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Centurion of FL v. HRDC, FL, Exhibit F to Declaration, Public Records Request, 2022

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Filing # 162200613 E-Filed 12/01/2022 02:30:01 PM

EXHIBIT F

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IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF FLORIDA
JACKSONVILLE DIVISION
SARAH MCCRIMMON and CARON
DETTMANN, as Co-Administrators of
the Estate of Curtis Dettmann,
Plaintiffs,
v.

Case No.: 3:20-cv-00036-BJD-JRK

CENTURION OF FLORIDA, LLC, et al.
Defendants.
______________________________________/
CENTURION DEFENDANTS’ MOTION TO DISMISS
PLAINTIFFS’ FIRST AMENDED COMPLAINT
AND INCORPORATED MEMORANDUM OF LAW
Pursuant to Fed. R. Civ. P. 12(b)(6) and Local Rule 3.01, Defendants Centurion of Florida,
LLC (Centurion), Rakesh Sharma, MD (Dr. Sharma), Marinette Gonzalez Morales, MD (Dr.
Gonzalez), David E. Rodriguez, MD (Dr. Rodriguez), Gerardo A. Pedroza-Sierra, MD (Dr.
Pedroza), John R. Quintino, LPN (Nurse Quintino), Luz Cruz, RN (Nurse Cruz), Kimberly A.
Nielson, LPN (Nurse Nielson), Linda Roberts, RN (Nurse Roberts), Alex Renelus, LPN (Nurse
Renelus), Cayman Smith, RN (Nurse Smith), Kayla McCarter, LPN (Nurse McCarter), Tanesha
L. Adkins, LPN (Nurse Adkins), Shenka Jackson (Nurse Jackson), Nikki N. Richardson, RN
(Nurse Richardson), April A. Mason, LPN (Nurse Mason), Elizabeth Morton, RN (Nurse Morton),
Clarissa C. Moody, RN (Nurse Moody), Tabatha L. Mahoney, RN (Nurse Mahoney), Michael J.
Roth, LPN (Nurse Roth), Ashley Harvey, LPN n/k/a Ashley Hawkins, LPN (Nurse Hawkins),
Pricilla L. Roberts (Ms. Roberts), and Tamara Taylor (Ms. Taylor) (collectively referred to as the

4833-7922-2464.4

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Centurion Defendants) 1 move this Court to dismiss Plaintiff’s First Amended Complaint (ECF No.
12) for failure to state a claim up on which relief may be granted and additional grounds. In support
of this Motion, Centurion Defendants rely upon the accompanying Memorandum of Law,
incorporated here.
MEMORANDUM OF LAW
I. FACTS AND PROCEDURAL HISTORY
A. Factual Background 2
Curtis Dettman 3 was an inmate in the custody of the Florida Department of Corrections
(FDOC) at the Reception and Medical Center (RMC) in Lake Butler, Florida. (First Amend.
Compl., ECF No. 12 ¶¶ 6, 21.) He suffered from a medical condition that caused painful skin
lesions. On January 10, 2018, Dettman underwent surgery to remove these lesions on his buttocks
at Jacksonville Memorial Hospital. (ECF No. 12 ¶¶ 22–23.)
On January 12, 2018, following his surgery, Dettman returned to RMC and was admitted
to the hospital there to recover from the surgery. (ECF No. 12 ¶¶ 24–25.) While recovering at
RMC, Centurion Providers provided treatment and care to Dettman, based on the objectively

Plaintiffs misidentify the following Centurion Defendants: Nurse Cruz is misidentified as “Nurse
L.C.;” Nurse Smith is misidentified as “LPN C.S.” and also referred to as “C. Smith;” and Nurse
Renelus is identified as a signature and also referred to as “LPN A.R.”

1

Additionally, for the purposes of this Motion, Centurion Defendants will be grouped into three
categories: (1) Centurion, a corporate entity; (2) the medical providers affiliated with Centurion,
including the physicians and nursing staff collectively (Centurion Providers); and (3) Priscilla
Roberts and Tamara Taylor, who are non-provider administrators affiliated with Centurion.
When considering the evidence and ruling on a motion to dismiss, the Court must accept the
factual allegations set forth in the complaint as true. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009).
2

The spelling of Dettman’s name appears differently in the First Amended Complaint and his
Florida Department of Corrections (FDOC) medical records. For the purposes of this Motion,
Centurion Defendants will adopt the spelling as it appears in FDOC records.
2
3

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presented medical conditions. After 10 days in the RMC hospital, Dettman was discharged back
to confinement on January 22, 2018. (ECF No. 12 ¶ 40.) Following a visit to the RMC urgent care
in the early morning hours of January 23, FDOC staff discovered Dettman non-responsive in his
cell later that morning. Dettman passed away later that day. (ECF No. 12 ¶¶ 42–43.) Plaintiffs
assert Dettman’s death was caused by a Clostridium difficle (C. diff.) infection. (ECF No. 12 ¶ 1.)
B. Procedural History
Plaintiffs are Sarah McCrimmon, Dettman’s sister and co-administrator of his estate
(McCrimmon) and Caron Dettman, Dettman’s mother and co-administrator of his estate. (ECF
No. 12 ¶¶ 7–8.) Centurion Defendants are comprised of Centurion, a Florida limited liability
company, which provides contractually specific health care services to inmates in the custody of
the FDOC pursuant to a contract, as well as medical providers and non-provider administrators
affiliated with Centurion. (ECF No. 12 ¶¶ 9–14.)4 The other defendants are FDOC employees.
Plaintiffs filed the original Complaint in this matter on January 17, 2020. (ECF No. 1.) The
day prior, on January 16, 2020, Plaintiffs mailed, via certified mail, a “Notice of Intent” to initiate
litigation for medical malpractice against Centurion Defendants, pursuant to Section 766.106, et
seq., Florida Statutes. (Ex. A.)
This Court issued an order striking Plaintiffs’ Complaint, finding the Complaint constituted
“an impermissible ‘shotgun’ pleading.” (ECF No. 10.) Plaintiffs filed their First Amended
Complaint on February 3, 2020. (ECF No. 12.) In the First Amended Complaint, Plaintiffs assert
39 separate counts, comprised of 42 U.S.C. § 1983 claims against each of the Centurion

Essentially, Plaintiffs named very medical provider whose name appears in Dettman’s medical
records during the relevant timeframe as a defendant.

4

Defendants L. Swanson, L. Brown, B. Purvis, and S. Cooper (ECF No. 12 ¶ 14) are not Centurion
Providers and are represented by other counsel.
3

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Defendants, the other providers, and several FDOC employees (Counts 1–36); a single intentional
infliction of emotional distress claim against the individual Centurion Defendants and nonCenturion providers (Count 37); a “respondeat superior” claim against Centurion (Count 38); and
a wrongful death claim against Centurion (Count 39). Centurion Defendants waived service and
this Motion to Dismiss is timely filed.
On May 21, 2020, following an agreed-upon extension, Centurion Defendants served their
Response to Plaintiffs’ Notice of Intent, in which they denied liability.
II. LAW AND ANALYSIS
A. Introduction
For the purposes of this Motion to Dismiss, Centurion Defendants organize Plaintiffs’
claims against them into three categories: (1) claims against Centurion, including § 1983,
“respondeat superior,” and wrongful death claims; (2) § 1983 claims against the individual
Centurion Defendants; and (3) an intentional infliction of emotional distress claim against the
individual Centurion Defendants. Centurion Defendants will address each of these categories in
turn.
B. Legal Standard
When considering the evidence and ruling on a motion to dismiss, the Court must accept
the factual allegations set forth in the complaint as true. Ashcroft v. Iqbal, 556 U.S. 662, 678
(2009). Additionally, the complaint allegations must be construed in the light most favorable to
the plaintiff. Gill as Next Friend of K.C.R. v. Judd, 941 F.3d 504, 511 (11th Cir. 2019). However,
“the tenet that a court must accept as true all of the allegations contained in a complaint is
inapplicable to legal conclusions,” which simply “are not entitled to [an] assumption of truth.”
Iqbal, 556 U.S. at 678, 680.
4

