Marys Medicine

OPSO Bidders' Questions and Answers – Medical
1. Page 9 is blank in the RFP. Please confirm that this page was intentionally left blank. Answer: Page was intentionally left blank. 2. "In 2013, OPSO booked approximately 30,795 inmates." In paragraph one the RFP states the current ADP is 2,545. Please explain the drop in ADP from the current ADP of 2,545 and the bidding ADP of 2,000. Answer: We anticipate the ADP at the beginning of the contract period to be 2,000. 3. What is the estimated ADP by facility at TP5, TDC, and MDC? Answer: TP5 – 280; TDC – 430; MCD – 90; Phase II - 1200 4. Where are female inmates housed currently and where will they be housed after the opening of Phase II? Answer: Females are currently being housed at the TNT facility in P5 and P7. There is also a female tier in TP5 A2. (I believe they'll be housed in Phase II). 5. Is there a separate infirmary for females? Answer: Currently, there is no separate infirmary for females. There is no Infirmary for males or females. Females requiring closer monitoring are housed on the Psych/Medical unit on TP-5, where there is 24-hour nursing support. 6. How many Dental chairs are expected to be in Phase II Dental Operatory and in TP5? Answer: There will be one in Phase II Operatory; there is one in TP5. 7. Who currently provides the portable on-site radiology? How many x-rays have been performed in the past 12 months? Answer: XPress Ray, Inc. 3400 Division Street, Metairie, LA 70002; provided in the statistical information 8. Who is your current provides the portable laboratory services? Answer: Labcorp 9. Is Optometry provided on-site? If so, how many optometry exams in the past 12 Answer: Not currently provided on-site. OPSO Bidders' Questions and Answers – Medical
10. Stated in the RFP is ".sometime in the future the OPSO may also seek ACA accreditation…" Does the Parish have a time frame for initiating the request for ACA accreditation? 11. As noted on page 27, the program is NCCHC accredited. When was the last NCCHC audit? Please provide the most recent report and findings from the NCCHC audit. Answer: Included with answers 12. "…will obtain medical accreditation for each facility by the NCCHC…" Does the Parish have a time frame for initiating request for NCCHC accreditation? Answer: OPSO is NCCHC accredited. 13. Please provide a list of all medical and office equipment and its current condition? Note: This is listed as Exhibit B in the RFP but was not included in the file posted on the website. Answer: Included with answers 14. Who provides the onsite dialysis at the facility? What dialysis equipment is on-site? How many dialysis treatments have been administered in the last 12 months? (140 off-site visits for last 12 months) Answer: Dialysis is not provided on-site. It is provided off-site by several vendors including DaVita Fleur De Lis, DaVita Inc – Total Renal Care Inc, BMA of East New Orleans, and Uptown Dialysis Center in New Orleans. 15. What other specialty services are provided on-site (besides dialysis)? Who are the providers of service(s)? Answer: Currently on-site specialty services are limited 16. Referring to Infirmary coverage at all times. How many beds are in the infirmary? Is it male and female? In what building is the infirmary? How many infirmaries are there between the four facilities? Answer: Currently there are no infirmary beds. 17. There will be a $100 fine for intake screenings that exceeds the 5 hour limit. Will there be exceptions for events such as a sting or Mardi Gras when more than the OPSO Bidders' Questions and Answers – Medical
amount of routine intakes occur? Will the Health Services Administrator be notified when a sting is occurring in order to arrange additional staffing? 18. What services are not covered by Louisiana Department of Corrections' Correct Care Integrate Health? Answer: Routine OB visits HIV care, Optometry visits and non-emergent ED trips. 19. What hospitals, physicians, surgery centers are covered under Louisiana Department of Corrections' Correct Care Integrate Health? Answer: Interim LSU Hospital (Children), Lalli Kemp and Touro Infirmary (for non routine OB [Children]). 20. There appears to be some information missing between pages 42 and page 43. If so, please forward any missing information. If not, please confirm the blank space is intentional. 21. Page 46 Left Blank. Please confirm that this was intentional? There are 10 lines of information and 11 numbers. 22. Will Proposer be financially responsible for costs related to transplants? Answer: No (We've normally purchased post-transplant meds, like cellcept. But we've never participated in an acute transplant. But. what if court-ordered?) 23. Will Proposer be financially responsible for costs related to blood factor products? Answer: No (Hemophilia center provides us Factor IX when needed) 24. Will Proposer be financially responsible for costs related to experimental procedures? 25. Will Proposer be financially responsible for the cost of HIV medications? OPSO Bidders' Questions and Answers – Medical
