episodic and chronic medical needs. Wellpath practitioners also receive training from the Wellpath clinical department on clinical decision -making in the correctional environment. Restricted Housing When notified that a patient is being assigned to restricted housing, a Wellpath Qualified Healthcare Professional (QHP) reviews the patient's health record to determine whether existing medical, dental, or mental health needs contraindicate the placement or require accommodation. If so, the QHP informs Correctional Facilities administration and provides a full explanation. We document the review and any subsequent notification in the patient's medical record. This review also allows healthcare staff to plan for continued service delivery for patients placed in restricted housing. We notify mental health staff when a patient is placed in restricted housing so they can participate in ongoing monitoring of the patient's progress. Restricted Housing Rounds Medical and mental health staff conduct restricted housing rounds on a schedule agreed to by Wellpath and Correctional Facilities administration. We have established the frequency of restricted housing rounds at the Correctional Facilities based on facility policy, accreditation standards, or degree of isolation. We conduct medical restricted housing rounds at least three times a week. We will continue to document restricted housing rounds in the patient's medical record. Documentation includes significant findings, date and time of contact, signature or initials of the staff member making rounds, and referral for care if needed. We promptly inform Correctional Facilities administration of patients who are physically or psychologically deteriorating, and those exhibiting other signs or symptoms of failing health. The following is Wellpath's Segregation Housing Notification and Review Form. 46 wel1r,,a *I Solicitation Event ID005301 Jail Health Clinic weliv ; t; r �" " " Segregation Housing Notification and Review Name: DOB: ID#: Daterfime: Allergies: Gender. All detainees that are in segregated housing must be reviewed by medical staff. The only exceptions are detainees that are placed in segregated housing for 3 days or less, all others must be reviewed. Fill out the below information and place in medical box. Medical will review for contraindications and return original form to classification. Medical must be notified immediately and no longer than 24 hours of detainee being moved. Type of Segregation (select one): ❑ Searegated/Restricted Housino: Also referred to as administrative segregation, administrative separation, protective custody, or disciplinary segregation. Segregated inmates are those isolated from the general population and who receive services and activities apart from other inmates. Segregated inmates have more than three encounters with other inmates or staff per day. Monitoring will be three times weekly by medical or mental health staff. ❑ Solitary Confinement: Also referred to as isolation, solitary confinement is an extreme form of separation where an inmate is isolated and encounters staff or other inmates fewer than three times a day. Monitoring will be daily by medical staff and at least once a week by mental health staff. Dates of Segregation: Housing Unit: _ I: Comments Shift Supervisor/Custody Signature: Date: Medical Staff Review L101 Received by: Date: ❑ No medical or mental health c t for segregated housing ❑ Patient is non ri Ily ill mental health patient ❑ Placement is contra' c ❑ Curre 1 1 ti n or previous suicidal ideation/suicide attempt in segregation ❑ Patie isa Mentally III (SMI) ❑ Patie s medical observation ❑ Developmentally disabled individual ❑ High risk and/or late term pregnancy ❑ Brittle chronic care conditions (diabetes, cardiac, seizures) ❑ Currently intoxicated or withdrawing from substances ❑ Other: Physician/QMHP notification if placement is contraindicated (name/date/time) Custody notification of contraindication (name/date/time): ❑ Accommodationllimitation related to segregated housing required for medical, dental, or mental health issue: CommenlslNotes Signature/title: Date/Time: Printed Name: 47 Solicitation Event ID: 005301 Jail Health Clinic Mental health staff with the Oakland Community Health Network monitor patients on suicide watch daily and create a treatment plan for follow-up care. When a patient is released from suicide watch by a licensed mental health professional, mental health staff follow-up based on a clinical algorithm, starting within one to three days post -suicide watch and consisting of two to three follow-up visits. Mental health staff administer the C-SSRS to assist in supporting the clinical decision to discontinue the watch. They also develop a treatment plan addressing suicidal ideation and its re -occurrence and provide additional follow-up care, as needed. The correctional staff at many of our facilities use our exclusive Patient Activity Monitoring Management (PAMM) system to complete patient observations. PAMM is a computer tablet and application offer- exr:iusively i,;r irr Vpath. We would like to demonstrate the system at your convenience. PAMM was custom-built to interface with our Electronic Record Management Application (ERMA), which sends patient information and observation orders to PAMM; PAMM then sends completed patient check information back to ERMA. Certain ERMA functions interface with PAMM and directly impact its usage, including: • Patient Status • Patient Location Precautions n Patient Observations (including activity and behaviors) A patient countdown timer tells medical, mental health, and correctional staff when the next patient check is due. The PAMM application is color -coded: * A red screen indicates that an observation is due immediately Yellow indicates that an observation is due within two to five minutes Green indicates that no observation is due for at least five minutes A patient observation list displays all patients scheduled for an observation, starting with those closest to their scheduled time. Each patient is displayed on an electronic "card." The elements of a card include: G Tin ._ Displays the time remaining until the next due observation " Obsewation interval Displays the interval at which the patient should be observed (Q15, Q30, or Q60 refer to observations needed every 15, 30, or 60 minutes) e, Last Observation — Displays when the last observation was performed and any associated information on that activity CIi ERMA provides the patient's location to PAMM, which then can be used during observation rounds without a Wi-Fi connection. During each observation, the patient's picture is captured directly on the tablet, and the patient's activity and behavior are documented. A note about the patient's activity at the time of observation may also be included. PAMM and ERMA synchronize when observation rounds are completed and the PAMM tablet is put back in the cradle and connects. PAMM observation data is available on a performance dashboard, giving accurate observation compliance statistics at all times. Infirmary Care There is no infirmary in the OCSO Correctional Facilities. Solicitation Event ID: 005301 Jail Health Clinic 100% tAk4lE,'a4h uriOprst,a;nds *he Speclal keakhcarc ikee& of female patiew,,s Eo'd har, to Ysi@SIii4 a proorsm at FZcilltieS that ?.,EZCI rE'SSF5 ,hese needs tollowa ng ;',li CHC: and Nil)CC standardf. We train medical staff working with the female population on the specialized aspects of care required. The Wellpath female health program includes: u Determining menstrual and gynecological problems at intake Determining pregnancy status by history and/or pregnancy testing, as appropriate Identifying activity capabilities for pregnant and non -pregnant female patients (medical clearance for work as appropriate) Screening for sexually transmitted diseases found at a significant frequency in the population Pap smear testing following the recommendations of major medical societies, modified to reflect individual patient medical needs Breast cancer screening following recommendations of major medical societies, modified to reflect individual patient medical needs (and with consideration to anticipated duration of confinement) Providing health education on issues specific to the female population Providing contraceptive counseling and/or medication as medically necessary Access to obstetrical and gynecological specialists '—weltpatt: wellpad ,.on, werv.n ..<ns.m>+mMam r:v e.r.wrnrt.drvo::gr ,i larinem,nv tine, ., .R.a-.nnn. en�'•[ed �� ro..non �oq,awm,, ,cM.+ed..eieT �.�•I�4nen:o .e.urtuge, rmes mu Rnrp 49 Solicitation Event ID: 005301 Jail Health Clinic Prenatal Care Pregnancies among women in custody are often unplanned and high -risk and compromised by poor nutrition, domestic violence, mental illness, drug and alcohol use, and inadequate prenatal care (which increases the risk of low birth weight and neonatal death). Wellpath ensures pregnant patients at the Correctional Facilities receive adequate prenatal care, effective education, and discharge planning that emphasizes continued care upon release and where to access it. Wellpath offers voluntary pregnancy testing at intake for female arrestees of childbearing age. We refer those testing positive for care by medical staff within 48 hours (72 hours on weekends). Pregnant patients are seen according to American Congress of Obstetricians and Gynecologists (ACOG) guidelines. Wellpath provides family planning counseling and discussion of options regarding the outcome of the pregnancy. We assist the patient based on her expressed desires, whether planning to keep the child, considering adoption, or seeking to end the pregnancy. We ensure each patient fully understands her options, so she can make the most informed decisions possible. Pregnant patients receive timely and appropriate prenatal care, specialized obstetrical services, and postpartum care when indicated. The Wellpath physician serves as the patient's primary provider, coordinating care with an obstetrical specialist at St. Joseph's Mercy Hospital, as appropriate. These services are provided through a scheduled on -site clinic whenever possible (typically through the first 24 weeks of an uncomplicated pregnancy and after delivery). Care of pregnant patients includes but is not limited to: Routine and high -risk care, including monitoring fetal growth and heart tones Appropriate counseling and assistance r Identification and management of chemically dependent pregnant female patients, including education and counseling Appropriate housing Counseling on appropriate levels of activity and safety precautions Prenatal vitamins c• Nutritional counseling and diet plan (diet and vitamins are planned per recommendations from ACOG and Registered Dieticians) Laboratory and diagnostic tests, including testing for gestational diabetes, HIV, and testing recommended by ACOG Observation for signs of toxemia, including urine testing for proteins and ketones Coordination of counseling and assistance to pregnant patients planning to keep their child, considering adoption, or seeking termination services Y On -site obstetrical care when it can reasonably be provided F Postpartum care, including but not limited to lactation, monitoring for postpartum depression, contraception, and education 0 Education on infant care • Counseling regarding future pregnancies • Family planning services before release 50 iNP wellp.-ia"ei. .., Solicitation Event ID: 005301 -d hlMlr_ Jail Health Clinic When a pregnant patient requires the services of an off -site OB provider, Wellpath staff coordinate with correctional staff for transport to off -site scheduled appointments. Wellpath provides designated correctional staff with an up-to-date listing of pregnant patients, anticipated delivery dates, and high - risk pregnancies to help them plan for required off -site travel. High -Risk Pregnancies An obstetrical specialist manages high -risk pregnancies and pregnancies past 24 weeks. We facilitate testing that can be performed on -site, monitor patients with high -risk pregnancies, and refer patients for hospitalization at St. Joseph's Mercy Hospital, when needed. A pregnancy is considered high risk if the patient: Has diabetes, cancer, high blood pressure, kidney disease, or epilepsy Has a history of tobacco, alcohol, or drug use Is younger than 17 or older than 35 t Is pregnant with more than one baby Has had three or more miscarriages Had pre -term labor, preeclampsia, or seizures (eclampsia), or gave birth to a baby with a genetic condition (such as Down Syndrome) during a past pregnancy Has an infection such as HIV, hepatitis C, cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, or syphilis Is taking certain medications such as lithium, phenytoin (e.g., Dilantin), valproic acid (e.g., Depakene), or carbamazepine (e.g., Tegretol) Perinatal Care Perinatal care (before, during, and after delivery) takes place in a hospital, following the obstetrical specialist's recommendations and the Emergency Medical Treatment and Labor Act (EMTALA). Wellpath provides appropriate postpartum care, including accommodation for lactation. When a patient returns to the Correctional Facilities, she is seen by healthcare staff and placed under medical observation for at least 23 hours. Mental health staff also evaluate the patient's emotional status, as separation from a child can trigger self -harming behavior. Wellpath staff monitor patients for perinatal mood and anxiety disorders and refer patients to licensed mental health staff as indicated. Opioid-dependent Pregnant Patients Wellpath coordinates assessment and enrollment of pregnant, opioid-addicted patients for medication - assisted treatment (MAT). If a pregnant patient reports active drug or alcohol use during the receiving screening, intake staff will contact the physician or mid -level provider for orders. When a medical provider is on -site, the provider will evaluate the pregnant patient immediately; otherwise, the patient will be seen during the next scheduled provider sick call clinic. We also refer the pregnant patient to an obstetrical specialist for a high -risk obstetrical evaluation. Because opioid withdrawal during pregnancy may be associated with adverse impact on the fetus, pregnant patients should continue MAT treatment already in progress. We treat opioid withdrawal during pregnancy by using specific opioid substitution medications, such as methadone or buprenorphine preparations. Buprenorphine is a partial opioid agonist: it activates and 51 17 p.e nt. 10 hra14 Hied 9vJi::». Solicitation Event ID: 005301 Jail Health Clinic blocks opioid receptors in the brain, reducing or eliminating opioid withdrawal symptoms (including drug cravings) without producing the "high" or dangerous side effects of heroin and other opioids. Buprenorphine is available for sublingual (under the tongue) administration, both in a stand-alone formulation (called Subutex) and in combination with another agent called naloxone. The naloxone in the combined formulation (marketed as Suboxone) deters abuse of the medication by causing a withdrawal reaction if it is intravenously injected. Physicians with special certification may provide office -based buprenorphine treatment for medical stabilization for withdrawal from substance use disorder and/or maintenance therapy. The Wellpath clinical department is undergoing a company -wide effort to staff physicians with DEA X-numbers, which allows them to prescribe buprenorphine and Suboxone. Wellpath currently has 250 physicians and mid- level providers with DEA-X waivers throughout the country. Our Norse ^iactits;ne. iC:n`c[i OfC, Coryediona Fa€:llitiel;, iC.'.!'= r4cavoy, NP, hr-.s DEA-X zk:enEure Dr. I€fiiichell;gnd our otoiev i%',iyi'>e Praditioner, Cara Doutehman arp;n the P"toes of getshig iiiEv' lict'nse. Methadone is also used to treat opioid dependence in adults. It is a full opioid agonist, activating opioid receptors in the brain to prevent withdrawal symptoms and reducing cravings. t ethr?:aarze is avai3aabl,� through W Specially Vicen5er; opioid treatn•ien'.- program (01P) at Sacred Hemt" If a pregnant patient is opiate -dependent and reports using methadone, Wellpath staff attempt to verify the treatment being received in the community. If the treatment cannot be verified, or the opiate -dependent pregnant patient is not currently receiving methadone, she may be treated on -site or referred to Sacred Heart for evaluation and recommendations for treatment. In addition to regular dosing, the patient is evaluated for potential dose adjustments throughout the pregnancy. If a pregnant patient declines to participate in an OTP, the Wellpath physician initiates an appropriate treatment plan for opiate withdrawal syndrome. The physician also initiates a treatment plan for postpartum patients with opioid dependency. Wellpath coordinates with community providers for follow-up care as part of our discharge planning process. We have provided in Tabbed Attachment D a Letter of Support from Sacred Heart. Family Planning Services A/ellpath provides fammily p!.%nfdng education to female patients, following applicable NCCHC sf:�;rdards. Contraception The Wellpath female health program complies with applicable laws, including those providing direction on birth control and family planning services. Following NCCHC standards, Wellpath provides female patients with nondirective counseling about pregnancy prevention, access to emergency contraception and continued contraception at intake, and appropriate long-term contraceptive options. A provider reviews female patients using contraception at the time of the arrest. All medications, including contraception, are reviewed and continued/ordered as indicated. Emergency contraception is available at intake when medically necessary, in accordance with Wellpath policy and NCCHC standard J- B-06, which states that "emergency contraception is available to women at intake" and "women who are on a method of contraception at intake should be able to continue this method as medically indicated." 52 To hoop :au: ;ter,[;-. F. Discharge Planning Solicitation Event ID: 005301 Jail Health Clinic Wellpath routinely offers family planning services at the Correctional Facilities before release, as well as counseling regarding future pregnancies. Our female health program complies with NCCHC and MOC standards, which provide guidelines for discharge planning and linkage between the facility and community -based care organizations, such as Planned Parenthood, to provide follow-up care to female patients upon release from custody. Wellpath has a written infection control policy to ensure a safe and healthy environment for patients, staff, and visitors at the Correctional Facilities. The policy includes recommendations from the Centers for Disease Control (CDC) for infectious disease diagnosis and treatment. Oversight includes medical care, monitoring, and case management of patients with HIV/AIDS, hepatitis C (HCV), and other infectious diseases. The primary drivers of effective infection control policies, procedures, and guidelines are idk nt=.ficnN-i: c, Prevention, Dlasgnnsis, and Treatment. The Wellpath infection control program aims to effectively control the occurrence and spread of communicable diseases by maintaining compliance with universal precaution procedures. We ensure employees have access to appropriate cleaning and personal protective equipment and we train them on general sanitation issues and preventing the transmission of blood borne pathogens. The goals of the Wellpath infection control program are to: * Identify individuals at risk for infectious diseases o Monitor and report infectious diseases among patients and staff Promote a safe and healthy environment through regular inspections, education, communication, and role modeling N Survey patients from their entry into the facility Provide timely, effective treatment when an infectious disease is identified Administer vaccinations to minimize the spread of infectious diseases Protect the health and safety of patients and staff through appropriate isolation precautions Establish effective decontamination techniques for cleaning of medical equipment and contaminated reusable items Provide safe means of disposal for biohazardous waste and used needles and sharps Implement standard precautions to minimize the risk of exposure to blood and bodily fluids File required reports in a manner consistent with local, state, and federal laws and regulations Establish and maintain a good working relationship with the local health department, the community, and the facility in matters related to preventing infectious diseases u Train staff on all facets of the infection control program Monitor the effectiveness of the infection control program through ongoing quality improvement data collection and statistical reporting S3 Solicitation Event ID: 005301 Jail Health Clinic We expect to reach these goals through our commitment to early identification from surveillance of potential and actual occurrences of infectious disease. Intake staff ask arrestees about their history related to infectious or communicable diseases and ensure complete clearance before their assignment to general population. Those at risk for spreading a communicable disease are segregated from the general population. The Wellpath clinical team addresses the control of all infectious diseases. For specific diseases, our staff consult the UpToDate° clinical knowledgebase (described in Section 2.1.8) and CDC guidelines for the latest protocols and coordinate with the Oakland County Health Division, as needed. Wellpath provides training and education to healthcare and correctional staff on the latest precautions for handling patients with communicable diseases. We use our Care Management system to customize a monthly report of patients diagnosed with an infectious disease. The report includes the patient's name and identification number, the date of service, the patient's disposition, and the infectious disease diagnosis. Clinic logs and statistical data are maintained by the HSA, Ms. Warren, who serves as the designated infection control coordinator. Ms. Warren also schedules and completes appointments using the Care Management system, Wellpath helps the health division meet its goals of promoting health and well-being in the community while preventing the spread of disease. As part of our infection control program, we will educate patients, identify and treat those infected with or exposed to contagious diseases, and maintain a collaborative relationship with health departments. We will continue to work closely with the County Health Division on significant emerging public health events impacting the community. Wellpath collaborates with the Health Division on communicable disease screening, continuing medical surveillance, case management, reporting, and patient referral in the community. We immediately report highly infectious communicable diseases to the health department, per local regulations. The HSA, Ms. Warren, reports incidents to public health officials; however, all Wellpath staff are trained on the notification process to ensure timely reporting if the HSA is not on -site. Our on -site healthcare team closely monitors and promptly communicates with the Correctional Facilities administration, the health division, and hospitals or other off -site service providers if a patient that was recently treated or will be treated at their location is diagnosed with a communicable disease. Ms. Warren manages, reports, and records these incidents and implement appropriate educational programs to prevent future occurrences. Public Health Events Wellpath is vigilant in addressing infectious outbreaks and pandemic events, like the current COVID-19 pandemic. As in any crisis, we proactively prepare for such events by initiating protocols and developing a plan of action to keep pace with any potential situation as it may evolve. Our primary concern is for our patients, staff, and partners in a crisis. We routinely partner with the Oakland County Health Division to stay abreast of developing crises in our communities. We understand that, unlike other potential catastrophes, a pandemic outbreak may result in dramatically reduced staffing levels. We will continue to ensure that key employees are available to carry out essential functions following appropriate procedures. The Wellpath Regional Medical Director, 54 Solicitation Event ID: 005301 Jail Health Clinic Cleveland Rayford, MD, in consultation with Correctional Facilities administration, determines guidelines for prioritizing the delivery of healthcare based on the severity of an outbreak and rates of absence. Coronavi rus/COVI D-19 Wellpath worked diligently to prepare the Correctional Facilities for the arrival of patients and others with coronavirus disease 2019 (COVID-19). We follow recommendations from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). We also work closely with local public health authorities. Where vaccines are available, we are offering them to our staff and patients. See Section 2.1.11 for details on our Pandemic/COVID-19 response. Vaccinations During the comprehensive health assessment, Wellpath staff gather information regarding immunization history and initiate needed immunizations and therapy. We coordinate with community providers to obtain vaccination records and initiate a treatment plan to complete the required vaccinations on schedule. Wellpath follows CDC recommendations for vaccinations and the Health Officer's instruction for vaccine recommendations from the Advisory Committee on Immunization Practices (ACIP). Tuberculosis Intake staff ask arrestees tuberculosis symptom screening questions and whether they have a history of tuberculosis. We typically administer a Tuberculin Skin Test (TST) during the 14-day health assessment. If documentation of a positive test is in the record or if the patient indicates such, we follow CDC guidelines for annual symptom screening and perform a chest X-ray if symptoms indicate the clinical necessity. Nurses read and document the results of tests within 48-72 hours. Sexually Transmitted Diseases Wellpath screens for sexually transmitted diseases (STDs) as indicated. Intake staff ask arrestees about their history related to infectious or communicable diseases and ensure complete clearance before their assignment to general population. We evaluate patients identified as having HIV or hepatitis and ensure they have access to infectious disease specialists, as well as necessary treatment and medications. We screen patients with a history of intravenous drug use annually during their incarceration, following CDC recommendations. HIV{AIDS Wellpath provides confidential, case -by -case Human Immunodeficiency Virus (HIV) testing and counseling to patients who request it. We report confirmed cases of HIV to the Oakland County Health Division. Medical staff evaluate patients identified as having HIV and ensure they have access to practitioners trained in the care of HIV disease and HIV medications. Housing for HIV -positive patients is determined by the physician's evaluation of acuity of symptoms, the patient's behavior to prevent the risk of transmission, or the risk of physical harm to the patient by others. 55 well Wellpath Center of Excellence for HIV Solicitation Event ID: 005301 Jail Health Clinic Wellpath Centers of Excellence (COEs) provide best practice chronic care management (e.g., HIV, Hepatitis C) powered by academic medicine -affiliated expertise. Wellpath COEs leverage telehealth to optimize best practice clinical outcomes, implement evidence -based protocols, increase access to subspecialty care, and achieve the highest community standards of care for chronic conditions. Wellpath chronic care COEs deliver best practice clinical management for chronic conditions through telehealth visits, addressing quality, access, the patient experience, and total cost of care. Wellpath's HIV COE incorporates best practice care delivery and best pricing for specialty pharmaceuticals in collaboration with provider specialists from our academic medical center partner. Therapeutic optimization addresses quality and total cost of care by choosing the correct drug regimens to suppress viral load and improve medication adherence. Specifically, we are able to use both generic and higher -cost specialty drugs to maximize outcomes, with HIV care being performed by infectious disease experts who specialize in corrections. Outcome measures include suppression of circulating virus, preserving immunologic function, reduction in morbidity and mortality, and prevention of transmission. These outcome measures are made possible by procedures to optimize screening, laboratory testing, continuity of care, and therapeutic optimization. HIV COE prc,grom has at hievrid viral suppression mtes 36% higher th a ; the rauttiut;',:l 340B Program Wellpath plans to administer a 340B Drug Pricing Program on behalf of OCSO in accordance16 with Michigan and federal guidelines and all applicable governing laws. Wellpath will facilitate a 340B agreement with our national partner, a covered entity under the program. 0 The U.S federal government created the 340B Drug Pricing Program in 1992 requiring drug manufacturers to provide outpatient drugs to eligible healthcare organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to stretch scarce resources as far as possible, reaching more eligible patients and providing more comprehensive services. Maintaining services and lowering medication costs for patients is consistent with the purpose of the program, which is named for the section authorizing it in the Public Health Service Act. Eligibility for the 340E Program is defined under federal law. In addition to specific categories of non-profit hospitals, there are 10 categories of non -hospital entities that are eligible based on receiving federal funding. Our proposed plan can include the following: 11 Wellpath will order HIV medications at the price agreed upon. Wellpath will schedule HIV positive patients for an initial, face-to-face examination by the covered entity's provider. Should the provider have the ability to see patients via telehealth, Wellpath will facilitate that process. Wellpath will refer HIV patients to the covered entity to be assessed for eligibility and registered for the program. 