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Nonetheless, the plaintiff must still meet some minimal pleading requirements. Jackson v.
BellSouth Telecomm., 372 F.3d 1250, 1262–63 (11th Cir. 2004) (citations omitted). While
"[s]pecific facts are not necessary[,]" the complaint should “‘give the defendant fair notice of what
the . . . claim is and the grounds upon which it rests.’” Erickson v. Pardus, 551 U.S. 89, 93 (2007)
(per curiam) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007)). Though detailed
factual allegations are not required, Federal Rule of Civil Procedure 8(a) demands “more than an
unadorned, the-defendant-unlawfully-harmed-me accusation.” Iqbal, 556 U.S. at 678. Thus, a
plaintiff may not rely on “[t]hreadbare recitals of the elements of a cause of action, supported by
mere conclusory statements.” Gill, 941 F.3d at 511 (quoting Iqbal, 556 U.S. at 678); see also
Jackson, 372 F.3d at 1262 (explaining that “conclusory allegations, unwarranted deductions of
fact or legal conclusions masquerading as facts will not prevent dismissal”). Rather, the wellpleaded allegations must nudge the claim “across the line from conceivable to plausible.”
Twombly, 550 U.S. at (2007). A plaintiff must allege “sufficient factual matter” to “state a claim
to relief that is plausible on its face.” Id.
C. Claims Against Centurion
(1) Count 1: Claim Under 42 U.S.C. § 1983
Plaintiffs assert a claim against Centurion for violation of 42 U.S.C. § 1983 for having a
policy or practice of routinely denying medical care and access to medical care to prisoners like
Dettman. (ECF No. 12 ¶ 58.) However, because Plaintiffs fail to adequately identify a policy,
custom, or practice that acted as the “moving force” for the purported constitutional violation, this
count is due to be dismissed.
The Eighth Amendment protects inmates from “deliberate indifference to serious medical
needs.” Estelle v. Gamble, 429 U.S. 97, 104 (1976). Medical treatment violates the Constitution
only when it is “so grossly incompetent, inadequate, or excessive as to shock the conscience or to
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be intolerable to fundamental fairness.” Rogers v. Evans, 792 F.2d 1052, 1058 (11th Cir. 1986)
(citation omitted). Nam Dang, by and through Vina Dang v. Sheriff, Seminole Cty. Fla., 871 F.3d
1272, 1280 (11th Cir. 2017) (also referencing the requirement of proof of more than mere
negligence, not gross negligence). These prohibitions can be enforced pursuant to § 1983. Salvato
v. Miley, 790 F.3d 1286, 1295 (11th Cir. 2015).
Private contractors who provide medical care for prisons act under the color of state law
for the purposes of § 1983. Ancata v. Prison Health Servs., Inc., 769 F.2d 700, 703 (11th Cir.
1985) (citations omitted). However, a medical contractor cannot be liable under theories of
respondeat superior or vicarious liability. Monell v. Dep't of Soc. Serv., 436 U.S. 658, 691 (1978)
(“Congress did not intend to create liability under § 1983 unless action pursuant to an official
policy or custom caused a constitutional tort.”); see also Grech v. Clayton Cnty, Ga., 335 F.3d
1326, 1329 (11th Cir. 2003) (en banc) (“Liability under § 1983 may not be based on the doctrine
of respondeat superior.”); and see Belcher v. City of Foley, Ala., 30 F.3d 1390, 1396 (11th Cir.
1994) (“Supervisory officials are not liable under section 1983 on the basis of respondeat superior
or vicarious liability.”).
Instead, a plaintiff may successfully state a section 1983 claim and show liability of a
government entity "only where the [government entity] itself causes the constitutional violation at
issue." Cook ex. rel. Estate of Tessier v. Sheriff of Monroe Cty., Fla., 402 F.3d 1092, 1116 (11th
Cir. 2005) (citations omitted). To establish that an official policy or custom of the government
entity causes the constitutional violation, a plaintiff must show it was the "moving force" behind
the alleged constitutional deprivation. See Monell 436 U.S. at 693–94. Thus, in order for a plaintiff
to successfully raise a section 1983 claim against a correctional medical provider, such as
Centurion, he must allege that his constitutional rights were violated, that the corporate entity had
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a custom or policy that constituted deliberate indifference to that particular constitutional right,
and the policy or custom caused the constitutional violation. McDowell v. Brown, 392 F.3d 1283,
1289 (11th Cir. 2004) (citation omitted).
A custom is an act "that has not been formally approved by an appropriate decisionmaker,"
but that is "so widespread as to have the force of law." Bd. of Cty. Comm'rs of Bryan Cty., Okla.
v. Brown, 520 U.S. 397, 404 (1997) (citation omitted). The Eleventh Circuit defines "custom" as
"a practice that is so settled and permanent that it takes on the force of law" or a "persistent and
wide-spread practice." Sewell v. Town of Lake Hamilton, 117 F.3d 488, 489 (11th Cir. 1997). It is
also a requirement that, "[t]o hold the [government entity] liable, there must be 'a direct causal link
between [its] policy or custom and the alleged constitutional deprivation.’” Snow ex rel. Snow v.
City of Citronelle, 420 F.3d 1262, 1271 (11th Cir. 2005) (quotation omitted).
To prevail here, Plaintiffs must reasonably plead that Centurion had an official custom or
policy of deliberate indifference or an unofficial custom or practice related to the treatment of C.
diff. that constituted the moving force behind the alleged constitutional violation. Instead,
Plaintiffs have not done so: they fail to identify such a policy, custom, or practice of deliberate
indifference that constituted the moving force behind the alleged constitutional violation.
Plaintiffs’ bare allegations on this point is that “[Centurion] maintained policies and practices
pursuant to which prisoners like Mr. Dettmann with serious medical needs were routinely denied
medical care and access to medical care” (ECF No. 12 ¶ 58), a boilerplate and conclusory phrase,
devoid of any factual development, which is so broad as to be virtually meaningless. 5 Even if
Plaintiffs had sufficiently identified such a custom or policy, they fail to show—in a non-

Plaintiffs continue by stating, in a conclusory fashion, that Centurion has policies and practices
of providing “unconstitutionally inadequate healthcare” and listing broad statements of purported
deficiencies without any factual tether. (ECF No. 12 ¶ 59.)
7

5

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conclusory manner (ECF No. 12 ¶ 60)—that such a custom or policy was the “moving force”
behind the purported constitutional violation. See Morgan v. Tucker, 3:13-CV-81-J-34PDB, 2016
WL 1089994, at *6 (M.D. Fla. Mar. 21, 2016) (holding plaintiff’s boilerplate and conclusory
allegations fail to state a § 1983 claim and fail to show that such a custom or policy was the moving
force behind the violation). Cf. Fields v. Corizon Health, Inc., 490 Fed. Appx. 174, 182 (11th Cir.
2012) (per curiam) (Plaintiff alleging the defendant had a custom or policy of not sending inmates
with paralysis to the hospital, unless near death).
Because Plaintiffs fail to establish Centurion had a policy, custom, or practice leading to
the purported constitutional violation in this case, Plaintiffs fail to state a claim under 42 U.S.C. §
1983. For this reason, Centurion respectfully requests the Court dismiss Count 1.
(2) Count 38: Respondeat Superior Claim
In Count 38, Plaintiffs assert Centurion should be held liable “for the actions of its
employees acting within the scope of their employment under state law” and “should additionally
be held liable” under § 1983 “for the conduct of its employees and agents acting within the scope
of their employment. (ECF No. 12 ¶ 178.) However, Plaintiffs fail to adequately state a claim on
either of these grounds.
Because Centurion adequately addressed the inapplicability of respondeat superior to §
1983 claims in Section II(C)(1), supra, Centurion will not repeat those arguments here. See Hatten
v. Prison Health Services, 2006 WL 4792785, at *5 (M.D. Fla., Sept. 13, 2006) (Ҥ 1983 claims
predicated on respondeat superior theories have been uniformly rejected”).
Turning to Plaintiffs’ argument that Centurion is liable for the actions of its employees
under state law, that claim also fails. 6 As a determinative point, as discussed in Section II(E), infra,

6

Plaintiffs do not directly state that they are arguing Centurion is responsible for its employees’
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Plaintiffs fail to adequately state a claim for intentional inflection of emotional distress against the
individual Centurion Defendants; therefore their claim against Centurion necessarily fails. Doe v.
St. John’s Episcopal Parish Day Sch., Inc., 997 F.Supp. 2d 1279, 1287 (M.D. Fla. 2014) (“Under
a theory of respondeat superior, the employer is not liable if the employee is not liable.”) (citations
omitted). However, even assuming Plaintiffs adequately state a claim against the individuals, their
claim for respondeat superior liability against Centurion fails.
In Florida, for an employer to be liable for the intentional tort of its employees or agents
under a theory of respondeat superior, the alleged wrongs must be committed within the scope of
the business. Dieas v. Asso. Loan Co., 99 So.2d 279, 281 (Fla. 1957); see Perez v. Zazo, 498 So.2d
463, 465 (Fla. 3d DCA 1986) (“It is entirely clear that responsibility for the intentional wrongful
acts of a servant-employee may be visited upon his master-employer under the doctrine
of respondeat superior only when that conduct in some way furthers the interests of the master or
is at least motivated by a purpose to serve those interests, rather than the employee's own.”) To
determine if the conduct at issue is within the scope of the employment or agency under Florida,
law, a court must determine if “1) the conduct is of the kind [the employee or agent] was employed
to perform; 2) the conduct occurs substantially within the time and space limits authorized or
required by the work to be performed, and 3) the conduct is activated at least in part by a purpose
to serve the master.” Iglesia Cristiana La Casa Del Senor, Inc. v. L.M., 783 So.2d 353, 357 (Fla.
3d DCA 2001) (citing Sussman v. Florida E. Coast Props., Inc., 557 So.2d 74, 75–76 (Fla. 3d
DCA 1990)).
In the First Amended Complaint, Plaintiffs make no substantive allegations, either in the