26. Will Proposer be financially responsible for the cost of Hepatitis C medications? 27. What types of prosthetics have been issued in the past six (6) months? Please specifically list amount and type. Will the vendor be financially responsible for prosthetics? Answer: The vendor will be financially responsible for prosthetics (Don't have numbers, but very infrequent. We've provided AFO devices for foot drop, stockings and gel pads for artificial limbs, but not the limbs themselves) 28. Are medication passes conducted in the housing units, or is it provided in a common Answer: Medication passes are conducted in the housing units. 29. How many medication passes occur daily? Are there established hours during the day that medication pass is currently conducted? Answer: Up to qid. Times: 8, 12, 4, and 8pm 30. How long does it take to complete each medication pass? Answer: Medication pass takes approximately 90 minutes for every 25 DOT medications. 31. Does the Parish currently have a Methadone program? If so, how many patients have utilized this program in the last twelve (12) months? Answer: No there is no Methadone program, nor Suboxone. 32. Are Mental Health Services provided at the housing units or cell to cell? Answer: Acute mental health care is provided in the acute mental health unit. (Acute and step down housing areas) Follow-up chronic care is provided in the medical clinics of each building. (NOT cell-to-cell) OPSO Bidders' Questions and Answers – Medical
33. Are there any negative pressure cells? If so, how many? Answer: No, patients in need of this are transferred to ILH. 34. Are there any ICE, Federal, other Parish holds as part of the daily ADP provided in the RFP? If so, please provide the average number of each. Answer: During Calendar Year 2013, there were no federal detainee holds. Included with the answers is a report entitled "Average Daily Population by type". 35. Is there a Keep on Person (KOP) medication list? If so, please provide Answer: Yes, most of our formulary is KOP, exceptions include: psychotropic, barbiturates, HAART and as clinically appropriate KOP privileges are revoked (all meds for psych patients, youth offenders, comprehension/compliance issues) 36. What is the current length of hospital stay (9/2012 to 8/2013), broken down by Answer:???? Not tracked. 37. How much (in dollars) has the Parish spent in the last year on off-site care? Please break it down to: In-patient, ER, Office Visit, One-day Surgery, Dialysis, and X- Ray. 38. How many off-site events has the Parish had in the last two years? Please break down to: In-patient, ER, Office Visit, One-day Surgery, Dialysis, and X- Ray Answer: January 2012 through December 2013.  Office visits (specialty clinics at ILH) – 766  One-day surgery – 46  Dialysis – 280  X-ray – in-house (contracted)  ED – 1558  Admits - 226 39. Regarding the requirement to: List all contracts held by the Proposer which were not renewed and the reason for the non-renewal. Will the OPSO accept a specific time OPSO Bidders' Questions and Answers – Medical
frame (e.g., 5 years) to give parity to the responses from companies with wide variations in years of providing correctional health services? 40. The RFP states that after two (2) years the proposer will be responsible for storage costs of inactive medical records. Is there a medical records storage area in the Orleans Parish Sheriff's Office Complex to store inactive medical files? Answer: The Sheriff's Office currently uses Gallagher. 41. What does the local health department provide in the way of HIV testing (i.e., kits, staff to administer the test and lab testing / result reporting)? Is it the desire of the OPSO that the vendor provide this service under the new contract? Answer: HIV kits (OraQuick Advance Rapid Test). (Yes, provide the service, with assistance from OPH. They provide kits, and working on syphilis testing, and we send monthly reports) 42. The YTD Statistical Summary includes telemedicine. What types of telemedicine consults are currently being performed? Please provide a list of telemedicine equipment available for vendor use (type, model number). Answer: The telemedicine equipment belongs to LSU Hospitals and was placed in HOD in July of 2010. Besides the camera there is a headset and stethoscope. 