0 Wellpath will ensure compliance with the 340E Program's policies and procedures. Wellpath will participate in scheduled program internal audits with the covered entity. Ei Ft` E. cT. r : Solicitation Event ID: 005301 5a' . s .. .....,� c:s Jail Health Clinic Wellpath can provide telehealth HIV consults conducted by Scott Kennedy, MD, Wellpath's certified HIV specialist. Dr. Kennedy has specialized experience in preventing the transmission of infectious disease and is certified by the American Academy of HIV Medicine. Wellpath Experience with 340B Wellpath has extensive experience partnering with third -party entities for our clients to access 340B eligible programs. We successfully partnered with the University of Louisville's Division of Infectious Diseases to provide 340B pricing for HIV and HCV medications for our patients at the Kentucky DOC facilities. We also coordinate with 340E covered entities in multiple state DOCs and local detention facilities, treating more than 50,000 patients annually with HIV, HCV, hemophilia, and autoimmune diseases. Hepatitis C Wellpath's clinical leadership is cognizant of evaluation and treatment considerations for hepatitis C (HCV) management, including testing and treatment considerations. Our HCV program is based on the April 2016 Federal Bureau of Prisons (FBOP) HCV guidelines. In January 2018, the FBOP updated its guidelines to include the following screening criteria for non -sentenced patients: A reported history of HCV infection without prior medical records to confirm the diagnosis Cirrhosis Chronic hemodialysis —screen alanine aminotransferase (ALT) monthly and anti-HCV semiannually 1. Elevated ALT levels of unknown etiology Evidence of extrahepatic manifestations of HCV — mixed cryoglobulinemia, mem bra noproliferative glomerulonephritis, porphyria cutanea tarda, vasculitis Unless clinically indicated based on the screening criteria, the FBOP guidelines suggest that screening should ordinarily not be pursued for asymptomatic, highly mobile, non -sentenced patients. Referrals to community HCV testing sites should be made when appropriate. Wellpath endorses continuation therapy for individuals that are confirmed to be on treatment for HCV upon arrival at the facility. Influenza Wellpath's influenza response program at the Correctional Facilities consists of surveillance, treatment, and monitoring that meet community standards and established policies and procedures. Healthcare staff evaluate patients identified as having contagious upper respiratory infections and may isolate them if necessary. ECtoparasites Wellpath has guidelines and protocols for the prevention, identification, and treatment of ectoparasites such as pediculosis (lice) and scabies. Our policies and procedures define the treatment of individuals exposed to ectoparasites, as well as best practices for prevention. Staff responsible for direct patient care are educated on ectoparasite identification and control. Ectoparasite control begins at intake and includes inquiry and observation regarding the potential presence of ectoparasites. We promptly address evidence of ectoparasites by isolating and treating the 57 y_4 ,-; Solicitation Event ID: 005301 P. Jail Health Clinic patient with approved medications according to the physician's orders. When determining the proper treatment, conditions such as pregnancy, open sores, or rashes are considered. MRSA Wellpath provides identification, testing, counseling, education, care, treatment, and follow-up of MRSA and related conditions. Wellpath staff follow our infection control policies and procedures for the treatment of infectious diseases. For specific diseases, including MRSA, Wellpath staff consult UpToDate and CDC guidelines for the latest protocols and coordinate with the County Health Division. Wellpath has issued a clinical monograph to our medical providers at the Correctional Facilities that addresses outbreaks of measles. Based on CDC guidelines, Wellpath staff consider measles when evaluating patients with a fever and rash and ask about the patient's vaccination history. Given the highly contagious nature of measles, providers receive guidelines and protocols on screening, risk factors, transmission, diagnosis and laboratory testing, isolation, and treatment. Wellpath staff follow established policies and procedures for the treatment of infectious diseases at the Correctional Facilities. We do not generate policies for all infectious disease diagnoses. When a serious infectious disease (e.g., legionella, norovirus, etc.) is identified, our priority is to provide timely, effective treatment to those affected. Many patients have special healthcare needs requiring ongoing medical supervision and/or multidisciplinary care. The Wellpath Special Needs Program at the Correctional Facilities focuses on the identification, referral, and treatment of patients with special needs, including chronic conditions (e.g., diabetes, hypertension, asthma, seizures, etc.) and communicable diseases (e.g., HIV, tuberculosis, etc.). This focus allows us to manage patient needs before they escalate and require off -site consultation, or result in grievances and litigation. We have included sample treatment protocols for HTN, COPD, seizure disorder, asthma, diabetes, TB, HIV and ESRD in Tabbed Attachment B. Please note this information is confidential and proprietary. Wellpath considers individuals with long-term healthcare needs related to chronic conditions or acute medical and/or mental health problems to be special needs patients. This includes patients who are mentally ill, developmentally disabled, and/or at high risk for clinical decompensation. We provide these patients with services that promote health maintenance and health improvement. The Wellpath Special Needs Program also emphasizes patient education to encourage adherence with treatment plans, both during and after incarceration. RE J { i.. - welt '- Solicitation Event ID: 005301 Jail Health Clinic Wellpath on -site specialty services and control of off -site costs start with an effective Special Needs/Chronic Care Program :: 7y�cai 0hronic�� clinics -`. it Special Needs Screening Wellpath staff perform a special needs screening during the intake process and again during the comprehensive health assessment. This screening addresses housing, monitoring, and follow-up for special needs patients. Results are documented on a Chronic Care Referral form in the patient's medical record. Wellpath staff receive focused training and guidance on interventions based on the results of the special needs screening. If a patient requires ongoing care, we recommend specialty healthcare services, appropriate housing, work assignments, and program participation. Patients with special needs are identified through self -report, during provider encounters, or by correctional staff. Self - reported conditions and referrals are entered into the patient's medical record and verified by the medical provider. Referrals from correctional staff are managed the same as reports made by the patient directly to medical or mental health staff. Classification and Housing Wellpath receiving screening guidelines address housing for patients with special healthcare needs, those who require monitoring, and those who may harm themselves or others. Wellpath recommends housing most suitable to the individual's needs. We inform correctional staff of patients with special needs that affect classification and housing. If the patient Chronic Care Referral Form _. ..i ma+,M1 .,RN Io 59 Solicitation Event ID: 005301 Jail Health Clinic requires enhanced monitoring, Wellpath staff notify the HSA or medical director. Sample Patient Flag Report in ERMA Patent Ft., Report e...nn :v..- rs..,xv.u,. r....,..�o.rt.... �.x.,. r...x.., r=•a*v.M. °rax.. s+asmxxw flror.a. - 11 :..:r-:�:.>i -...-., m-,E.> A,<. - .-.. •.-:.r.. ... ,.. - �ox The physician or mid -level designee develops a written individualized treatment plan for patients with special medical conditions requiring close medical supervision, including chronic and convalescent care. The plan is based on medical history and physical examination findings. Patients with a mental health special need condition are seen by a mental health clinician who performs an initial mental health special needs assessment and develops an individualized treatment plan. Special needs treatment plans act as a reference for healthcare personnel involved in the patient's care by providing instructions regarding diagnostic and therapeutic interventions, pharmaceutical therapy, special diets, and patient education. Treatment plans also include short-term and long-term goals and the methods of pursuing them. They include information regarding the patient's disposition, scheduled appointments, housing assignment, ability to function in general population, impact on programming, and frequency of follow-up. They also include medical or mental health instructions to healthcare providers and others involved in the care and supervision of the patient. We share these plans with the OCSO, as needed, to facilitate housing in the appropriate area of the Correctional Facilities and ensure proper treatment of patients with long- term and individualized healthcare needs. M Solicitation Event ID: 005301 Jail Health Clinic Sample Initial Chronic Care Visit in ERMA :ya Orel WLenttrnrre N9a In PatimtGarl a.. - BUIk Pnn<(Ol 5ra. uni. i-4+ 'II`❑Patmnt re6lseo Pon Lhronic torn Giabmc¢Mcibum Ninel Vrsin mxmo.< ---. �' SHBJLCTNE(Nevlw vhmunr oIW toldtlal p:nM[rnn) 'Nc mmylemu - rnmor.oreaemr.w- Omfal ' . HaatN Psmsmmts Infirmary _ Imaiesane iam(m rw.. .. _.rr c...ra .. Grp °1 Jrc Ca'ea '� 1)S� v.�.L m. _no e. E; + u e4ng Lnummprmn PalpxaYd' ' [rrah>(cz r 34`t\arplp: -I-Y r \n.el cf Cr.==se 04.E ..:WnSae r,j 11 1s v Medical special needs patients are typically seen by a physician or mid -level provider every 90 days, or at other intervals when medically indicated. We document this consultation in the patient's medical record and include the date and time of the consultation, the provider's name and title, and new orders for the patient's treatment. Wellpath clinicians determine the frequency of chronic care visits based on the patient's condition(s) and recommendations from the Wellpath Minimum Standards for Care of Chronic Disease. We see mental health special needs patients at least every 30 days for the first 90 days of placement into the mental health special needs program. After 90 days, the mental health clinician may reduce the frequency of each mental health special needs follow-up visit to no more than 45 days. Additionally, the mental health special needs treatment plan is updated at least every 180 days until the patient is removed from the special needs program. 61 --"` Solicitation Event ID: 005301 Jail Health Clinic Sample Practitioner Chronic Care Order Set in ERMA eeer s"e� _:S:_. ..i-_ PrezLfiurre.OrrunrcGreOeaer Se. >rt^:5"'Jek' • c..:e. - m t':'er.P:B raavrr<m mmewo.mP=Imrnwn !t —' .r, . AN Pnnt (0) _Bulk — _._ ..J:r-iW nrW1 E1_ _ [Irmnrz6re .• nR_i "E iF:I.: _ �..,. Eal_ Li '..Gz ai'v'1_E•:.ic__r...r r.f_G ,92u GC'c?"`_ 6EIc. is xn .lar.'r ".'r l . HeatlM1 rvsnarrmrs i InlaNaantl trensrzrs ,�, �,-iz,l�„�r".�P,,.f i/n '.chlzm "�f.r-nc'ey t r Nwrn9 Puamentalron Pnllrrv=is ' r irealmml xnoras za Ge:+ - 31,- zry �. Gqu •.• C. lu ❑c-„hc , Cn Vn AT FAST � 1 I ME Y INDICATE THE OFDER SET(S) TO 4F USED ANP A W II4T MEET SETS AS NECESSARY TO AVOID DUPLICATIVE ORDERS MPSTHM1tA!CGPD �-- - �-- Fea:.l:meaJwn T=:'- u..rs ^alzmzS. men m-r Ie't=elr.c When feasible, treatment plans maintain connections between patients and the community agencies that have been or will be serving them. Wellpath has a long history of establishing connections with local resources to ensure they are ready and willing to accept patients from incarcerated settings. Wellpath provides a complete chronic disease management program at the Correctional Facilities that meets NCCHC standards. Our chronic disease management program is designed to reduce the frequency and severity of symptoms, prevent disease progression and complication, and foster improved function. Our multifaceted program includes disease -specific guidelines, clinical decision support tools, and a clinical informatics platform to guide population -based interventions consistent with national clinical practice guidelines for common chronic diseases such as: n Hypertension Diabetes Asthma/COPD Seizure disorders r Sickle Cell Anemia Substance use disorder Mental illness Coronary artery disease Chronic (non -cancer) pain L Tuberculosis HIV Hepatitis Renal disease and dialysis 62 -1k weli� Chronic Care Guidelines Wellpath practitioners follow disease -specific, evidence -based clinical decision support protocols to ensure continuity of disease management at the initial and follow-up patient encounters. Practitioners also use a set of established minimum standards for the care of chronic disease to guide their treatment decisions. Wellpath has developed clinical monographs that represent the best practices our practitioners use when treating specific medical conditions. These monographs reduce variability in the care provided to groups of patients with similar healthcare needs. Topics include: Asthma I GERD Benzodiazepine Use HIV Cataracts Hyperlipidemia Cirrhosis Hypertension COPD Kidney Disease a Diabetes Measles Emergency Contraception Seizures Adherence to Chronic Care Guidelines Solicitation Event ID: 005301 Jail Health Clinic Sickle Cell Anemia Thyroid Disease Tuberculosis URI Withdrawal from Alcohol and Benzodiazepines Wound Closure The Wellpath CQI program includes screens such as Continuity of Care — Chronic Disease, Patients with Special Health Needs, and Special Needs Treatment Planning to ensure adherence to appropriate chronic care guidelines. To ensure we provide optimal patient care, our clinical staff and leadership stay abreast of peer - reviewed research and developments, including emerging therapies, with a focus on their potential use in correctional medicine. We will assess new and emerging therapies and proposed care innovations for feasibility and appropriateness in the correctional setting throughout the term of the contract and in collaboration with the OCSO. All such proposed therapies will be based on recommendations from the Centers for Disease Control and Prevention and/or other recognized authorities on the management of chronic diseases. Additionally, our staff have access to UpToDate® Clinical Knowledgebase and Support Tools, an online medical resource for evidence -based clinical reference and patient education materials. UpToDate provides valuable medical references and client -specific patient education materials on multiple topics. UpToDate helps improve patient care by allowing providers to print educational materials for discussion during patient encounters. 63 well.,` °=r ' Solicitation Event ID: 005301 Jail Health Clinic UpToDate covers more than 10,000 topics in 22 medical specialties and includes more than 9,000 graded recommendations; 27,000 graphics; and 380,000 Medline abstracts, as well as references and a drug database. Content is updated every weekday. This instant availability of continuously updated, evidence -based healthcare information helps medical staff provide the highest quality care. Topics available within medical specialties in UpToDate include: Medical Calculators Adult Primary Care Allergy & Immunology Cardiology Critical Care Drug Information Emergency Medicine Endocrinology Gastroenterology Nephrology Neurology Hematology Hepatology Infectious Diseases Oncology Pulmonology Rheumatology Surgery Internal Medicine Geriatrics r. Psychiatry Dermatology Palliative Care Chronic Care Tracking Wellpath tracks patients with chronic illnesses on a chronic care roster and reports these patients to the OCSO each month. We maintain a list of chronic care patients that includes the date of intake, the date referred to the chronic care program, the date of a most recent visit, and the date of the next scheduled visit. We discuss statistics, such as the number of patients by chronic care diagnosis and number of chronic care patients seen in the clinic by the providers, at monthly Medical Administration Committee (MAC) meetings. 64 Solicitation Event ID: 005301 Jail Health Clinic Chronic Care List by Problem Patient Profile- Chronic Care by Problem wells-, it opron MviXw-ceremy ilitea Cory aemrtax�n-nia wwl.ars wo wa: NnMxr:cwe m:ucc Iro cyRlaer.r v:>.a.,.,s n,Xaav REXACRX Jill L Pe1,m6: a, proWem+17 t"vmlvL,ry Prima¢ 16 o L M I.. x4a (Irt zl c w mm�n xb.Xa M r vz vwmn INn Xd n c Inmx �rxxls larza M 4 N f✓llAfY R4M M c M vJrmn Ialeae W •c ei V1l/aa Tale X,t - n c Inznx lazvren Imwal w u a nlMin I�.a� ' P3.fl-W 1VNNA INSM N' A I VAFR I1(Efl�tln W! W BR X 4 YY)dtl al a r Io4sA V1. MM6a Denul-PaXenN 1 - - -- -- - -- •• - •- •• vuvru.a: ,w..,•.,... �� w ri.r . �i,. ua n� .,w m r-n VIPoi xmul . -_------------- The Wellpath Electronic Record Management Application (ERMA) generates statistical reports and identifies outliers beyond agreed -upon timeframes between chronic care visits. We can provide these reports automatically or on -demand. Wellpath staff enters chronic conditions into the patient's problem list in their electronic medical record. The list is updated and labeled appropriately at chronic care visits. ERMA allows for automated tracking of chronic problems in the master problem list by combining problem codes for nurses with and diagnosis codes for providers. Problems are typically identified by nursing staff and are later confirmed by a provider. Wellpath provides emergency medical services 24 hours a day for individuals in custody of the OCSO. Correctional healthcare personnel at the Correctional Facilities are trained to respond to emergencies within four minutes. A Wellpath staff member will report to the area of the emergency with necessary equipment and supplies. By training our nurses in emergency response and offering on -call physician services, we can often reduce off-site/ER trips and hospital stays. 65 .IL, welt,-', r,..-"A�,. Solicitation Event ID:005301 T_h,n,-,A iury Jail Health Clinic Healthcare staff determine if a patient needs to be transported to McLaren Oakland Hospital or St. Joseph's Mercy Hospital for treatment. They stabilize the patient on -site, then transfer the patient to an appropriate medical facility if necessary. We will continue to coordinate with McLaren and St. Joseph's in emergencies and communicate with correctional staff for emergency transport and ambulance services. On -site healthcare staff may make emergency off -site referrals based on established guidelines and their professional interpretation of a patient's need. The on -call physician will be notified as soon as possible. The site Medical Director conducts a retrospective review following an ER referral to ensure that the action was appropriate and to identify any additional staff training needed. Retrospective Review Form for Emergency Services — Care Management System Wellpath has customized monthly reports of emergency room visits for the OCSO. Data includes the patient's name and identification number, the date of emergency service, the patient's disposition, and the emergency treatment received. W Solicitation Event ID: 005301 Jail Health Clinic ER Trips Report — Care Management System Event Detail Report wetlw .11 P59e 1 of 2 1011212019 ING4015 VALLEI CARE 10,3]1201c 10102IZ919 HY'HL<HC HOSPIT.L MIECCIR IZMIN1S VALLE CARE 10i1P✓�C 19 IGAe'019 VALLEYCARE 10116^_919 16f10.2019 HOSPRiL W*,'201P 1CJ_C:2019 HIGHLAND 1cC2019 11162�1015 EC'EN HOsp 4L 1321/2015 IUpEZGIE VALLEI CAREROOLI 2902 ICf21i2019 IVVI.0019 JOHIl2EOB.SE 10/MUIS lb/i;3,2019 Hlv HLAMPHOSPFAL 10,'23k619 IGW2019 VALLEY CAPE ER I022'2019 10232019 VALU) Emergency Transportation Wellpath staff coordinate emergency transport and ambulance services (Star EMS) with v; r •_� rw "L correctional staff. Healthcare staff work cooperatively with correctional staff to ensure that C", transportation services are provided in a safe and timely manner. Emergency Treatment for Visitors and Staff Wellpath provides emergency medical treatment and first aid to stabilize staff, visitors, employees, or subcontractors who become ill or injured and require emergency care while on the premises. Once the individual's condition is stabilized, we direct the patient to a personal physician or local hospital as appropriate. Wellpath staff document services provided. Emergency Equipment Wellpath will continue to maintain adequate emergency equipment and mass disaster supplies on -site. The Wellpath Emergency Preparedness Plan (discussed in Section 2.1.10) ensures the presence and proper use of emergency equipment and supplies, including crash cart equipment and disaster bag/mobile equipment, as well as a disaster kit for needs encompassing the entire facility. Wellpath staff are trained on the proper use of emergency equipment and supplies. 67 well. .'.Is., is 't Solicitation Event ID: 005301 Jail Health Clinic Wellpath staff use an Emergency Response Bag Contents List and Verification Log to ensure the constant availability of emergency response bag supplies. If unopened, the tags/locks on the emergency response bag are checked daily. The bag is also checked and restocked when opened. The emergency response bag contains doses of Narcan for known or suspected opioid overdose. Additional information regarding Narcan is provided in Section 2.1.1. Wellpath has an effective emergency plan in place at the Correctional Facilities with detailed procedures to ensure continuity of care during unexpected events, disruptions, and natural or man-made disasters. Our emergency preparedness plan ensures proper staff recall and allocation, patient movement to designated safe areas, and availability of emergency equipment and supplies. Our plan covers the four major phases of emergency preparedness management —Mitigation, Preparedness, Response, and Recovery —as described in the following graphic. Activities that prevent an emergency, reduce ihectianceof an emergency happening, or reduce the damaging effects of unavoidable emergencies. Actions taken to return to a normal or an even safer situation folloxmg� an emergency. Plans or preparations made to save lives and to help response and rescue operations. Actions taken to save lives and prevent further property damage in an emergency situation. The Wellpath emergency preparedness plan follows NCCHC and ACA standards. It is outlined in our Policies and Procedures manual, which has been reviewed and approved by the OCSO. We will continue to work collaboratively with Major Childs or his designee to define the roles of healthcare staff in a disaster and to incorporate our plan into the overall emergency procedures for the Correctional Facilities. The emergency preparedness plan has been approved by the Executive Lieutenant and includes: e Establishment of a command post Healthcare staff's responsibilities during an emergency Triage procedures Use of emergency equipment and supplies Establishment of primary and secondary triage areas and sites for care Continuity of care and safety of patients Prevention of interruption in medication Pharmacy and medical supplies contingency plan Protection and accessibility of patient care data at predetermined locations Training modules Disaster bag/mobile equipment contents, breakaway seal system 29 welt., , ;=s Solicitation Event ID: 005301 Jail Health Clinic Contact list for recall of key healthcare staff and community emergency response system Evacuation procedures in coordination with security personnel Evacuation routes and means of transport out of the institution for injured, ill, disabled, or restrained individuals Emergency treatment documentation Medical staff participation in facility emergency procedure drills Procedure for conducting man -down and emergency drills Backup assignments for each contingency element Wellpath trains Correctional Facilities healthcare staff on the emergency preparedness plan, which includes "man down" incidents, fires, and hostage situations. We train new employees on the health aspects of the plan during orientation, and we require the healthcare staff to review the plan annually. A health emergency "man down" drill is practiced annually on each shift where healthcare staff are regularly assigned. Wellpath will continue to participate in disaster drill planning programs as requested and we will perform an annual critique of the drills. Wellpath trains healthcare personnel to respond to sTARTTriage emergencies within four minutes. We conduct assess, Treat, (use bystanders) periodic proficiency training on emergency response have wneneacolor,STOP-Tac-naoveoN — Move Walking Wounded and other integral components of our program using _NO RESPikaT,orasafterheadrrrr established core competency checklists. We assess —Breathing but UNCONSCI0US core competency annually or more frequently — Respirations - over 38 depending on an individual's needs or responsibilities. — Perfusion CapP'ary refill > 2 - orPio RADIAL PuLSE Control bleeding ' We also train our healthcare staff on implementing an Mental status unable to follow �imple commands incident command system (ICS). We have provided a a—otherviise E sample Healthcare Provider Emergency t REMEMBER. Equipment/Response Com etenc Checklist and Competency " Res°'rayons - so Y Perfusion - z Disaster Bag/Mobile Equipment Inventory List in E Mental status - Can Do Tabbed Attachment C. Please note this information is Confidential and Proprietary. Our staff is trained to manage multi -casualties using the START (Simple Triage and Rapid Treatment) system, developed by Hoag Hospital and the Newport Beach Fire Department in California. The triage portion of START, which is the focus of our training program, allows for rapid assessment of every patient, identifying those who have life -threatening injuries, and assigns each patient to one of four categories: minor, deceased, immediate, or delayed. This allows first responders to focus on those with the best chance of surviving. Wellpath's primary goals for the OCSO Correctional Facilities during the COVID-19 pandemic have included: Preventing the spread of COVID-19 through supplemental screening at intake Prompt testing, identification, and isolation of patients with possible COVID-19 M., -�L yyqq ti.... tSr «-,:•.=,� Solicitation Event ID:005301 Jail Health Clinic Care for patients with confirmed or suspected COVID-19 Initiation of COVID-19 emergency procedures in the event of an escalating outbreak, such as requiring the use of masks, practicing safe distancing, and postponing outside contact, as possible Monitoring and managing potential staff exposures Effective communication and collaboration within the facility, with the client agency, and with local public health authorities To this end, Wellpath has taken the following key actions: olai'iue't nsie € — We have in place an executive -led, multi -disciplinary COVID-19 Task Force —a team of operations, clinical, and other leaders from our organization. The Task Force meets regularly and works to ensure our sites have the information and resources they need to manage the situation. 3- i9 Y rw r enr,r ,' ; r;l; i >:;F f=-, c;h,«,.kl;,l; _" This has been implemented at all Wellpath sites. It includes staffing contingency plans; ongoing monitoring, reporting, and tracking of potential and confirmed cases; medical supply management; and supplemental intake screening procedures. tUelir_:a hl Molk'zad F.a<z rhjddS�-;, -- Wellpath clinicians lead conference calls with our Home Office and field -based clinical and operations leaders to share information, provide guidance, and field questions. Key participants include Clinical, Nursing, Procurement, and Human Resources. Pz rtner lA?c iain, f s -These periodic Zoom sessions provide our clients with a COVID-19 update from Wellpath executive, clinical, operational, and procurement leadership, as well as our correctional partners or other guest speakers, who share information on best practices, clinical updates, and status of supplies and personal protective equipment. Wellpath has also developed a comprehensive, publicly accessible COVID-19 resource portal (ht,rmfly olloathcaie.conn/co id-19-resources) to share important information and updates. Topics covered in the portal include but are not limited to: Preventing the spread of COVID-19 and the Delta Variant Promptly identifying and isolating patients with possible COVID-19 Infection control practices Sample staffing plans to address various situations Guidance for healthcare workers exposed to COVID-19 Interim risk assessment and public health management COVID-19 management procedures Testing information Isolation guidance Pharmacy updates Pandemic plans Screening forms 70 ell .r :..: . Solicitation Event ID: 005301 Jail Health Clinic .,y 2, wig^ �zs�'•g-tivaa:e P:..g. ..e; sry't. EnN,,or AAbinar Vitleo B presentation Slides - March 25, 2024 I If Bane County Jnd Inmates aegin Reinnm Mil C..... gnris Vaecme - i _ 1 The following is our Staffing Plan During Facility -Wide High Call -Off Situations, in place for the OCSO Correctional Facilities. Our Pandemic Plan for the OCSO Correctional Facilities is included in Tabbed Attachment R. Please note this information is confidential and proprietary. Staffing Plan During Facility -Wide High Call -off Situations Instructions: 1) Enter the number (staff and position osmgnments in Me left-hand alumn nod then hose the staffing assignment will be madfredfar ... hm ainpercentagaall(taws an ameophnts and not h.", in you feel not be able b"Merct which stiff will spenfirnlly evil ojf�bvt mrr focus on what asvgnmrnes hwepn..ty to jdl 2) Colcalots the number fsh Nwha wauldcep offforeach percentage up to 5M$call off 3) Note an each .1..dwhere rolesarpa"Mmsw,It be flledregardlese of staff imams, -Ions, un.... offallob rates - there is no way to predict who will/wdl not be calling off.. Mark unfewpodposifhods by tuming)antlight Seen. 4) Enter the impact of dremased oustodybasedon dlsassion with asMdy Assmne similar all-hmtes (orbnth nrsmdy amf medsoi 5) Enter the impact ofetremsed medical stafon services 6) Create nnanlan pfanjareach scenario. W-11aH Weekend staffing .Ilsbffts W..kd.y SteMmg AN shin. WookaM ua, Son,. PM Shift. Neo Shift Addhlonal Day Stilt' Weekday PM Shift/ Nor Shift I hired be Curtodv Acting Plan Full Services M.dkal5arvicos Full -Services ITPBR 10i: cell off 2W: call off 30e-ll off W. call off 50. cuff off Imul.ipy hoe behow'.lune. eff (muhipl.b..osmff (muhlpNbeeostaff (muhlplpbrse'tff state 0.3) x02) x0.3) x0A) _ x0.5) Us,v_h;rt. Oz'Sf tiff o,y-nfc fhy Shirt Dsy Wit. PM SMk: PM Shift: PM Shift PM Shift PM Shift' Nac S4lft Noc96ft: Nor shin" Nor ShIR Nrc Shlm oav SMR' Day SINS, �4Jk Day shift PM%.f. PMShih. PM Shifr PMShf Poe ShIR: Ner Shift Nec Sher Ism Shift Na-Sind: Noeshlf- 71 Solicitation Event ID: 005301 Jail Health Clinic Wellpath will continue to provide pharmaceutical services for the Correctional Facilities in accordance with all applicable laws, guidelines, policies and procedures, and accepted community standards. Our pharmaceutical management program includes formulary and non -formulary oversight; prescribing, filling, and administering of medications; record -keeping; appropriate licensure; Drug Enforcement Agency (DEA) management; and the secure and proper storage of all medications. Wellpath will continue to subcontract the OCSO's pharmaceutical services to Correct Rx Pharmacy Services, Inc. (Correct Rx). - Correct Rx is a full -service pharmacy, available 24/7, that providesCO-e;v �� accurate and timely dispensing and delivery. We have a national PI JARA4ACv SERVICES contract with Correct Rx, which allows us to receive competitive pricing. The owners of Correct Rx have 100 years of combined experience in institutional pharmacy services and correctional healthcare, serving more than 200,000 lives in 195 correctional facilities across the U.S. Wellpath and Correct Rx share a commitment to provide the best value and quality by offering safe, efficient, evidence -based pharmacy services that are also cost effective. We have provided a Letter of Intent from Correct Rx in Tabbed Attachment D. As our pharmacy vendor, Correct Rx maintains all necessary pharmaceutical licenses in accordance with State of Michigan and federal regulations. It also provides: On -time delivery with accessible local backup pharmacy to ensure 24/7 availability Computerized systems for provider ordering through medication administration t Inventory management and medication reordering Safe medication administration practices Simplified processes for emergency medication ordering and formulary exceptions Accurate medication order delivery r Knowledgeable and accessible customer service available 24/7 Delivery Schedule Wellpath provides pharmacy services at the Correctional Facilities seven days a week, with scheduled shipment of medications six days a week and local backup pharmacy services (Walgreens and CVS) available on Sundays, holidays, and in urgent or emergent situations. We document all prescription orders in the patient's medical record. Emergency Medications Wellpath does not delay medications for life -threatening, mental, or serious chronic conditions. Our list of "no -miss' medications facilitates this process following intake. We make every effort to verify and administer these medications before the next scheduled dose. We obtain and administer other medications within 24 hours. 