or agents’ torts of intentional infliction of emotional distress (ECF No. 12 ¶ 177), but that is the
only state law claim against the individual Centurion Defendants advanced by Plaintiffs. (ECF No.
12 ¶¶ 169–174.)
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respondeat superior count against Centurion (ECF No. 12 ¶¶ 175–178) or in the incorporated
paragraphs (ECF No. 12 ¶¶ 1–55), related to any purported intentional infliction of emotional
distress or meeting the elements of respondeat superior liability. See Iglesia Cristiana, 783 So.2d
at 357. Accordingly, Count 38 fails to meet even the minimal pleading requirements in Fed. R.
Civ. P. 8(a), Jackson, 372 F.3d at 1262–63, and constitute nothing more than an “unadorned, thedefendant-unlawfully-harmed-me accusation.” Iqbal, 556 U.S. at 678. For this reason, Count 38
should be dismissed for failure to state a claim.
(3) Count 39: Wrongful Death Claim
In Count 39, Plaintiffs assert a wrongful death claim against Centurion pursuant to Section
768.19, Fla. Stat. Because Plaintiffs failed to comply with the pre-suit notice provisions required
of medical negligence actions prior to filing this action, which operate as conditions precedent to
this claim, this count should be dismissed.
The Wrongful Death Act is set forth in Section 768.19, Fla. Stat., which states that “when
a death of a person is caused by the wrongful act [or] negligence . . . of any person” and the act or
negligence “would have entitled the person injured to maintain an action and recover damages if
death had not ensued,” then the purported wrongdoer “shall be liable for damages . . .
notwithstanding the death of the person injured . . . .” A wrongful death claim is derivative of a
personal injury to the decedent: A wrongful death action “is predicated on” the wrongful act or
negligence committed by the defendant, which transforms a personal injury claim into a wrongful
death claim. Laizure v. Avante at Leesburg, Inc., 109 So.3d 752, 756–57 (Fla. 2013).
“Consequently, courts generally agree that wrongful death claims are derivative in nature, at least
in the sense that they are dependent on a wrong committed against the decedent. Id. at 757; see
also Gaboury v. Flagler Hosp., Inc., 316 So.2d 642, 644 (Fla. 4th DCA 1975) (holding that a
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wrongful death claim should be “governed by the same general principles of practice as it would
have been had the injured person not died and was suing to recover damages for the wrongful
act”).
Here, the gravamen of this claim is the underlying medical treatment provided to Dettman:
“Defendant Centurion breached a duty of reasonable care in failing to provide medical care to Mr.
Dettmann while Mr. Dettmann was incarcerated at RMC.” (ECF No. 12 ¶ 181; see generally ¶¶
1–55.) Had Dettman not passed, his claims, if any, would have sounded in medical negligence.
Accordingly, because Plaintiffs’ wrongful death claim is derivative of any potential medical
negligence claims Dettman could have brought against Centurion, Plaintiffs are required to comply
with the pre-suit notice statues under Florida law. See Section 766.106(1)(a), Fla. Stat. (stating
“‘claim for medical negligence’ or ‘claim for medical malpractice’ means a claim, arising out of
the rendering of, or the failure to render, medical care or services”); see also J.B. v. Sacred Heart
Hosp. of Pensacola, 635 So. 2d 945, 949 (Fla. 1994) (holding Chapter 766’s “notice and presuit
screening requirements apply to claims that ‘arise out of the rendering of, or the failure to render,
medical care or services’”); Kural v. Mekras, 679 So. 2d 278, 280 (Fla. 1996) (holding Chapter
766 sets forth a presuit investigation procedure that a claimant “must follow before a medical
negligence claim may be brought in court”).
The pre-suit notice requirements are set forth in Section 766.106, et seq., Fla. Stat. Section
766.106(2)(a) states, “After completion of pre-suit investigation pursuant to s. 766.203(2) and
prior to filing a complaint for medical negligence, a claimant shall notify each prospective
defendant . . . of intent to initiate litigation for medical negligence” (emphasis added). Section
766.106(3)(a) provides that, following service of the pre-suit notice, “No suit may be filed for a
period of 90 days after notice is mailed to any prospective defendant.” Further, Section 766.106(7)
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states, “Failure to cooperate on the part of any party during the presuit investigation may be
grounds to strike any claim made, or defense raised, by such party in suit.” See Univ. of Miami v.
Wilson, 948 So.2d 774, 776 (Fla. 3d DCA 2006) (“Timely written notice of intent to initiate
litigation is a condition precedent to maintaining a medical malpractice action.”). These pre-suit
notice provisions are strictly construed. Patino v. Einhorn, 670 So.2d 1179, 1179 (Fla. 3d DCA
1996) (holding the pre-suit notice provisions “are limitations on Article I, Section 21 of the Florida
Constitution, and therefore should be strictly construed”).
Here, as noted in Section I(B), supra, Plaintiffs served their pre-suit notice (Ex. A)
contemporaneously with the filing of this complaint and did not wait the minimum 90 days. (ECF
No. 1.) Accordingly, Plaintiffs failed to comply with the pre-suit notice requirements. These
requirements being strictly construed, Count 39 should be dismissed. See S. Neurosurgical
Associates, P.A. v. Fine, 591 So. 2d 252, 254–55 (Fla. 4th DCA 1991) (holding that where “the
required presuit notice is served simultaneously with the filing of the complaint, the complaint is
subject to dismissal”).
(4) Sovereign Immunity
Additionally, Plaintiffs’ state law respondeat superior and wrongful death claims against
Centurion fail under the doctrine sovereign immunity. Florida law affords entities like Centurion
certain sovereign immunity and limitations with respect to tort claims brought against them. See
§ 768.28(5), Fla. Stat. Specifically, Florida courts have extended Section 768.28 immunity to
private companies where there is a sufficient degree of control retained or exercised by the state
entity. See Bean v. Univ. of Miami, 252 So. 3d 810, 816 (Fla. Dist. Ct. App. 2018) (collecting
cases), writ denied sub nom. Vallecillo v. Univ. of Miami, No. SC18-1432, 2018 WL 6418570 (Fla.
Dec. 5, 2018), and review denied,- No. SC18-1476, 2019 WL 1498810 (Fla. Apr. 5, 2019). Among
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the rights and limitations is that no “officer, employee, or agent of the state or of any of its
subdivisions shall be held personally liable in tort or named as a party defendant in any action for
any injury or damage suffered as a result of any act, event, or omission of action in the scope of
his employment or function” unless those agents “acted in bad faith or with malicious purpose or
in a manner exhibiting wanton and willful disregard of human rights, safety, or property.”
Section 768.28(9)(a), Fla. Stat. Health care contractors for FDOC are explicitly included as agents
of FDOC and the State of Florida for sovereign immunity purposes, while acting “within the scope
of and pursuant to guidelines established in said contract . . . .” Section 768.28(10)(b), Fla. Stat.
This section addresses the legislature’s public policy concerns about the potential liability of health
care providers like Centurion. See e.g. Mingo v. ARA Health Services, Inc., 638 So. 2d 85, 86 (Fla.
2d DCA 1994) (stating the “legislature found it necessary to create state agency status of such
health care providers by specific statutory enactment”). Instead, the exclusive remedy is by again
against the governmental entity, the head of the entity, or the constitutional officer deemed the
employer of the head of the entity. Section 768.28(9)(a), Fla. Stat.
As alleged by Plaintiffs, Centurion provided health care to inmates, including Dettman, at
RMC. (ECF No. 12 ¶ 3.) The language of the statute is clear: Centurion and the Centurion
Defendants are agents of FDOC and thus immune from suit on the showing of two elements: (1)
a contractual agreement that Centurion is considered an agent, and (2) Centurion’s employees were
acting within the course and scope of that contract and have not acted in bad faith, with malicious
purpose, or while exhibiting wanton and willful disregard. Section VII (I) of the contract meets
the first element. 7 (See Exhibit C, Centurion Contract with FDOC at 107.) Centurion has

The Court may consider Centurion’s contract with FDOC for the purposes of this Motion to
Dismiss because it is referred to in the First Amended Complaint and is central to Plaintiff’ claims.
See e.g. Horn v. Volusia Cty., 2008 WL 977179, at *3 (M.D. Fla. Apr. 9, 2008) (relying on medical
13
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contractually agreed to act as an agent for FDOC to provide health care services to inmates housed
in FDOC facilities. Id. (“In the Contractor’s performance of its duties and responsibilities under
this Contract, the Contractor shall, at all times, act and perform as an agent of the Department”).
The second element is also satisfied: Plaintiffs seek to hold Centurion liable for the medical care
provided by Centurion Providers within the course and scope of Centurion’s contract with FDOC.
Further, Plaintiffs do not plead that Centurion or Centurion Providers acted in bad faith, with
malicious purpose, or while exhibiting wanton and willful disregard. Accordingly, Plaintiff’s state
law claims are barred by Centurion’s sovereign immunity.
D. 42 U.S.C. § 1983 Claims Against Individual Centurion Defendants
(1) Counts 2–6, 8–10, 12–15, 17, 19–29: Failure to State a Claim
In these counts, Plaintiffs assert § 1983 claims related to Dettman’s medical care against
each of the individual Centurion Defendants. Because the First Amended Complaint fails to state
a cause of action under § 1983, these claims should be dismissed.
As noted, the Eighth Amendment protects inmates from “deliberate indifference to serious
medical needs.” Estelle, 429 U.S. 97, 104 (1976). Medical treatment violates the Constitution only
when it is “so grossly incompetent, inadequate, or excessive as to shock the conscience or to be
intolerable to fundamental fairness.” Rogers, 792 F.2d at 1058 (citation omitted).
To state a claim of unconstitutionally inadequate medical treatment, a prisoner must
establish “an objectively serious [medical] need, an objectively insufficient response to that need,
subjective awareness of facts signaling the need, and an actual inference of required action from
those facts.” Taylor v. Adams, 221 F.3d 1254, 1258 (11th Cir. 2000). Kuhne v. Fla. Dep't of Corr.,

contractor’s contract with department of corrections on contractor’s motion to dismiss in finding
medical contractor was entitled to immunity under Section 768.28(9)) (citing Brooks v. BCBS of
Fla., 116 F. 3d 1364, 1369 (11th Cir. 1997)).
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745 F.3d 1091, 1094 (11th Cir. 2014). “A serious medical need is 'one that has been diagnosed by
a physician as mandating treatment or one that is so obvious that even a lay person would easily
recognize the necessity for a doctor's attention.' In the alternative, a serious medical need is
determined by whether a delay in treating the need worsens the condition.” Mann v. Taser Int'l,
Inc., 588 F.3d 1291, 1307 (11th Cir. 2009) (quoting Hill v. Dekalb Reg'l Youth Det. Ctr., 40 F.3d
1176, 1187 (11th Cir. 1994)). To demonstrate deliberate indifference to serious medical needs, a
plaintiff must satisfy both an objective and a subjective inquiry. See Brown v. Johnson, 387 F.3d
1344, 1351 (11th Cir. 2004) (citation omitted). For the objective component, a plaintiff must show
that he had a serious medical need. Goebert v. Lee Cty., 510 F.3d 1312, 1326 (11th Cir. 2007).
Next, for the subjective component, he must adequately present an allegation “that the prison
official, at a minimum, acted with a state of mind that constituted deliberate indifference.”
Richardson, 598 F.3d at 737.
However, medical treatment violates the Constitution only when it is “so grossly
incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to
fundamental fairness.” Rogers,

792 F.2d at 1058 (citation omitted). Further, matters of

professional judgment do not constitute deliberate indifference. Estelle, 429 U.S. at 107–08.
Additionally, even if the treatment provided could be considered less or even medical malpractice,
“[a]ccidents, mistakes, negligence, and medical malpractice are not 'constitutional violation[s]
merely because the victim is a prisoner.’” Harris v. Coweta Cty., 21 F.3d 388, 393 (11th Cir. 1994)
(citing Estelle, 429 U.S. at 106); see also Estelle, 429 U.S. at 106 (holding “a complaint that a
physician has been negligent in diagnosing or treating a medical condition does not state a valid
claim of medical mistreatment under the Eighth Amendment”); and see Hamm v. DeKalb County,

15

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 16 of 23 PageID 467

774 F.2d 1567, 1575 (11th Cir. 1985) (“Although [the inmate] may have desired different modes
of treatment, the care in the jail did not amount to deliberate indifference.”).
As to the individual Centurion Defendants, Plaintiffs fail to state a claim for deliberate
indifference. At the outset, Centurion Defendants note Plaintiffs fail to mention the following
providers at all in the allegations (¶¶ 1–55): Nielson, Adkins, Richardson, Mason, Moody, Roth,
Roberts, Smith, Hawkins, Renelus, Cruz, and Jackson. Plaintiffs do not levy any allegations
against these Centurion Providers by name or identify any factual circumstances underlying the
claims against them. 8 Plaintiffs fail to identify any wrongs purportedly committed by these
Centurion Providers and fail to establish causation between the act of any of these Centurion
Providers to Dettman’s injuries. The allegations against these Centurion Providers wholly fail to
meet even the minimum pleading standard. Jackson, 372 F.3d at 1262–63.9
As to the remaining Centurion Providers (Dr. Sharma, Dr. Gonzalez, Dr. Rodriguez, Dr.
Pedroza, and Nurses Quintino, McCarter, and Morton), Plaintiffs likewise fail to allege sufficient
facts to state a plausible claim for deliberate indifference.10

8

-

Nurse Quintino is mentioned only once and is alleged to have received a complaint
from Dettman. (ECF No. 12 ¶ 25.) He is not mentioned again.

-

Dr. Gonzalez is mentioned several times. (ECF No. 12 ¶¶ 26, 27, 30, 31, 39, 41.) In
these paragraphs, Dr. Gonzalez is alleged to have received complaints from Dettman
and provided treatment, including ordering several different medications and I/V
fluids, and referring him to a specialist.