43. Please provide a list of the medical supplies and inventory available for the new vendor at the start of the new contract. Is it the expectation that the new vendor start the contract with its own inventory? Answer: As the contract may not begin for several months, it is difficult to estimate inventory levels. Any inventory remaining will be available to the new vendor. 44. Will the OPSO leave in place an inventory of the current pharmacy meds for use during start-up? If so, will these medications be at no cost or charged to the vendor? OPSO Bidders' Questions and Answers – Medical
45. Can you provide any drawings of the medical areas in the new facility? Please describe the size, nature and scope of the new acute care infirmary in Phase II. What is the capacity in number of beds? Will this unit house both males and females? 46. Page 33, paragraph 11 discusses the use of KOP medications. Please provide us a current list of approved KOP medications. Answer: Attached (see previous answer, with exceptions) 47. Page 35, paragraph f discusses the staffing of a mental health step down unit and/or mental health crisis beds (that will be located in the newly renovated TDC). How many beds will be dedicated for each purpose and what is the anticipated census for each? What programmatic services are contemplated in each of these units? Where will females needing these services be housed? Answer: The programmatic services are to be determined by the vendor based on the consent judgment. 48. Page 45, paragraph 5.a states that after 2 years, inactive medical records will be, at the Proposer cost, properly stored so as to remain intact and accessible. Where are the medical records currently being stored? Will this storage facility be available for the use of the Proposer? Answer: On-site. No. 49. Page 47, Part C requires, in part, proof of AMA certification of your staff and State Licensing reports for the past three years. Please advise as to what constitutes AMA certification. Answer: ??? (State nursing and medical board licensing??) 50. Page 22, Part C requires, in part, Comprehensive General Liability with limits of $3,000,000 / $5,000,000. This appears to be high for our industry. Would the Parish consider reduced limits of this coverage to $1,000,000 / $3,000,000? 51. Page 22, Part C requires, in part, Comprehensive Automobile Liability with uninsured motorist coverage. Considering that this is not a contract with transportation services being provided by the Contractor, would the Parish consider deleting this requirement? OPSO Bidders' Questions and Answers – Medical
52. Page 22, Part C requires, in part, Professional Liability coverage with limits of $1,000,000 / $3,000,000. Would Parish consider enrollment in the Louisiana Patient Compensation Fund (LAPCF) with coverage limits established by the LAPCF? 53. Would you please provide us with a copy of any and all policies, procedures, protocols from the Orleans Parish Sheriff's Office that pertain to the delivery of Inmate Healthcare Services, including medical care, mental health care and dental care. Answer: No. Significant workload requirement with limited utility to bidder. 54. Please provide the most recent NCCHC survey. Answer: Attached. 55. Please provide the number of dialysis patients served in 2011, 2012 and 2013 and the number of treatments provided. Please provide the name and address of the dialysis treatment center used by the Parish. Answer: The OPSO uses several providers in the local area. 56. Will there be a radiology suite in Phase II? 57. Will the detainees in the work release center be included in the daily census for per diem calculations? 58. Will the existing TP5 satellite medical clinic continue to operate after the opening of Phase II? Will inmate care continued to be delivered in the TP5 satellite medical clinic or will inmates be moved to Phase II? Answer: Yes; the medical clinic will continued to be used. 59. On the equipment list provided at the pre bid meeting, please explain the following: a. Is this a list of existing equipment that you currently have on site and available b. Is this a list of equipment for use in Phase II only? OPSO Bidders' Questions and Answers – Medical