72 .i %�well�t,� Solicitation Event ID: 005301 Jail Health Clinic Wellpath expedites orders for emergency medications. We use local pharmacies (CVS and Walgreens) to supply emergency prescription medications and as a backup for pharmacy services. If there is an immediate need to initiate medication, we obtain it from the backup pharmacy as quickly as possible. Stock Medications Wellpath uses in-house stock medications as necessary and allowable within state guidelines. If a needed emergency medication is not available from our emergency medication kit or starter packs, and the medication is not available quickly enough from the pharmacy provider, we order a minimum quantity from a backup pharmacy. The site Medical Director collaborates with the pharmacy provider to determine which medications need to be added to the emergency stock supply to help minimize future emergency orders. Wellpath has a customized formulary for the Correctional Facilities to optimize efficacy and total cost of care and we review the formulary regularly for updates. Immediate formulary°'; changes, with the approval of the site Medical Director and facility administration, are ,ajai�. s• incorporated with the release of new medications, when clinical information identifies new safety concerns, and when generic products become available. We have included Wellpath's formulary -related policies and procedures in Tabbed Attachment E. Please note this information is confidential and proprietary. Utilization is important for formulary management and development. Correct Rx reviews and provides evidence -based literature review articles specific to areas that may affect utilization and the cost- effectiveness of medications. Correct Rx also monitors pricing fluctuations daily. Correct Rx pharmacists receive daily price change reports for review, as well as weekly information from their wholesaler when new medications are expected to receive generic approval and pricing. The site medical director reviews this information when assessing a medication's formulary status. Wellpath can provide a monthly Formulary Management Report (FMR) that illustrates monthly expenditures, usage, prescribing habits, and trends. We can also provide a formulary exception report listing all non -formulary medications prescribed over a period and sorted by prescriber, medication name, and patient. The report includes the medication's name and strength, dispense date, inmate name and number, prescriber, cost per prescription, order stop date, primary therapeutic class, secondary therapeutic class, formulary status indicator, and total cost per medication dispensed. Formulary Exceptions Intake staff ask arrestees whether they were undergoing medical, dental, or mental health treatment before arrest. If so, we try to get the names of their medical providers in the community. We contact the providers regarding current treatment and verify any prescribed medications to facilitate continuity of care. PmmWary Exception Request 73 ell::. c . Solicitation Event ID: 005301 Jail Health Clinic We ask individuals who report medication use at intake to complete a Release of Information (RO1) form, allowing the medication verification process to begin. A prescribing clinician (physician or mid- level provider) reviews verified medications and continues them as clinically indicated. We expedite medications for life -threatening or serious chronic diseases by obtaining them from Walgreens or CVS, our local backup pharmacies. Wellpath bridges non -formulary medications for up to 30 days to prevent a break in care and allow the clinician time to review the necessity of the medication. Given the nature of jails as short -stay facilities, we typically continue verified medications (formulary or not) throughout the duration of a patient's stay, unless the patient reports side effects, poor response to the regimen, or a different medication is deemed more clinically appropriate. To continue a non -formulary medication after the initial bridge order, the prescribing clinician will request continuation of the medication (to include a brief clinical rationale for the medication) through the Wellpath non -formulary medication request process. The Regional Medical Director reviews non - formulary requests daily. The HSA, Ms. Warren, is notified if a non -formulary medication is ordered without the non -formulary request form. Sample Open Non -Formulary Requests List _. rretlVa 1k'r'a s. i.vc Pst<�ra .ren: u.vldz�:ptnl n _ x :...m -ar,a:a-: aK��ere1 -al:d'«u rtna PvrvHlller Y �<.H -`.A�v-a—nb+crJ Wa.11lr F:J Y�Ir Few (:'1 10 w o<c,ev:pealx 0: tA - _Part za Ape,<v M 74 Sample Non -Formulary Detail Report in ERMA Non -Formulary Detail Ppa.re'JrJt tb I��vr FePwOnPflwiNr tw___ _ _ lunry a Oare i.vn.�a Iltlye vnmie P•&•m Ir .aSIF V ESrE Non -Formulary Reviews Solicitation Event ID: 005301 Jail Health Clinic ..0 Lx 4MWW INisI ] - 9) 5rcg 1.e.rtavatw.PC.Ge ^rv. (:.y:u«v.; +MrvRcl+•e V.vf ]MS]4 -Feree•na..cSAe.,n,a�:,�. :cs-r; V:1'G a:y4rr'r.9+v� .1P 1I 1.11m+uaPo 711.1 _ r.an..cce o>xa m. `tl ume nuw ;aotmeiP4eo •aw=ee Nux cwn.a,:'ar. l�rto..; usam 'n 4 A`fv }: u4rt Nrn. x?.a;✓.wn[Ivryrvt lPourc�c'. iE[fay ^zuvJ.4m 9�.e�mp<LG HS Nma `h.nryawlnl lElm, tlu_p,�e ]6&m .Yh<W UYSicx aW pan:y..roesim]Lakotlryxw< 0:. t A x 1faYNF44?NY a.ip: Diamond enforces Wellpath formulary compliance by providing pharmacist reviews of non -formulary medication requests. They screen orders for formulary compliance daily and provide consultation on formulary alternatives that best meet our clinical and cost containment goals. The program works as follows: o The pharmacy receives an electronic order for a non -formulary medication. A clinical formulary specialist reviews the patient's profile and determines if formulary alternatives can be substituted without compromising patient care. The pharmacist's review is sent to the Wellpath clinician with a recommendation for a formulary alternative, a request for additional information, or a recommendation to submit the non - formulary request in accordance with our policy. Generics, Narcotics, and Off -Label Use Wellpath prescribes generic medications whenever possible, unless the clinician justifies a brand name request. We track the percentage of generic versus non -generic use and provide statistical reports on all areas of pharmaceutical management. We only administer non -narcotic medications to patients in general population. Patients requiring narcotic medications are housed in the appropriate non -general population for the period the medications are prescribed for appropriate medical oversight. In keeping with Wellpath policy, providers use sleep and pain medications only when clinically indicated. Wellpath policy discourages the dispensing of medication (prescription or OTC) for any off -label use. 75 elf Solicitation Event ID: 005301 Jail Health Clinic Wellpath has established a protocol to provide over-the-counter (OTC) medications to Correctional Facilities patients upon consultation with Dr. Mitchell, the site Medical Director, and facility administration, who jointly approve patient access to non-prescription medications. Approved OTC medications are reviewed annually. The KOP program at the Correctional Facilities gives patients immediate access to medications for an urgent medical need. It also helps reduce the amount of time healthcare staff spend administering medications. The KOP programs educate patients about their medications and promotes their responsibility for maintaining their state of health. KOP medications are limited to those that may be safely self-administered with the proper education and are typically dental -related or over-the-counter. The list of allowable KOP medications has been approved by facility administration. We only give KOP medications to patients who need immediate access to them, based on their chronic care treatment plan (e.g., inhalers for those with severe COPD or severe, persistent asthma). Healthcare staff at the Correctional Facilities instruct patients on the proper use of KOP medications. Patients must sign an informed consent statement acknowledging that the medication is only to be used as clinically directed, must be kept on person at all times, and must be presented for inspection to any officer or healthcare employee who requests to see it. Patients found to be using KOP medications improperly or abusing the privilege may have their KOP privileges limited or rescinded, based on a physician's review. Wellpath has a system for renewals that ensures continuous availability of medications for Correctional Facilities patients who require them. A clinician evaluates the need for continued medication, documenting the evaluation and re -order in the patient's health record. A psychiatric provider evaluates patients needing psychotropic medications before renewal. Inventory Control Storage and Security Wellpath will continue to store medications and pharmaceutical supplies in a secure, locked area approved by facility administration. The medication room and all cabinets will remain locked at all times when healthcare staff are not present. Patients do not have access to any medication other than those administered by a qualified staff member. Wellpath stores bulk supplies separately, taking inventory weekly and when they are accessed. We will continue to maintain inventory records to ensure adequate control. Controlled Substances Wellpath stores a limited supply of controlled drugs on site under the control of the responsible physician. The HSA, Ms. Warren, or her designee monitors and accounts for these medications. Controlled substances must be signed out to the patient at the time they are administered. As an W. 74L III 1' _ 4" `-'`''' '' Solicitation Event ID: W53M Jail Health Clinic additional level of control, Wellpath treats certain medications that are not controlled, but have the potential for misuse or abuse, as controlled substances. Wellpath trains nursing staff on the proper procedures for administering, storing, counting, and logging controlled substances. Class II, III, and IV drugs are counted at the end of each shift by one staff member going off duty and one coming on duty. Any count discrepancies must be reported immediately and resolved before the outgoing staff member leaves. Wellpath maintains a clear "paper trail" to comply with DEA guidelines for accountability and record -keeping. Counts are tracked in a Controlled Substance Log Book with an index and numbered pages to ensure a perpetual inventory and usage record. Controlled Substance Log Books must be retained on site for five years. Sharps and Supplies Wellpath instructs new employees on handling sharp instruments, utensils, and supplies. Needles, syringes, and other high -risk items are secured in locked areas and signed out when used. Sharps are inventoried at each change of shift. Each employee is responsible for ensuring count accuracy and cannot take a coworker's word when conducting sharps counts. Used sharps are considered biomedical waste and are discarded in a leak -proof, puncture resistant container designed for this purpose. Example of a Sharps inventory Sheet X X Y We PaOent Name Nurse Slgnalure Tme r l I I IIII I I IIII w iy w Im I I i Imlm ml I (I n tt II II au IR III III ININ Pharmacy and Therapeutics (P&T) Committee The Pharmacy and Therapeutics (P&T) Committee oversees pharmaceutical processes and utilization practices at the Correctional Facilities. This Committee manages the formulary and balances efficacy, safety, and cost by requiring prior approval of certain medications. Consulting Pharmacist Services A consulting pharmacist reviews the on -site pharmaceutical program regularly according to State of Michigan regulations. The pharmacist's review is documented and a report is provided to facility administration. The Quality Improvement Committee reviews the report and establishes corrective action plans for any problem areas. 77 Solicitation Event ID:005301 Jail Health Clinic The consulting pharmacist provides the following services On -site audits consistent with NCCHC guidelines Quality assurance reviews Written reports identifying any areas of concern and/or recommendations for improving pharmacy services Inspections of stock medication storage areas Assurance that all medications are stored under proper conditions Removal and replacement of all compromised or expired medications Participate in meetings of the Pharmacy and Therapeutics Committee Electronic Ordering System Healthcare staff order medications electronically or by phone. Emergency prescriptions are submitted to Correct Rx to contact the back-up pharmacy (CVS or Walgreens) and arrange for the emergency prescription. Prescription Review Pharmacists screen for interactions, allergies, and other potential issues (such as non -formulary medications) that may need to be addressed with on -site staff before dispensing an order. Pharmacists also screen each patient's medication profile to ensure safe and therapeutic medication administration. The pharmacist contacts the Correctional Facilities before filling expensive prescriptions so on -site staff can consider alternatives or request a smaller supply if a patient is scheduled for release. Before dispensing an order, the pharmacist checks for the following: Duplicate therapy from medications in the same therapeutic class Medication interactions and incompatibilities (including drug -drug, drug -order, and drug -age interactions) Excessive/sub-therapeutic dosages Appropriateness of medication therapy Medications refilled too soon, based on facility -specific established parameters Medications ordered past the designated stop date Clinical abuse or misuse Medications that are to be administered as DOT only Medications that are to be administered from stock only The pharmacist alerts healthcare providers before dispensing an order for a prescription with an inappropriate strength, duplicate orders with existing medications on a patient profile, potential drug - drug interactions deemed to be clinically significant and medically justifiable, and any medication that triggers a documented allergy in their pharmacy system. 78 Solicitation Event ID: 005301 Jail Health Clinic Wellpath provides written systems and processes for the delivery and administration of medications based on facility layout and procedures. We have tailored medication pass for timeliness and accuracy of the process, including coordination with security staffing and mealtimes to ensure accurate and effective medication administration. Appropriately Michigan -licensed personnel administer medications, including over-the-counter medications. Our proposed staffing plan provides nursing coverage for medication pass as follows: Daily-0900 BID — 0900 & 2100 1, TI D — 0900, 1300, 2100 QH S — 2100 Trained healthcare personnel administer medications within 24 hours of when the pharmacotherapy was ordered. Wellpath staff will continue to educate patients on prescribed pharmacotherapy when it is ordered and document the education in the patient's medical record. Wellpath provides orientation training and mandatory continuing education regarding medication administration and preventing medication errors. We do not permit the pre -pouring of medications and we monitor the medication delivery process to ensure it does not occur. Nurses observe patients taking medications, especially when Direct Observation Therapy is required by physician's order. Wellpath trains staff on providing Direct Observation Therapy for medications subject to abuse, psychotropic medications, and those related to the treatment of communicable and infectious diseases. Medication Administration Record Wellpath healthcare staff document medication administration and missed doses in a patient -specific Medication Administration Record (MAR). These records become a permanent part of the patient's medical record. All information relative to a patient's prescription is recorded in the MAR, which includes instructions, injection site codes, result codes, and non -administered medication reason codes. If a patient misses or refuses doses on three consecutive days, or if a pattern is noted, we document the refusal and refer the patient to the clinician. 79 Solicitation Event ID: 005301 Jail Health Clinic Sample Scheduled But Not Documented Medication Orders Report in ERMA 24 Hours Scheduled But Not Documented Medication Orders col Site Nma, _,ee d euruu..-•,. , "...•.• .xrueu.rlrnuuwl, ...,... Room GfOnp: ROSIMUD M1115an. Ale:Inp Nmedlmtbn Vdare lm Iach Me ethedu'ed admivahbllcRAm not *,,d-e 1Ad In Ibc pxbl2t pour Number Of Scheduled Adm matron W number Oocumemcd 264 'n Ommm"lm l Me III emus OrOer Ho InaWCXana SllrpuleOq Oa}x yart Oale Ertl Ostt OrM9Ww IIJIiIIII,IIU III nII IId IhIx IIIIx111dIIx III X l l l I I I ® .m 3]mgnl Vrve1 h.'v1.'6:R•I'A: U/ 1.: /•_VILC WLM I.iPAIt'!59 If, I Submliu•J ]a.I Sm,, Ml Q b 'err_trr,reI. u.rr- I ___;<uaba:eowxi�]s my ."A3rzz —_ ie:aaoa,nu �_. a?enauluexaF+ jItI I•miu:ni�eui �I—L,m,/"d " I irgnm M)nnlnrrn lr.]d.Y; r ® J yu•/huw Jnc3 921it'tOt I,A: UI' /IF2Lrt 114l nN I.VhrYrl'+.1 eWrr,rr.V ]r • irtl�+MIM)X INur'Irt.Irys off • ® Jbxb.ueluenk RSr,y rulbyk pnel j IrIfi2VIPC IX�/�N CI (cal'=rMY06CH•+rr.lx]d}: Irl:r3f:61£COMI t'Ie Rn19115efM � Wm Sllpl . � I ' r 1 ® lnr.t LI II'C'.'u:tlfyM1 1WrX':b.t •1.I6'Nld<WI'F' md,M,rlb, repute p0 4 n Nrnrs Ur ". ary'. �`M`h%Q1. ® JrA+Yn.+ryor.Iu,,n,mr.,a^"T+'J 1.1L VteBIX•gF• L'1 14'//NIbCW/•M L"%plbn04AM tr-LL-N:niAM9 Sd,rin rl rrlrsrMMRfI IIn,xeilrx3rlrye �_ � rlr4xPnteV'n�fe4mq.nlrsuu yc. 1 I:r"11XotlIY.•!.K I tl:!/1mnC VUAM li'n:'rl:b /'JI M1 SWmtl.d . wt`wpornuwrau.; P.n I �VVI ® Ihxn4-ilblrl Ad.1^Ixl ynx I'1rcHrla Pp/AM' I lir'✓12n111/M1lP4 112UlA it re It Sr9n'XM1•b liAI,` beet l'OOOIIZR1r YIdPVs ' III ® ;> 1eY1ul pJ Nrerr r V1x71rtrra Mrfw ri( t ItL nnL rVt/,r rn tL:Vxµ Mt 11"MA Ix'aNulnry•:w.:!,rrt9 PI TD AM Me 5IA W Itroo I Sample Medications Administered Summary in ERMA Medications Administered Summary ph, I or I Reaorr Description: This feport displays a count oitlBHnd patients rafh Inedlcations Sdmimsiered rrNtin thedme peflod. Both curtently, Incarcerated and released Madams may be mUu4atl In the moots. "Total mlous Menial HaaOp" Is a count rf patents went only non-Mantal Mason madinalonIS adr-aftterad, PCt Non-Formuiary" 15 th? Count of parents ulUl at least am No -Formulary medlcadon tlwided by the "Trial Pa days a th Medladhons Trial Total Moderate with Malrtal Michael Idea- Mct Nom Srta PMatlmbef Medications Healih Health Mulls, Fumummy " I 1 ins r2 In9 Ito tb cs% at trh,n 13 116 la - . -Iat»n— Electronic Pharmaceutical Management Wellpath provides electronic pharmaceutical ordering, administration, and tracking at the Correctional Facilities through our Electronic Record Management Application (ERMA). Ordering Medications Wellpath supports online pharmaceutical order entry through ERMA. All prescription orders are logged in the patient's record in ERMA, where medical staff can check order status. Medication Order Entry is a key portion of the ERMA patient profile. Authorized users can place new orders, renewal orders, and Will n i, ECr.. Solicitation Event ID: 005301 Jail Health Clinic discharge orders from the patient's profile screen. Relevant information is available at a glance without scrolling. Medication Order Entry in ERMA— Patient Profile ..., shart�rr +lv-re � ain,9'eatl Pa:x c: G4:'p Paen (l: 46g00 PA Su•t✓eb i.'Y20'J ._ -SI, oo , sr, wo oo00 - - of -e:cn h ^e armuez _ :.m Gerrtor.n,a„or, narrN -- ➢u> eF-r - - rus.. .cr L452o333:57'A] rM ay_Jwr_r 'tune--'s rsr.+.:, _ _ _ CT hFz Parr UC-1 Rl-e) i,:z Sure Ir.�� _ oC:uunz nrtclpte ,Fe ?.bi: ..r•.. F, M1el.,ti, \:'u[a e,e:arAhone mart as nNe - rc _ z: rimn Cen=.r rc .,r... El, _..rr, vT - .r c-9�ars L s, trs �x P��4A rl _ Le Ges aaeo c_ fnmmzar Ccv azc:v e;:v. m. P¢Y.�Cnn.::: ea:•v iz:z`z2 d�sfa� ap:.o0 e .:ur53 ERMA is updated to include the medication, administration orders, and stop date after a patient's medication order is entered. Active patient orders are shown in the patient profile. m Solicitation Event ID: 005301 Jail Health Clinic Medication Orders in ERMA— Patient Profile -- —_-- Atltva Pa4errt Profilelums - BSI! Pa0�0601100 t ei c - Clc �emonnntbn 4atlllry � �' Sx M .'c.rz tp:_•e rssnec_x.-.Jn....e .. ..ns ass--ac4mc.n Cs. � ll VIUM1 3.1101 PM (.r,x' ..%... •- .- -- wn ros am r/pe 1.-., �. •s'T;a;. :: _e - _ - h.sE FlcSk _.:-- - Llmic ..rtl+rr J'rLer C.vzr iP' v.t ..c Gce m:� .F n_r Sole r.acz.c r ' •r v a: PaI CR . .-0JJ,rx„. <PPCST.J �} �.. Ot:ef'e• .e ,f far.sr'r er..._ ?J x .-[ � .n`-} !o 11_ z Y -4trsraz:C .. Pe :.1�. z wcvs+ Cv.e 'J:.a.r Sic Cn F-r' Immediate access to a full list of active medication orders is available through a one -click drill -down in the patient profile. Active Medication Orders in ERMA — Patient Profile aamsn.r ==i .. omen 9at•• 09=- .mtrt sr=rccate - ra ]ale ---rw aeer.rs,: _-- Cr - 1-1— nW OPA __ in'. »moa. c'^.N--.. ..••'r. _, .>.3,.m1 .. ]. ... a..r :< p{ — n. eoe e/3n961 :.r ;:,_c:a:.-r. ,,-.,:,,-.-.:. _J . -.__. pr n _ o - •.- .u..co„ ](]SRI11339:-0I PM ' CIC-SA 197 _ , '.=fL:>_i;'-p:c..r Pu: :�•: [r.. 3.__J _ n r it Chart -:aSmli!�,1= -__' a:te t";]li.:.-'[-�•-...�-•:.: ]:.3:Ill Sm+-.:: fl _ 11 r� pr�l,m, JJ LF ' 'h�rsrnan Odars N Solicitation Event ID: OOS301 Jail Health Clinic Order Sets ERMA supports site -specific medication order sets that allow providers to place complex medication orders such as CIWA or COWS with just a few clicks. Order sets increase efficiency, minimize errors, and provide treatment consistency. Order Sets in ERMA 5dert oraar 5e1cil - - - - 0,i" t'si'rem9re list ve'a:.. +'m,n ;Jutone rrrvlti 1-0•1e•, ,. trcnr C e n[t a esc :I!. stares G(Nen, uyir't, p+^g�,wr zserc6 rC eFe w\ tnn tl.t e G'SE: SM - ' tn� Pam - Nu=cua=tel=tal Pam 4rspxP'e UVA —_ wt•,c Y¢ada he _ NV ExchaugrAery'3 _ 111V bdwhl Cnnrylnd _ hC. Eandrgc{pjtom ,, MY Er!hanUtlrvuida blmSt+Ual Yarn GaY - Seism �Mei ram: OYm..ev fmNy rm: SR,.m111eC I P•fam �nn< IFGccb mr-•.^I I i•<als: - Lts�kr fiu-+ ' � tlstnll<�YF � _".r..Jxe rs,�. ri.:b e4altl rr.� Y n _ __ r �. :bLLt r��•+. vV t4'FI•br'v':r ne, moo, uu ur...e.r � -'nP'n-r +. �,-pt". "t+nr .IS4�i-+eo--.r n,-r rra. .[C•o rnu.w l'w..: 3ln �\ _ ,,,.-„,vsrct,-:.nxo-m:o-cn�l•,mr. rorvr.r �,+r..>r.. ,,, .,--a,-.r+: , Pharmacy Interface Wellpath ensures seamless and secure communication between ERMA and Correct Rx through a bi-directional interface. ERMA is the sole repository for information regarding all patient services, including medication orders, which allows practitioners to initiate, review, and manage orders quickly and efficiently. Correct Rx electronically notifies Wellpath if a new or refill order cannot be filled (because it is too soon to fill, there are no more refills, blood work is needed, a non -formulary authorization is needed, or a provider signature is needed, for example). 99 Solicitation Event ID: 005301 - r•="'.-;,,;�. Jail Health Clinic ERMA supports the integration of medication order entry and HU transmission to Correct Rx. This integration gives Correct Rx immediate access to medication orders to provide medication substitutions to Correctional Facilities healthcare staff. ERMA is also integrated with First Databank, a national provider of drug interactions and warnings. This integration gives ordering providers real-time prompting of contra -indications, duplicate therapies, allergies, interactions, and dosage warnings. Formulary compliance is also integrated into ERMA. If orders are placed for off -formulary medications, an off -formulary request is automatically generated and sent to the site Medical Director Dr. Mitchell for approval. Approved orders are expedited through electronic transmission to Correct Rx. Administering and Tracking Medications Wellpath recognizes the importance of pharmacy controls within the correctional environment. We are proud to have the Wellpath electronic medication administration record (eMAR) in place at the Correctional Facilities. Our eMAR provides an additional level of performance and the delivery of a progressive healthcare and medication management system. The Wellpath eMAR is a professional, easy -to -use medication system that tracks pharmaceutical provisions from order placement to patient administration per state boards of pharmacy and nursing. It gives Wellpath's healthcare staff the benefit of a completely paperless medication administration system and allows users to work online and offline. The Wellpath eMAR has an advanced administration feature that allows the user to easily track vitals, administer OTC/KOP/PRN medications, and document injection sites and quantities through a customized interface. The Wellpath eMAR in ERMA e n,M --- - Into Zoom Moue Tvnl. Clm.lip 0.ata�c l�,unNns�• ' I l..m<: me BOJV 1 Inma,en l2]6s6I690 ev,esx xo.�a.exros„s co�•awiw ms,muoe a•.a..=�• nm�re�mmulnom - - -- _ .�r..xTewa- mxooaoo,a Solicitation Event ID: 005301 Jail Health Clinic The eMAR module is part of our ERMA system. Because the system is web -based, there is no software to install. All data is maintained in a secure and redundant environment to ensure accessibility and continuous maintenance of all patient information, despite natural or man-made catastrophes. The Wellpath eMAR system offers the following features and benefits include: v Efficiently orders and reorders medications for initiation/continuation Reduces paperwork Updates and provides instant access to patient profiles and medication histories v Creates change orders in real-time Monitors self -medication programs (e.g., Keep on Person) Controls costs through instant notification of non -formulary orders Prints utilization data and other administrative and management reports for easy analysis of statistics for review and planning purposes Prints paper copies of prescriptions and activities for patient charts to allow transfer of patient information to hard copy if necessary Point of Care Companion When administering medications, Correctional Facilities nurses use an off -network laptop —the Point of Care Companion (POCC) system —with their medication cart, marking and electronically signing off on the administration of medications. During medication pass, nurses note in the system if a patient does not receive needed medication for any reason. Once the nurse returns to the medical unit, the laptop is docked and the information from the medication pass is synchronized within ERMA so administration records are immediately up to date. This ability to synchronize data provides increased flexibility for nursing staff by allowing them to use the system in facilities where Wi-Fi or mobile internet connectivity is unavailable. This also allows medication passes to continue even if the facility loses internet connectivity. Since the laptop is battery -powered, loss of power does not affect its use. The features and benefits of ordering through this user-friendly software include: r i a; ?oiM ;F`Core Ctrmpnrtrcra v The ability to order (or reorder) prescriptions or stock orders quickly, through the use of drop - down screens or order refill buttons Increased accuracy by reducing transcribing errors and clarity issues that may result from faxed order sheets ✓ Improved formulary compliance; If a medication is not on the approved list, a non -formulary alert is automatically sent to the prescribing clinician's queue, where the clinician can easily complete the non -formulary request process online; once the non -formulary request is :"<<' > '.v ',. Solicitation Event ID: 005301 Jail Health Clinic approved, the order is automatically forwarded to the pharmaceutical provider to facilitate expedited ordering V Over the counter (OTC), stock, and emergency medications are easily initiated and documented as profile medications on the electronic medication administration record ✓ Time savings through the elimination of paper physician's order sheets, which are no longer needed The ability to view patient profiles and determine when a medication was last filled before transmitting the order Password -protected access for approved staff to patient profiles, medication orders, and history from any web -based computer located on -site or off -site Tracking and documentation of patient allergies and drug interactions Immediate notation of exceptions in the patient's medical record, including missed doses, refusals, and complications Wellpath offers the most dynamic and complete reporting capabilities in the correctional industry, including customized pharmaceutical reports for the Correctional Facilities. Analysis of monthly utilization data, formulary management data, expenditures, clinical metrics, poly -pharmacy prescribing data, and overall prescribing habits of clinicians is crucial for properly managing budgetary dollars, ensuring proper care, and optimizing patient outcomes. Statistical data is accompanied by graphs illustrating usage and trends. Wellpath offers statistical reports for pharmaceutical management that simplify analysis of monthly usage, expenditures, prescribing habits, and trends. Basic, ad hoc, requested, and customized reports are available if requested. Disposal , Medications that cannot be returned to the pharmacy (e.g., non -unit -dose medications, medications refused by the patient, and/or medications left by dischargedpatients) are destroyed. Wellpath makes every reasonable " accommodation to minimize the quantity of pharmaceuticals destroyed. We ; Tt dispose of pharmaceutical waste in compliance with federal, state, and local laws77, and regulations. Wellpath conducts regular audits to remove discontinued or expired medications. The pharmacy provides a daily report of medications approaching expiration. They also have established a trigger to alert staff before a medication expires. Wellpath staff at the Correctional Facilities place pharmaceutical waste in approved collection containers as soon as possible and complete the appropriate disposal form. We provide RX Destroyer containers, which remain locked in the medication room cabinet. Wellpath staff ensure that pharmaceutical waste is kept in a secure location. Controlled waste is counted until disposal. All controlled substances are stored in a double -locked area with restricted access and continued counts at each shift until they can be destroyed by authorized individuals. This is M Solicitation Event ID: 005301 Jail Health Clinic tracked in the Controlled Substances Log Book. The HSA, Ms. Warren, ensures compliance with the pharmaceutical waste disposal policy. GARCIA Wellpath provides diagnostic laboratory services at wY i ,BEN C g the Correctional Facilities through our national i-ABORA`OR l contract with Garcia Clinical Laboratory (Garcia). Garcia is a Women's-Owned Business Enterprise (WEE) with 50 years of experience serving physicians and their patients, and more than 20 years in corrections. Garcia operates a sophisticated laboratory network, providing laboratory services to more than 650 correctional facilities in 36 states, with more than 375,000 patients. Garcia is CAP accredited and CILIA certified. Wellpath's contract with Garcia provides leading -edge medical laboratory tests and services through a national network of primary clinical laboratories and specialized centers. We have taken advantage of our negotiated pricing in the preparation of our cost proposal to Oakland County. The laboratory program for the Correctional Facilities includes necessary supplies and a dedicated printer, timely pickup and delivery, and accurate reporting within 24 hours on most labs, including STAT labs upon request. We have provided in Tabbed Attachment D a Letter of Support from Garcia. We will continue to ensure that qualified healthcare personnel are trained to collect and prepare laboratory specimens. All point -of -care lab services are processed on -site, including but not limited to: Dipstick urinalysis Finger -stick blood glucose Pregnancy testing Stool blood testing A medical provider reviews and signs off on laboratory results, which we receive via ERMA. If test results indicate a critical value, Garcia alerts the provider by telephone. The provider reviews laboratory results within 24-48 hours (72 hours for weekends and holidays) and immediately for STAT lab reports and any abnormal test results. Preliminary results, when available, receive a medical review. All results imported into ERMA are placed on the action list for the on -site provider, who reviews all results and electronically signs off on them. 95 eta:.:... Lab Interface in ERMA—Abnormal Results Solicitation Event ID: 005301 Jail Health Clinic �.,. V,�".. r_:...1.