Counts 8–10, 12–14, 17, 19–22, 24, 26–27 apply to these Centurion Providers.

Plaintiffs do reference several actions by unidentified “Nursing Defendants” but likewise fail to
identify which individual Centurion Providers committed the acts of these “Nursing Defendants.”
Additionally, it is not evidence if this term refers to the same set of Centurion Providers or some
shifting set of providers. (ECF No. 12 ¶¶ 14, 27, 31.)

9

10

Counts 2–6, 15, and 23 apply to these Centurion Providers.
16

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 17 of 23 PageID 468

-

Dr. Rodriguez is alleged to have seen Dettman on merely two occasions. Plaintiffs
assert he “did nothing.” (ECF No. 12 ¶¶ 32, 33, 38.)

-

Dr. Pedroza is mentioned in a single paragraph, in which he is alleged to have ordered
a diet change and referred Dettman to his primary care physician. (ECF No. 12 ¶ 34.)

-

Nurse McCarter is alleged to have seen Dettman on a single occasion. Plaintiffs assert
she also “did nothing.” (ECF No. 12 ¶ 37.)

-

Dr. Sharma is also mentioned only two times, and he referred Dettman to a specialist.
(ECF No. 12 ¶¶ 41, 54.)

-

Nurse Morton provided care to Dettman on a single occasion, in which she referenced
the appropriate protocol and referred him for a mental health evaluation. Nurse
Mahoney did not treat Dettman but signed-off on this referral. (ECF No. 12 ¶¶ 42–
43.)

In these basic allegations, at a minimum, Plaintiffs fail to meet the subjective component of the
deliberate indifference analysis by failing to assert that any of these providers “acted with a state
of mind that constituted deliberate indifference.” Richardson, 598 F.3d 737. Additionally, on its
face, the First Amended Complaint does not plead that the medical treatment was “so grossly
incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to
fundamental fairness.” Rogers, 792 F.2d 1058. Additionally, Plaintiffs fail to plead a factual causal
connection between the individual actions of these individual providers and Dettman’s injuries.
Accordingly, Plaintiffs fail to adequately plead an Eighth Amendment violation. Finally, based on
the allegations, the treatment provided could merely be considered medical malpractice, at most.
Harris, 21 F.3d at 393 (“Accidents, mistakes, negligence and medical malpractice are not
‘constitutional violations merely because the victim is a prisoner.’”).
Finally, Plaintiffs assert § 1983 claims against two administrative Centurion Defendants,
Priscilla Roberts and Tamara Taylor for purportedly refusing to ensure Dettman received proper

17

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 18 of 23 PageID 469

medical care. 11 Neither Roberts nor Taylor are medical providers. These Defendants’ interactions
are limited to receiving complaints from McCrimmon in a non-provider context. (ECF No. 12 ¶¶
46, 49, 53.) Plaintiffs do not plead either of these Centurion Defendants could have provided
different care than that which was provided. Additionally, Plaintiffs do not plead facts establishing
any causal connection between their actions or omissions and Dettman’s injuries. For this reason,
these claims fail to state a claim and should be dismissed.
(2) Qualified Immunity
Each of the individual Centurion Defendants—who are sued in their individual
capacities—is entitled to dismissal based on qualified immunity. Qualified immunity offers
complete protection for officials sued in their individual capacities acting within their discretionary
authority if their conduct “does not violate clearly established statutory or constitutional rights of
which a reasonable person would have known.” Harlow v. Fitzgerald, 457 U.S. 800, 818, (1982).
Unless the plaintiff's allegations state a claim of violation of clearly established law, a defendant
pleading qualified immunity is entitled to dismissal before the commencement of discovery.
Nichols v. Maynard, 204 Fed. Appx. 826, 828 (11th Cir. 2006) (citing, Marsh v. Butler County,
268 F.3d 1014, 1022 (11th Cir. 2001) (internal citation omitted). Without such allegations, the
district court should grant qualified immunity at the motion to dismiss stage. Id. (citing Gonzalez
v. Reno, 325 F.3d 1228, 1233 (11th Cir. 2003)). Here, Plaintiffs fail to state a claim for a violation
of clearly established constitutional right and fail to state adequate claims for deliberate
indifference. Accordingly, these claims are due to be dismissed with prejudice based on qualified
immunity.

11

Counts 28 and 29.

18

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 19 of 23 PageID 470

E. Intentional Infliction of Emotional Distress Claims Against
Individual Centurion Defendants
Finally, in Count 37, Plaintiffs assert a single state law intentional infliction of emotional
distress claim against the individual Centurion Defendants and other non-Centurion providers.
Because this allegation fails to state an adequate claim for intentional infliction of emotional
distress, dismissal of this count is appropriate.
Under Florida law, to state a claim for intentional infliction of emotional distress, a plaintiff
must establish four elements: (1) extreme and outrageous conduct; (2) an intent to cause, or
reckless disregard to the probability of causing, emotional distress; (3) severe emotional distress
suffered by the plaintiff; and (4) that the conduct complained of caused the plaintiff's severe
emotional distress. Hart v. United States, 894 F.2d 1539, 1548 (11th Cir.). “‘Outrageous’ conduct
is defined as that which goes beyond all possible bounds of decency and is intolerable in a civilized
community.” Blount v. Sterling Healthcare Group, Inc., 934 F. Supp. 1365, 1370 (S.D. Fla. 1996).
Further, “[l]iability has been found only where the conduct has been so outrageous in character,
and so extreme in degree, as to go beyond all possible bounds of decency, and to be regarded as
atrocious, and utterly intolerable in a civilized community.” Metropolitan Life Ins. Co. v.
McCarson, 467 So.2d 277, 278–79 (Fla. 1985).
Here, Plaintiffs attempt to take their allegations of inadequate medical care and transform
them, without additional factual support, into an intentional infliction of emotional distress claim.
Plaintiffs assert that by denying Dettman “medical evaluation or treatment, or access to medical
evaluation or treatment,” the individual Centurion Defendants “engaged in extreme and outrageous
conduct.” (ECF No. 12 ¶ 170.) Additionally, Plaintiffs assert the individual Centurion Defendants’
actions are “rooted in an abuse of power or authority” (ECF No. 12 ¶ 171), were “undertaken with
intent or knowledge that there was a high probability that the conduct would inflict severe
19

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 20 of 23 PageID 471

emotional distress” (ECF No. 12 ¶ 172), and were “undertaken intentionally, with malic, and/or
with reckless indifference” to Dettman’s rights (ECF No. 12 ¶ 173). However, each of these
statements constitutes a bare legal conclusion, without any factual support. Count 37 incorporates
by reference paragraphs 1–55, but a review of those allegations, even with the appropriate
deference at the motion to dismiss stage, does not reveal any support for the intentional infliction
of emotional distress claim. The allegations do not set forth any specific actions of any of the
individual Centurion Defendants, nor do they establish a causal connection between any acts and
Dettman’s injuries. Accordingly, Plaintiffs fail to state a claim, and this Count 37 should be
dismissed.
Additionally, Centurion Defendants note Count 37 is substantively like the intentional
infliction of emotional distress claim found in the original Complaint. (ECF No. 1, Count IV.) The
Court struck the original Complaint, finding the Plaintiffs impermissibly lumped “all Defendants
together without specifically alleging the allegations pertinent to each individual Defendant,”
which was “altogether unacceptable.” (ECF No. 10 at 2–3.) In striking the Complaint, the Court
ordered Plaintiffs to refile an amended complaint complying with its directives. (ECF No. 10 at 3–
4.) Though Plaintiffs filed the First Amended Complaint, Count 37, as substantively similar to the
count stricken, contains the same deficiencies the Court previously identified. For that reason,
Centurion Defendants request the Court dismiss Count 37.12

These individual Centurion Defendants are likewise shielded by the doctrine of sovereign
immunity, as set forth in Section II(C)(4), supra. Centurion Defendants incorporate those
arguments here and respectfully request the state law intentional infliction of emotional distress
claims be dismissed under the doctrine of sovereign immunity.
20

12

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 21 of 23 PageID 472

III. CONCLUSION
For the foregoing reasons, Centurion Defendants respectfully request the Court dismiss
Counts 1–6, 8–10, 12–15, 17, 19–29, and 37–39 against them.
Dated: June 23, 2020.
Respectfully submitted,
/s/ Eliot B. Peace
Brian A. Wahl (FBN 95777)
BRADLEY ARANT BOULT CUMMINGS LLP
1819 5th Avenue N.
Birmingham, AL 35203
Tel: (205) 521-8800
bwahl@bradley.com
Eliot B. Peace (FBN 124805)
BRADLEY ARANT BOULT CUMMINGS LLP
100 North Tampa Street, Suite 2200
Tampa, Florida 33602
Tel: (813) 559-5500
epeace@bradley.com
Counsel for Defendants Centurion of Florida,
LLC, Rakesh Sharma, Marinette Gonzalez
Morales, David Rodriguez, Gerardo Pedroza, John
Quintino, Cayman Smith, Luz Cruz, Kimberly
Nielson, Linda Roberts, Alex Renelus, Kayla
McCarter, Tanesha Adkins, Shenka Jackson,
Nikki Richardson, April Mason, Elizabeth
Morton, Clarissa Moody, Tabitha Mahoney,
Michael Roth, Ashley Harvey n/k/a Ashley
Hawkins, Priscilla Roberts, Tamara Taylor

21

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 22 of 23 PageID 473

Local Rule 3.01(g) Certification
Pursuant to Local Rule 3.01(g), counsel for Centurion Defendants was not required to
confer with opposing counsel prior to the filing of this motion.
/s/ Eliot B. Peace
Counsel for Centurion Defendants

22

Case 3:20-cv-00036-BJD-LLL Document 63 Filed 06/23/20 Page 23 of 23 PageID 474

CERTIFICATE OF SERVICE
I hereby certify that on June 23, 2020, I electronically filed the foregoing with the Clerk of
the Court using the CM/ECF system, which will send notification to all counsel of record, as
follows:
Jesse B. Wilkison, Esq.
SHEPPARD, WHITE, KACHERGUS &
DEMAGGIO, P.A.
215 N. Washington Street
Jacksonville, FL 32202
sheplaw@sheppardwhite.com
Counsel for Plaintiff

Michael L. Glass, Esq.
Christine N. Gargano, Esq.
STONE, GLASS & CONNOLLY, LLP
3020 Hartley Road, Suite 250
Jacksonville, FL 32257
mglass@sgc-attorneys.com
pleadings@sgc-attorneys.com
thumphrey@sgc-attorneys.com
Counsel for Julies Jones, Erich Hummel,
Thomas Reimers, Timothy Whalen, David
Allen