c. Does OPSO wish us to price the equipment on this list for clinics x 3 and ER and Dental Suite for purchase? d. The list following Phase II (Clinics x3) – Does this refer to exam rooms on the tiers or exam rooms in the clinic area? Our assumption is that this pertains to exam rooms in the clinic areas. If correct, what is available in the exam rooms on the tiers? e. The list following ER – Does this list refer to a main treatment room in the clinic area? How many rooms will be so equipped? f. In the list following Dental Suite, will there be any dental tools and/or instruments provided? Answer: ??? (Don't have any info about a list, or purpose) 60. We understand the current Orleans Parish Prison (OPP) health care program is accredited by the National Commission on Correctional Health Care (NCCHC). Can the Parish please provide a copy of the most recent (April 2013) accreditation audit report for the facility? Answer: Attached 61. We appreciate the list of positions the Parish provided with the RFP. a. Can you please also indicate the number of hours and/or FTEs associated with each employee and position? b. Can you please also indicate the hourly rate or salary associated with each employee and position? Answer: The list of positions is of no relevance as the majority of services will be provided in the new facility. No additional information is forthcoming. 62. Please provide a list of all current health service vacancies, by position. Answer: No. This is not a staffing contract. 63. Will the Sheriff's Office allow "grandfathered" credentialing for incumbent professional staff already employed or contracted by the Parish? Answer: If the staff is properly credentialed, they may be grandfathered. 64. Please confirm the time health services staff members spend in orientation, in-service training, and continuing education classes will count toward the hours required by the contract. Answer: (Orientation depends on position and work site. Typically 2-3 weeks for nurses. Staff are required to perform 12 hours/year of CME) OPSO Bidders' Questions and Answers – Medical
65. Who is financially responsible for the cost of health care employees at the OPP accessing the Internet: the Parish or the Vendor? 66. Please identify with whom the incumbent vendor subcontracts to provide laboratory Answer: Labcorp 67. How are radiology services currently provided: (a) onsite, with permanent OPSO- owned equipment; (b) onsite, by a mobile radiology vendor (PLEASE IDENTIFY VENDOR); or (c) offsite? Answer: Radiology services are provided onsite by a mobile radiology vender. The vendor is Xpress Ray, Inc. (with specialty studies, such as CT/MRI/Ultrasound, done at LSU) 68. How are optometry services currently provided: (a) onsite, with permanent Parish- owned equipment; (b) onsite, through mobile optometry (PLEASE IDENTIFY VENDOR); or (c) offsite? Answer: There is currently no optometry services at OPP. 69. How are dialysis services currently provided: (a) onsite, with permanent Parish-owned equipment; (b) onsite, with vendor/subcontractor-owned equipment (PLEASE IDENTIFY VENDOR); or (c) offsite? Answer: Dialysis services are provided offsite by the patient's established dialysis center. 70. With regard to community providers: a. What are the designated emergency or "911" facilities (hospital or other urgent care provider) for the OPP? Answer: (911 = city of NOLA EMS. "Charity Hospital/ILH/MCLNO" is backup emergency center) b. What are the hospitals most frequently used by the OPP? Answer: Previously answered. 71. For each OPP medical observation area, please provide the following information OPSO Bidders' Questions and Answers – Medical
a. Average occupancy/fill rate for the unit b. Staffing schedule for the unit's clinical personnel c. Are patients in the unit always within sight or hearing of a qualified health care Answer: There is currently no infirmary or observation unit. ("Medical Housing includes OPP D-1 [20 inmates] and D-2 [40 inmates]. These are dorms in close proximity to the 24-hour clinic/nurses. Not in sight/sound. 72. Please provide the current Sick Call schedule (days of week and timeframes) for each OPP unit/facility. Answer: I can attach last week's sick call schedule. 