<, �„. :Fs.,,.". r,;:. :v� . GCS Wellpath on -site staff have been trained on laboratory policies and we provide them with a diagnostic procedure manual that includes reporting on STAT and critical values. We document diagnostic laboratory reports and follow-up care in the patient's medical record. We perform on -site services per the Clinical Laboratories Inspection Act (CLIA) and in compliance with the Clinical Laboratory Improvement Amendments of 1988. The laboratory program for the OCSO Correctional Facilities also complies with standards set forth by the American College of Pathology and state requirements for medical pathology, specimen handling, testing, and reporting. Although Wellpath does not provide psychiatric services, our laboratory budget includes expenses incurred from lab orders written by OCSO Correctional Facilities psychiatrists. Wellpath has in place the most cost-effective and Of o 1 e x usr, comprehensive radiology program available for the Correctional Facilities. We deliver on -site radiology services through our (001- national contract with MobilexUSA (a division of TridentCare). We have provided in Tabbed Attachment D a Letter of Support from MobilexUSA/TridentCare. Mobilex is the country's leading provider of mobile X-ray and ultrasound services, serving more than 6,000 facilities nationwide. We will continue to work with Mobilex and Correctional Facilities administration to maintain a routine schedule for on -site radiology services, including: m Solicitation Event ID: 005301 Jail Health Clinic Mobile X-ray services Ultrasounds Sonograms Doppler studies Holter monitor studies We receive results electronically, via fax, or on paper. We log the type and number of X-rays completed and the results received. Medical personnel review the log daily to ensure timely reporting. A board -certified radiologist reads X-rays and radiology special studies and provides a typed and/or automated report within 24 hours. The radiologist calls the facility for immediate intervention if needed. If notified of abnormal results, the site Medical Director or physician/mid-level designee reviews, initials, and dates X-ray reports within five working days. We document and store digital images and radiology reports in the patient's electronic medical record. The site Medical Director or physician/mid-level designee meets with the patient to discuss results and establish a plan of care. Patient follow-up is noted in the medical record. Wellpath will continue to coordinate efforts and work together with the OCSO to address the special medical and behavioral needs of inmates in the Correctional Facilities. We will continue to collaborate with the OCSO, Easter Seals, and the Community Mental Health Authority as appropriate to maintain a multidisciplinary approach to ensure a combined, comprehensive mental health program that provides effective suicide prevention and mental health services. Wellpath staff pay close attention to the direct observation housing units designated for inmates with identified special needs and a small housing unit used for inmates at high risk of suicide and/or medical complications. Mental health referrals can occur at any time during the inmate's incarceration. Inmates currently being prescribed psychotropic medications, those currently receiving mental health treatment, and those identified as having a history of mental illness or self -harm will be referred for care. Urgent referrals will be managed by mental health staff immediately; on -site medical staff will address urgent referrals received after hours and will contact the on -call psychiatrist as needed to manage these cases. Wellpath works cooperatively with local mental health providers to ensure all patients in need of a more intensive level of treatment are transferred to appropriate community placements. Wellpath gives Easter Seals staff access to the ERMA system to maintain complete and accurate records of all mental health care. Wellpath will continue to maintain up-to-date health records consistent with NCCHC, MDOC, and ACA standards, OCSO policies and procedures, community standards of practice, and federal, State of Michigan, and local law. Healthcare staff are responsible for entering patient information in the individual medical record. W Solicitation Event ID: 005301 Jail Health Clinic We have included Attachment F: IT Technical & Architectural Requirements Response Table as Tabbed Attachment F. Following the receiving screening, Wellpath staff initiate a comprehensive medical record that becomes the single source of medical, dental, and mental health information for the patient. Each record provides an accurate account of the patient's health status from admission to discharge, including on -site and off - site care. Medical records minimally contain: Patient demographic information (name, number, date of birth, sex, etc.) A problem list containing medical and mental health diagnoses Patient allergies Immunization records, if applicable Referral queues to track patient referrals Action items to ensure provider orders and documents requiring additional sign -off are addressed Date and time of each clinical encounter Signature and title of each documenter Wellpath standard form set, including but not limited to: o Chronic Care / Provider Care o Clinic Forms o Communicable Disease / Infection Control o Consents and Refusals o Dental o Detox / MAT o Diagnostic o Discharge Forms o Health Histories and Physical Exams o Health Service Request Forms o Hospital / Emergency o Infirmary/Outpatient Housing Unit o Intake o Mental Health o Monitoring o Nursing Documentation Tools o Outside Records o Pharmacy o PREA o Referrals o Suicide Watch m Solicitation Event ID: 005301 Jail Health Clinic Confidentiality of Medical Records Wellpath adheres to laws regarding confidentiality of medical information. We will continue to secure medical records as required by law and other applicable state or federal statutes and regulations. We maintain records in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) �, AA and the Health Information Technology for Economic and Clinical Health (HITECH) amendment to HIPAA. We train all Correctional Facilities employees on HIPAA and HITECH during orientation and each year thereafter. Access to Medical Records Wellpath manages the security and accessibility of patient medical records in compliance with state and federal privacy regulations. The site Medical Director, Dr. Mitchell, approves medical record policies and procedures and defines the format and handling of medical records. The HSA, Ms. Warren, controls access to medical records to ensure patient confidentiality. We maintain each patient's medical record separate from the confinement record and give Correctional Facilities administrators access to information needed to determine a patient's security rating, housing assignment, job suitability, etc. Transfer of Medical Information Wellpath prepares medical information to accompany patients traveling off -site to a specialty appointment or emergency room, or when transferring to another detention facility. We send a medical transfer form with information required for the continuation of treatment with patients transferring to another facility. Ownership of Records Wellpath maintains medical records for the length of a patient's stay in accordance with HIPAA rules and regulations. Wellpath serves as custodian of medical records; records belong to the OCSO. Upon conclusion of the contract, medical records will remain the property of the OCSO, and we will support a smooth transition of records. Release of Medical Information Wellpath treat patient medical information as confidential and does not share it with outside entities, except as permitted by law. During criminal or civil litigation, where the patient's physical or mental condition is at issue, Wellpath will provide access to the patient's medical record upon written request. Lost Records If a patient's medical record cannot be located within 48 hours of a discovered loss, Wellpath will generate a duplicate record. We will repeat clearance information that cannot be determined. Upon locating the missing record, we will join it with the duplicate record to create a single file. The risk of losing recorda i> ehsnlnated With the use. of 4nf0fs21h's Electronic Medical Record .Application (ERVVIA). Records Retention Wellpath retains inactive medical records according to NCCHC, MDOC, and ACA standards, state law, and American Medical Association (AMA) requirements. If a former patient returns to the correctional system, we locate and reactivate the record. Wellpath stores inactive paper medical records atthe Administration Annex 2 in accordance with state regulations. We retain patient medical records for an agreed -upon timeframe and dispose of them according to OCSO Correctional Facilities policy. 91 Solicitation Event ID: 005301 Jail Health Clinic Electronic Record Management Application (ERMA") We IIpath's Electronic Record Management Application (ERMA®) has been in use at the Correctional Facilities since 2016. ERMA is a web -based application specifically designed to operate as part of the healthcare delivery system inside correctional facilities. In addition to the OCSO Correctional Facilities, more than 150 Wellpath clients use ERMA as their complete electronic medical record solution, including: City of New Orleans, LA (ADP: 2,100) Palm Beach County, FL (ADP: 2,080) Louisville Metro, KY (ADP: 2,356) Mecklenburg County, NC (ADP: 1638) Pasco County, FL (ADP: 1,575) 0ald-nd C;rurity, MI (t`DPi 1,`iVI) Westchester County, NY (ADP: 1,400) Marion County, IN (ADP: 1,280) Macomb County, MI (ADP: 1,273) Douglas County, NE (ADP: 1,250) Milwaukee County, WI (ADP: 1,100) Yakima County, WA (ADP: 1037) ERMA interfaces with the OCSO's Jail Management System (JMS), Intellitech (MACS, to give medical, mental health, instant access to important healthcare information for each patient. Our advanced technology has created operational efficiencies by giving you the information needed to better manage care. Wellpath developed, owns, and supports ERMA, which gives us the flexibility to make 33' aa�9. enhancements to the program and upgrade with new features as they become available, a=t no ;cfd Y'Ionm cos... Since ERMA is a hosted application, the OCSO does not have the added cost and responsibility of housing a server. Non -hosted solutions require a Windows Server on -site and additional steps for daily data backups, the burden of which falls on the facility. ERMA's features and benefits are summarized in the following table. Ease of implementation Increased efficiency and -- improved patient care Remote hosted solution High -availability platform Web -based system with no software to install, making implementation easy Instant access to current and past patient records; immediate availability of health data for re -admitted patients; Problem lists are retained across all incarcerations - within the facility - - Hosted on Wellpath servers, which removes the burden of on -site hosting; ensures continuous access to records, even during a disaster Highly available and scalable; uses Microsoft technology, Including SQL Server Enterprise and C#.net; load balanced across many web servers andhostedin two fully redundant data centers; client systems only need the Microsoft -,Net Framework and Google Chrome to access system - - - - 92 -tl Solicitation Event ID: 005301 Jail Health Clinic Functions as part of the overall healthcare delivery platform to increase Enterprise architecture productivity and efficiency among all disciplines; secure connection provides access to patient data, regardless of housing location or movement within the facility Flexibility to use both direct data and scanned paper entry to integrate workflows Dynamic and static into a single patient chart; dynamic documents allow for capture and reporting document capabilities capabilities Supports the integration of medication order entry and HL7 transmission to the Physician order entry pharmacy provider, providing real-time prompting of contraindications and/or duplicate therapies Customized queues give single-click access to manage patient referrals (e.g., Customizable Queues_ patients needing receiving screenings, health assessments, and chronic care follow-up) Master problem list tracks chronic and acute, active and inactive problems via ICD Automated problem 10 codes; problems may be reported (as entered by a nurse), or confirmed (as tracking entered by a provider) Site -configurable to allow capture and reporting of pre -determined sick call and Patient fee tracking prescriptions fees; easily creates list of approved charges for processing Distinctive scheduling capability gives utilization management teams a Integrated Care comprehensive view of the patient's medical history, including on -site and off -site Management for off -site care; Wellpath care management team provides integrated case notes, allowing services on -site providers to continue directing patient care even when the patient is off site Unique reporting ` Designedexclusivelyfor the correctional environment, with reporting features that capabilities support daily activities in correctional facilities More efficient use of Designed specificallyfor correctional workflows, allowing our staff to perform their jobs more efficiently; other EMR systems necessitate increased staffing to nursing resources accommodate longer process flows UpToDate provider Integrated with the UpToDate® Clinical Knowledge -base and Tools set, providing - reference and patient single-click access to valuable medical resource materials; supports integration of education materials site -specific patient education materials A Premiere System ERMA is a multifunctional medical record developed and configured with accreditation standards in mind, making it the ideal EMR system for the Correctional Facilities. We pride ourselves on enabling standardized configurations that have been vetted by our internal Steering Committee for best practice. Any additions or changes to the system are presented to the committee, comprised of clinicians, HSAs, IT personnel, and Wellpath executives, to ensure continued best practice in the OSCO Correctional Facilities and all sites companywide. In the event of contractual or OCSO-specific obligations, ERMA can be customized at the discretion of the committee. 93 The Separate Modules of ERMA integration with allthird-party systemsand vendors Full online WARand eTAR Complete online medical history in one place, regardless of housing location Contract complianceas a rare function Complete Care Management module including UM, econsults, ,elehealth, third- panyinsurance, and claims processing Computerized physicianorder entry Solicitation Event ID: 005301 Jail Health Clinic Training Other EMR systems require intense training sessions that leave staff feeling overwhelmed and unsure of how to work the system into their everyday processes. ERMA's user -friendliness allows OCSO Correctional Facilities medical personnel to become competent beginner users in a fraction of the time. Prior to completing a traditional ERMA training course, staff are asked to complete online training videos. This gives staff the opportunity to familiarize themselves with certain features of the program. The following graphic shows examples of ERMA training curriculum for nursing staff. m welt,.:. 6Fiv.r, gp..a.r."'"'...hc:briar o,a:-n: CIS:;:, e.roou.e r RIO,j r.,p�.onrae,ri n[dolai .:Uadul.. Solicitation Event ID: 005301 Jail Health Clinic Following the successful completion of the online training videos, staff members receive a certificate of completion. This certificate may then be presented to our Implementation Specialists to complete formal ERMA training. Formal training is completed either in person and/or remotely. Our Implementation Specialists train medical personnel to integrate ERMA into their current workflows by providing easy to follow workflow diagrams. 95 I lli Sample ERMA Workflow Diagram Solicitation Event ID: 005301 Jail Health Clinic Patient Management Capabilities ERMA organizes OCSO Correctional Facilities patient records to allow record indexing and retrieval by patient name, patient number, date of birth, admission date, or other identifiable data elements. Action items Patient Documents It Reporting Tools Admin Parent Searnv.' �� Indvde Rele35ea y�yy Last Name FF. Name Nuent# BU1h Date Lueatlun Bookingx Atlmluian Df harge Site Department - - Joseph V. Cunte In Test OC-00000 C % > Ib2015 -- Fault, M. Solicitation Event ID: 005301 Jail Health Clinic Patient Profile Patient Profile provides a snapshot of the patient's essential information including, but not limited to the following: problems, medications, allergies, diets, appliances, etc. Data flows seamlessly between other areas of the patient chart back to the Patient Profile. `Izr'= Icfn latto,.nple pane^I I_ 123V56/8 .ece=' M Nmis Pn 60/16201i yli P?.39:'o0P 4?e 3: H^.: np gHIK .c. _n,e ate Training Gxlrcy-Smlanl w s E- nsp�m, tlr swnYc^s GENFftAL Repea, OHende- - Patimi Hags NIV SUKWWaW Ampvree Bottan B.* Ilepaulrs AssaWI.Gs.f iE AuaWeminmaWRnNmt Iv r pmrt v Section 4 %iroe PaticN PmfiM items it ns nr,rs t# emf�.m, ,r _ - . ,:..f,lE-l:,lnf,: GY,r t•, .. rv.,_e:. .. [nf [>r: , - rzlxlam;ams P,:amu [.u,.,a. r.. ,::,. � _ r.�eri ,u✓, -_.- It Problem List Medical records will comply with the problem -oriented medical record format and standards. The Problem list contains both acute and chronic care problems via a list of ICD 10 codes. Problems may be identified by OCSO Correctional Facilities nursing staff in a "rule -out" status, which can later be confirmed by a provider, or entered by the provider themselves. Problems may be added from the Patient Profile screen or from a dynamic form. 97 it. Patient Profile - Test Test v00-00000 Qwck❑s ___ __ - - - - - - - - Adtletl Date. 2/28)2031 Picblem T", - _- 'radial 520""nan •mrrmiatl_G-re (HIV;c• { Problem Status: CrM.no,d Added 61' Ye7,,cPo, -oar, s'<r' at Medal Nags sw#er, tutu, Added Date Added By Not I n Solicitation Event ID: 005301 Jail Health Clinic �i�Flein, i rssoa3.d cbdn: ostt,rzct ' Assonated latervs . CIIJr fire "-' Uottmi la edd a oen nme v I Cup nt Probl.rm Type Category Problem Code Added Date Confirmed Chronic Infectious Drease Human Immunodeficiency eires [CIV] disease E20 2/23(20.1 Yes Acute COVID-19, COVID-19. confirmed U07.1 9(ZP020 No m confired -"-- Chronic Resp Mddmteromut asthma,uncomplicated J4520 9(2J2020 No -.-- Chronic Circulatory Essential (primary) hypertension Ito 8)26/2020 No --_ Chroom Endocrine Type 1 diabetes meludus without compkattons E10.9 6/2e/2020 No Documents ERMA supports dynamic (interactive data entry) and static (scanned) documentation. Following creation by the Wellpath Forms Committee, forms are then passed on to our Administration Specialists for implementation in both static and dynamic format in ERMA. All future changes and/or site -specific changes to forms must be approved by the Wellpath Forms Committee prior to implementation. This allows for consistency among all sites companywide. Dynamic Documents Healthcare professionals at the OCSO Correctional Facilities document patient encounters quickly and easily through ERMA's dynamic documents feature. Dynamic documents are built, implemented, and maintained by our Administration Specialists. elf Solicitation Event ID: 005301 Jail Health Clinic Abbreviated Receiving Screening -a eelNne :-^NOr cep @:�Hvu Nm^'.-. • Gt5, resr re:r �oo a0o0a �n.e, annsoc iaarzurt For patients who were discharged and readmitted In less than ] days Patient All.opest _ Admissions t Screening Arrest Date --- - Dah, of Ia'd 9carceratan at ih5 lacilip, Puur Rereving Scrcerung FounlPnhen[ Histaly Rewecead '_ Yes' No Trai sidbon need and provided? _: YesNo Patient refused ©emission until ITRdicully cleared _ )Patient refused screening Level of Consciousness - AVPU select the rrost appropriate for patient 'Alert Responds to V¢ca Responds IC Faro" , UnrssponstvW Static Documents Static documents located in the ERMA system may be printed for handwritten documentation. Each document is barcoded for ease of indexing upon scanning back into the ERMA system. 9z Abbreviated Receiving Screening °'aLtr. `kimc• nr.•-r.+R:•rw� 1 .wArt?Y_v bV Test. Test t 90-00900 Solicitation Event ID: 005301 Jail Health Clinic �t3'VS Adul JJ.I'!1w^_ feJE2n Tto, =Gdc 111119OO 2281202i Admissions! Screening___,____ ! Arrest Gate I Gafe Of Iasi InLaice'aLon at tilts fay-Irty i No, RecPrvmq Screenuu; fofrnFabent HtstorY Revte+ved JYks )NoA no exaan Tra151aloinneed acid Woi'ided> )Yes )WO UySS llst9uagel )SPRosA if 1,ts langnage bpe asedi' .ryes JNt Pahanl refused admnsdn UN't mad-cais cleared Reason j_ PZLent'Okeed t,vo?Pin: ^1p8itPn?l2NSkO 5CtPPrttn9.ret+'f 10'fk1E.531 mCn't0/'a4 y'YCP55 - ! Laval of CODSCIOUSTUtSS- AVPU—Selrcc the msr app'Opuate taraaLet, --�-- ---� Ater jRes(rnnn5 to Vatce )Rrs:wnos to Pa'ri ) Unres{<rns,ve' It'es vctl5 to halt ortr • ohs ume5 onare rrobty t'eatth care p'o✓tlet and'or aa,vate ETAS ' Vital Siqns - 'Contact health care pro"der it Witt Sgns are oats'do Of ameters i U? P Patyu Pest ( Temp 02 Sal i"tiol j L°+iieh'. Ducsi Suoai l I 'S6F'z'e!t pt =9?r "remains 'persistency;'=?Gt"F` <yot; )Fie; aneU Jke; uieu 'drn;noarr' i'GBf'<itU trebO ziiti tr :. V] GiOa ..Ji 1 AliUd''JriGJal +_ I Obsonatlon � AppearunCe J Unten'a l,,.Utt J Lhnv/UshevelaU J Soeatiny'J 1:emiis J Curet, P.iO.rmeW J (Ca'J UH'er Ll Cast 25pimt- lafto,JAnn j aazk J Leg J "teen Reapenbmis'J UrvemmtatAe J petsts,"a u'agn J St1tttlP.es> of 61e3Et J Rap•d otep t,raeprz:nypeoen!ndtmn ❑'Jlhe: I 1 Sent J Unremathaoie J am+wv J Red'aesc J LRema 'J Sca's J Rash J LicezScaotes J Ja:ndmr, J Needle tlwki J Re' enf i.,dou J tes+on> Desarte J Ulher Nrrravmr J Apprtlpnate J Inapptort,ta!e J Uncaoperabls J ll)Wti,bW '_1 Other. J Appears untie, the inR'i,"Le niox+vateet+r`rrlra>v:n'} irom S'O'ot'K' i Speech J CledneNteBht J iYnpi6'^rex+.retl J Sluaei J itl<Oner enl J Citho+ tdOrxl J Unrum;at.atle J Aneraus J MW,y J thmbly Ceg;essed J Eort+pnuc J hadui Ll Olhrvt i Conant-nis and Anoo nhai OMerntlinm Document Signatures The capturing of electronic signatures is a feature of all dynamic forms. In addition, ERMA also offers a signature hierarchy feature. For example, specific documents can be routed to OCSO Correctional Facilities nurses, medical providers, and/or mental health providers for review, capturing electronic signatures at each step. Signature Hierarchy Requirements First - Nurse Practitioner 100 '=welL. Solicitation Event ID: 005301 Jail Health Clinic Order Entry ERMA Order Entry is a state-of-the-art medication and treatment ordering system used by OCSO Correctional Facilities clinicians. Medication orders are sent via HU interface to Correct Rx to be filled. Orders also immediately flow to the patient's eMAR for administration by nursing staff. Test Test n=rm•s!s; o�ee,a,m nag. esi [rt4m;'v;i9i n:m.n1 `®J' m-.�:-�.. X I--.' le', F_ J Scheduler The ERMA scheduling feature allows OCSO Correctional Facilities staff to schedule future patient appointments within the EMR system. Appointments may be marked as scheduled, attended, refused, etc., and may be viewed by patient or by facility. Schedule, For Pattem : Test, Johnny 8 a000MU FPPo;n�aena iodaY 3; i;'U2f to V2C/2IPl V. � FUN, See OeoaHment - Fm Name -�Wv Name J,hm,y T<t �- v.mon aw ,crne< fl G 31109011 Sdfc0. Ca ryHouze of L"Nvoo TeA 8Cl2a AM Cone, A t IYJ9-Pa9ertw Weere Status-� _ - ,+}, --� S "SIJ3/130fi 'r ,Fo .edu;e:, i 05,101/1W 0Ucro eel Queues ERMA queues allow tracking of key events in the patient care lifecycle. These include receiving screenings, health assessments, chronic care visits, patient referrals, etc. ERMA allows customization of the queues to organize only the queues applicable to the user's job duties. For example, patients needing receiving screenings or health assessments can be viewed by the clinician in a list view. 101 Sample Health Assessment Queue in ERMA - r Fnt tln,, Ott IW'e AeabWL 11. u., _ - h=slt,Azzi x,t FEndm 5y Lee (Pj - :t SL�ni', nEL�E:I�fOr re ^:ny PEG"es:z N: - .ev._LcaM:'E:0) -- FaraceG io be PP SfEaiEtl cppm-rc,ert'.:[' nECn^'za dppa�inm¢ :Oj Sec:es:e Lx 35 LE I'25 S - ct," _ _ _ Zoa; I' 1 _' 3 J 5 6 e a- 9110 .. : y. .' , s. ► r Heahhls:esmmt{3J?} Patlml= iusto4Y :Itx nmi 'vl Pagaca :J +-- Solicitation Event ID: 005301 Jail Health Clinic ERMA generates statistical reports and identifies outliers beyond agreed -upon periods. The ERMA report library contains more than 100 standard reports that can be customized to meet specific requirements. The following sample reports show receiving screening statistics, the number of health assessments completed within the required timeframe, and chronic care clinic compliance. 102 Solicitation Event ID: 005301 Jail Health Clinic Sample Receiving Screening Statistics Report Receiving Screening Clue Statistics Report By Site V51EO7)011202100:OOAM- 12WI202111:59PM :-'c'•*'.':'�-'- B6pOM,h,, ptt9n: C,Lvanl II Se;:ce-rc' iu sl Pis>leut teC. nhrle`adu=;nc.nc'.:Ie:Y-Ra:rn r9 ^neen",v P'r;:ers :]e'd:-i dDt '•> tt _ :a lrp :ryc+c �KT:u1,,:e-CC duf.l:.�'1 a,.:.. 1! t"A. ��.--•.l'l'�v`]SLl r�:cnl] Pou:ct.ura; Fn[w•Se l7go 4Vcro i?uaz`-PrAaaul� ?iIS N. rcrbvr W Pd119f1K Vm.,(,uri rmn,(.Wr:uuq'r.'•iror. {Tim IF, Nuu'Oo of Scroorur,os Wll6, a lVar Ti¢:u Lime thsr 2S Hour, 20 t LlmLer ai S::eefr:us Not Btn¢Aui' 4) Pen<a:nw_:11>reenn.;ts'AltbuI.:-1 Hour 11, 431, Streenings completed vrttfl a Watt Time More than 24 Hours :�cr.L: ;iiCU='• frGiT"' iT}^::1' ._. bi AS .n. -,;1 1 ..... iS.. .. -.. 103 well, Solicitation Event ID: 005301 Jail Health Clinic Sample Health Assessment Statistics Report = I k Initial Health Assu5snaent Statistics Report By Site well P; 01:tlI12021 00:00W- 17110021 1%:59PNI y c"I A, 1 ;,11 1 'Ix". H,A"!, Sample Chronic Care Clinic Compliance Report Chronic Care Clinic Compliance Registry Visit Due Within: 0210U2021 00:OOAM - 0712812021 I I;59PM RP..d 15,wilnyiow A 1;,t of Patients 9'0qld by 941' Mnaon,.w ,h,, N,.v an vlm• clac,'I Care Pron'rin O,d IT moo= Twat Vhks O,m --- 14 1111111111111M atM Vi,,Ift Due- Attended - u , Au.ndnd - Non Compliant:C lo 4 T.E.1 Visftl Due - N.tAtIn.ndad ulvishal)UP Rafined-corepiant Ou" V"`� ft.aflng facility Training facility'! Cycile'y Pran4. Satin. V.0N. V,.A V,,-tAMa&d nerwymd W, dIwdtttvd 11W-11N .,illla 2M,-021 2+i6=1 rta 192,�Z1 R.ICU 2112U. L.'ali ZI:c-I ",.t f2l 10flrd.0 1 iM Rj.0, ?U-Mll ,,O,- Zra J2t nt::2ddi IM"M 104 Solicitation Event ID: 005301 Jail Health Clinic a r' >r t r. Wellpath ensures seamless and secure communication between ERMA and our contracted vendors at the OCSO Correctional Facilities. Vendor systems are integrated into ERMA through an interface. Following completion of the integration, ERMA is the sole repository for information regarding all patient services. This allows for orders and test results to be reviewed and managed quickly and efficiently. Lab Interface Lab results from Garcia Laboratories may be viewed using the Lab Results queue within ERMA. Abnormal results are flagged to alert the medical staff that expedited review is necessary. The medical provider is notified immediately to review all STAT lab reports and any abnormal test results, which are displayed in red to alert the provider. If test results indicate a critical value, the provider also receives a telephonic alert. Lab Results Screen in ERMA Order- .[ - - ---- Ia60rtlen 05629196369"1A8- •fin --_-_-- - F'.ieYTMs,^f`» m«r—^s°?.•n' .,, _'^�^` '"--,:r.: _. _C ." z�z-w. mgry., M117117 .. 514 o Ftr.;q•.`Ri±.n':,L'g.x;'rv'w'�M,r+:M,�F Jos. FeC ate�e: S- b i P:ae:e' �EJ Pharmacy Interface ERMA supports the integration of medication order entry and HL7 transmission to Correct Rx. This integration gives the pharmacy immediate access to medication orders and the ability to provide any medication substitutions to the on -site staff at the OCSO Correctional Facilities. ERMA is also connected with First Databank, a national provider of drug interactions and warnings. This link gives ordering providers real-time prompting of contraindications, duplicate therapies, allergies, drug to drug interactions, and dosage warnings. ¢=rer ruPar , cam,�lia;tr is aisu i€ttegr- ted int:5 CRivr[h. If orders are placed for off -formulary medications, an off -formulary request is automatically generated and sent to Dr. Mitchell, the site Medical Director, for approval. Once approved, the order is expedited through electronic transmission to the pharmacy. Technical Support and Customer Service Wellpath offers the OCSO the highest level of technical support programs in the industry. We will continue to work closely with you to provide uninterrupted support of our ERMA system. The Wellpath 105 R Solicitation Event ID: 005301 Jail Health Clinic Helpdesk is available from 7 a.m. to 7 p.m. ET Monday through Friday with an after-hours service taking calls outside of normal business hours. The special needs screening performed at intake includes verification of medically necessary special diets. We will continue to make recommendations regarding special dietary needs based on the patient's medical history and physical evaluation. Wellpath only prescribes therapeutic diets, not preferential diets, and ensures that documented food allergies are medically indicated. Wellpath staff works closely with the Correctional Facilities' food services supervisor to communicate special dietary needs and share suggestions for recommended diets. We review patients with special dietary needs every 90 days and notify the patient and the food services supervisor if a special diet is no longer required. The Food Service Division receives a daily email with a current list of special diets, auto - generated from the electronic medical record. Sample Diet Listing in ERMA Patient Profile -DIR Listing Opnnvlunal IDox. Cmmnrly NearnvaMtl Pa0.. tartly peoort o.,.,ano er:raor.<rro,:xr.,".:r�,nn.u„r..:=-n er<r,u:,rar:a.nr..:nrr«ry aa: � =aa de6=ar - nn i i i u nixniii x uuui m Pxr.n iy Pmh= it - ® w run, ru .w r..wn.nwr.. •.v .. - ® are -am rn. rnr nn.n••�nn n.. n...vno n.r r. •. q9.a~• .r.rf ® .nu.ur. +mr vv .inn m�mnx m. u. Jw ® mw.a +i .nvemrnw h. M�tir � ... rvrl rvJ.[.v .rr,.Vrrr uNAN M S'UP^ Patients can refuse this aspect of care, consistent with their options for participation in care within the community. If a patient refuses a special diet, we document the refusal in the patient's medical record. t r, 10 0 It Our first responsibility is to provide access to care and treatment to meet the medical needs of our patients. We train and expect our staff to operate efficiently and appropriately while respecting those needs. Wellpath personnel receive grievance resolution training to learn how to address concerns at the point of contact before the patient initiates a grievance. Our record of reduced grievances and our excellent litigation history illustrate the exemplary care our team members provide. 106 -;U, Solicitation Event ID: 005301 Jail Health Clinic The Wellpath grievance process follows national standards and complies with OCSO policy. We provide standardized data reporting with full transparency of written grievances or complaints received from patients or concerned third parties (e.g., family members, advocates, lawyers). "Looking back, I wish I had kept track of each time an inmate grievance was quickly unfounded, without further legal action, as a result of meticulous medical documentation. I can only speculate on the astronomical amount of time and money that [Wellpath's] thorough medical chart documentation potentially saved us." Capt. Byron Shelton Bell County, TX Resolution and Review Wellpath staff respond to grievances, complaints, and inquiries as soon as is practical, generally within 72 hours of receipt. All members of the healthcare team attend to medical grievances, which include complaints such as not being seen promptly for a sick call request, medications not being started promptly, and healthcare staff conduct. The site Medical Director or designee resolves urgent grievances that involve an immediate need for healthcare services. Your HSA, Ms. Warren, or her designee works with the Correctional Facilities administrators in the investigation, follow-up, and resolution of complaints and implements their recommendations. Ms. Warren or her designee coordinates with mental health (Program Services Supervisor), dental, pharmacy, or other appropriate service providers as needed to resolve complaints. When necessary, we conduct a face-to-face interview with the patient and participate on the Grievance Committee. If the grievance is substantiated, Ms. Warren or her designee develops and implements a corrective action plan. The QI Committee and Medical Administration Committee (MAC) reviews and categorizes grievances to identify potential issues and patterns that exist or are developing. Wellpath maintains a daily log of all grievances that includes the name of the person filing the grievance, the date and nature of the grievance, staff named in grievance if any, whether the grievance is founded or unfounded, staff responding, and date and nature of the response. 107 Solicitation Event ID: 005301 Jail Health Clinic Sample Grievance Log Grievance Log coven wm Y'a`M L�N c (9 11 1' 1t 16 x C.vain,GLn,us1EY0.XECnroa,Vae�a��An�:�uro I.. .E306,N�P6X esans. I S,:.Ilrn�: -' a.nwm:soea nsrtamn i �at.a.m .x rc i Shs lJwWv. rt i �wma+v ee.er�nRiamaluuiamwa+n n Wellpath submits a monthly report of patient grievances, which includes copies of medical grievance requests and their resolutions, to facility administration. We categorize all grievances received and provide grievance statistics as a part of the monthly health services statistical report. Grievance data includes, but is not limited to: G Number of patients with grievances Number dissatisfied with staff conduct Number dissatisfied with medical care Number dissatisfied with dental care Number dissatisfied with mental health care Number dissatisfied with delay in healthcare Problems with medications Requests to be seen We also provide an annual report summarizing all grievance data for the year. IM L Solicitation Event ID:005301 -' - -= Jail Health Clinic Sample Annual Grievance Summary Report in ERMA Well path will continue to assist the OCSO in appropriately charging the co -pay to all patients who have received treatment, and will continue to track and report medical services provided to patients and supply this information to the OCSO. Medical staff track co -payment transactions and prepare a report, which is sent via interdepartmental mail to Yvonne Tipton in the Fiscal Services Department. This report is prepared and delivered several times a week to prevent excessive lag time between the date of service and the date of charge. Wellpath staff do not collect or handle inmate funds. Wellpath provides dental care to patients at the OCSO Correctional Facilities following NCCHC, MDOC, and ACA standards. We take the dental needs of our patients seriously, as dental health can have a serious impact on the overall physical health of a patient. Neglect of dental needs can lead to serious infection, affecting both the health of the patient and the cost of treatment. Consistent with the Wellpath care philosophy, Mark Kowa[, DDS provides services on site to the extent possible. Dental personnel licensed to practice in Michigan provide dental services, including but not limited to exams and treatment (e.g., emergency fillings and extractions). The Wellpath proposed staffing plan includes a Dental Assistant to assist the dentist, manage the treatment schedule and care requests, and properly maintain and sterilize equipment. 