Arthur R. Loevy, Esq.
Sarah C. Grady, Esq.
Stephen H. Weil, Esq.
LOEVY & LOEVY
311 N. Aberdeen Street, 3 rd Floor
Chicago, IL 60607
sarah@loevy.com
arthur@loevy.com
weil@loevy.com
Co-Counsel for Plaintiff

Niels P. Murphy, Esq,
Jordan M. Janoski, Esq.
MURPHY & ANDERSON, P.A.
1501 San Marco Boulevard
Jacksonville, FL 32207
nmurphy@murphyandersonlaw.com
scassidy@murphyandersonlaw.com
jjanoski@murphyandersonlaw.com
gherman@murphyandersonlaw.com
Counsel for Lois Brown, Lorie Swanson
and Barbara Purvis

Barry A. Postman, Esq.
COLE, SCOTT & KISSANE, P.A.
Esperante Building
222 Lakeview Avenue, Suite 120
West Palm Beach, FL 33401
barry.postman@csklegal.com
Counsel for Sharon Cooper

/s/ Eliot B. Peace
Counsel for Defendants Centurion of Florida, LLC,
Rakesh Sharma, Marinette Gonzalez Morales, David
Rodriguez, Gerardo Pedroza, John Quintino, Cayman
Smith, Luz Cruz, Kimberly Nielson, Linda Roberts, Alex
Renelus, Kayla McCarter, Tanesha Adkins, Shenka
Jackson, Nikki Richardson, April Mason, Elizabeth
Morton, Clarissa Moody, Tabitha Mahoney, Michael
Roth, Ashley Harvey n/k/a Ashley Hawkins, Priscilla
Roberts, Tamara Taylor
23

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 1 of 6 PageID 475

EXHIBIT A

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 2 of 6 PageID 476

SHEPPARD, WHITE, KA.CHERGUS

&

DEMAGGIO,

P.A.

Attorneys & Counselors at Law

215 WASHINGTON STREET
JACKSONVILLE, FLO RIDA 32202
WM. J. SHEPPARD
Board Certified Criminal Trial Lawyer

MATTHEW R. KACHERGUS

904/356-9661
Telefax 904/356-9667
email: sheplaw@sheppardwhite.com

ELIZABETH L. WHITE
Also admitted to the Oregon Bar

JESSE B. WILKISON
CAMILLE E. SHEPP.ARD

BRYAN E. DEMAGGIO

January 16, 2020

Via: United States Certified Mail, Return Receipt Requested
Centurion of Florida, LLC; Centurion Managed
Care of Florida, LLC; Centurion, LLC;
MHM Services, Inc.; Centene Corporation
Ruth Feltner; Tamara Taylor
7700 Forsyth Blvd.
St. Louis, MO 63105
Robert E. Smith Jr.; Dr. Rakesh Shanna; Priscilla Roberts;
Dr. Marinette Gonzalez; Dr. David Rodriguez
Dr. G. Pedroza; J. Quinto' L. Swanson, LPN, C.S.
Nurse L.C,; K. Nielson; L. Brown; L. Roberts; NW-se

&..-~,,,..2 0

Nurse C. Smith; K. McCarter;
S. Cooper, T. Adkins, B. Purvis; S. Jackson, LPN A.R.;
Nikki Richardson; A. Mason; E. Morton; C. Moody; T. Mahoney;
M. Roth; L. Swanson; A. Harvey; S. Jackson
7765 S. Cr. 231
Lake Butler FL, 32054
Julie Jones; Erich Hummel; Bryant
Goodwin; Thomas Reimers; Timothy Whalen;
David Allen; Maurice Radford
Florida Department of Corrections
501 South Calhoun Street
Tallahassee, FL 32399-2500
Re:

Curtis Dettmann -Notice of Intent

To All Concerned:

NOI 000001

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 3 of 6 PageID 477

Sarah McCrimmon, personal representative of the.Estate of Curtis Dettmann, who resides at 2442
Ambrosia Drive, Middleburg, Florid~ hereby notifies you, pursuant to Section 766.106 and
768.28, Florida Statutes, of her intent to initiate litigation against you for medical malpractice. To
the extent. currently knovm to Ms. McCrimmon, the following health care providers, are
prospective defendants; Florida Department of Corrections, Centurion of Florida, LLC; Managed
Care of florida, LLC;. l\,lliM Services, Inc.; Centene Corporation; Rakesh Sharma; Marinette
Gonzalez; David Rodriguez; G. Pedroza; J. Quintina~ L. Swanson; LPN C.S.; Nurse L.C.; K.
Nielson; L Brown; L. Roberts; Nurse &-- ~":~ ~ ;C. Smith; K. McCarter; S. Cooper;
T. Adkins; B. Purvis; S. Jackson; LPN A.R. Nikki Richardson; A. Mason; E. Morton; C,_Moody;
T. Mahoney; T. Mahoney; M. Roth; L. Swanson; A. Harvey; S. Jackson Priscilla Roberts; Robert
E. Smith, Jr.; Julie Jones; Erich Hummel; Curtis "Bryant" Goodwin; Thomas Reimers; Timothy
Whalen; David Allen; and Maurice Radford. The individuals whose full-names are not listed are
derived from Mr. Dettmann's RMC medical records who provided care to him in January 2018.
The claim for medical malpractice is based on providing inadequate medical care to Curtis
Dcttrri.an,.11 while in the custody of the Florida Department of Corrections. The inadequate ca.re
rendered includes, but is not limited to, failme to identify and treat Mr. Dettmann's C. Diff
infection following a routine operation at Memorial Hospital Jacksonville. The foregoing
description of the prospective defendants' negligence is not exhaustive but is merely intended. to
comply with the statutory and rule notice requirements. We reserve the right to include any and
all allegations of negligence that Iilay be revealed during pre-suit discovery or during litigation.
A more extensive discussion of the prospective defendants' negligence, as well as
corroboration of reasonable grounds to initiate medical negligence litigation, is provided by tb.e
enclosed verified expert opinion report of Dr. Car Maier. Dr. Ellen Murray has also rendered an
opinion fmding medical negligence, which will be forwarded upon receipt. Their expert opinion
letters are by reference incorporated into this notice of intent to initiate litigation. Copies of the
records that were reviewed by the experts are submitted herewith. Also attached is a list of all
known health care providers seen by the claimant for the injuries complained of subsequent to the
alleged act of negligence, and a iist of all known health care providers during the 2-year period
prior to the alleged act of negligence who treated or evaluated the claimant.
Pursuant to Section 627.4137, Florida Statutes, please immediately provide the name and
limits of any liability insurance coverage that may be applicable to the claims herein. In addition,
as provided by Section 627.413 7, Florida Statutes, you are required to forward to each known
insurer our request for the following information, which must be furnished within 30 days from
the date hereof, in a statement under oath of a corporate officer or the insurer's claim manager or
superintendent: (a) the name of the insurer; (b) tl1e name of the insured; (c) the limits of the liability
coverage; ( d) a statement of any policy or coverage defense which such insurer reasonably believes
available to such insurer; and (e) a copy of the policy. You are also requested to immediately
furnish copies of any and all correspondence indicating any "reservation of rights" by any
insurance carrier or any otl1er correspondence reflecting any potential coverage defenses.
In addition, and in accordance with Chapter 766, Florida Statutes, and Rule 1.650, Fla.R
Civ.P,, you are required to immediately provide the following information:

2

NOI 000002

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 4 of 6 PageID 478

1. · Please state the date on which you contend the presuit period under Chapter 766,
Florida Statutes, expires.

2. Please state the full name.and date of birth, address, and social security number of all
personnel participating in the care or treatment of Curtiss Dettmann during 2018.
3. State whether any of the prospective defendants or their agents or employees have made
· any statements in any form to any entity or person regarding any aspect of the medical
treatment of Curtis Dettmann and if your answer is in the affirmative, please state the
· name and presen_t address of each entity or person to whom the statement was made;
and as to each such statement, state the date each statement was made, the form of each
such statement, whether written or oral, by recording device or stenographer; whether
·such ·statement if written was signed; and the name and present address of each person
presently having custody of each such statement.

.4. Describe in detail how Mr. Dettmann's condition was diagnosed and treated, including
all actions taken by the prospective defendants to identify and treat his malignant
hypertension.
5. Describe in detail each act or omission on the part of Mr. Dettmann that you contend
constituted negligence that was a contributing legal cause of the incident in question.
6.' Do you contend that any perso·n or entity other than the prospective defendants is, or
may be, liable in whole or in part for the claims asserted in this notice? If so, state the
full name and address of each such person or entity, the legal basis for your contention,
the facts or evidence upon which your contention is based, and whether or not you have
notified each such person or entity of your contention.
7. Were any prospective defendants charged with any violation of law, rule, or regulation
arising out of the incident described in this notice? If so, what was the nature of the
charge; what plea or answer, if any, did the prospective defendant(s) enter to the charge;
what court or agency heard the charge; was any written report prepared by anyone
regardi:qg th~ charge, and if so, what is the name and address of the person or entity
who prepared the reports; do you have a copy of the report; and was the testimony at
any trial, hearing, or other proceeding on the charge recorded in any manner, and if so,
what is the name and address of the person_who recorded the testimony?
8. List the names and addresses of all persons who are believed or known by you, your
agents or attorneys to have any knowledge considering any of the issues described in
this notice and specify the subject matter about which the witness has knowledge.
9. Have you heard or do you know about any statement or remark made by or on behalf
of any in.ember of the Dettmann family, or by any prospective defendant other than
yours~lf, concerning any issues described in this notice? If so, state the name and
address of each person who made the statement or statements, the name and address of
each person who heard it, and the date, time, place and substance of each statement.