73. Please identify any specialty clinics currently conducted onsite, and indicate how many hours per week each clinic is held. Answer: Psych – 48 hours per week Dental – 38 hours per week 74. Please identify the number, type, and timeframes of any backlogs (e.g., chronic care clinics, offsite referrals, dental encounters, etc.) that currently exist. Answer: As of 4/4/14  124 pending combined primary and chronic care appointments pending. Average wait time was 14 days (for routine cases. Urgent cases are triaged to the next sick call clinic)  Dental – 17 – average wait time 13 days  Psych – 3 – average wait time 1 day  Social Services – 13 – average wait time 6 days 75. Please provide monthly statistical data for each of the following categories. a. Number of outpatient surgeries (if these are included in the category "Specialty Referrals," please break them out) b. Number of trips to the emergency department (is this the "Hospital Routes" referenced in the data provided with the RFP?) c. Number of hospital days (as opposed to number of admissions) d. Number of ER referrals resulting in hospitalization e. Number of ambulance transports f. Number of dialysis treatments Answer: You have these numbers. OPSO Bidders' Questions and Answers – Medical
76. Please provide annual spend amounts for the past two years for the following a. Total offsite care b. X-ray services Answer: January 1, 2012 – December 31, 2013. Dialysis Care - $135,780.00 Xrays - $106,878 77. Please confirm that under the new contract, the Contractor will not be financially responsible for any of the following services. a. Neonatal or newborn care after actual delivery b. Elective or mandated abortion c. Cosmetic surgery, including breast reduction d. Sex change surgery (including treatment or related cosmetic procedures) e. Contraceptive care including elective vasectomy (or reversal of such) and tubal ligation (or reversal of such) f. Extraordinary and/or experimental care g. Elective care (care which if not provided would not, in the opinion of the Medical Director, cause the inmate's health to deteriorate or cause definite and/or irreparable harm to the inmate's physical status) h. Autopsies i. Any organ (or other) transplant or related costs, including, but not limited to labs, testing, pharmaceuticals, pre- or post-op follow-up care, or ongoing care related to a transplant, etc. j. Medications for the treatment of bleeding disorders, including, but not limited to Factor VIII and IX Answer: Confirmed 78. Please confirm the following costs will be included under the cap on offsite care. a. Inpatient hospitalization b. Outpatient surgeries c. Other outpatient referrals d. ER visits e. Ambulance transports f. Offsite dialysis g. Offsite diagnostics (lab/x-ray) Answer: Confirmed OPSO Bidders' Questions and Answers – Medical
79. Please identify the relative weight the Parish will assign to each scoring category listed 80. We are looking for the formula (or other methodology) that the OPSO will use to evaluate, rank, and assign scoring points to bidders' prices. For example, a formula commonly used in other correctional health care bid evaluations is as follows. Lowest price of all proposals x # points possible for Price component = Price Score Price of proposal being evaluated How will the Parish assign scores and/or relative ranking to bidders' submitted prices? 81. Please indicate the order of precedence among the solicitation documents (e.g., the RFP, initial responses to questions, subsequent responses to questions, exhibits and attachments, etc.) so that in case of contradictory information among these materials, bidders know which of the conflicting data sets to use to create their narratives and calculate their prices. 82. Page 33 of the RFP states the OPP is "currently exploring the use of 340B drug pricing through University Hospital system." Please provide a name and contact information for the individual the Parish is working with at the hospital system to investigate 340-B pharmacy pricing. Answer: (Paolo Zambito) 83. With regard to inmate health care services covered by the Louisiana Department of Corrections' contract with Correct Care Integrate Health: a. Please provide a detailed description of exactly which services are covered under the DOC/CCIH agreement b. Please describe the process flow for how services are covered under the DOC/CCIH agreement are approved/authorized. c. Please describe the process flow for how services are covered under the DOC/CCIH agreement are billed and paid. Answer: Referrals for specialty care are entered into Eceptionist (DOC program) after approval from Medical Director. CCS will use criterion provided by DOC and upon OPSO Bidders' Questions and Answers – Medical