109 11::; Oral .Screening Solicitation Event ID: 005301 Jail Health Clinic Nursing staff conduct an initial oral screening at intake to identify complaints needing a referral. A more in-depth oral screening takes place during the comprehensive health assessment within 14 days to identify additional dental needs or required referrals. A qualified healthcare professional performs the screening and educates the patient on proper oral hygiene. Nursing staff receive documented training from or approved by a Dentist on performing oral screenings, including questions to ask and what to look for. The oral screening includes: Taking dental history Documenting evidence of visible cavities/decay, missing restoration, or tissue abnormalities Providing oral hygiene instruction and preventive education Initiating dental specialist referrals, if needed Unless an emergent need is identified during the oral screening, the Dentist will perform an oral examination within 12 months. The examination will include a dental treatment plan and X-rays. Patients can request dental services through the sick call process. The Dentist evaluates the patient's initial oral screening, assesses the severity of the complaint, and schedules a dental exam. The Dentist prioritizes and schedules treatment, as needed. If non -treatment would compromise the patient's health, the appropriate dental services are provided as soon as possible. The Classification and Priority Treatment program gives priority scheduling to: Patients needing emergency dental treatment, including but not limited to those with abscessed teeth, trauma, and severe facial swelling Patients with chronic medical conditions such as diabetes, heart conditions, or any condition that compromises their immune system Emergency dental services are available, as needed. Medical staff evaluate the emergency following dental emergency protocols and refer the patient to an off -site emergency or dental provider, if clinically appropriate. Wellpath staff coordinate transportation and security with facility staff. A medical practitioner evaluates patients needing emergency dental care and provides appropriate intervention until the patient can be seen by a dental practitioner or transferred for emergency care. Dental needs are categorized as emergent or urgent: Emergent intervention is provided within four hours; urgent intervention is provided within 48 hours by a medical practitioner. Emergent and urgent dental needs are addressed by a medical practitioner until a dentist is available. 110 !t n''t4 c'f �; lhbot?ni,. Tooth avulsion Suspected fractured jaw Difficulty breathing or swallowing due to swelling from a tooth abscess Uncontrollable bleeding Acute cellulitis compromising the airway Solicitation Event ID: 005301 Jail Health Clinic Pericoronitis Heavy calculus accumulation with inflammation Visual evidence of decay Visual evidence of missing filling(s) Swelling surrounding affected tooth/teeth Redness of gingival surrounding affected tooth/teeth Drainage from affected tooth/teeth Generalized mild facial/cheek/jaw swelling without compromise to airway Quality Assurance Wellpath completes regular dental audits to ensure the provision of appropriate services at each facility. Dental audits are designed to ensure, at a minimum: Proper PPE is worn when treating patients Patients are wearing protective eyewear when receiving treatment Instruments are properly sterilized Instrument counts are logged properly Weekly spore counts are conducted regularly Completed dental screening training and competency assessment for nursing staff Proper maintenance of equipment logs Current certifications for anyone taking dental X-rays Sharps counts are conducted and logged properly Peer reviews are current on the dentist ■.-. � s i, Wellpath arranges with local providers and hospitals to treat patients with healthcare needs beyond the scope of care provided at the Correctional Facilities. We authorize, schedule, and coordinate off -site services, such as outpatient surgery, diagnostic testing (e.g., MRI, CT scan, etc.), and ER ambulance services though Star EMS. Wellpath staff initiate referrals for off -site treatment through our Care Management system. Referrals are limited to the chief complaint(s) indicated through a referral form and/or medical consultation. Approvals are based on appropriateness and necessity. We have provided an example of the Request for Consultation form for inmates who require specialty care services in Tabbed Attachment G. Please note this form is confidential and proprietary. The following screenshots show the form used to refer patients for off -site treatment and a view of submitted requests. 111 well,. Solicitation Event ID: 005301 To NYC 4: W", IWI Health Clinic Off -site Service Referral Form — Care Management System IWO— vlll mom r p" T111,1- 1, !,kc, - '," FW- Submitted Requests View —Care Management System 112 Solicitation Event ID: 005301 Jail Health Clinic Preferred Provider Steerage When a user creates an off -site referral in the Care Management system for an office visit or office visit with a procedure and selects a specialty, the user is prompted to click a link to select a provider from a list of preferred providers. This enables Wellpath to .oi A i6$ er. fa�.ts and ensure that patients are seen by specialists who are established within our ;r preferred provider network. Wellpath's tiered provider system ensures that appointments are secured with the most appropriate specialist: Tier 1= Preferred Tier 2 = In -network Tier 3 = Out of network 113 -c Nam= Rwru Addrm Gly iPir.e.t- L'L?if:pL I -.ear ..r .IJLA-1K,r Fc crrrra t-4crc ¢i .. S; ✓L{W`J mLJE n,na4m avice 4rv�re= 7V ar'A:C rtiSAu=nt, lmvr 011 .:= $t,te Spcldry Lp cd. Na .cl..nn rar., -ry .)LLa 6L me Cei..u-q UN] G=r.ne tare zr �1JI5 it-reuv C.ru�:n 3iJli Solicitation Event ID: 005301 Jail Health Clinic t Once the referral is approved, Wellpath staff schedule an appointment through the Care Management system. The Care Management system is a valuable tool for healthcare staff when prioritizing specialty appointments. This powerful scheduling function makes our Care Management system an integral tool in the provision of care. Features include: Recurring appointments (ideal for chronic care patients) Cancellation of appointments for patients who have been released Rescheduling of pending appointments for patients who are re -admitted to the facility Easy -to -view daily/weekly/monthly calendars for staff review 0 Shows missed appointments (due to security, court appearances, etc.) and allow for rescheduling The following screenshots show various views of the appointment process in the Care Management system. 114 Solicitation Event ID: 005301 Jail Health Clinic Appointment Scheduling — Care Management System a-F Gmb APWi`hnmb r.l.. �. ._ .. 1. £mmtv..e.n �}4er +.n + � Ralortal A�33�5&16 P«Iv.l Clrrkt..�la rv.2P'N=Stl'cc. ry d_ :'I�taPnrtrc: ': vrv.G. c::^� �.: •r.•v Sample Scheduled Appointments list (Off -Site) .lnzssvrea taf. c9,iP i , v.feti. i.'l l.11 Y = ��,:•�••. •>. SJ=iC P,r IN All.m, N,E ,C(U') r c._tt_s deztd le.arra^R-tsli.:: °`- AbvMe.fqua's (Ol - -- all _i SIC. n<-� 1^vx2 Reme S�ral"[Lz 115 411-welL, _ Solicitation Event ID: 005301 r - - -'- Jail Health Clinic Sample Appointments Unattended Report in ERMA Appointments Unattended Report v/ss(zme. La/zme vvssss rvn servl..<iVP++Cirronit Cart.PonraI,FP/nlml llral, "al,I'll ,IlIn,1eelliallSn�RM..s. m, at, 1,,ml,.,,o, Ik, ral, w ro>w.. e... ....,. �. .... .......... ..,,.r ,....., a .a I ®r •_ Ord ^�y ® a rvw.v*= x,a. •r may, ®nv .rrm Lo✓®'vrvrnx. .r..vr non Transportation and Security Wellpath coordinates transportation and security with OCSO correctional staff for all off -site services. We work cooperatively with correctional staff to ensure safe and timely transportation. Patients are not informed of scheduled appointment dates, times, or the location of outside providers. We provide correctional staff with advanced written notice of scheduled appointments. We attempt to consolidate the scheduling of off -site appointments with McLaren Oakland and St. Joseph's Mercy and other healthcare providers to minimize the impact on transportation personnel and available vehicles. ERMA allows us to sort and view scheduled appointments by type, location, day, patient, and other criteria. This helps coordinate scheduling in a way that minimizes multiple trips to the same location when possible. Transfer of Medical Information Pertinent medical information accompanies patients traveling to an off -site specialty appointment, hospital, another detention/correctional facility. Upon transfer to another facility, the patient travels with a medical transfer form containing all necessary information required for the continuation of treatment. Documentation and Follow-up Wellpath maintains an active log of off -site care. When patients return from an off -site appointment or hospital stay, a medical provider sees them during the next provider sick call clinic and documents the follow-up in the patient's medical record. All information and documentation returned with the patient from an outside provider become part of the patient's medical record. This typically includes a disposition and instruction sheet that describes actions taken, orders written, findings from consults, treatments performed, and a detailed discharge summary for those returning from inpatient hospitalization. 116 Solicitation Event ID: 005301 Jail Health Clinic Wellpath authorizes, schedules, and coordinates inpatient services when a patient requires hospitalization. We work with McLaren Oakland and St. Joseph's Mercy when an acute care setting is required, communicating frequently with hospital administrations. Healthcare staff make referrals for inpatient care through our Care Management system. The site Medical Director, Dr. Mitchell, authorizes hospitalizations. ihi+? nave diAi v c rirnrnuv)h-agar1,: Xrcgin d'i'' liib: riLA, .,% ro!-.. )r ISr. I[1t':;'chell thrcazf,l'i --hn CaZT, Ms. VYaa: r2m inai mini !.sarriFon Fong, 01—,, the FR birecW at 'Pic -I.a re n. Emergency Room and Inpatient Referral Form — Care Management System �.2nP�c.�•[ ::el^nP l+r:e r'.i C�+:e<2':r 'i:4. e. [e _ IT e -fin:' Si-n[: J:bib .11i DI" Pe eo:y ]:ffik o: Wellpath will continue to communicate frequently with the OCSO to provide the most complete evaluation and treatment of the patient population. When inmates are hospitalized, we will provide Major Childs or his designee with a daily inpatient census report, which can also be accessed directly through the Care Management system. 117 Solicitation Event ID: 005301 Jail Health Clinic Inpatient Census Report — Care Management System ;.`= Inpatient eemv. Report- - - - - - weile. ra..arypv, rvwro.ssan.rmkm:+.wv-�nvw+oeo�mµire-ieFmes. snev. usms n.-oorta:.m�r sm.m�a =m�om�.en..o�u�vmos, o.i. m.v�..nmukure 4m�a w�aa MAR Prospective Review (Prior Authorization) Wellpath requires prior review and authorization of non -urgent or non -emergent care. Our clinicians follow NCCHC standards and correctional guidelines to review and approve services. The site Medical Director initiates a second review if standards are not clearly met. Alternative treatment is at the discretion and direction of a physician. Emergency Services Wellpath does not require prior authorization for emergent services. Medical personnel may make emergency off -site referrals based on established guidelines and their professional interpretation of a patient's need. Off -site medical services exceeding the scope of the initial emergent episode are not covered. Unrelated, non -emergent diagnostic services or treatment initiated in conjunction with an emergent event require prior authorization. Length of Stay Management Wellpath Regional Care Manager Cindy Whitten will continue to oversee off -site inpatient care through daily contact with the hospital. Our Care Management Team is notified at the time of inpatient admissions. Ms. Whitten and Regional Medical Director Dr. Rayford follow NCCHC standards, InterQual Criteria, and correctional guidelines to review inpatient services daily. Concurrent Review Ms. Whitten conducts telephonic clinical rounds twice weekly to ensure inpatient stays are appropriate and meet national guidelines, such as InterQual Criteria, for continued inpatient stay. InterQual Criteria are evidence -based clinical decision support guidelines used to determine the appropriate care setting based on severity of illness and level of care required. The Wellpath site Medical Director (Dr. Mitchell), Regional Medical Director (Dr. Rayford), and Regional Care Manager (Ms. Whitten) attend clinical rounds discussions. This multidisciplinary approach ensures inpatient stays are well -managed, and appropriate transitions of care are completed with improved accuracy. 118 Solicitation Event ID: 005301 Jail Health Clinic Retrospective Review The Wellpath Care Management Department and Wellpath OCSO Correctional Facilities leaders retrospectively review emergency care to resolve claims issues, determine appropriateness of care post - delivery, and perform focused reviews. The Care Management Department can also perform focused reviews at the request of the provider. Discharge Planning Wellpath manages a robust hospital discharge planning process that begins at inpatient admission. Our Regional Care Manager, Ms. Whitten, will continue to work collaboratively with our on -site staff and hospital staff to ensure appropriate transitions of care. This partnership helps us ensure that excellent care continues from hospital discharge through return to the facility. Documentation and Follow-up Medical staff see patients returning from a hospital stay for follow-up during the next provider sick call clinic and document the follow-up in the patient's medical record. Detailed information and documentation returned with the patient, such as discharge summary, disposition and instruction sheet describing actions taken, orders written, and treatments performed, become part of the medical record. Wellpath's web -based Care Management system is in place at the OCSO Correctional Facilities. This system enhances clinical control and cost efficiencies for off -site care by, allowing us to track off -site services, ensure timely return from off -site visits, manage laims,` and provide reports that assist the OCSO with cost containment and budget preparation. The Care Management system functions alongside the OCSO's Intellitech IMACS system to ensure accurate reporting. If desired, the OCSO has access to the Care Management system to view management information and monitor off -site scheduling and inpatient status. With our robust Care Management system, Wellpath offers a level of automation and accuracy in reporting that no competitor can match. Advanced Utilization Management Wellpath has the s%reinges:t utl'<i7ztioE, man7genr rnt pnigrarn in the industry for managing patient care. Our Care Management program uses evidence -based guidelines to determine medical necessity as part of our approval process. The Wellpath Care Management program is clinically overseen by Medical Director of Care Management Donald Rhodes, MD, and is operationally managed by Vice President of Care Management Pablo Viteri, MS, MHP. Dr. Rhodes and the Care Management team work together with Regional Medical Director Cleveland Rayford, MD, and on -site medical personnel to ensure patients receive medically necessary healthcare services in the most appropriate setting. Wellpath coordinates, validates, and tracks off -site care and invoicing through the Care Management system. Our established review process ensures that off -site referrals are medically necessary and payments are appropriate. Following is a summary of the Wellpath Care Management process. 119 Solicitation Event ID: 005301 Jail Health Clinic 1. When an on -site provider determines that a patient may need community -based services, the provider uses the Care Management system to document and communicate the Consultation Request. 2. Our Regional Medical Director, Dr. Rayford, accesses the Care Management system daily to Wellpath provides clients with review requests and takes one of the following complete access to our easy -to -use actions: Care Management system, including real-time utilization o Authorizes a specific diagnostic or reporting. We are fully transparent therapeutic modality n our Care Management process, o Recommends an alternative treatment assuring our clients that only plan necessary off -site trips are made. o Requests additional information 3. If the requested service is medically necessary, it is approved. An authorization number is established in the Care Management system, which automatically sends the authorization number to the OCSO Correctional Facilities and the Wellpath Claims Department. 4. Once the OCSO Correctional Facilities receives an authorization number, we schedule an appointment within the system. Authorization numbers are only valid for a specific period. Wellpath communicates service approval to the community provider and requires pre -approval to assume financial responsibility for services rendered. We also verify that all invoiced charges are appropriate. Since the system sends the authorization number to our Claims Department, they can review every invoice to ensure you are billed only for the approved services. 5. If a patient is released from custody before a scheduled appointment, Wellpath notifies the community provider that the OCSO is no longer financially responsible and removes the pending appointment from the system. 6. The site Medical Director, Dr. Mitchell, reviews and addresses discharge summaries and medical recommendations that the community provider makes. 120 Solicitation Event ID: 005301 Jail Health Clinic The Wellpath Review Process I.S toA enters 2 negiovalCar¢Manager i. RCM mnlarh a. ACM enters S. RCM nohiie55R¢ bRCMen(ersdiuhaige Inpatientrefen,d into .i (RCM)"wowsCM rystem —+ hospitaldallyfvr --i apprvvziinty --♦ of planned deahage ---i dates lnlnCM system - Cane Management dailyfarnewinpatients. elini®i information and CM rystem. antl needs. and mmpietere£enrl. (CM)synem disahmgepianning. L Sitedlnictan)AA L Regional Medlml J. RM0revlewsreoferrrilinfM S. Slte Cll.khrolm Oocare(RMD) reviews enters Inpatient referral s,stemand approve commends a. Site0H6dan/nn I t tlrereferzalwhen — Crystedaily for M m intvfM syrtem. alte srhedulerserviees' tientreceivessovks. pa newrefermis, additionalof,amayrequest additional lnimuu[imr). 1. sitoobdfian/AAento. emergemy ,off.[ Into CM zystem.(Note. 2. RMD revIewS CM system 3 SRe Clinirian/HPcomp efes [herererral _ AUMorizafionis for henJingas emergent dailyfornewreforr h. whenpatientrecews'sedice. care doesnot requireprlm anthoriza[ionj. 4mhonast approval data is p use d from CM rystem to the claims system each Monday. I wellpathwillinformtheslle po@ CM Ihatthedannil—rreetand — YES — ntem NO matches claimClaim iz heidont dater systapRroval . appropriateior payment. Utilization Review The Wellpath Care Management system generates reports that allow us to analyze the utilization of off - site services on behalf of the CCSO. We use this data to assess the need for additional on -site and off - site services, as well as the potential impact that systems such as telemedicine may have. We continuously evaluate the number of cases and the costs associated with transporting patients to determine which clinics are held on -site. Constant evaluation of specialty services ensures the most cost-effective solution for clinics. Following is an example of Wellpath's Event Detail Report, which provides a snapshot of off -site visits. 121 A� f- welLs Solicitation Event ID: 005301 Jail Health Clinic Sample Event Detail Report Event Detail Report weld: c: c; Page t of 2 t US Dal INPATIENT HOSPTTALIZATION Total$ IOBSERVATION d EVENT(S) 1CiC'. =015 IG'OUZOii eCG1 - i' I.+atl cad t I;?0r01c I_'G'J2C 1P EU 1 PtG �G15 1'_fC2'". f,19 rcoi t''fS2014 t:JCf �019 E00t 4 OBSERVATION Totals 32 EVENT(S) C.tFGIOLOG ,' '. C/C 460 I4 I-G R4l 2 G71 .4C VAh4L0�L�4=L SUPGERT tbIGCt IS i�ORAL :,I:C ft01 F1Arh10f4C1%L SURGER`.' Icalrg,l4 leli IVluo lillill�l'IIV ecG1 oPHTHoleo; t t:�`aC1S III ml m oi6iYJndpllp cCtlt I:ci FinarciaBy UROLGG; Liacte 1 I'i's+_01P ORAL"a 60G5 Pre-Eustmg G=rALLOF:Ct<L SURGEPr f ll.10'�019 025TE'RICs 6G07 'r NCI F)l o,y LI3GY Among the numerous reports Wellpath provides the OCSO is the Event and Expense Detail Report, which itemizes each off -site referral entered into the Care Management system and tracks cost data. We review this report at least monthly and confirm its accuracy by the third business day of each month. We use this report to establish the monthly off -site cost accrual in the facility's financial statements. We train Wellpath staff to ensure: Events are showing up on the report (compare the events on the report to any internal tracking process) Dates of service are accurate, especially ER dates All provider information is showing up on the report No duplicate records All referrals are in the correct category (e.g., ambulance, off -site, dialysis, radiology) 122 Solicitation Event ID: 005301 ... :v=� Jail Health Clinic IN Inmate type is correct (e.g., State, Federal, ICE) All dialysis appointment dates are listed u Discharge dates are entered and accurate Custody release dates are entered when appropriate Following is a sample Event and Expense Detail Report, which can be exported to Excel and sorted by hospital, service, or patient, offering full transparency into off -site costs. Sample Monthly Event & Expense Detail Report welli:.l+'P Event 8 Expense Detail Report REfllonz. JI.N PMB(II.PNGE 23 PJ£NTISY hnu ram r.,.r rv. u�. ir:•I ♦ t_IYf'' i^n ..... - n �a.e n ) U ../.' ] P.<CU^n yr 5 1:I YR•S 11.nNf Y`'SI Sn4' 4'v U ANEVLiMCE iMNs 4z,v3i00 i;585m SxwR weVLaXCEitlAs ttAi29B zf.SnM _ Y EMEAGENCY ROOM 142EVENT(S) al5 RIav,0TEOt ' my Onww Fxlllt n1R�'.9 /.TJ �qn 5 T IJfYa fifSY:iv - v r rr Ul)4RUS� rr:]Cfro4B i50 Y � r II:sFi45 SV :' k•fu EnEn eENev Bwx inex+ z+sAsz SU $I,ui BN o,',ne, tWE:RY3"P1Y.Y•Y9E. .•MCC. U.^.n 4:ai a. — cExcv noom rnln. uElien f OBSERVATION IEVENTIS) os6:nvATou'mas SV UO SBm e.M O68ERVATGNTmgs W.W MM 5JW INPATIENT HOSPITALIZATION EEV.T(.) J0115 REONCTEOCOUIrty OBlMibn r.o t m.C4^nSnlrcvRnyn iMn - �� SNPU p14J f .n 5 n tYset33u nn c n'lt Yl.'S.ti •. ruNo _ ry9 oU mW F oai.Bav clvfi0 0 15 [m B Y i.tit.a lieu SODU WW M� o :S WNSI INVATENi Np:PIIFIlZA1WN (erels TSS'UU SU Iq IB08W NPATENi NBS>ITAL1I.MN'.I" JQi fv4B 123 Solicitation Event ID: 005301 Jail Health Clinic RmAGTEO CounIYDPcenlpn Fecplt sU. 4 .� ..1 i1a.Z 112.111 Sa533 Sa .3 2)'i 0 `• /.G "1 �O, c 1'�'"OHM13 Il�']I'. Snsi 40o Av.. OEFlCEYIEB1cPL f1 f9i1} {ESt OE S1.I1ln NLIu KSv 53 P.T355 OFFICE NSITS WRH PROCEDURE 66YENTOO O...E.O.c :M3 v.uv n,3..v $Isl au :a cu imr pJ ' OiFlCEMI&R1nM PROCEWflC3tdua KI)90 SOW OFP,cs Ns*sNT1 oRGclbYPEs iaas 10K �iN' RADIOLOGY iEvENT(M J#k T. LE REGACTEO.... YD .'.F.Oft Sample Event & Expense Detail Report—YTD Summary -ttr Event & Expense Detail Report vvell;..t t Regions: Jails AMBULANCE 22 $1,882198 $1,69596 $2,794,22 EMERGENCY ROOM 122 $19,693.50 $7.26766 $21,594.13 OBSERVATION 1 $0,00 $400 $0,00 INPATIENT HOSPITALIZATION 45 DAYIS) 9 $968.00 S0,00 $268,00 OFFICE VISITS 14 S1,191.42 $658,52 $1,372.95 OFFICE VISITS WITH PROCEDURES 5 $647.96 SO.00 $647.96 RADIOLOGY 3 $808.79 12,43409 $2,703,02 45 DaV(E) 176 $25,196.0 $11,951A3 $30,065.291 22 $1,88298 51,595.9E $2,794.22 AMBULANCE EMERGENCY ROOM 122 f19,m,50 $7,262.89 $21,594.13 OBSERVATION 1 $aw $0 GO $0GO INPATIENT HOSPITALIZATION 45 Dq(l) 9 $969.09 $0.00 $m n0 OFFICE VISITS 14 $1,197 4Z $658,52 $1,312,95 OFFICE VISITS WITH PROCEDURES 5 $647.96 $0.00 $647.96 RADIOLOGY 3 $80G 29 $2AUA9 $2JO3,02 45 DaY(M 176 $25,196.65 $11,951.43 $30,085,281 lww Fobrum $U.UO $0.00 S000 11.00 Rlarch $25,196.65 $41,951.43 $18,133.85 $30,08i28 $25,196,65 $11,951.43 $18,13365 $30,0GS201 124 lvlwe:.. . Solicitation Event ID: 005301 Jail Health Clinic Our Care Management system produces reports for the OCSO containing detailed data for cost analysis and containment. These reports include information on all medical, dental, and associated costs, including laboratory, radiology, and other ancillary services; specialty services; pharmaceuticals; and medical supplies. We analyze utilization statistics and continuously evaluate the potential benefits of establishing on -site clinics. Wellpath has successfully reduced off -site medical and security costs at the OCSO Correctional Facilities by providing cost-effective, medically necessary healthcare services to our patients. The Care Management system is a powerful tool for tracking and analyzing utilization data. The system's visual dashboards allow for comparison of historical data and trends in patient care, providing operational and outcome trending on: Admits per 100/1000 Admits by diagnosis Re -admission rates ER visits per 100/1000 ER visits by diagnosis ER conversion rates Infection rates Non -formulary utilization trends n Non -formulary lab trends Prior authorization turnaround times Prior authorization outcome rates r Standard vs. expedited authorization requests Sample Care Management Dashboards — Off -site Referrals & Inpatient Events n 125 ell Solicitation Event ID: 005301 Jail Health Clinic uzrm;,—Pzn wxv _ ERMA can also generate reports showing the average length of stay for that month's inpatient admissions. Sample Inpatient Average Length of Stay Report in ERMA Inpatient Average Length of Stay WLL F Il E.ul': m,vf xn:m iW felcesulor(on: Fahaalil-1 Ill Fafm:rt uuliI C II lI'll, .,I u fnn'eNi numbry nllnca'ert 'enh�nP mOnNIIP•d .�Lmbe'ydtlmh<yyrE..'hi016n rca'T 19l"I argil IN lft mleW3 ro`eH.i ln'N�z'apMre lnB tdal.n�yfoxrN xnPrUe; f=p1y.,mn me,monh e ¢ r mmtFrol traJu�ps v anmw mo+m.ldzl n.++:e, dnm<se'nz mm n Ile m'nih Xumw Pa,umxem pmlRm %gMlt YUOeWru.eM Wme One one ou Ill— u RnfCe lv, ex. el lfn] lt..' l`l'. a' a •iai iiei„e.e,.bu, ixxii Pa4rnIAven9Plm9IM1 of Stayc] I ® zi n,...., �.mrueen �: ®® I n.vrnm Bunn, r.visner i.v el.1 ena'rn>an:..�ln:< e odm � I ' t1111 ..m n •zwzr ,iy of+ c:»7o-;.a. „uzJfe:caev ; ' ee n,..w, u.f „>.e»d I. I..t.>.r 3.,o'll Inln>_�a •znaa= ,: �--- n i• i . 6 d uuui iiinidnembi uux Ptlenu c l Avenge III of SW• 2 - .... ,n r,.rn...-, o-..I emau m:=emu r :n..e v, ni-n, r, •,.,rfr,en, - {Inr.... ___. ._.__. _. rill, If an incoming patient requires hospitalization or medical care that cannot be provided on site, the arresting officer notifies the Sheriff and the information is recorded on the Jail Sergeant's hospitalization status board. Wellpath staff review the status board daily and initiate the Care Management process for any new arrestees who are transferred off site by adding the patient into our electronic Care Management system. 126 Solicitation Event ID: 005301 Jail Health Clinic When a patient is transferred to the hospital prior to booking, they have not yet been entered into Intellitech IMACS or the Wellpath Care Management system. When Wellpath staff are notified of any patient receiving off -site treatment prior to booking, they manually enter the patient into the Care Management system in order to track and review the patient's status as we would with any patient admitted to the hospital. This also allows Wellpath to ensure that the hospital is billing the correct source and that the patient is discharged as soon as clinically appropriate once the patient's condition allows them to be cared for in the facility by Wellpath staff. Any chart notes or other information returned with the patient from the hospital is synced with the Care Management system if and when they return to the facility. Pre -book hospitalizations bypass the typical approval process because they are emergency room visits. Dr. Mitchell conducts a retrospective review following an ER referral to ensure that the action was appropriate and to identify any additional staff training needed. Wellpath provides reports of emergency room visits, with data including each patient's name and identification number, the date of emergency service, the patient's disposition, and the emergency treatment received. Wellpath will continue to perform warranted evidentiary blood draws in accordance with NCCHC standards. Wellpath does not routinely participate in the collection of forensic information. The role of the health care staff is to serve the health care needs of the incarcerated population and the position assumed by the health care staff is a neutral one. Therefore, medical personnel are not involved in the collection of forensic information (e.g., DNA testing), except when: Complying with state laws that require blood samples from inmates, provided there is consent of the inmate and health care staff are not involved in any punitive action taken as a result of nonparticipation in the collection process Conducting blood or urine testing for alcohol or other drugs when done for medical purposes by a physician's order Conducting patient -specific, court -ordered laboratory tests, examinations, or radiology procedures with consent of the inmate 127 Solicitation Event ID: 005301 Jail Health Clinic Well path uses industry -leading talent acquisition and employee retention techniques to consistently recruit and retain highly qualified employees. Our initiatives include strategic talent acquisition plans, competitive benefits programs, opportunities for professional development, and structured onboarding programs to educate new employees and welcome them to the Wellpath team. Our skilled and responsive Human Resources professionals facilitate the recruitment, development, and retention of healthcare professionals for our clients. At Wellpath, we have the opportunity every day to improve the health of many of society's most vulnerable and at -risk patient populations. Most healthcare professionals choose this profession to help others and give back to society. We provide them with one of the most meaningful ways to do that. Wellpath's dedicated Talent Acquisition team of physician recruiters, nurse recruiters, managers, and coordinators source high -potential candidates, screen applicants, and conduct interviews. They use competency -based behavioral interview questions and collaborate with our clinical and operational specialists to make informed hiring decisions. Wellpath performs primary source verification of credentials and licensure concurrently during the interviewing and screening process. We then select the best candidates based on qualifications and credentials, experience, references, interview results, and other information. National Recruiting & Sourcing Tools Wellpath recruiters are vigilant in their search strategies for talent, especially in a time of low unemployment rates for healthcare professionals. We work hard to keep our pipeline for the OCSO Correctional Facilities full by using effective tools to identify and communicate with candidates. We use strategic media partnerships to evaluate and rotate our posting needs daily. A few of those partnerships include TextRecruit; App Feeder; Indeed; and Connect, a Contact Relationship Management (CRM) program for engaging passive talent. Wellpath also uses resources that share job postings and information across dozens of recruiting databases and job sites through a single source. Our strategic use r of various databases ensures a continuous feed of the so newest resumes and candidates into an Applicant Tracking System our recruiters use to find the best ;. candidates for the OCSO Correctional Facilities in the shortest amount of time. 128 =,Ii-welt, - -'.'