3

NOI 000003

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 5 of 6 PageID 479

10. Do you intend to rely upon any expert witnesses or corroborating expert reports, in the
event you deny the claims set forth in this notice? If so, state as to each such witness
the name and business address of the witness, the witness's qualifications as an expert,
the subject matter upon which the witness is expected to testify, the substance of the
facts and opinions to which the witness is expected to testify, and a summary of the
grounds for each opinion.
11. Have you made any agreement with anyone that would limit that person or entity's
liability to anyone for any of the damages set forth in this notice? If so, state the terms
of the agreement and parties to it.
12. Please state if you have ever been a· party, either plaintiff or defendant, in a lawsuit
other than the present matter, and if so, state whether you were plaintiff or defendant,
the nature of the action and date and court in which it was filed.
13. Please state whether any claim for medical malpractice has ever been made against you
alleging facts relating to the same or similar subject matter as this notice, and if so, state
as to each such claim the names of the parties, the claim number, the date of the alleged
incident, the ultimate disposition of the claim, and the name of your attorney, if any.
14. If you believe or contend that this notice of intent and/or the verified opinion letter
submitted herewith are defective in any way, or fail to satisfy any statutory rule
requirement, then state in detail the basis of that belief or contention.
In addition, please provide the following documentary material within 20 days of receipt of
this letter, as required by Rule l.650(c)(2)(B), Fla.R.Civ.P.:
1. Any and all articles, literature, or other information obtained or viewed by the
prospective defendants in conjunction with the treatment or care of Mr. Dettmann
and any memorandum, notes or other written comments or communication in the
respective defendant's possession, custody or control which were made at any time
while Mr. Dettmann was in their care and which related to Mr. Dettmann' s care,
condition or treatment.
2. All liability insurance policies, including all attachments, endorsements,
amendments and riders, including all "excess" or "umbrella" policies, providing
coverage to the prospective defendants which may provide coverage for the claims
set forth herein.
3. Any and all correspondence with the Dettmann family.
4. Any and all statements obtained from or reportedly made by any member of the
Dettmann family.

4

NOI 000004

Case 3:20-cv-00036-BJD-LLL Document 63-1 Filed 06/23/20 Page 6 of 6 PageID 480

5. Any and all contracts of employment and any and all correspondence or
memorandum pertaining thereto, which were in effect with respect to any
prospective defendants providing care to Mr. Dettmann during 2018.
6. A list of all medical malpractice claims which have been filed against the
prospective defendants in the last 7 years, including the name and case number of
all claims, the names of the claimants, and the names of the claimants' attorneys.
Your failure to provide any of the above information could seriously interfere with our
ability to conduct a full investigation. Therefore, please ensure that your response to this request
for information is complete and timely.
We encourage you to consult with your insurers and attorneys immediately in order to
ensure compliance with Florida law. Any communications you wish to make to any member of
the Dettmann family should be addressed to the undersigned counsel.
Please be governed accordingly.
Sincerely,

Jesse Wilkison
Enclosures
cc: Mark S. Inch (Letter Only)
Jimmy Patronis (Letter Only)

5

NOI 000005

Case 3:20-cv-00036-BJD-LLL Document 63-2 Filed 06/23/20 Page 1 of 121 PageID 481

EXHIBIT B

Case 3:20-cv-00036-BJD-LLL Document 63-2 Filed 06/23/20 Page 2 of 121 PageID 482
CONTRACT #C2869
CONTRACT BETWEEN
THE FLORIDA DEPARTMENT OF CORRECTIONS
AND
CENTURION OF FLORIDA, LLC
This Contract is between the Florida Department of Corrections ("Department") and Centurion of Florida,
LLC ("Contractor") which are the parties hereto.
WITNESSETH
Whereas, the Department is responsible for the inmates and for the operation of, and supervisory and
protective care, custody and control of, all buildings, grounds, property and matters connected with the
correctional system in accordance with Section 945.04, Florida Statutes;
Whereas, it is necessary that budget resources be allocated effectively;
Whereas, this Contract is entered into pursuant to Section 287.057(3)(e)5., Florida Statutes, which authorizes
health services involving examination, diagnosis, treatment, prevention, medical consultation, or
administration to be procured without receipt of sealed competitive bids or competitive sealed proposals; and
Section 945.025(4), Florida Statutes, which provides that nothing contained in Chapter 287, Florida Statutes,
shall be construed as requiring competitive bids for health services involving examination, diagnosis, or
treatment; and funded in Line Item 737, General Appropriations Act, 2015; and
Whereas, the Contractor is a qualified and willing participant with the Department to provide Comprehensive
Healthcare Services to the Department’s inmates in Regions I, II, and the following institutions in Region III:
Avon Park CI, Central Florida Reception Center (CFRC), Florida Women’s Reception Center (FWRC),
Hernando CI, Lake CI, Lowell CI, Marion CI, Polk CI, Sumter CI, and Zephyrhills CI, and their assigned
satellite facilities, including annexes, work camps, road prisons and work release centers.
Therefore, in consideration of the mutual benefits to be derived hereby, the Department and the Contractor
do hereby agree as follows:
I.

CONTRACT TERM AND RENEWAL
A.

Contract Term
This Contract shall begin on February 1, 2016, or the date on which it is signed by both
parties, whichever is later (“Contract Start Up”) and shall end at midnight on January 31,
2018 (“Contract Termination”). In the event this Contract is signed by the parties on
different dates, the latter date shall control. The Contract Implementation period shall be
defined as 12:01 am of April 17, 2016 up through and including no later than 12:01 am on
June 1, 2016.
This Contract is in its initial term.

B.

Contract Renewal
The Department has the option to renew this Contract for up to three (3) years, or any
portion thereof, after the initial Contract period upon the same terms and conditions
contained herein and at the renewal prices indicated in Section III., COMPENSATION.

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Exercise of the renewal option is at the Department’s sole discretion and shall be
conditioned, at a minimum, on the Contractor’s performance of this Contract and subject to
the availability of funds. The Department, if it desires to exercise its renewal option, will
provide written notice to the Contractor no later than sixty (60) days prior to the Contract
expiration date. The renewal term shall be considered separate and shall require exercise of
the renewal option should the Department choose to renew this Contract.
II.

SCOPE OF SERVICE
A.

General Service Description/Purpose
1. The Contractor is to establish a program for the provision of staffing and operation of
health, mental/behavioral health, dental, healthcare network and utilization management,
and any claims management services for all institutions. The program is to meet
constitutional and community standards, the standards of the American Correctional
Association (ACA) and/or National Commission on Correctional Health Care
(NCCHC), Florida Statutes, Florida Administrative Code, court orders, applicable
policies, procedures, and directives regarding the provision of health services in the
Department. Department policy, procedure, or directive language will take precedence
over the Contractor’s policies and procedures in the event of any conflict between the
two.
2. The Contractor shall provide services in accordance with the American Correctional
Association (ACA) Performance Based Standards, Expected Practices and Outcome
Measures and/or National Commission on Correctional Health Care (NCCHC) and
prevailing professional practices. The performance of the Contractor’s personnel and
administration must meet or exceed standards established by ACA and/or NCCHC as
they currently exist and/or may be amended. The contractor shall identify the clinical
criteria utilized to determine necessity for health care and treatment that at a minimum
meet National Clinical Practice Guidelines (i.e. internally developed or other national
criteria).
3. Under no circumstances shall service delivery meeting less than the minimum service
requirements be permitted without the prior written approval of the Department.
Otherwise, it shall be considered that services will be performed in strict compliance
with the requirements and rules, regulations and governance contained in this Contract
and Contractor shall be held responsible therefore.
4. The Contractor shall be responsible for all pre-existing health care conditions of those
inmates covered under this contract as of 12:00 am on the first day of the Contract
Implementation, per location as set forth in a schedule agreed upon by the Parties prior
to the Contract Implementation period. The Contractor shall be responsible for all health
care costs incurred for services provided after 12:00am on the first day of contract
implementation without limitation as to the cause of an injury or illness requiring health
care services.
5. In addition, the Contractor shall implement a written health care work plan with clear
objectives; develop and implement policies and procedures; comply with all state
licensure requirements and standards regarding delivery of health care; maintain full
reporting and accountability to the Department; and maintain an open, collaborative

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relationship with the Department’s Administration, Office of Health Services,
Department staff, and the individual institutions.
6. The Contractor understands and agrees that the Department’s institutions are first
charged with the responsibility for maintaining custody and security for inmates.
Therefore, the Department retains authority to assign inmates to the most appropriate
institution. The Contractor shall not dispute or refuse acceptance of any inmate
assignment based on any medical, dental and/or mental health condition (s).
7. The Contractor shall ensure that any person performing work under the Contract agrees
to adhere to all Department procedures, policies, and codes of conduct, including
procedures concerning fraternization and contact with inmates. The Contractor shall
ensure compliance with all applicable statutes, promulgated rules, court orders, and
administrative directives pertaining to the delivery of health care services. The
Contractor shall employ health care professionals whose licenses or certifications are
clear, active and without on-going discipline.
8. Access to and provision of comprehensive healthcare services will be in accordance with
minimum constitutionally adequate levels of healthcare and in compliance with
Department Policies and Procedures, court orders, Health Services’ Bulletins (HSB’s),
Technical Instructions (TI’s), Department Healthcare Standards, and Department
Memoranda regardless of place of assignment or disciplinary status.
B.

Health Care Services
Whenever possible, services will be provided on-site.
1. Reception and Health Screenings
Inmate reception/receiving screening shall include, but not be limited to:
•
•
•

Initial intake screening
Transfer/Arrival summary
Release screening

All newly committed inmates receive an Initial Intake Screening which occurs at the
point of entry into the Reception Center. The screening is conducted by a registered
nurse, licensed practical nurse, or trained nursing support staff. Initial Intake Screening
includes a review of:
•

•
•
•

•
•
•

Past history of serious infectious or communicable illness, and any treatment or
symptoms (e.g., chronic cough, hemoptysis, lethargy, weakness, weight loss, loss of
appetite, fever, night sweats that are suggestive of illness), and medications
Current illness and health problems, include communicable diseases
Dental problems
Use of alcohol or drugs, including type(s) of drugs used, mode of use, amounts used,
frequency used, date or last time of use, and history of any problems that may have
occurred after ceasing use.
Gynecological problems (female only)
Past pregnancies or current pregnancy (female only)
Previous screening, tests (including TB Screening/testing and lab tests),
immunization history and labs, and other diagnostic procedures, e.g. chest X-Ray

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that would normally be performed on all inmates upon their arrival, transfer and/or
release, in accordance with Department procedure.
Documentation of observation of the following:
•
•
•

Behavior, including state of consciousness, mental status, appearance, conduct,
tremor and sweating
Body deformities and ease of movement
Condition of skin, including trauma markings, bruises, lesions, jaundice, rashes,
infestations, recent tattoos and needle marks, or other indications of drug abuse

Documentation of medical disposition of the inmate:
•
•
•

General population
General population with prompt referral to health care service
Referral to appropriate health care service for emergency treatment.