approval of the referral an appointment will be generated for either face to face or telemedicine clinic. (see previous question regarding excluded services) 84. Will the Parish be evaluating each bidder's separately listed equipment prices? If so, please describe how the equipment prices will be integrated into the evaluation process. 85. Will the Parish be evaluating each bidder's separately listed price for an Electronic Medical Record (EMR)? If so, please describe how the EMR price will be integrated into the evaluation process. 86. We do not see any Dental Assistants listed in the staffing complement provided with the RFP. What position currently performs the functions of Dental Assistants? Answer: There is one Medical Assist who currently assists the dentist part time 87. Are any members of the current medical staff part of a bargaining unit? If so what 88. In relation to the YTD Statistical Summary provided on the flash drive: a. What is depicted in the line marked; HIV grant (Pos. Chrg)? b. Under testing there are two lines for x-ray; one for x-ray and one for chest x-ray. Are both of these for x-rays provided on site? Answer: A. This is the NOAIDS case manager who visits the HIV positive inmates. This is a grant-funded position to increase linkage to care upon release. There is no charge for this visit. B. Yes, both are for x-rays provided onsite. 89. Can you provide information for the past three years regarding the OPSO Medical Services budget and by how much the OPSO has been under or exceeded the allotted budget by line item? Answer: You have the line item and expenditures. Info either already provided, or Elizabeth Boyer would be a point of contact. Don't have info with me. No formal budget historically to exceed. 90. Please include the total cost of offsite care for the past three years. OPSO Bidders' Questions and Answers – Medical
Answer: The total cost from 1/1/2011 through 12/31/2013 is $321,737. (Dr. Gore this includes all dialysis, xray and ambulance) 91. Can the OPSO provide the total number of claims in the past three years that have exceeded $50,000 and of those that have, by how much? 92. How many dialysis treatments have been done annually over the past three years? Answer: This information was not tracked during this time frame. (Two-year totals provided earlier) 93. What has the cost been for dialysis annually for the past three years? Answer: The total cost for dialysis from 1/1/11 through 12/31/13 is $155,014. 94. Where is dialysis currently being provided? Answer: Patients continue to receive treatment in their established dialysis centers. 95. Does the OPSO have a formalized agreement with any hospitals? If so can we be provided with a copy of that agreement? Answer: State statute that MCLNO will provide emergency care. Otherwise, any DOC contracts that have been recently implemented. 96. Can current salary information be provided? Answer: Excluded in previous question/answer 97. What is the frequency and length of the on-site OB/GYN clinic and who is the current Answer: There is no on-site OB/GYN provider. 98. Is the OPSO open to alternative pricing options? Answer: The bidders are required to bid in accordance with the directions given in the Request for Proposal. 99. In relation to the Phase II equipment list provided on the flash drive: OPSO Bidders' Questions and Answers – Medical
a. Is this the list of equipment identified as needing to be procured by the successful bidder? b. We had understood that the proposals should only include a list of equipment priced at more than $500.00. Please clarify. c. We had understood at the bidder's conference that the dental operatory would be moved from Orleans Parish. Is that correct? d. Is there a list of equipment to be procured for TDC in addition to what was provided on the flash drive for Phase II? Answer: A. ??? B. ??? C. ??? D. ??? RFP page 29; 3- For an easier comparison of bids; because it is not known if the contract will begin prior to the completion of the Phase II jail and in addition to staff being added, staff will be shifted as facilities close, should the bidders provide staffing and pricing for the facilities as they currently are being utilized and then separate staffing and pricing for the Phase II jail as a separate line item on the pricing sheet (Not taking into account the shifting of staff since the schedule for doing so may be fluid)? Answer: ??? RFP page 41; 2 – Please provide clarification in regards to the responsibility of the healthcare provider for commissary. Answer: ??? What is the timeline to obtain clearance for a new hire to begin work? Answer: ??? This should be answered by HR. In the document named "Staff Outline – 14-3-29," provided by the OPSO at the bid conference, what does the acronym "TNT" represent? Answer: This is the Tent Facility. Provide the number of inmates with hepatitis. Confirm that there are NO cases of Hep B or Hep C in the jail. Answer: Cannot confirm. NO acute, new, active cases. There may be untreated cases, and there are periodically cases on treatment, which we continue. Length of time for medication pass. Answer: It takes approximately 90 minutes for every 25 DOT medications. OPSO Bidders' Questions and Answers – Medical