- ' Solicitation Event ID: 005301 Jail Health Clinic We invest in technology to promote our open positions and provide industry -leading people analytics. This helps us understand the growing needs in staffing, as well as the outcomes of our efforts. Our Talent Acquisition Team has a full candidate marketing plan and we use a multitude of resources, including: B,>£crcrf-c:rra. Our organization uses the Linked In Employer Page and Career Profile Pages on Facebook and Instagram to organically promote events, hiring incentives, and the benefits of becoming a team member. Additionally, we run sponsored Custom Audience campaigns via Facebook, which enables us to reach a more refined target audience, specific to providers. We are constantly optimizing our social channels to further enhance our online presence and we will hit 2,000 page likes by EOY. ?r.f.j'c;?t tti,:ia;rF Google and YouTube are the two largest search engines in the world. We advertise with them on a large scale, ensuring that the efforts work together to yield the largest ROL YouTube Ads amplify our Google Search performance as shown in this figure. ;«crate rtt;ri 6"rs 47vbr Video amplifies Search ads We implement search campaigns to drive targeted traffic to our career site and display campaigns to raise branding awareness. Google Remarketing is used to re-engage candidates who visited our site but did not apply. We run YouTube campaigns to take advantage of the behavioral learning capabilities. A candidate does not have to search for us or ourjobs to get served our YouTube ad. i4hl, irl ;✓:::azf; cFncler rf Tcx, rye;.erll�.rx:: Events and Targeted Ads are some of our most powerful tools for start-up facilities, as we see great ROI when running for various audiences. Indeed Events delivered over 1,100 candidates YTD to our start-up facilities. o We launch text message campaigns to relevant audience pools to reach candidates on their most used device, their phone. We leverage internet radio via Spotify as opposed to local radio stations. It's proven far more powerful due to machine -learning and tracking capabilities. Spotify has the two highest performing campaigns for all campaigns YTD. DlyRol Adveriisin.q Tools Talent Community We maintain a large and always -growing talent community to keep candidates who have expressed interest engaged with our brand, using the leads to deploy email and text blasts. We have 172k candidates in our Talent Community! Lrmdrn r Pao,-: We direct candidates to landing pages to minimize candidate drop-off. Candidates convert at a 3X higher rate when directed to a short form as opposed to a full career site "-_porting & A ,atyti,s: We use Bayard Advertising to report on all campaign metrics, allowing us to evaluate successful vs. unsuccessful campaigns, and manipulate those campaigns based on what is proving to be prosperous 129 L Solicitation Event ID: 005301 Jail Health Clinic Wellpath Candidate Service Level Agreements Local, regional, and national recruitment campaigns keep a constant flow of qualified candidates within reach to discuss opportunities at the OCSO Correctional Facilities. In today's market, we know that candidates are best retained if they are contacted and screened in the first 48 hours of their application or contact with Wellpath. We use standardized Service Level Agreements (SLAB) to manage our applicant flow and ensure we process candidates and fill positions quickly. :5- 4:j' .5�6? 1 ::f (-Cables. i«`•%` r r.: ...5. - "p .. a '. u'�'�::,-'_��-.�:"I J .i';s ."ai•"1�.:r�t'�'%'i-"M1 tii".<'t ,�t�'%>�, 2 Days i 3 Days 12 Days 1 Day Wellpath uses the iCIMS Applicant Tracking System (ATS) and Contact Relationship Manager (CRM) to maximize talent acquisition. Hiring managers work with our dedicated recruiter, Letia Mangum - Patterson, to advertise open positions in the ATS. The iCIMS ATS leverages mobile, social, and video technologies to manage the talent acquisition lifecycle. It helps us build CRM talent pools and automates our recruitment marketing, applicant screening, and onboarding processes. The UMS CRM contains more than 50,000 pipelined candidates, with more than 50% in the nursing industry. Our talent acquisition process is illustrated in the following figure. 130 Solicitation Event ID: 005301 Jail Health Clinic Internal Recruiting Wellpath posts job openings internally and externally and gives internal applicants initial consideration for opportunities to help advance their careers. Wellpath employees in good standing can apply for internal opportunities after completing six months in their current role. If a team member wishes to transfer to another position or location, he or she must validate they have informed their manager of their interest. The hiring manager or regional leadership typically conducts internal candidate interviews. We will continue to welcome input from you during the interview process for key positions. College and University On -Site Recruiting Our proactive recruitment model is based on building relationships with resources in and around Oakland County. We strive to hire locally since hiring individuals with a personal interest in our healthcare mission better serves our patients at the OCSO Correctional Facilities. A key part of our recruitment plan includes working with local nursing schools and residency programs to attract healthcare professionals to a career in corrections. We have developed programs for nursing students at the OCSO Correctional Facilities, and we have expanded our outreach to residency programs. These programs pre -pandemic included: Oakland University Oakland Community College 01 University of Detroit By increasing community interest and education regarding corrections, we are able to attract and recruit healthcare professionals who may have otherwise overlooked a career in correctional healthcare. Equal Employment Opportunities Wellpath is an Equal Employment Opportunity (EEO) employer with a thorough diversity policy in place to appropriately guide recruiting and hiring processes. We comply with all provisions of federal, state, and local regulations to ensure that no employee or applicant for employment is discriminated against because of race, religion, color, gender, sexual orientation, genetics, gender identity, marital status, age, disability, veteran status, national origin, or other legally protected status. Salary and Benefits Wellpath offers competitive salaries and benefits to attract and retain qualified staff for the OCSO Correctional Facilities. We conduct local due diligence and salary surveys to ensure that our proposed rates are competitive within the surrounding area and to ensure that staff recruitment and retention efforts are successful. By showing our employees that they are a valued part of our company, we save our clients unnecessary operational expenses and added costs created by turnover. Our benefits program exceeds market standards and is designed to attract and retain healthcare staff while recognizing the diverse needs and goals of our workforce. Wellpath also promotes retention through: 0 131 Solicitation Event ID: 005301 Jail Health Clinic Retention bonuses Referral bonuses for hard -to -fill positions Incremental increases of benefits like vacation and 401k vesting based on length of employment Annual salary increases based on performance and qualifications Monetary assistance and time off for CMU/CEU programs related to specific skill sets Employer tuition reimbursement program, which can be used for licensure renewal Malpractice insurance coverage for practitioners Company -sponsored gatherings Discounted offerings for theme parks, restaurants, movie theaters, and other activities Salary and Wage Analytics Wellpath has invested in economic modeling data that allows us to evaluate each market based on real- time salary and market analytics. Our multidisciplinary team of experts across disciplines — including clinical, compensation, and recruiting — analyze and agree on our wage rates. This team examines market supply, validates compensation data, and reviews the competition from companies advertising for the same positions in the market. These tools give us better insight to know where people live versus where they work, and how many actual jobs are being filled every month. Employee Benefits Program Wellpath offers a comprehensive, flexible benefits program for the OCSO Correctional Facilities that focuses on health and well-being. New hires, transitioning employees, and current staff can sign up for Wellpath benefits through our online and mobile enrollment system, which streamlines communications, education, forms, and all other benefit -related options. They also have the option of calling our Benefits Service Center to speak with someone who can answer questions and help them enroll. Wellpath offers three medical plan options with a robust pharmacy program, two dental plan options, vision, and company -paid life insurance, as well as additional insurance options for employees, spouses, and children. We also offer short-term and long-term disability plans to offset income loss in case of an emergency, as well as various supplemental insurance programs that pay staff directly for illness or accidental injury. Additionally, we offer a wellness program that encourages employees to take steps toward healthier lifestyles. Our wellness initiatives also include an online health education program that rewards employees for learning more about their conditions and wellness in general. This program helps employees better understand and self -manage their health, in consultation with their doctor. Members also gain peace of mind knowing their doctor's care is consistent with "best practices' published by independent and highly credible sources. Affordability is a top priority for all Wellpath benefit programs. We work closely with our vendors to ensure that we provide competitive benefits at affordable rates, and vue subsidize a larger portion of ^.'hE. total cost o> heait:hcara_ for staff with lower income. We also offer a health savings account option with an annual employer contribution that allows employees to make pre-tax contributions to pay for doctor's visits, medications, and other health services. 132 Solicitation Event ID: 005301 Jail Health Clinic Financial wellness is another important aspect of retention, and Wellpath offers a traditional 401k with a discretionary company match, a Roth IRA, and a college tuition reimbursement program. Wellpath offers a competitive paid time -off program based on years of service, as well as paid holidays throughout the year. Our benefits programs are summarized in the following table. Paid Time Off Accrual begins immediately; eligible year one = 15 days for use after 90 days of employment Holidays Immediately eligible Six company -paid holidays per year, plus three floating holidays Full-time employees who have one Pregnancy Disability Leave year of completed service and have Up to two weeks of paid leave during received medical certification under pregnancy or after giving birth FMLA Military Leave - Immediately Two weeks paid per year/difference between military pay and base salary Funeral Leave Immediately The company pays for three days off for immediate family member The company pays the difference between jury Jury Leave Immediately pay and regular pay if scheduled workdays are - missed Service date with prior company Up to 12 weeks in a rolling 12-month period for FMLA/LOA drives FMLA date; also offer a 30-day FMLA personal leave of absence Immediately (see probation period); pays 60% of monthly salary up to $20,000; Long -Term Disability - pre -ex applies benefits begin 180 days after covered injury or sickness - Short -Term Disability Immediately (see probation period); Pays 60% of weekly salary up to $2500; benefits pre -ex applies begin after eight days of injury or sickness Multiple options through Aetna and Health Medical/Health Insurance Immediately for retained employees - Cost Solutions such as PPO, HSA, and HMO (in during an acquisition somelocations)plans; provided for employees anddependents Prescription Benefits Immediately for retained employees Retail and mail order pharmacy benefits during an acquisition Dental Insurance Immediately for retained employees Two dental options; provided for employees during an acquisition and dependents Vision Insurance Immediately for retained employees Comprehensive vision; provided for employees during an acquisition and dependents Basic Life and AD&D - Immediately for retained employees - - 1x annual salary up to $500,000 - - during an acquisition Voluntary Life Immediately for retained employees Option to elect up to 5x annual salary up to during an acquisition $1,000,000 Family Life Immediately for retained employees - - - during an acquisition - - Available with Voluntary Life; benefit cannot exceed 50% of coverage; spouse benefit in $5,000 increments up to $250,000; a- dependent benefit of $10,000 - 133 -1 "I e . - - - Solicitation Event ID: 005301 q r. ('srmnb Jail Health Clinic Tuition Assistance After six months of service The company pays up to $2,000 in rolling 12 months Employee Assistance Available immediately Provides up to three in -person visits and Program - _ - - _ _ _ _ _ _ numerous other resources- - 1) Flex plan for health and dependent care Other Benefits reimbursement; 2) Legal and Identity Theft Program; 3) Critical Illness, accident, and hospital indemnity Eligibility is first of the month after 60 Retirement/Pension, 401K, days employment; team members Employer Contribution automatically enrolled at2%of base pay unless they elect otherwise ZM3MMMMM= Traditional 401k plan or Roth 401k through Prudential - - Wellpath understands the importance, for continuity of care, of providing full-time staff members. Consistent staffing improves the quality of patient care and minimizes issues that can lead to grievances and lawsuits. We focus on prudent staff deployment to promote high efficiency, fewer mistakes, and improved morale. Wellpath will continue to offer benefit -related incentives to entice those who may be considering a slightly higher rate of pay as per diem staff to commit to full-time employment. We are proud to say that Fail (, c*lr ir1 is at t'n'a OC O Cwrrect Iona; Faulifles a;-e ;tiled i:Adi pen-nakion e?"F'tj'I.ftFyr't•`. (any open positions are temporarily filled through overtime and PRN staffing pools). We attribute our retention success and low turnover at the OCSO Correctional Facilities to maintaining competitive salary and benefits packages, embracing diversity, rewarding superior performance, and providing meaningful work in a friendly environment. Professional Development and Tuition Assistance A successful operation requires motivated employees who have the tools they need to succeed. Caring for and respecting patients at the OCSO Correctional Facilities requires hiring ethical and competent professionals and building upon their skills through continued training initiatives. Wellpath has a dedicated organizational development department offering a full range of professional development opportunities that include training programs, continuing education, clinical exposure, promotion preparation, succession planning, and peer reviews. We are dedicated to our employees' continued development and long-term professional satisfaction to create lower turnover, reduced costs of replacement and training, and strengthened team spirit through mutual respect and recognition of each individual's contributions. We encourage OCSO Correctional Facilities employees to take advantage of advancement and professional growth opportunities. We offer tuition assistance to employees to advance their skills and their career. Additionally, Wellpath employees and their children who have graduated high school can apply for Wellpath-sponsored college scholarships each year. We awarded seven $2,500 scholarships in 2021. 134 HiL Solicitation Event ID: 005301 Jail Health Clinic Employee Survey Responses "Working for and with [Wellpath] has been a great opportunity for me. I enjoy everything the company does for the sites as a whole as well as on an individual basis. They continue to help us grow and develop as a group through effective communication, patience, and understanding." "When I started in corrections, I worked for [a competitor]... I know [Wellpath] has a vested interest in my success and personal well-being. I have the tools needed to do myjob, and through CORE and startups I have been able to expand my knowledge and believe my opinion and talents are important. This is the company I want to retire from." Nurse Outreach and Support Wellpath has adopted several outreach techniques for our nursing professionals, including advanced training opportunities and open communication through the Nurse Channel, an online resource for Wellpath nurses. In addition to providing useful information, the Nurse Channel also recognizes Wellpath nurses with a record of outstanding job performance upholding our high standards for patient care. Employee Recognition Wellpath attracts and retains skilled and competent personnel through several employee incentives, but incentives alone do not build loyalty. A friendly company culture also affects the long-term satisfaction of our employees. The primary reason for dissatisfaction in the healthcare field is feeling undervalued. At Wellpath, each person is treated with respect, incentivized and rewarded for dedication and performance, and viewed as a valuable asset of our team. The Wellpath employee recognition program enhances our ability to retain healthcare professionals throughout the life of a contract. Our program encourages positive behavior and builds a sense of pride in each team member. By recognizing our top -performing employees, we can influence employee morale, which positively impacts the quality of care we provide. The primary program is the SH Award, which represents the values by which Wellpath strives to exist: Hunger, Honesty, Hard Work, Humility, and humor. We recognize employees whose contributions echo these values. At the OCSO Correctional Facilities, we incorporate employee recognition into our site operations, and we have in place a committee to recognize employees monthly and quarterly. These awards are based on attendance, customer service, teamwork, and overall performance. Each year, the leadership team of each Wellpath business unit chooses one individual from each of the quarterly winners to be nominated for the President's Award. All quarterly award winners and nominees, and President's Award winners, are recognized on the Wellpath website and eligible for a monetary award, certificate of recognition, and a gift. Flexible Scheduling When possible, Wellpath allows flexible scheduling to meet employees' needs. We employ part-time and per diem personnel to provide coverage for scheduled absences and to supplement full-time staffing needs. 135 Solicitation Event ID: 005301 Jail Health Clinic Wellness Program Wellpath appreciates the importance of health and well-being for our employees. We encourage our team members to participate in a Wellpath wellness program that includes exercise programs, healthy eating tips, and other initiatives that promote a healthy lifestyle. Various Wellpath sites offer incentives or contests to encourage employee participation in programs that create a healthier staff, including smoking cessation and weight control programs. Wellpath also offers telemedicine services through AmWell for employees to access care providers on their own schedule, 24/7. Primary care visits 6: E G 1VVe are covered by Wellpath at no charge to the employee. Specialty services such as mental health, nutrition, lactation support, and psychiatry are also available with a nominal co- pay - Employee Assistance Program Wellpath offers an Employee Assistance Program (EAP) through Cigna. All Wellpath employees and their household dependents have 24/7 access to a range of free services and educational materials to help with a variety of life/work challenges and crisis management. Assistance is available through a confidential phone call or referral to a specialist for up to three sessions of in -person support. The Cigna EAP also provides discounted services and programs that promote health and wellness. Dare to Care Wellpath established the Dare to Care Employee Assistance Fund to support our valued team members when they need it most. Employees and eligible dependents can apply for economic assistance during unexpected economic hardship. Employees may be eligible for assistance if they experience extreme or catastrophic circumstances beyond their control, including loss of property due to natural disaster life -threatening illness or injury, or loss of a family member. We started Dare to Care in 2010 in response to the flooding that a .., devastated the City of Nashville. Since its inception, the Dare to Casr i€an;.€ It35 %F'CsY?!{jeC{ ,,,x i'tti:IiQn E?^ fi,'}a(te.i?I to more than 880 employees and their families in their time of need. In 2020, Wellpath team members contributed $390,000 to the Dare to Care fund, and so far 2021, Wellpath team members have already contributed $113,000 Wellpath partners with the Community Foundation of Middle Tennessee to manage all funds and award gifts. The application process is confidential and requests are reviewed by an impartial and experienced third party. Dare to Care is funded through employee donations and matching contributions from Wellpath. Medical and mental health services are provided at the OCSO Correctional Facilities by professionals fully qualified and appropriately licensed, certified, or registered in Michigan. Wellpath ensures employees and contractors are properly licensed or certified for their positions. We maintain proof of malpractice insurance for applicable employees. 136 .t- welt, Solicitation Event ID: 005301 Jail Health Clinic Applicable employees are required to attest to completion of annual training necessary to maintain licenses and/or certifications. Healthcare personnel maintain current first aid and CPR/AED certification and attend appropriate workshops to maintain licensure. WeIIpath's credentialing process ensures that medical personnel remain current with state lice nsure requirements. Medical providers at the Correctional Facilities must complete the Wellpath credentialing process before starting work. The credentialing process (described in the following graphic) begins as soon as we have decided to make an offer of employment to the candidate. The Wellpath credentialing department oversees credentialing activities. The Wellpath Credentialing Process Ptisiun� �Cand�deka �fferesi, aomPYRes, onijn,� Recraiter'. ccedCnT�aL nB` aPPliction �tiniJs Candidate xlomi5tertts Interim Privileges (Fast Track) Wellpath refers to the process of granting interim privileges as "fast tracking." To initiate fast tracking, the health care practitioner (HCP) must submit the following forms: Completed credential application Copy of current state license (verified) Copy of current malpractice certificate of insurance (if not covered by Wellpath) Copy of DEA Copy of diploma Copy of certifications (if applicable) Copy of CPR Copy of resume 137 ell: U Solicitation Event ID: 005301 Jail Health Clinic Wellpath credentialing specialists verify and submit the information listed in the following table. A committee reviews the HCP's credentialing file and denies or grants interim privileges. Final initial approval is given after references and other required documentation are submitted and verified. Wellpath requires re-credentialing every three years on the anniversary date of the original fast track credentialing. Valid, current, and unrestricted state professional Primary source verification through issuing state license No recorded revocation or limitation of professional license Current DEA privileges with no involuntary restrictions Current state Controlled Substance Registration with no involuntary restrictions (if applicable) Acceptable malpractice claims history Graduation from accredited medical school (or other professional programs for non -physician professionals) Acceptable completion of an accredited residency program Never been subject to medical staff monitoring or special review activity of public record (or reasonably discoverable upon proper inquiry) No recorded expulsion or suspension from receiving payment under Medicare or Medicaid programs No recorded conviction or charge of a criminal offense No record of disciplinary actions in prior states in which the provider practiced Board certification in a listed specialty (where certification is applicable) Personnel files Primary source verification and National Practitioner Data Bank Primary Source verification with Federal DEA Primary Source verification with the appropriate state agency National Practitioner Data Bank National Student Clearinghouse INK) for Primary Source Verifications or direct verification through the institution if not available through NSC; for Physicians and Physician Associates, a second verification occurs with the American Medical Association (AMA) report American Medical Association (AMA) report National Practitioner Data Bank National Practitioner Data Bank and verification of no reports from the Office of Inspector General (OIG) National Practitioner Data Bank National Practitioner Data Bank American Medical Association (AMA) report Once we select on -site personnel, Wellpath provides the OCSO applicable certification and licensing information. Before employment, Wellpath provides copies of background and credentialing information for professional staff, including appropriate licenses, proof of professional certification, Drug Enforcement Administration (DEA) numbers, malpractice insurance coverage, evaluations, position responsibilities, and current resumes. We maintain personnel files of Wellpath and contract employees assigned to the Correctional Facilities at the Home Office and on -site. Facility administration has access to these files, which include copies of current registration or verification certificates for licensed practitioners. We provide updated data and other relevant information on request. 138 1- 44 1.r well,,°:.-�r,4.,,J. Qualifications Screening Solicitation Event ID: 005301 Jail Health Clinic Wellpath recruits and interviews candidates who are fully qualified and appropriately licensed, certified, or registered in Michigan. Our recruiters pre-screen candidates by phone or in -person to confirm they have the necessary technical skills and knowledge for the position. Wellpath performs primary source verification of credentials and licensure concurrently during the interviewing and screening process. We select the best candidates based on qualifications and credentials, experience, references, interview results, and other information. Using competency -based behavioral interview questions and partnering with our clinical and operational specialists enables us to make informed hiring decisions. In addition to the background screening process described in Section 3.1.2, Wellpath recruiters screen potential nursing and medical staff with questions regarding previous corrections experience and general clinical experience. Our recruiters work closely with the HSA, Ms. Warren, or other site leaders to develop interview strategies and value -based questions that best meet the site's specific needs. Examples of corrections -specific questions include: Is there anything in your background that would prevent you from working in a secure environment? Do you have previous experience in correctional medicine? Why are you interested in this line of work versus pursuing opportunities in another healthcare setting? Eligibility criteria are reviewed against the position -specific job description, which includes training and certification requirements. Based on the results of the screening, candidates either move forward to the interview stage or are removed from consideration. As part of the interview process, Wellpath requires that screened applicants visit the facility before we make a formal employment decision. Wellpath uses competency -based position profiles and corresponding behavior -based interview guides. Our processes ensure the OCSO Correctional Facilities have an adequate number and complement of licensed, certified, and/or professionally trained health services staff. At this time, Wellpath does not use a specialized testing tool to assure qualifications of potential employees; however, our Human Resources Department is currently exploring this option. i , r Wellpath will continue to cooperate fully with any investigation conducted by the OCSO. We provide the name, date of birth, local address, social security number, and copy of the driver's license for all employment applicants. Wellpath also conducts a background investigation as a part of the application process. All proposed Wellpath staff, including any subcontractors, are subject to a criminal records check, fingerprinting, and a forensic panel drug screen before employment. All screened applicants must visit the facility before a formal decision of employment. 139 Solicitation Event ID: 005301 Jail Health Clinic Wellpath's HSA Vicki -Lyn Warren, BSN, RN, CCHP has provided nursing services for the OCSO Correctional Facilities since 1994 and has served as HSA since January 2015. Ms. Warren is the designated Responsible Health Authority for the OCSO Correctional Facilities. She manages the healthcare program based on defined goals, objectives, policies, and procedures, delivering healthcare according to the contract and ensuring all services meet state and local regulations, as well as NCCHC and ACA standards. Ms. Warren oversees the administrative requirements of the medical program, including recruitment, staffing, contracts, data gathering and review, monthly reports as required, medical record -keeping, and other contract services management. Ms. Warren also provides administrative supervision for the site Medical Director and all other medical staff by performing the following essential functions: Monitor the implementation and effectiveness of procedures and programs Evaluate financial/statistical data and program needs/problems and recommend improvements Develop, use, revise, interpret, and ensure compliance with Wellpath and facility policies and procedures Monitor subcontracted services, including pharmacy, laboratory, X-ray, and specialty providers Maintain communication and a good working relationship with facility administration, correctional staff, Wellpath employees, contracted providers, and outside agencies As HSA, Ms. Warren is the single point of accountability in all matters related to the healthcare program and has the authority and responsibility to resolve problems and ensure your continued satisfaction. She coordinates contract requirements with facility administrators and resolves service performance issues. grin i' i i, Wellpath personnel comply with current and future state, federal, and local laws, regulations, court orders, administrative regulations, administrative directives, and the policies and procedures of the OCSO Correctional Facilities. 3.1.5 BLS -CPR Training Wellpath health care personnel are trained and certified in Basic Life Support -Cardiopulmonary Resuscitation (BLS -CPR) with re -certification as required. Wellpath provides appropriate orientation and training for all OCSO Correctional Facilities healthcare personnel. The lives and health of our patients depend on the knowledge, practical skills, and competencies of the professionals who care for them. We begin with the identification, validation, and recruitment of the very best people, then we orient them to our company culture and operations through an established onboarding process. We also train OCSO correctional staff in medical issues as requested. 140 Solicitation Event ID: 005301 Jail Health Clinic Wellpath has in place an orientation program for all Correctional Facilities healthcare staff. This includes comprehensive orientation curricula, schedules, appropriate forms, tracking and recordkeeping, and required documentation to support evidence of orientation of personnel. Each new employee has online access to the Wellpath New Employee Orientation (NEO) Curriculum, which outlines required onboarding steps for all healthcare staff, as well as additional required onboarding steps for specific positions. We have provided a sample NEO curriculum in Tabbed Attachment H. Please note that this information is confidential and proprietary. Wellpath provides a comprehensive three-phase training program for new employees. New staff members complete the Wellpath onboarding process and then receive ongoing skills/knowledge assessment through our Performance Enhancement and Leadership Development programs. All new employees participate in each of the three phases. The frequency and focus of each training phase are determined by the position and learning capacity of individual employees. Phase 1: Onboarding Critical to the success of each new employee is his or her initial experience with the organization. To ensure a smooth transition, we offer a three-part onboarding process: orientation, on-the-job training, and follow-up. Virtual onboarding is available to all Wellpath nursing staff. Available weekly, modules are completed in the first 30 days of employment. This Zoom training is led by a Regional Director of Nursing (RDON) and allows for extension to on -site orientation shadowing. In addition to specific training topics, RDONs hold office hour calls each week that are open to any nurse. Wellpath advises new employees to join at least one call during their first three months. The primary goal of virtual onboarding (which does not replace required training for new employees) is to promote consistency, connections, and confidence. New Wellpath nurses are introduced to correctional nursing and common workflows. They also review nursing assessment skills using Wellpath's Professional Nursing Protocols. Onboarding Step 1: Orientation Each new hire participates in an eight -hour learning experience, where they are introduced to our company culture and our policies and procedures. Physicians have additional requirements. The program establishes clear expectations and involves new employees in the success of the company. in Cabbed Attachment 1, we have j31G;sided a link to a Weicorr>E: tO ij'f,!Ipath t idcO U.Sed dUring ne w employee orientation. Please note that this video is confidential and proprietary. Onboarding Step 2: On -the -Job Training (OJT) On-the-job training is guided by standards, detailed checklists, and a qualified preceptor. While there are time schedules with expected milestones, the preceptors work with the new employees to ensure appropriate knowledge transfer. This step is not considered complete until the new employee feels capable of performing the job. 141 Solicitation Event ID: 005301 Jail Health Clinic Qnboarding Step 3: Follow-up During this last step of the onboarding process, the new employee can provide feedback about his or her experience with the HSA. The HSA also shares information about his or her leadership style and performance expectations. Phase 2: Performance Enhancement Performance enhancement training includes skills labs and webinars. Medical personnel participate in scheduled online training and in-service learning opportunities, such as "lunch and learn" sessions. We also offer webinars with a variety of Subject Matter Experts (SMEs) to staff members as applicable for their roles. Phase 3: Leadership Development Leadership development training invests in the continued growth of our employees to develop leaders from within. Each training session varies in delivery and duration and is designed to strengthen the leadership competencies of our employees. Leadership development training is a collaborative effort between Wellpath's Home Office and our leaders at the OCSO Correctional Facilities. Daily Agenda Wellpath Leadership Transition Academy Wellpath's Leadership Transition Academy (LTA), held at our Home Office in Nashville, is a multi - day leadership development program for personnel in key leadership positions, such as the HSA, DON, and Regional Medical Director. The LTA program focuses on functional and behavioral competency development and offers attendees the chance to connect, learn, share, and collaborate on critical business issues. Ms. Warren attended the LTA program in 2013. New Practitioner Orientation GOAL Begin yoar joamay as a lea4e,,A Wellpath A9r1 toMMVNggi4 _ - _ , OdiE 1.4fF :GYIt tH51CN :r: )lAi'C x4•I'in^'t+LPadnS.rP ltAlr:rrnMS-+19P tram re. 9'i:.m -/"Sr ��- V..e�x+n � i+e+uiin�.