The Transfer/Arrival Summary occurs every time an inmate transfers between
Department institutions. The purpose of the transfer/arrival summary is to create a check
and balance system designed to maintain an inmate’s specific appropriate continuum of
care. It includes a brief review of the health record and a face-to-face interview with the
inmate. The screening and summary must incorporate review of the problem list,
suicide history, known allergies, impairments, treatment plan, tuberculosis (TB) screen,
age appropriate interventions, medication review, review of special needs, current
behavior, vital signs and any other unique aspects of care. Orders and medications
issued at one institution are considered valid at all institutions unless specifically
discontinued by an authorized prescriber at the receiving institution. When the nurse’s
transfer summary identifies a problem or a question, consultation with the practitioner –
either on site or on call – should occur immediately. This process contrasts with, but is
similar to, the required immediate review that should occur upon return from any outside
medical institution. Both have as their purpose delivery of seamless and appropriate care
to inmates.
For all reception and transfers, an explanation of procedures for accessing health
services shall be provided to inmates verbally and in writing upon their arrival to the
institution. The Contractor shall develop a procedure to ensure the transfer of pertinent
medical information to emergency institutions, outside specialty consultants, and for
inmates who are transferred to other state institutions.
When inmates are transferred to other Department institutions, the medical record (and
medications) shall be transferred with them in a sealed container marked confidential
unless there is a complete electronic health record that will be available at the receiving
institution.
In addition, prior to an inmate’s release, the health record of an inmate must be
reviewed and a medical screening conducted in accordance with Department procedures.
2. Service Lists Upon Transfer between Institutions
The Contractor shall ensure that adequate communication occurs between health
professionals to ensure continuity of care. Inmate’s health care needs should be triaged
in an expeditious manner upon arrival. A patient should not drop to the end of a service

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list for a medically necessary service simply because they are new to the institution, if
they had been waiting for the service in their former institution.
3. Infirmary Care
The Department operates institutional infirmaries. The infirmaries shall be under the
supervision of a registered nurse twenty-four (24) hours a day. These units are not
hospital units and cannot substitute for hospitals, but will meet ACA and/or NCCHC
standards. The Contractor is expected to manage these units and ensure that infirmary
care is available for all inmates. The Contractor is responsible for maintaining all
infirmary equipment that will ensure the healthcare delivery to the inmates. The
Contractor will work with the Department to arrange transfers among the secure care
institutions when that will improve inpatient unit utilization. In general, infirmaries shall
provide convalescent care, skilled nursing care, pre- and post-surgical management, and
limited acute care. When existing infirmaries cannot provide necessary care (whether
because of program characteristics, bed availability, or other reason) but outpatient care
is not appropriate, the Contractor shall comply with established policy.
The Contractor shall assure that the following characteristics are maintained or
implemented in all infirmaries:
•
•
•
•
•
•
•
•

A physician is on call or available 24 hours a day, with a telephone response time of
15 minutes or less.
Admission and discharge shall be upon the order of a physician, dentist, nurse
practitioner, or physician assistant.
Clinicians will make daily rounds in the infirmary on all inmates requiring overnight
stays (patients who require more intensive care than can be provided by the existing
coverage must be hospitalized and not maintained in infirmaries).
When inpatient services are provided, the infirmary will be staffed twenty-four (24)
hours per day by health care personnel.
The infirmary shall maintain a current policy and procedures manual and clinical
protocols approved by the Department’s Office of Health Services for use in the
institutions.
All patients will be within sight or sound of staff at all times.
The infirmary space and equipment shall be adequate and appropriately cleaned and
maintained for the intended purposes. The Contractor must maintain a preventive
maintenance program.
Each admitted patient shall have:
○ A separate and complete inpatient record with chief complaint, history of
present illness, past history and review of systems (physical examination that
includes a review of systems, vital signs, initial impression, medical care plan,
nursing assessments and clinician progress notes, discharge summary, new
orders, problem list, and treatment plan.
○ An initial nursing assessment is completed within 2 hours of admission.
○ A mental health or medical health nursing assessment is completed each shift
unless otherwise ordered by the clinician.
○ Staff shall make rounds at least every 2 hours for all inmate patients in the
infirmary.
○ An initial admission note by the nurse reflecting a summary of the patient’s
status.

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○
○
○
○
○
○
○

An initial admission note by the admitting practitioner reflecting the purpose for
admission and anticipated treatment process, generally completed within 24
hours of admission.
An admission history and physical examination, problem list and treatment plan
prepared by the responsible practitioner specifically for the inpatient stay
initiated within one business day of the admission.
When mental health concerns are the primary focus of health care needs, mental
health staff will perform daily (Monday – Friday, excluding holidays) treatment.
Diagnostic studies appropriate to the patients needs.
Progress notes from physician, nursing, and other staff reflecting ongoing care
and progress.
Discharge planning initiated as soon as possible after admission.
Discharge summaries including general patient education and care provided,
completed within 48 hours of discharge.

4. Health Appraisals and Assessments
The Contractor’s clinician shall:
•
•
•

•

•
•
•

complete a health appraisal within 72 hours after the inmate’s arrival at reception;
review the initial intake screening;
complete a history and physical examination which must include:
○ Collection of data to complete medical, dental, immunization, and appropriate
psychiatric histories
○ Record of height, weight, pulse, blood pressure (BP), and temperature
○ Vision and hearing screening
○ Complete medical examination with evaluation of basic mental health status and
dental health status, referral if needed, and /or treatment when indicated.
○ History of alcohol and /or substance abuse.
test for communicable diseases, including appropriate laboratory and diagnostic tests
(STD’s and TB skin testing as appropriate); the Contractor’s physician must test for
HIV (HIV testing is offered at reception and upon transfer, but is optional until the
required pre-release test);
initiate and prescribe treatment, therapy, and/or referrals when appropriate;
perform other tests and examinations as required and indicated, including physicals
for work release inmates and food handlers when necessary, and
Mental health status and history.

Information obtained during the health appraisal must be recorded on a form approved
by the Department’s Office of Health Services. This information will be reviewed by
the Contractor’s physician for problem identification and entered in the patient’s
permanent health record.
A review of the initial health appraisal process shall be required each month from each
institution through one or more of the following processes: Contractor’s reports to the
Department, the Department’s Contract Monitoring staff review, and/or EHR data
collection.
•

The findings of the preliminary screening and evaluation will be documented in the
inmates’ health records. Additionally, transferred inmates initial screening forms
will be reviewed and verified for their accuracy by qualified health care staff.

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•
•

•
•

Health care professionals shall refer inmates exhibiting signs of acute mental illness,
psychological distress, or danger of harm to self or others to the qualified mental
health professional staff member for further evaluation.
The preliminary health evaluation will include a review of the respective transferee’s
medical record from the transferring reception center, including:
○ Inquiry into:
ƒ Current illness
ƒ Communicable diseases
ƒ Alcohol and chemical abuse history
ƒ Medications currently being taken and special health care requirements
ƒ Dental health status
ƒ Chronic health problems
ƒ Immunizations
ƒ Dietary requirements
ƒ Suicide risk
○ Observation of:
ƒ Loss of consciousness
ƒ Mental status (including suicidal ideation)
ƒ Odd conduct, tremors, or sweating
ƒ Condition of skin and body orifices including signs of trauma, bruises,
lesion, jaundice, rashes, infestations, and needle marks or other indications
of drug abuse.
Explanation of procedures necessary for inmates to access medical, mental health
and dental services.
Inmates will be classified into one of the following categories:
○ Immediate emergency treatment needed
○ Assignment to infirmary
○ Referral to an appropriate health service
○ Assignment to the general population

5. Daily Processing of Inmate Sick Call Request
The Department utilizes a written “Inmate Sick Call Request Form” to permit inmates to
request health care services. These forms are collected and reviewed daily by nursing
staff. Most Inmate Sick Call request forms require a face-to-face meeting with health
services staff, which must occur within one working day. After this review, inmates are
“triaged” to various health care professionals and/or provided with a written response
appropriate to the described need and the existing health record information.
Inmate Sick Call requests must be processed at least daily as follows:
•
•

Health services providers personnel (physicians, mid-levels, or nurses) will review
and act upon all complaints with referrals to other qualified health care personnel as
required.
The responsible clinician will determine the appropriate triage mechanism to be
utilized for specific categories of complaints.

Sick call must be held at least five (5) times per week by a registered nurse(s) for each of
the institutions named in this Contract and must be accessible to all inmates regardless of
their custody status.

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All routine physician care must be provided on site. A physician or mid-level provider
shall be on-site through the completion of call outs, treatments and follow up care. A
physician shall be on call 24 hours per day, seven days per week. The Contractor must
make provisions for additional sick call out hours if the inmate’s waiting time exceeds
48 hours. If an inmate’s custody status precludes attendance at a sick call out
appointment, arrangements must be made to provide services at the designated medical
room in the area of the inmate’s confinement. Note: The Department will allow certain
health care services to be provided via Telehealth, under the conditions outlined in
Section II., B., 24.
Referral from routine triage to other health care staff members shall occur in accordance
with Department procedures. The Department requires routine referrals to take place in
accordance with established policy and procedures as follows:
•
•
•
•
•
•

From review of Inmate Sick Call Request Form (SCRF) to face-to-face review
(when indicated by routine health need) – no more than one working day.
Referral to a practitioner for routine care – one working week or less.
For review of SCRF routine dental, request by dental professional – within seventytwo (72) hours
For review of routine mental SCRF by mental health staff –. within seventy-two
(72) hours
To optometrists – within one month.
To other on-site professionals – in a time frame appropriate to the patient need.

The Contractor is required to meet these standards and to notify the Department in
writing within one business day when any of the institution’s waiting lists exceeds the
time-frames listed above.
6. Chronic Care Management
When chronic diseases are identified, necessary medical services must be provided and
documented. The Contractor shall enroll the inmate in a chronic illness clinic and
implement a chronic disease management plan. For each identified condition, the
medical record must reflect the identified chronic disease and a current problem list
appropriate to the individualized treatment plan.
Interventions for inmates with chronic diseases must meet generally recognized
standards of care. When outside specialty review is appropriate, it shall be provided in a
timely manner consistent with the standards described above.
When an inmate with a chronic disease is released from a Department institution, the
condition must be identified during the pre-release stage to identify community
resources to meet the inmate’s health needs
7. Medication Administration
The Contractor is responsible for prescribing and administering medications in
accordance with ordered or recommended dosage schedules, to document such
provision, and to ensure that all dispensed medications are properly stored and all related
duties are performed by properly licensed personnel. The Contractor shall manage the
dispensed and stock supply medications to be in compliance with all applicable state and

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federal regulations regarding prescribing, dispensing, distributing, and administering
pharmaceuticals.
8. EKG Services
EKG services must be available at the institutions at all times. EKG services will have
the following characteristics:
•
•
•
•

A printed EKG will be available immediately and placed on the chart.
Whether or not a computer interpretation is provided, all EKGs shall be reviewed by
a physician. A review by a cardiologist will be available upon request by the
institution practitioner.
EKG equipment will be properly and safely maintained.
Physicians reading will determine when an inmate may require a consult and/or offsite evaluation.