Number of inmate assaults requiring medical intervention. Answer: Need clarification for time frame. (need info from SOD. All assaults require medical evaluation/care) What software will be provided and installed on the computer provided by DOC? Please provide review procedures and criteria that the Medical Services Provider must follow to secure authorization for hospital admission and or continued stay. Answer: (Reason for route/ED visit/hospitalization entered into Eceptionist) Provide the dialysis contract and dialysis utilization information. Answer: Dialysis is not provided on-site. It is provided off-site by several vendors including DaVita Fleur De Lis, DaVita Inc – Total Renal Care Inc, BMA of East New Orleans, and Uptown Dialysis Center in New Orleans. Provide ADP for each facility covered under this RFP. Provide medical, dental, and mental health examination rooms available at each facility. Answer: TP5 – 280; TDC – 430; MCD – 90; Phase II - 1200 Youth offenders will be housed at which facility? Will there be separate treatment space for medical, dental, and mental health services for this population? Answer: Currently Youth Offenders receive treatment in the clinic area. What is the "Stock Meds" Policy for usage? Answer: Upon order by licensed provider (including OTCs) nurses will start from stock while awaiting for medication card. OPSO Bidders' Questions and Answers – Medical
Will there be ANY inmates with SMI in any facility other than TDC? Answer: (SMI = "serious mental illness"?? If so, stable patients may be housed in general population) When are the suicide watch inmates kept, are these video surveillance areas? How often are these seen by Psychiatric currently while on watch? Answer: Already answered in previous question. What were the 10 deaths over the past 3 years caused by? Answer: You have the mortality reports. What specialty was the telemedicine evaluation for? Answer: Orthopedics, Cardiology, Nephrology, Gen Surg, GI & GU Is there a HIV grant? If so how does the grant for and how much? Answer: (Defer to Anne McKinley the status of any HIV grants) What is intensive incarceration (YTD Statistical Summary episodes of care) Answer: This grant may have expired. (Related to females with HIV. Case management and linkage to care. I believe it has expired.) Why did the number on suicide watch go from 37 to 465 in March/April 2013? Answer: (I don't have these numbers in front of me. Not sure if interpretation of submitted data is correct. Off hand, this doesn't sound right) Is there currently a process on how non formulary meds are decided on and monitored by the medical director? Answer: Yes. The vendor may describe its process in its response Is everyone tested for HIV? OPSO Bidders' Questions and Answers – Medical
Answer: Yes, it is an opt-out program. (done at the time of PPD testing, day 5-7 of incarceration, so not ALL inmates tested) Provide the location of where the 2400 inmates will be housed? Answer: TP5 – 280; TDC – 430; MCD – 90; Phase II - 1200 Utilization rates for the physical/occupational services on-site? Answer: None on site. Is there a separate physical therapy subcontractor? Number of inmates allowed compassionate release in last two years? Answer: Not tracked. Current specialties providing service via telemedicine Answer: Answered in previous question. Is the medical department notified of an impending release for timely reentry Answer: Yes (sometimes) How many beds will the new infirmary have? Provide the number of inmates on chemotherapy. How many AED's are on site? Answer: A total of 7, one in each of the housing units. OPSO Bidders' Questions and Answers – Medical