+f!'x\'Pa+3 exa:i Wa.vosianJ_oslr{ivN. • •:l: S„u'+(i i.[r, t� r,rnP flrv^Veor.n l,r.vrrd- r, arn�•.:!-a�irrRlp,+ rt/ES/=VtC i.4�m ,Va{'tN.n fla¢fvalwvou - StP,p+n New Wellpath physicians and mid -level practitioners undergo a structured newe practitioner orientation process focused on = critical thinking and clinical decision -making in the correctional environment. The Wellpath Chief Clinical Officer or a designee presents the training. New practitioners receive an orientation manual that also serves as a reference tool for information related to their daily work in corrections. Over the first 12 months of their employment with Wellpath, practitioners work with their assigned coach/mentor to ensure a thorough onboarding and to provide the resources for their clinical work in correctional healthcare. At the end of the first 120 days of employment, practitioners participate in a focused clinical review, and at the end of their first year, they participate in a peer review with their mentor or the Regional Medical Director, Dr. Rayford. 142 .i ggpp ggyy 4: New Practitioner Clinical Orientation Completion Checkbst Practitioner initials Mentor Initials Date ❑ 7 Minutes to Save (PPT & Mentor) Alcohol & 6enzodiazepine Withdrawal Solicitation Event ID: 005301 Jail Health Clinic Suicide Risk R. -' r..m @vl _c4tidhir�5riegtadu(t, <. :. c0a5enr$ 2ef1I5 -lNc1 to of Welipat -i Up to Date •mnwRprc 011 aol,M esla yQj Pe Tollslo, Ron WRM1aratral lvlaen&Menton ] Minutes to 5arejppi6 Menia(j A1wko168en io0i:ied,p t4Ylnuar'. al Dpla`e tth Nalan'sI E 8�,ntleaAflea.rtan Q.. rurs a EflMn a 3 (nmm�l a,N Aei orals airn NAnendee[enr, ,III HepexeaseloHHl wmlaol wellpaW(IT nr npsn omeM. renahons 111.o none,a yMemorn x=.r¢marP rra<eaam wh slini[al Cnnaltleeaxans (urA[(o minndaalon Neetla RehaimramerM..IT.'laanerj p ,1"eo aigcA, ill,' a lions bt, eoal"To, P',."loner) Meinarall(IleTltl—'. MPnrorj Mel+lorlalljAa[[M1len erR Menl urn pvletl. rnMA LborHc (ar a IPea[tl(bnern PhlNsgrM1Yn He Galevanaes t#IIOe[ate lndl ((ermie co,. Pafkntin., WONPmMR haallor, A¢ommoaatlon;in[Iuifin, .so,, Phemlary )Mtn Hers [n Sdve(Pro, area LR Is4haad,ri PI`mnyn Seauxary�urve}' iah Vte el4nrt'e no to pate M1earinar.ma Cheat Pan .a rar o'.sema'N.'xx) In (eatluus 0lsea ae.MR�A metlti[IAh, A.elvanlsmpa nummlanam xlgUllghls el tare GUltlelmes:ASHlma, ;Nypealrmbr{N4urev rI`i NIV A,ni m,gnblmn io" enlnnnlR W"Inio,, .sdo'165 ngeslnP.lWoyw` Will, "I mi6.1.1l aWt[nLl loos.11 isystlon UMalary Mannor Mn,ltor [alljPraaAlinnPr6 Mentnrj .sae ..sn.1 Snmatrl llao tloels Lon,Paxslon 1.011ate sa rasa To.(In,, ssse,p nnP,eav,ammsa,�e • nnatnry0154ress S ryF'I^FSa eSom[sl m.n [mm�an Cause of AFeu•nnal can trNgra Delta br wman[ Pr amannea rotrxRev;Pw_ana can xeleaeelAetl,< nvillaLle xew,111, naese NeWorFm6 Wellpath practitioners receive ongoing training and clinical decision support from our Clinical Department. Clinical leadership and Regional Medical Directors mentor and coach our on -site providers. Regional Medical Directors are available to our medical staff for knowledge -sharing and clinical decision support. The Wellpath Clinical Department conducts webinar events to train practitioners on timely and relevant correctional healthcare issues. Administrative/Support Personnel Orientation The Operations Support Team provides in -person training for administrative personnel at the site level and quarterly training at our Nashville Home Office. The team also provides daily remote operational support and assistance by phone and email. Wellpath offers a quarterly three-day Administrative Assistant (AA) training program that provides in- depth information on all departmental processes and procedures necessary for the AA to succeed. The program is held at our Home Office, where representatives from each Home Office department can explain their processes. This allows administrative staff to receive information directly from and establish a valuable relationship with all departments. Wellpath also conducts a monthly administrative conference call for all HSAs and AAs covering topics such as human resources, workers' comp, payroll, ERMA, and more. Attendees have an opportunity to ask questions or discuss challenges, and to offer information regarding best practices during this call. 143 Solicitation Event ID:005301 Jail Health Clinic ,t well}'• , Ad nuu,tr.-:uve , . �,. ,• rw: .- wel¢si'^ AA:niii.tr.:�ive rmrouaa - Director of Nursing (DON) Orientation All new Wellpath Directors of Nursing (DONS) undergo a three-day onboarding session that provides hands-on skills training and advanced correctional nursing instruction. This intensive educational event, which is held quarterly at our Nashville Home Office, equips DONS with additional skills and resources they can take back to their sites and their staff. #' t Wellpath offers ongoing professional development and training opportunities and will continue to work with the OCSO to ensure on -site personnel receive corrections -specific training opportunities. We offer both in-house and community opportunities for continuing education programs specific to correctional healthcare. By encouraging our employees to take advantage of these opportunities, we are building a strong, professional staff equipped to meet your diverse needs. While employees are ultimately responsible for their development, we provide Wellpath team members the proper tools to build on their knowledge and further their success. We maintain a Continuing Nurse Education (CNE) provider license that allows us to offer continuing education credits to nursing personnel as an employee benefit. Employees can complete a variety of CNE modules focused on topics commonly seen in the corrections environment. Mfellpath's iaursf, if, i.;ducailon Unit is accredited as a l:novider of nursing c€aneinuing pro,essicnal development by the Anv-riean Nurses Ciedentia'fing Ceme:`<Comn-Ossion on Accreditatiom 0 Wellpath Academy Learning Center Wellpath has partnered with Skillsoft for our Wellpath Academy Learning ` Lri-w e I I P a. Center, which we use to deliver, track, and manage training content, including p,piv r; 144 _: '11 welte { Solicitation Event ID: 005301 Jail Health Clinic E-learning courses, classroom courses, other learning events, certifications and licenses, and more. When our OCSO Correctional Facilities employees sign in to Wellpath Academy, they see assigned training courses with due dates. When new training is added to an individual's To -Do list, they receive an email notifying them of the new required training and the due date for completion. Mandatory courses for all Wellpath employees include HIPAA, sexual harassment, bloodborne pathogens, and hazard communication. We can add site -specific courses to the learning center. Once employees have completed their assigned courses, they can complete elective courses for further professional development. They can add courses completed outside of Wellpath to their transcript. Employees can also add information regarding certifications, licenses, resuscitation cards, and more to their profile. ,$ wei6 :e J0'I Wellpath maintains a video library and other reference materials that our team at the OCSO Correctional Facilities uses to build site -specific training programs. The Wellpath Organizational Development Department also offers self -study continuing education and training programs, which can be tailored to meet the specific needs of the OCSO Correctional Facilities. The self -study programs are available electronically and the organizational development team is available for assistance as needed. The self -study training programs build on the foundation established during the orientation process and meet professional and legal standards. For example, Wellpath ensures that all staff members are trained on PREA standards by providing education, testing their knowledge, and providing certification based on demonstrated competency. Suicide Prevention training is CLINICALTRAINING REQUEST �.,.nwn o.mmmnro<e im ga aurNen,I 1IAIr —IM9 rn•II nrr/rw _ eT.1 tmh. ..ra.,n••, r. rr,ru.,rne rr«<x o-...r,e--r.....,...� Frym,<emWhr,.�nrn. m.n,.e<,.nw anrrrmrttnrrArnnemQA,n.ry,r.,nrinm,m ,nFlrt 1/-:h.{ LS�Is ICr=net J'J ti�rl�/xh'n r<L1'<If-<n.{I1=L,W ar.1aA,'` <i 145 ,-!1e11." 4 Solicitation Event ID: 005301 Jail Health Clinic mandatory for Wellpath new employees during orientation and is required twice annually for all Wellpath employees and subcontractors. Ms. Warren ensures healthcare personnel receive regular training on topics specific to the OCSO Correctional Facilities. Wellpath identifies new topics regularly through our continuous quality improvement (CQI) program. Additional training may be requested through a clinical training request submitted to Mark Morrissey, the Regional Director of Operations. Ms. Warren maintains documentation of completed training in an individualized training record for each employee. 7 Minutes to Save Wellpath is mindful of the need to provide timely guidance and education to both healthcare and correctional staff at the facilities. We developed our 7 Minutes to Save campaign to present topics vital to the management of urgent and emergent issues encountered within a correctional setting, In short, Cra;+-' 'Cf•s iFl; elt<. CFi)lt,aMirfg ,e_r Sifl ES. 7Minutes to Save is a Rapid Response Series designed to standardize our approach to trauma evaluation. The program addresses many topics, including suicide prevention, pregnancy, trauma, and optimized care for OCSO Correctional Facilities patients experiencing alcohol and drug withdrawal. Training topics for healthcare staff include: Alcohol & benzodiazepine withdrawal Altered mental status Chest pain Choking Head trauma Opioid overdose Opioid withdrawal Primary & secondary trauma survey Respiratory distress Seizures Serious abdominal pain Suicide risk reduction Triaging the surgical abdomen Use of force -.,. MINUTES TO SAVE CAMPAIGN The Wellpath Clinical Department has also developed a 7 Minutes to Save rapid response series focused on patient care. The goal of the Patient Care Series is to equip clinicians with up- to-date information to guide their recommendations for diagnostic and therapeutic interventions. The training series emphasizes intentional concern for patient needs based on the STEEEP principle, which dictates that patient care should be Safe, Timely, Effective, Efficient, Equitable, and Patient -Centered: 146 gg 1:r• i :.'r.:'..f t Solicitation Event ID: 005301 Jail Health Clinic ^zafe-- Avoids injuries to patients from the care that is intended to help them i irewl;r.- Reduces waits and delays for both those who receive care and those who give care Hfc>rflvz- -- Based on scientific knowledge, extended to all likely to benefit, while avoiding underuse and overuse Avoids waste, including waste of equipment, supplies, ideas, and energy c,i-i?aEr?Er -- Provides consistent quality, without regard to personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status o-^o4ie 'cera;yrcd 'Respects and responds to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decisions Specialized Nurse Education The Wellpath Nursing Services Department promotes correctional nursing care focused on patients, formed in a collaborative and supportive environment, and grounded in evidence - based competencies and practice. This department is leading the charge in making Wellpath the leader in healthcare delivery through excellence in nursing practice. Nursing services' primary focus is the development and delivery of nursing education through an assortment of training initiatives, including Continuing Nurse Education (CNE), independent/self-study, in -person clinical education, distance education (webinars, conference calls, etc.), and corrections - specific video training. In addition to our cutting -edge training programs, we have developed educational materials that are placed conspicuously in the jail to remind nurses of basic protocols, like SEAR. communication (Situation, Background, Applicable nursing data, Request/Recommendation). Regional Directors of Nursing hold virtual office hours twice a week so DONS and other nurses can call and ask questions related to nursing practice, training questions, or resource needs. Additionally, our Vice President of Nursing Initiatives, Karina Purcell, RN, holds virtual office hours twice a week for our nurse leaders. Core Competency Training and Evaluation � 5 { SITUATION .:............... BAC{GFOUND Prc n3iir^: ; n i:-a; APPLICA13LE 14URSING DATA •,i,r :. acnrei Coca.cc.. _....... .. REQU£sT1RECOMMENDATION Wellpath offers regular training opportunities for OCSO Correctional Facilities nurses to keep their skills sharp on the latest clinical developments. The Wellpath Nursing Services Department distributes an annual clinical training calendar with monthly training assignments focused on a variety of core knowledge topics, such as patient evaluation, emergency response, suicide prevention, and withdrawal management. Each monthly training assignment includes a Clinical Skill Competency (CSC) component designed to provide technique refreshers and verification of clinical skills. The Clinical Skill Competency modules are part of the Clinical Skill Competency Evaluation Manual developed by the Wellpath Nursing Services Department to ensure our nurses are well equipped to care for our patients. 147 Solicitation Event ID: 005301 Jail Health Clinic The purpose of the Clinical Skill Competency Evaluation Manual is to identify competent clinical practice, areas requiring additional training, and opportunities to improve skill sets through practice and re- evaluation. The manual presents nursing professionals with a variety of scenarios to assess their clinical competency and decision -making ability. Wellpath nurses must demonstrate the clinical skill covered in each CSC module to pass their evaluation. Nurses are trained and evaluated on clinical skills essential for the effective and efficient delivery of healthcare in the correctional environment, including but not limited to conducting intake screenings, health assessments, and sick call. CSC evaluations are developed by the Corporate Director of Nursing in collaboration with the Patient Safety Officer, based on current evidence and peer -reviewed nursing resources. The manual is reviewed and approved annually and updated as needed. 3.3.3 Health Training for Correctional Officers Wellpath will continue to train OCSO correctional staff in medical issues as requested by the OCSO. We routinely educate correctional staff on the importance of recognizing and responding to specific medical and mental health concerns. Wellpath provides resources for a presentation to each New Hire Correctional Academy giving an overview of the jail health clinic's role and responsibility within the corrections setting. Wellpath also provides an annual in-service training for Sheriff's staff to explain Wellpath's process for administering medication to inmates. Correctional staff play a vital role in healthcare delivery, especially since they are often the first to respond to problems. Wellpath offers training for correctional staff on responding to potential emergencies, handling life -threatening situations, and their responsibility for the early detection of illness and injury. Wellpath has developed a Health Training for Correctional Officers Manual that complies with the requirements of NCCHC Standard J-C-04. The manual is offered as a supplement to facility -provided education. It comprises 16 training modules addressing the essential information that correctional staff must understand when presented with potentially urgent or emergent situations. Each training module includes a topic -specific slideshow presentation, a curriculum outline for the presenter/trainer, and handouts for participants. Wellpath staff present training topics, which are based on our 7 Minutes to Save Rapid Response Series and are designed to be presented in an average of 7-15 minutes. Training topics for correctional staff include: Alcohol& benzodiazepine withdrawal Altered mental status Basic first aid Chest pain Diabetes Head trauma Health -associated infections o Heat -related illness Ingestions Diploid withdrawal Recognizing signs of mental illness Respiratory distress Rhabdomyolysis Seizures Serious medication reactions Suicide prevention 148 r$"-.iy.Yi.yss; i4r `... Patients it alrohollbenzodiczepme withd!awal may exhibit S,vu ea Nausea/vomiting Abdominal pmn Agitation Solicitation Event ID: 005301 Jail Health Clinic A.n*IetV11 je!yousness Tremojs Ha'tftj:jaionS(may see, heai, and/or Sweating feel things that aienG�.:`"ys"•is,��,-r{'y"::;.n- ,.�,....-_-r; ,::j: m-.c•rr ._,.:.. NLref mentel stag. �.t".FY"` �, ei; .. j.�t,jj;L iF &;�P'E�.,�.@;t.`al:,`.f::i...-ta::-<tayi If van susoect withdrawal; Having swzu: es • Having lemurs Having voimtlnq aadror Ojai, hea Ecpuwngnq ttaltucma!ions Vau should. Wily med!rai for urgnnl assistance • Do not leave metl¢al ilooe vnlh the patiert Prepo:e to act1vOe EMS zud do not leave the pah.nt nutit tney leave with 6MS Wellpath will continue to collaborate with the OCSO to develop additional training topics specific to the facilities, as needed. We schedule training sessions in coordination with the OCSO. Ms. Warren or her designee maintains documentation of completed training sessions. All positions in our staffing plan work within their scope of practice, directed by job descriptions that include qualifications and specific duties and responsibilities. Wellpath provides the OCSO with written job descriptions and protocols for all assignments at the Correctional Facilities. Employees are given a copy of their job description to review at the time of their employment and the job description is used for performance evaluations. All job descriptions meet the requirements of the Americans with Disabilities Act. Wellpath conducts employee evaluations using designated forms for full-time, part-time, and relief employees. Reviews are conducted three months from the date of active employment and annually thereafter according to hire date or date of contract renewal, depending on the specifications designated by the Home Office. Regular full-time and regular part-time employees are eligible for merit increases when they receive their annual performance evaluation. PRN/on-call employees are not eligible for merit increases at each review; however, the appropriateness of PRN rates is reviewed periodically, and PRN employees may receive a merit increase if written approval is received from the Home Office. The Wellpath performance evaluation process is conducted as follows: a Four weeks before evaluations are due, managers begin work to ensure timely completion and delivery. 149 Solicitation Event ID: 005301 Jail Health Clinic The evaluation should be objective and give specific examples for feedback in the comments section of the evaluation; it should also include detailed analysis on areas for improvement, tasks performed effectively, and goals. The evaluation should encompass the entire timeframe since the last evaluation; managers should avoid using only very recent performance as the criteria evaluated. The supervisor meets with the employee to review the evaluation; both supervisor and employee should sign and date the evaluation. A copy of the evaluation should be provided to the employee. Annual merit increases are provided based on the contract renewal date. The original evaluation and signed Employee Action Form must be submitted to Human Resources for processing and proper filing. Evaluations are completed promptly; late evaluations require a detailed written explanation as to why it is late; merit increases are retroactive, so employees are not penalized. If problems are identified in the evaluation, we conduct performance reviews more frequently and report any unsatisfactory performance to facility administrators. Wellpath reports problematic practices or behavior to facility administrators within one business day, with documentation of investigation within one week, or sooner if requested. Problematic practices or behavior might include misconduct or breaches of facility policies and procedures, fraternization with inmates, patient care errors, leaving posts uncovered without appropriate relief, unprofessional conduct as deemed by Wellpath and/or facility administration, and criminal activity. Wellpath staff report problems and/or unusual incidents to Ms. Warren or her designee and Correctional Facilities administration. Problematic practices or behavior might include misconduct or breaches of facility policies and procedures, fraternization with patients, patient care errors, leaving posts uncovered without appropriate relief, unprofessional conduct as deemed by Wellpath and/or facility administration, and any criminal activity. Identification of serious issues may require an HR investigation or in-depth peer review with improvement planning. If the outcomes of these initiatives are not satisfactory, we may work with the employee to find a more suitable position. We report concerns about the appropriateness of a medical or dental provider's clinical judgment to the Wellpath Chief Clinical Officer or Chief of Dentistry. Any concerns regarding mental health providers is reported to Easter Seals. This includes patient care complaints or observations made by other health services providers, correctional staff, or other non -medical providers. In some cases, these concerns are referred to the peer review panel for formal review. Wellpath management staff (e.g., Regional Director of Operations, HSA, Medical Director, and Director of Nursing) will continue to represent the health unit in discussions with local civic groups or visiting officials as mutually agreed upon by the contractor and Correctional Facility Administrator. Wellpath will continue to ensure that a provider is on -call 24 hours per day, seven days per week. We have in place an appropriate schedule for the utilization of staff and the effective delivery of services. 150 Solicitation Event ID: 005301 Jail Health Clinic Well path employees wear the appropriate uniform and identification badge as directed by the Correctional Facility when on -site at the Correctional Facility. We have provided in Section 4.5.7 a staffing plan that outlines how physicians, mid -level providers, nurses, dentist, dental assistants, administrative staff (HSA, DON, etc.), emergency medical technicians, and clerical staff will be used to provide the health care services. We have provided a list of positions, including the number of FTEs for each position, necessary to maintain the level of medical services needed at the Main Jail and East Annex locations. We have also provided the detailed contingency plan in place for loss of staffing addressing situations similar to the COVID-19 pandemic or other unforeseen circumstances that could potentially cause a loss of staff in both the short (a couple weeks) and long-term (potentially months to years). The following is our Staffing Plan During Facility -Wide High Call -Off Situations, in place for the OCSO Correctional Facilities. Our Pandemic Plan for the Correctional Facilities is included in Tabbed Attachment R. Please note this information is confidential and proprietary. Staffing Plan During Facility -Wide High Call -off Situations Instructions: 1) Enter the number ofstaff and position assignments in the left-hand column and then how the staffing assignment will be modrfiedfor each urcrease in percentage call off Focus on assignments and not licenses as you will not be able to predict which stuff will spenfimlly ,all off -but con focus on what assignment, hove priority to fill 2) Calculate the number of stuff who would toll off for each percentage an to 50'.b call off 3) Note on each column what roles a, pasftsm, will befilled regardless cifsmff hcense- focus an essenealiob roles —there.... way to predict who will/will not be calling off Mark uncoveredposrhons by turningfnit light grey. 4) Enter Mermpact afdecreasedcustodybasedan discussion with custody Assume onedarcoll-ffmtesfor both custody and medical. 5) Enter the Impact ufdecreased medicalstaffon services 6) Creoteanacdanplanforeachscenario. O%call.ff SOelp call off Zp%call off 3OY.ca11.ff 40'fficalio11 Sap call off (multiply base (multiple base staff (multiple base staff (multiply base staff (muhiply base staff Gaff.0.1) .021 x0.3) x0.41 xp.5) e.k.zd Staffing p Weekday Staffing All shifts WeekeM Day Shift Day Shift Day Shift Day Shift Day Shift. Day Shift Pel Shift PM Shift PM Shift PM Shdt PM Shift: PM Shift Nac Shift Noc Shift: Nor Shift N.c Shift Na, Shift Noc Shift. Additional p 511ft Da)> Day Shift Day Shift Day Shift Day Sl lift: Weekday PM Shift PM Shift, PM Shift: PM Shift PM Shift PM Shift Noc Shift Noc Shift Noc Shift; N«Shift Nor Shift Not Shift Impact be Curtody 1 Acton P6n Full Services 1 Madical5 hikes Fill Services Impact The United States is experiencing a nursing crisis, with the most acute supply -demand imbalance in generations. The aging of America has increased demand for nurses dramatically over the past decade, even as the nursing workforce has been aging along with the rest of the country (more than half of all nurses are over 50) and nursing schools aren't graduating enough nurses to meet rising demand 151 well Solicitation Event ID: 005301 Jail Health Clinic The Covid-19 pandemic has put a significant strain on nursing and custody staffing levels, as you are aware. The stress, anxiety, and exhaustion brought on by COVID has driven enough nurses out of the field to create the current crisis. We cannot know how long the current crisis will last, but we believe that the rapid rise in compensation is not sustainable and that wages will return below these crisis -driven wage rates. We do believe salary costs will remain above the compensation levels prior to COVID levels, representing a new normal requiring a permanent increase to our nursing compensation. We have a strategy to minimize the financial impact of these new, higher wage levels on our partners, however, nursing wages are significantly higher than they were 12 months ago nationally. This imbalance has driven nursing salaries (when they can be found) to record levels, as temporary agencies and nurse travel companies have bid up hourly rates, in some cases, more than $100 per hour. An August 21, 2021 New York Times article cites the danger of this widespread shortage, noting a health system that "has been losing experienced nurses to recruiters who offer $20,000 signing bonuses and $140-an-hour wages." Unfortunately, the pain of the shortage has not been shared equally. The 2020 CARES Act included a $178 billion Provider Relief Fund to help acute care hospitals manage increased costs during the pandemic. This enormous subsidy allowed hospitals to pay ever-increasing rates, while providers in correctional settings, who have received no CARES Act funding, are unable to compete. Fortunately, there are now federal funds available to help address this crisis. On May 10', the U.S. Department of the Treasury announced as part of the American Rescue Plan Act (ARPA) the launch of the Coronavirus State and Local Fiscal Recovery Program (SLFRP), to provide $350 billion in emergency funding for eligible state and local governments, including for Ozikland County. The approved uses of funding include providing "premium pay directly, or through grants to private employers" to a broad range of essential workers including correctional healthcare workers. This is notjust a compensation problem, so we are executing long-range plans to create resiliency against this type of challenge in the future. To help navigate in the near -term, however, we would like to discuss with the County the potential to use a very small portion of its $244 million SLFRP funding over the next 12 months to supplement nursing pay if required to attract and retain staff. For arty bonuses piovided throughGhe CARES Ad dollars, we will provide fuli dccumeni _+.ion of the distribution of these funds to our ttlnscS, and all distributions, will require that a recipient guff us a 12-month minlown eiytl:loyn'bem cornmitment. r Wellpath acknowledges its personnel are subject to the security regulations and procedures of the Correctional Facility. Wellpath personnel are also subject to removal from the facility at any time for security reasons as determined by the Correctional Facility Administrator or his designee. Wellpath has provided a detailed description of the policies and procedures used when transporting inmates outside of the Jail to access health care services in Tabbed Attachment J. Please note this information is confidential and proprietary. 152 _,L y Solicitation Event ID: 005301 Jail Health Clinic Wellpath has a national contract with Stericycle for thed Stericycle disposal of biohazardous and infectious waste at the OCSO " Correctional Facilities. Stericycle is a leader in the medical waste industry and specializes in biohazardous waste disposal. Through the services of Stericycle, Wellpath collects, stores, and removes infectious waste and sharps containers following state and federal regulations. Biohazardous waste disposal is governed by policy and procedure, and includes proper containment, housing, and disposal. Stericycle provides red biohazard bags for waste disposal and biohazard boxes for bundling and disposal. Wellpath controls the proper disposal of sharps using disposal containers. Wellpath has in place a pickup schedule approved by the OCSO. Pickup frequency is typically based on volume and storage space availability. Ms. Warren, the HSA, maintains pickup tracking forms on -site. We will follow standard precautions to minimize the risk of exposure to blood and body fluids of potentially infected patients. 153 eta.