What is the current hospital fee schedule for inpatient and outpatient at each hospital? Answer: Medicaid rate fee. Where will the youthful offenders be housed? Answer: Currently at the Conchetta facility. (in future, Phase II ??) Total number of ambulance uses over past two years. Answer: This number is not tracked. Please list the names and addresses of each Dialysis Treatment provider and the contract terms and amounts for each. Answer: Dialysis is not provided on-site. It is provided off-site by several vendors including DaVita Fleur De Lis, DaVita Inc – Total Renal Care Inc, BMA of East New Orleans, and Uptown Dialysis Center in New Orleans. Please provide a list of reentry services presently being provided. Answer: ??? Not medical. refer to re-entry. (Re-entry part of TDC population. Reentry counseling not performed by medical dept) Provide a comprehensive listing of all required reports and the frequency these reports are expected to be delivered? Answer: Statistical reports will be provided at regular intervals to the Chief Corrections Deputy, and upon specific request, to detail the volume of medical, dental and mental health services provided, outcomes of care, infectious disease management, off-site utilization, adverse events and more. Health care activity statistics reported by site will include, at minimum, the following: A comprehensive monthly and annual statistical report will be provided to the Chief Corrections Deputy in accordance with ACA, and NCCHC standards. This report will reflect the operational status of the contract year as well as trends, appropriate assessments and subsequent action plans for necessary interventions. The operational report will include the following: OPSO Bidders' Questions and Answers – Medical
A. Status of audits B. Staffing trends C. Programs related to retention issues D. Disaster Plan update – dates of drills, scenarios, appropriate critiques E. Summary of medical grievances in graph form F. Coordination of service concerns between custody staff and medical Vendor will ensure that narrative reports are submitted on the fifth calendar day of each month with data reflecting the previous month's workload, to include:  Inmate requests for services  Inmates seen at sick call  Inmates seen by physician  Inmates seen by dentist  Inmates seen by psychiatrist  Inmates seen by psychologist  Infirmary admission, patient days,  average length of stay  Mental Health admissions  Off-site hospital admissions  Medical specialty consultation referrals  Intake medical screening  Fourteen day comprehensive health appraisal (history and  Psychiatric evaluations  Diagnostic studies  Report of third party reimbursement pursuit and recovery  Percentage of inmate population dispensed medication  Inmates testing positive for sexually transmitted infections  Inmates testing positive for HIV infection or clinical AIDS  Inmates testing positive for tuberculosis  Inmate mortality  Number of hours worked by entire medical staff, specifying each  Other data deemed appropriate by the Chief Detention Deputy Vendor will ensure that a narrative report for the previous twenty-four (24) hours, capturing the following data is submitted on a daily basis prior to 9:00 a.m. to include:  Transfers to off-site hospital emergency departments  A list of identified communicable diseases  Suicide data (i.e., attempts and precautions taken)  Status of inmates in local hospitals and infirmaries  Staffing rosters  Copies of completed medical incident reports  Copies of completed medical grievance reports  A listing of filing discrepancies OPSO Bidders' Questions and Answers – Medical
 A status report of Health Appraisals (history and physicals) Please provide the number of off-site psychiatric hospitalizations by facility. Answer: ??? (court ordered competency hospitalizations only. Not tracked.) Discuss the current KOP program. Answer: Patients are given a blister card with a 2 week supply of medications. Typically cards are exchanged every Wednesday. (only for chronic, stable meds. See previous questions for many exclusions. Also, we are in the process of eliminating KOP medications altogether. We will be accomplishing this goal soon, as staffing levels permit.)



3601_e20_p438-453 2/19/02 8:59 AM Page 438 Seizures and Syncope in the Cancer Patient ALEXANDRA FLOWERS Neurologic complications in cancer patients com- may be present in a patient, so an accurate evalua- monly involve altered levels of consciousness. This tion will require a comprehensive work-up of each chapter discusses seizures and syncope, two prob- lems in cancer patients that can have multiple causes.Whereas normally it is easy to distinguish between


Orthodontic considerations for gingival health duringpregnancy: a review Authors' affiliations: Abstract: Gingivitis is caused by several known systemic Padma M. Mukherjee, Division of and local factors. Among systemic factors, the role of Orthodontics, Department of Craniofacial hormonal changes during pregnancy is well established. Sciences, University of Connecticut School