-t`::k;. ZContractor Requirements ,�.l Corporate Experience Solicitation Event ID: 005301 Jail Health Clinic Wellpath is the premier provider of localized, high -quality, compassionate care to vulnerable patients in challenging clinical environments. The Wellpath family of companies formed in October 2018 when affiliates of Correct Care Solutions, LLC (CCS) and Correctional Medical Group Companies, Inc. (CMGC) combined to form one company business. CCS (now known as Wellpath LLC) was founded in 2003 and has 18 years of experience administering correctional healthcare programs; CMGC was founded in 1983 and has 38 years of experience administering correctional healthcare programs. The combined resources and experience of these leading public health companies provide OCSO with the best and most cost-effective services available. Wellpath is specifically organized to provide comprehensive correctional healthcare services to facilities similar to the OCSO Correctional Facilities, where we have provided medical, dental, and pharmaceutical programs for individuals in custody since March 2012. During this time, we have demonstrated the necessary capabilities and resources that make us the most qualified and willing partner for OCSO. You will continue to receive the excellent level of service you have come to expect from us. Today, more than 15,000 Wellpath employees care for 330,000 Home Office' 1283 Murfreesboro Rd., Ste. 500 patients in 34 states, with more than 60,000,000 patient encounters Nashville, TN 37217 each year. The knowledge we gain from the patients we treat r. ;chfgan Regional Coflce throughout our client base leads to improved care at each site. Lansing, Michigan California Office San Diego, California Florida Office Deerfield Beach, Florida Pennsylvania Regional Office Lemoyne, Pennsylvania Maine Regional Office Augusta, Maine Arkansas Regional Office Pine Bluff, Arkansas Kentucky Regional Office Louisville, Kentucky Massachusetts Regional Office Foxboro, Massachusetts Georgia Regional Office Atlanta, Georgia *The Wellpath Name Office is responsible forsupporting this contract. Our Mission C)ur m=ssion is to provide quality care to every patient with Compassion, collaboration, and innovation. We are a true solutions provider in the healthcare industry and in the communities we serve. Our constant focus on patient care will continue to deliver innovative solutions to meet your program objectives and local, state, and national standards of care. 154 well!_-.- . >°+.°r viSi+:7"➢ ! :'i,it iY iP}#'Cti :t� a::l"EC"v^E'C by dcdivEi II'Sgg hope .1:ld he afiq,i cbroLq i; p,,r+li( hr: Ecit partrrcrshi s. Wellpath was born from the joining of two great companies that shared the importance of putting patients first and providing high -quality care to an often -overlooked population. We believe in transforming public health by delivering hope and healing to those who need it most. We treat our patients with dignity and compassion because we care about them as human beings. We are the right people, striving to do the right thing while creating healthier communities —one patient at a time. Solicitation Event ID: 005301 Jail Health Clinic "When you think about our patients, they tend to be the most underserved, and I think there is no greater calling than to work with and to care for those people who have historically been left out and received the least healthcare." Jorge Dominicis, Wellpath CEO Our Phil{<,,;ph# [ i., sirrlple: wlre €i5 en to our clien":si titre assess -(he sittdation and -we o i+er lar ezed Irtplemenl:ible *clltaSitsrs. Wellpath concentrates on establishing partnerships with county, state, and federal agencies experiencing challenges meeting their healthcare delivery needs in a fiscally responsible way. We focus on creating and maintaining successful partnerships with our clients and we create value in our partnerships through long-term cost savings and improved patient care. Our focus is best summarized by what we call The Five Ps: Patients, People, Partners, Processes, and Performance. Wellpath recruits and retains only the best personnel in the industry. We strive to hire individuals who possess the qualities that we value most in ourselves, our employees, and in others. These attributes are known by the Wellpath family as The Five Hs: Humility, Honesty, Hunger, Hard Work, and Humor. n PATIENT' We cu[nder pa[ienti naeds and ,Utcnmes FIRST in all v,e mats, �EOPU l Wavamet,nrpatrents paben[a'famflles, stab and all StaV.1,11,IV, jY wccu.r,h, Weer aLaclnerabtev a>con!ro<tPo nod pmv¢Ie our partram cnth the test>ermu:. PHCk:EsF( �� We believe that c<nslanl aahereace to beet practices lead: to sueeess(uI eutmmes. P�.r,Fctu�,Fry�t' i®-p WestrivemperrarmaUoveevpeataeonsinella,easot F" nvr bdzinesv ,<Well;;Yb / rfr,nd t.,rr A rmndee, that ensares we haver lose sight of uur rdcnti[y Intl avr Ioy.+ItY to thner wry arrv±and cppport. HONESTY V 6 mmmdnent ro ffre filghest l.vct of perscmal and Prateeeiondl1l}}inlegt ry e+i:4 our Purinmsand our oaPn,ts. ii DJIGLI", R desire tpr ail ps sonnet to lucr q teach and crew in a tram-urpnortrd envirnnmcrt. Ftfiy4 itiGRK z Ladamanlat wALngrees tq waK. Hamer antl sm,:genn the in:eroei of p,ovldin9 be!t s ser;¢e fo our par!rters and pa[lent5 Of;umctt? �. Nstressre4evetude anessentailtormaintenin, a woo. C 155i6hatC aLUIUdC and a SnPC'laY [I U.11ly PI t'tf at t4PYY. wellp th 155 Solicitation Event ID: 005301 Jail Health Clinic Wellpath provides a wide range of healthcare services and ancillary services for our clients, including: Wellpath will continue to maintain a mutually beneficial partnership with OCSO based on the continued communication that creates cost savings and helps you meet your program objectives. Hands-on Approach The Wellpath executive team is closely involved with the delivery of services for our clients. Continuous communication helps minimize surprises and ensures a mutual understanding of decisions and protocols. Employee Advocates "Wellpoth's professional, administrative and clinical skills come packaged' in a sincere, witty and caring manner, Our relationship continues as a direct result of Wellpoth's flexibility, humility and their committed reputation as an outstanding correctional healthcare provider." Thomas C. Havel, Warden San Juan County, NM Our employees are our most valued assets, and we equip them with the tools to succeed. We provide our site leaders with management training to foster the proper culture for working and succeeding in a challenging environment. To be the cc rnpany :hat clients warn to work with, vve most be the company that employees want to work,for. 156 well The Wellpath Healthcare Cloud Solicitation Event ID: 005301 Jail Health Clinic The Wellpath Healthcare Cloud is a revolutionary and proprietary telehealth platform specifically designed to provide patients specialized clinical expertise in the shortest amount of time possible. Available across the country in a variety of challenging environments, including jails, prisons, hospitals, and residential treatment facilities, the Wellpath Healthcare Cloud provides real-time emergent and specialty care through a technologically sophisticated telehealth platform. Superior Technology Our Electronic Record Management Application (ERMA), in place at the OCSO Correctional Facilities, is a web -based application designed to operate as part of the healthcare delivery system inside correctional facilities. Our advanced technology creates operational efficiencies by giving you the information you need to better manage patient care. ERMA includes electronic medication ordering and administration through its eRx and eMAR modules. Proven Success Managing Chronic Care Wellpath will continue to provide on -site services, including chronic care clinics, for OCSO. Our continued focus on the identification, referral, and treatment of patients with chronic conditions allows us to manage patient needs before they can escalate and require off -site consultation or result in grievances or litigation. Cost Containment Our objective is to uncover all areas of savings for our clients without sacrificing quality. Wellpath negotiates contracts for goods and services and seeks efficiencies in staffing, pharmacy, and off -site costs. Our national vendor contracts offer economies of scale that create savings we pass on to our clients. Because we provide healthcare for more than 330,000 patients nationwide, we have significant buying and negotiating power, which allows us to secure the best possible rates with on -site and off -site providers. Advanced Utilization Management The Wellpath Care Management system, in place at the OCSO Correctional Facilities, is a browser -based web application that allows us to track off -site care, ensure a timely return to the facility, manage claims, and provide reports to assist with cost containment and budget preparation. Our Care Management system functions alongside your Jail Management System (1MS) to create added clinical control and cost efficiencies for on -site and off -site medical, dental, and mental health activities. Community Connection A successful medical program has a positive community impact, and Wellpath's established relationships benefit Oakland County in many ways. We have partnered with local organizations to maximize continuity of care for each patient and work with local agencies to develop training programs for nursing students and new correctional staff. We work with local charities such as Oakland Family Services and the Oakland County Animal Shelter to identify opportunities that allow us 157 •i;well 4e .ti l Solicitation Event ID: 005301 Jail Health Clinic to give back to the community. Wellpath extends continuity of care by helping connect patients with community resources, which can help reduce recidivism. U0077,731TRATWIT, The Wellpath Executive Team has more than 400 years of combined correctional healthcare experience. We also have several former sheriffs and jail administrators in consulting roles with nearly 175 years of combined law enforcement experience. Our team works together and is fully engaged in the successful operation of programs and services at the OCSO Correctional Facilities. Wellpath's program for the OCSO will continue to meet or exceed community standards of care, as well as standards established by the National Commission on Correctional Health Care (NCCHC) and the Michigan Department of Corrections (MDOC). Wellpath will continue to ensure that the OCSO Correctional Facilities maintains full compliance with NCCHC and MDOC standards. We have extensive experience achieving and maintaining NCCHC accreditation and compliance with MDOC standards. We will continue to ensure that the OCSO medical program maintains NCCHC accreditation (next survey in 2022) and MDOC compliance for the duration of the contract. Our annual inspection record with the Michigan Department of Corrections (MDOC) can be summed up by its report comment on an audit of 50 inmate health records this month (September 2021): ` tt'Fa`Iprrih faros doae c,n a;;r.<'*frer jai: Eiwl EVr.,5; ,' ii*7 one 74 day herdth approis wd, Our accreditation history is welkdocumented: We-llpsah has neither failed to nbtain nor lost medica'=, r:c� �cr itaihJn at an'? of c:ur dient sites. We conduct mock accreditation surveys before an actual on -site audit and discuss our findings and recommendations with the on -site staff. Additionally, our internal quality improvement programs ensure the OCSO Correctional Facilities meets and maintains the applicable standards. Praise for Wellpath NCCHC Audit `I wanted to take the opportunity to let you know what a greatjob your HSA did in preparing for and handling the recent NCCHC audit! Both during my personal interview and during the exit interview, both of the auditors had nothing but the highest praise far your NSA and her staff and the medical services your company provides. While this facility has maintained that accreditation for over 30 years, we have never partnered with better company than yours. It takes me back to the day we interviewed you for the initial RFP and the pledge you made and you stood by ever since. Thank you." Jail Administrator at a Wellpath Client Site Client Accreditation Status Wellpath currently provides healthcare services for X98 fsci€ities accredited by the NCCHC and/or ACA, including the OCSO. The following table summarizes our current accreditation status. We have provided a detailed list of these accredited facilities in Tabbed Attachment K. Please note that this information is confidential and proprietary. 158 ll; ~h ,-_ .F i NCCHC, ACA & CALEA (Triple Crown) 25 NCCHC & ACA 15 NCCHC Only 44 ACA Only 114 TOTAL 198 Solicitation Event ID: 005301 Jail Health Clinic Wellpath has enjoyed unparalleled success in our accreditation experience. Many Wellpath sites have been found 100% compliant during their accreditation surveys. Furthermore, uve czurythe c.islior:aJc—n .S counting; 25 -, virde crrw,rn facilidc:: �,11Crlg our ciieEZts. The National Sheriffs' Association (NSA) presents its prestigious Triple Crown Award to correctional facilities that achieve accreditation by the NCCHC, ACA, and CALEA. According to the NSA, "Achieving these accreditations individually is a daunting task. Acquiring all three at the same time is an extraordinary feat. (01 The Triple Crown distinction is so rare, that since the establishment of the award in 1993, fewer than 100 sheriffs' offices have qualified." CALEA FOUNDED 1870 Wellpath manages Triple Crown facilities in: Alameda County, CA f. Alexandria. VA Arapahoe County, CO Augusta -Richmond County, GA Broward County, FL (5 Triple Crown facilities) Charleston County, SC Clark County, NV (2 Triple Crown facilities) DeKalb County, GA i Durham County, NC Elkhart County, IN r El Paso County, CO 1 Frederick County, MD Jefferson County, CO Lake County, IL Marion County, IN McHenry County, IL Monroe County, FL New Hanover County, NC e Orange County, NY Polk County, IA Shelby County, TN (2 Triple Crown facilities) Each year, the NCCHC presents its Program of the Year Award to one standout program among thousands of accredited jails, prisons, and juvenile facilities. Two Wellpath facilities have received this prestigious award. The long-term care program at the Columbia Regional Care Center in South Carolina, which is managed by our Recovery Solutions Division, was recognized in 2012 for the exceptional quality of care provided for seriously medically and mentally ill patients. We received the award again in 2017, when Wellpath's team at the Westchester County Correctional Facility in Valhalla, New York, had the vision to provide additional services to our mental health 159 Solicitation Event ID: 005301 Jail Health Clinic patients. Health Services Administrator Alexis GendelI, PsyD, and her Wellpath team at WCCF worked directly with the Westchester County Department of Correction and community providers to make this vision a reality. The resulting Community Oriented Re -Entry (CORE) Program was recognized by the NCCHC as its 2017 Program of the Year. The NCCHC also selects a Facility of the Year from among the nearly 500 accredited jails, prisons, and juvenile facilities. A Wellpath site was named Facility of the Year in 2012 when the NCCHC recognized the professional delivery of Wellpath-managed healthcare services at the Chittenden Regional Correctional Facility in Vermont. Unique Accreditation Perspective Wellpath has strong connections to the NCCHC and ACA. Charlene Donovan, Ph.D., RN, PMHNP-BC, Vice President of Behavioral Health for Corrections, was on the NCCHC committee that developed the Certified Correctional Health Professional -Mental Health (CCHP-MH) certification exam. Wellpath has a unique perspective on the accreditation process due to our employees' participation in the following NCCHC activities: Standards development Standards interpretation On -site accreditation surveys Training NCCHC lead surveyors Hosting and conducting Certified Correctional Health Professional (CCHP) exams to encourage advancement and professional certification of our employees We typically send more than 50 staff members to the annual NCCHC conference each year for training. Wellpath staff members regularly serve as presenters and educational session leaders at the conference. We host CCHP examinations regularly at our Home Office in Nashville, Tennessee, and at various locations throughout the country for the convenience of our employees taking the exam. 160 Solicitation Event ID: 005301 Jail Health Clinic Ashley Biller Dantella Hoskey, Summer La{1gov, Tophor Rarest, Deleca Aeynolds-Balles Kelly Kyded Elizabeth Samson Emma Whisner qr.. 1Q L:; : (all times listed are in Central Standard Time) • 1.30pm - 2:30pm Synthetic Cannabinoids Behind the Watts PUc 2G2t (all times listed are in Central Standard Time) 10 00am-11;00am. Effects of Social Determinants of Health en MedFation Compliance '��t..ur Kr.VPLif] iittn-L PilFl;l+,i--V4v'.-'r i'+irl+p t. �i:al'.aG� S-'vi:El 2:30pm - 3:30pm Transgender Inmates Charged With Sexual Offense Treatment Strategies D;initlb 1. ash ; t P'y ' - Toi.'t:e: 6:ve^:c, ''_;H<- eic.nai L_db".en::..i 4=nth'_on;ain, tot 2.30pnt - 3:30pm: Nonstuddal Self-Inmuty on Mental Health Watch: Innovative Approacb,s to Prevention EP; fo!�tt 5-rnen ';4HC, r-t:i 1P ` SS CPII', ,. .. :,1':1'1 no)c: t Ml;,w;1 r „- .'..rti'wyi 330pm - 4:30pm: Using Activity Tracking Devices to Better Monitor Patients With Chronic Care Needs Lrr C LPAi, is rR�M, •Wnr I H_Mth r..,1es.lo: e7 A nuzm Laoov.' L°, - 6h;m:d 1;:' 9tit uire<tat ,'Ly sd.. ,..__ e, sits ,'s ._= y3'K ".*n :eP-:a:,' ,, `In ,:.A1 �}�i WiV3s-r- ,.< x.: -m ... '- :;,, ti.F= 1 i '.,adv xF',a. `. ,dSRz ^'"'.:?.:z:sdFfsa3a.i>sa`ia: i� i ^sr,iine':a nM'.".t'?`.;rS „-'.:: Wellpath is also proud to include ACA Past President Daron Hall (Sheriff for Davidson County, Tennessee, and former NSA president) among our clients. ACA Past President Endorses Wellpath 'As advertised, your organization has been extremely responsive to our needs and the proactive manner in which you operate is in stark contrast to our previous provider... While I hove been extremely impressed with [your] responsiveness, 1 have been even more impressed with the level of excitement and enthusiasm which has been instilled in your line staff. This is refreshing! It gives me great comfort to know that your staff respects your organization and its commitment to quality." Sheriff Daron Hall, ACA Past President Davidson County, TN ..-...Kt". .. _.- m. 161 7��' •_ � � Solicitation Event ID: 005301 Jail Health Clinic Wellpath encourages our medical professionals to obtain certification through the vo aecnay NCCHC and ACA. Becoming a Certified Correctional Health Professional (CCHP) o vy through the NCCHC and a Certified Correctional Nurse Manager (CCN-M) through the U ccHp ACA offer immeasurable benefits. These certifications are steps toward increased goFrs `asp knowledge, greater professional recognition, and identification as a leader in the complex and ever -changing field of correctional healthcare. Health professionals working in correctional settings face unique challenges, including working within strict security regulations, dealing with crowded facilities, and understanding the complex legal and public health considerations of providing care to incarcerated populations. Achieving professional certification ensures the skills to meet these challenges. Wellpath reimburses testing fees for employees receiving certification. We have provided detailed information regarding our proven recruitment and retention capabilities, licensing requirements, and background investigations in Section 3. Medical Clinical Staff Management as required by the REP. We have provided our proposed staffing plan in Section 3.7 Staffing. Wellpath will continue to provide a full range of professional management services to support the OCSO medical program. We have established policies and procedures to ensure the continued quality of our medical programs, and we are dedicated to maintaining a high quality of care for our clients and the patients we serve. The Wellpath program for the OCSO is supported by the Wellpath Home Office in Nashville, Tennessee and our Regional Management Team. Wellpath is a "hands on" provider and a member of our Regional Management Team and/or Home Office Team will continue to be on site at least once a month to evaluate the medical processes and meet with OCSO administration. This is our corporate pledge to the OCSO as your medical provider. Regional Management Strengthening communication and operational workflows in the Wellpath program is our Regional Management Team, containing individuals who are familiarwith State of Michigan requirements and the operations at the Correctional Facilities. These team members will continue to be readily available to the OCSO. The Wellpath leadership team for the OCSO includes: fl Regional Vice President: Stan Wofford, MBA, CCHP Regional Director of Operations: Mark Morrissey, MSN, RN, CCHP Regional Medical Director: Cleveland Rayford, MD 162 Solicitation Event ID:005301 Jail Health Clinic Regional Director of Nursing: Mary Ann Wollett, BSN, RN Vice President of Partner Services: Kelly Pribble, RN, CCHP, MSN, VIOL Director of Partner Services: Renee Negri, CCHP Stan Wofford, MBA, CCHP — Senior Regional Vice President Mr. Wofford provides guidance and management to regional leaders in the Midwest as Senior Regional Vice President. He is responsible for supervisory training, quality improvement, risk minimization, and accreditation compliance. Mr. Wofford oversees the development and implementation of health systems; accreditation preparation, including the American Correctional Association, National Commission on Correctional Health Care, and various state audits/accreditations; troubleshooting; client retention; and staffing issues resolution. He also acts as a site liaison for Home Office staff. Mr. Wofford joined Wellpath (formerly CCS) in 2007 as a Health Services Administrator and, through hard work and dedication, worked his way up to his current position. He earned his bachelor's degree in healthcare management from Southern Illinois University and his MBA from North Central University in Arizona. Mark Morrissey, MSN, RN, CCHP — Regional Director of Operations Mark Morrissey has more than 20 years of experience in various aspects of nursing, ., including leadership roles with Wellpath since 2012. He has served in leadership # roles including health services administrator and more recently as regional operations director for Michigan and Indiana. He is a hands-on leader and a strong proponent of NCCHC, ACA, and state and local standards. He recently was credentialed by the NCCHC as a Certified Correctional Healthcare Professional (CCHP). Mr. Morrissey earned his master's degree in nursing and health services management and a BSN from the University of Detroit Mercy. His nursing career began on an interventional cardiac unit in a hospital in Pontiac, Michigan. After two years, he transitioned to a career in correctional healthcare and has provided care in Michigan ever since. He is a resident of Edwardsburg, Michigan. Cleveland Rayford, MD — Regional Medical Director Y.Me Dr. Rayford has been in practice for 27 years, with most of his time spent in correctional medicine. He has extensive experience serving in a Medical Director capacity for several entities, including the Arkansas Department of Correction, where he supervised a site medical unit, providing clinical care for the most (� seriously ill patients and monitoring all inpatients in the ARDOC system. In his current role as Regional Medical Director for Wellpath, Dr. Rayford is responsible for the clinical management and oversight of Wellpath sites in his region. He will supervise the Wellpath site Medical Director and provide utilization management of services provided on site or referred outside the facility. Dr. Rayford received both his Bachelor of Science in biology and his medical degree from the University of Arkansas. He was recognized as the 2019 Wellpath Clinician of the Year. 163 Solicitation Event ID: 005301 Jail Health Clinic Mary Ann Wallet, RN, RSN — Regional Director of Nursing Ms. Wollet has 34 years of nursing experience, with 24 of those years focused on correctional healthcare. She is responsible for the professional development and training of site leaders and staff in her region. Ms. Wallet previously served as a health services administrator and a district administrator with oversight for multiple state prisons. She has hands-on experience with both NCCHC and ACA accreditation audits. Ms. Wollet earned her Bachelor of Science in Nursing degree from Kent State University in Kent, Ohio. Kelly Pribble, RN, CCHP, MSM, MOL — Vice President of Partner Services Ms. Pribble is responsible for the retention of current local government contracts, including overseeing the re -bid process and associated contract amendments. She also manages the Partner Services team while working closely with all Home Office departments and local government operations leaders. Ms. Pribble joined Wellpath in 2012 as the HSA in Weld County, Colorado. Since then, she has been a regional manager, an operations specialist for the business development team, and most recently the director of partnership operations. Kelly's clinical and operational experience have contributed to her success as she has continued to accept positions of greater responsibility within Wellpath. She is an RN, has a BS in business and accounting. In 2018, Ms. Pribble received an MS degree in management and another in organizational leadership from Colorado State University. Ms. Pribble holds a compact RN license and has been CCHP certified since 2013. Renee Negri, CCHP— Director of Partner Services Ms. Negri joined Wellpath in August 2019 as director of partnership development and engagement for our state and federal division. For more than a decade, Ms. Negri has successfully strategized and secured local, state, and privatized healthcare partnerships across ten states. Her experience includes serving privatized correctional facilities and private correctional healthcare companies in development, engagement, partner services, and operations. In 2021, Ms. Negri joined Partner Services to ensure communication between facility administration and the Wellpath Home Office and working closely with our regional management team to support compliance with all appropriate points of service. She will be fully accessible as a client liaison for the duration of the contract. Her background also includes sub -acute nursing care and personal care home administration. Ms. Negri earned a Bachelor of Science degree in business administration from the California University of Pennsylvania. She will be fully accessible as a client liaison for the duration of the contract. Wellpath seeks to provide the best on -site care possible while being fully accountable to the OCSO. We expect to be measured by our performance, including reduced medical grievances; accountability as evidenced by operational and financial reporting; reduced staff turnover; and fewer off -site referrals. 164 Solicitation Event ID: 005301 Jail Health Clinic These are our goals and we will continue to share the details of our performance by providing regular operational and financial reports on these criteria. ty;aAcFdly irhvlder; n`ta,e r_;Irdcal yid t*i,err¢ :osivt re,lao in sham any G.,ther comp atty in U-te Indus«rv. We will continue to provide a full set of operational reports customized to meet your specific needs. We deliver detailed monthly statistical reports for your review and can provide daily operational reports upon request to continually review the effectiveness of our program and improve overall program quality and efficiencies. "The record keeping by Wellpath staff has always been complete and thorough and 1� responses to questions or concerns are always quick and efficient. The reports generated by their electronic records system (ERMA) are specific to our needs and are highly useful and effective." Mark Rockovich, Director Luzerne (PA) County Wellpath maintains an extensive logging system for collecting data and statistics to analyze trends in the utilization of healthcare services. Demonstrating accountability through transparent reporting is a Wellpath core competency. In all medical operations, but especially 0 in the corrections environment, it is essential to keep detailed accurate records that are readily available and easily accessed. Wellpath's clinical and operational leadership teams use powerful business intelligence software, such as Tableau®, to ensure efficient delivery of services. Tableau tracks key indicators such as off -site referrals, ' ` + } inpatient/ER utilization, claim details, pharmacy utilization, labs, filled/vacant FTEs, and overtime. These tools allow us to identiiy trc=ud.a as + e a u they en'to�rge. As stewards of Oakland County, we will continue to be responsible and accountable for the success of your program at the Correctional Facilities. Daily Reports If desired by the OCSO, Wellpath can provide a daily narrative report covering the previous 24 hours (Saturday and Sunday reports may be submitted Monday morning). Daily reports outline important events of day and night shifts, such as: Transfers to off -site hospital emergency departments Communicable disease reporting Suicide data (i.e., attempts and precautions taken) Report of status of inmates in local hospitals Report of status of inmates in the infirmary Staffing roster changes Completed medical incident report copies Completed medical grievance report copies Receiving screenings performed Health assessment status report 165 Solicitation Event ID: 005301 Jail Health Clinic a a . Wellpath will continue to provide monthly statistical reports regarding the operation of the OCSO Correctional Facilities healthcare program, staffing fill rates to demonstrate compliance with the contracted staffing plan, and financial reports to aid the OCSO with future budgeting efforts. Monthly reports delineate the status of the healthcare program, including potential problems and suggested resolutions. We can also provide reports on monthly paid and projected costs, as well as monthly aggregate and projected aggregate costs. Wellpath submits a customized report package to Major Childs or his designee on a mutually agreed - upon day each month. Monthly reports reflect the previous month/term workload, with data such as: Patient requests for various services Patients seen at sick call Patients seen by a physician Patients seen by a dentist Patients seen by a psychiatrist Infirmary admissions, patient days, and average length of stay Off -site hospital and emergency room admissions and cost Medical specialty consultation referrals and cost Intake medical screenings 14-day history and physical examinations Diagnostic studies Report of third -party reimbursement, pursuit, and recovery Percentage of inmate population administered medication Inmates testing positive for TB, STDs, HIV, or HIV antibodies Inmate mortality Number of hours worked by entire medical staff and compliance with contract staffing levels Other data deemed appropriate by the OCSO We have provided samples of statistical reports that have been customized for the OCSO, in Tabbed Attachment Q. Please note that this information is confidential and proprietary. Quarterly Reports Wellpath will continue to provide a quarterly summary of health services utilization data to Major Childs. Quarterly reports include summaries related to progress toward agreed -upon objectives for the healthcare program and the status of personnel -related activities. Wellpath will provide an annual report based on the contract year, giving a comprehensive review of the monthly statistical and program reports and examining significant trends and issues. We submit the annual report to Major Childs no later than 60 days after the end of each contract year. Annual reports include utilization statistics and a narrative summary of our accomplishments for the year, as well as recommendations for desirable changes in medical procedures and/or protocols. 166 Solicitation Event ID:005301 Jail Health Clinic 4. ,.3 Wellpath Client Portal Wellpath continues to innovate and deploy meaningful correctional healthcare technology. One of our more recent innovations, the ehtJ lfttz',Lh Cl€`eerie :^rn ta,!, gives the OCSO near I {- rir,,v epriFflnjg on statistics related to the delivery of care, such as staffing hours provided and off -site treatments. Through ERMA, the OCSO will continue to have access to medical compliance statistics such as intakes, health assessments, and medication passes. The Client Portal is a secure digital gateway for shared communication and information accessed via a web browser, giving facility administrators confidential, secure online access to key information, such as: Current performance reporting Major contract deliverables, such as health services reports and other required data m Wellpath contact information The following screenshots illustrate the type of data the OCSO can easily access through our Client Portal. Client Portal — FTE Trending FTE Trending -TE i'.c ... rx lCantmcted rv...l6�eP.ma J I - t11rz[11 1-12119 li.t[Rets IirYents ilna t1R-, t, ,irate iv_t/luls 2toeol3 trzviv 11ra,_119 NI.-.Ofv II Ib:Oto il.-.Ylv ti_N 13 Ltentling o1' ETE Prctluctlbc tr t� ll lelel.. "I'll, -1.0% au .p i.. ri.• _cs i. ..v e [ee„v<do,+ ..=�n.pm. IeT algal. w I,a .�. t ,. ,.. ,-. ,., . a wellpatit 167 -IN- welt..-., Client Portal — Off -Site Dashboard Solicitation Event ID: 005301 Jail Health Clinic Off,itc, Dashboards welly! 16 1 Inpatients e, .1 Mnini,lit 5thialul" Ontpabort Appeartmerte in Next 7 pays on, 4 4 ER Ttips$InOanent Acern-er, Is' ------- — -- lt 51 Client Portal — Compliance Dashboard compliance Dashboard ;,- weik,:i:n 5--, ics, GcW, An^,, I.,n, ICI,',S X., 168