9. Laboratory Services
All laboratory and phlebotomy services must be provided for Departments’ inmates and
will be the responsibility of the Contractor. Laboratory specimens are to be collected by
a qualified health care person. Results must be placed in the inmate’s health record upon
receipt and the Contractor’s physician will review all normal and abnormal results.
Contractor is responsible for phlebotomy personnel, laboratory services, and all related
supplies.
10. Optometry and Ophthalmology Services
Optometry and ophthalmology services should be provided on-site wherever possible. Any
exception to these requirements must be approved in advance by the Department. All
optometric and optical services, including the cost of lenses, frames, and cases, will be the
responsibility of the Contractor. All optometry services are the Contractor’s responsibility.
11. X-Ray Services
Contractor will be responsible for providing X-Ray services or performing on-site
radiographs necessary for medical evaluations. All X-rays will be provided in digital
format.
12. Radiotherapy Services
The Department currently maintains a contract for radiotherapy services with CCCNFLake Butler, LLC (Department Contract #C2573). The Contractor shall use the CCCNFLake Butler, LLC (pursuant to the referenced contract) for all radiotherapy services
provided under this Contract or Department designated substitution. The Contractor is
responsible for all costs incurred in the provision of radiotherapy services by CCCNFLake Butler, LLC. The Contractor shall pay CCCNF-Lake Butler, LLC (Department
Contract #C2573) directly. The Department shall provide all supporting services
outlined in the contract with CCCNF-Lake Butler, LLC.
13. Inpatient Hospital Services
The Department currently operates a prison hospital at the Reception and Medical
Center that meets AHCA licensure requirements, and contracts with Memorial Hospital

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in Jacksonville and Kendall Regional Medical Center in Miami for the provision of
hospital care at secure units within the hospitals.
The Contractor shall provide inpatient hospitalization services. When hospitalization of
an inmate is required, the Contractor will be responsible for the arrangement and timely
access to care. In emergency situations, the Contractor shall have a process in place for
the inmate to receive emergency services.
Acute hospitalization care for mental illness that requires involuntary placement and
involuntary medication must be accessed through judicial proceedings in accordance
with Sections 945.40 through 945.49, Florida Statutes (The Florida Corrections Mental
Health Act). The Contractor’s staff will be expected to provide testimony in support of
the institution’s request for involuntary placement and/or treatment.
The Contractor shall review the health status of inmates admitted to outside hospitals
daily through a utilization management program, to ensure that the duration of the
hospitalization is not longer than medically indicated. Contractor shall provide the
Department’s Office of Health Services with a daily update/report of the health status of
all hospitalized inmates from each institution.
Currently, the Department has an established fee schedule for services provided by RMC
Hospital/Institution to Wexford Health Sources inmates and inmates housed at private
prisons. The Contractor shall be entitled to reimbursement for services provided to
Wexford Health Sources inmates and inmates housed at private prisons in accordance
with this fee schedule. The fee schedule will be reviewed at least annually, but not more
than semi-annually, by the Department and the Contractor. All fees shall be approved
by the Department.
The comprehensive health care Contractor for the nine institutions in South Florida (the
areas previously referred to as Region IV) will not be required to transfer patients to
RMC Hospital/Institution for services; however, the Contractors may use the services
provided if cost reductions can be achieved.
The reimbursement for using RMC Hospital will be based on an all-inclusive Daily
Inpatient Rate established by the Department. The rate will be invoiced per twenty-four
(24) hours or any part thereof over twelve (12) hours. Inmate services provided for less
than twelve (12) hours will be charged at one-half (1/2) the Daily Inpatient Rate. The
reimbursement for using outpatient services at RMC will be based on the reimbursement
rate between the Contractor and the vendor providing the services.
In order to ensure equal access to RMC services for all Contractors, the Department
shall approve, pre-authorize, and retain final authority for all movement/transfers, except
for emergency hospital admissions.
14. Specialty Care
When possible the Contractor shall make specialty care available on-site. Off-site nonemergency consultations must be recommended by the appropriate Contractor’s
institutional health care staff and reviewed by Contractor for approval. Contractor’s
utilization review process shall be in accordance with established Department policy and
procedures.

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When this is not possible, the Contractor shall make referral arrangements with local
specialists for the treatment of those inmates with health care problems, which require
services beyond what can be provided on-site. The Contractor shall coordinate such care
by specialists and other service providers in the state. All outside referrals shall be
coordinated with the Department for security and transportation arrangements.
The Department strives to minimize the need for inmates to travel off-site. Specialty
referrals must be scheduled in accordance with established policy and procedures and
completed within a reasonable period of time consistent with the community standard.
The services listed below must be made available under this Contract, but additional
services may be required. The Department expects that the majority of the specialty
services be performed on-site.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Oral surgery
OB/GYN Services
Gastroenterology
Surgical services
Orthopedic services
Physiotherapy services
ENT
Podiatry
Dermatology
Urology
Neurology
Internal medicine
Audiology
Neurosurgery/Neurology
Oncology
Nephrology
Endocrinology
Infectious disease treatment
Ophthalmology
Respiratory therapy
Cardiology
Physical therapy
Orthotics

15. Emergency Medical Services
Comprehensive emergency services shall be provided to inmates in the Department.
Contractor shall make provisions and be responsible for all costs for twenty-four (24)
hour emergency medical, mental health, and dental care, including but not limited to
twenty-four (24) hour on-call services.
16. Ambulance services
All medically necessary inmate transportation by ambulance or other life-support
conveyance, either by ground or air, will be provided by the Contractor. All costs for
ambulance services are the responsibility of the Contractor. In accordance with Florida

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Statutes, County Emergency Medical Services are solely responsible for determining the
need for air transport (Life Flight); however, the Contractor will cover the costs of such
services. The Contractor is expected to have a written plan with appropriate community
resources for required emergency transportation services. Contractor shall provide the
Department with a copy of the plan. Such ambulance and or advanced life services shall
be by pre-arranged agreement.
17. Dialysis Services
The Contractor shall identify and provide all on-site and off-site peritoneal and/or
hemodialysis services, supplies, equipment, and other related expenses. The Contractor
shall provide a Board Certified Nephrologist to supervise all dialysis services. The
Contractor is responsible for developing a renal dialysis Quality Improvement and
Infection Control Program to include accountability of sharps and waste.
18. Specialty Care for Impaired, Pregnant and/or Elderly Inmates
The Contractor shall provide appropriate care for inmates with complex medical needs
in compliance with state and federal laws, and shall coordinate with the Department’s
ADA Coordinator for reasonable accommodations. The Contractor shall ensure inmates
with a known or suspected medical or physical impairment or mental retardation receive
appropriate care. Care for impaired inmates should meet the needs of the inmate as both
an inmate and an impaired person, and focus upon the total person and the
mainstreaming service concepts, the continuity of required services, and inmate selfresponsibility within the limitation required by incarceration.
19. Emergent or Urgent Offsite Care
The institutions must have access to 24/7 on call availability of physician, psychiatrist,
psychologist, dentist, and health care administrator services. The on-call coverage shall
be made available by the service Contractor responsible for on-site services.
When inmates experiencing emergent or urgent health problems are brought to the
attention of institution personnel, health care personnel must be prepared to address
them immediately. This response may consist of permitting the patient to report or be
escorted to the health services unit/infirmary for evaluation, or sending health services
personnel to the patient’s location. The Contractor must plan in advance for the
management of emergency services, and must maintain an “open” system capable of
responding to emergency circumstances as they occur.
Contract employees shall not provide personal transportation services to inmates.
20. Infection Control Program
Infectious diseases of special concern within an institutional setting include TB,
Hepatitis B, Hepatitis C, Human Immunodeficiency Virus (HIV), gonorrhea, syphilis,
Chlamydia, influenza, Varicella and Methicillin Resistant Staphylococcus Aureus
(MRSA). Communicable diseases must be monitored closely by all health care staff.
When communicable diseases are diagnosed, the Contractor must take proper
precautions and promptly transmit the appropriate reports to the Florida Department of
Health, outside hospitals/healthcare delivery facilities and notify the Department’s
Office of Health Services. All Contractors’ employees and sub-Contractors must provide

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documentation of Hepatitis B immunizations, and annual TB screening and skin test
clearance.
The Contractor shall implement an infection control program, which includes concurrent
surveillance of inmates and staff, preventive techniques, and treatment and reporting of
infections in accordance with local and state laws. The program shall be in compliance
with CDC guidelines on universal precautions and OSHA regulations.
Other areas of concern include monitoring and management of nosocomial infection and
pediculosis both in inpatient units and in the general institution units, sterilization and
sanitation practices (especially in dental departments), management of isolation
activities, and kitchen sanitation (monitored but not managed by health care services).
Infection control workgroups should meet regularly at each institution and report their
findings through the Quality Assurance process.
As part of the infection control program, the Contractor will administer an immunization
program according to National Recommendations of Advisory Committee on
Immunization Practices (ACIP), a tuberculosis control program according to CDC
guidelines and any youthful inmate institutions shall participate in the federal Vaccines
for Children program (VFC). This program provides all vaccines used in youth settings,
including but not limited to HBV, at no cost to the Department. The Contractor’s
personnel must register for this program.
The Contractor will administer a Bloodborne Pathogen Control Program according to
National Guidelines and Department practices. The Contractor must comply with all
provisions of this plan. The Contractor will be required to offer Hepatitis B vaccine to
all new Department employees as part of the Bloodborne Pathogen Control Program.
21. First Aid Kits, Automatic External Defibrillators (AEDs), and Protective Devices
The Contractor will be responsible for providing and maintaining emergency first-aid
kits in all housing areas, vehicles, work sites, training areas, classrooms, and other areas
designated by the Department.
•
•

The Contractor will be responsible for providing and maintaining Automatic
External Defibrillators (AEDs) in designated areas of the institution as determined
by the Institutional Health Services Administrator or designee.
The Contractor will supply all personnel who come in contact with inmates with
personal protective equipment

22. Sexual Assault
The Contractor shall follow and enforce the Department’s Prison Rape Elimination Act
(PREA) policies which mandate reporting and treatment for abuse or neglect of all inmates
in the secure institutions. The Prison Rape Elimination Act (PREA) is federal law, Public
Law 108-79, signed into law in September 2003 by the President of the United States and
now designated as 42 USC § 15601-15609. PREA establishes a zero-tolerance standard
against sexual assaults and rapes of incarcerated persons of any age. This makes the
prevention of sexual assault in Department institutions a top priority. PREA sets a standard
that protects the Eighth Amendment right (Constitutional right prohibiting cruel or unusual
punishment) of Federal, State, and local inmates.

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23. Utilization Management (UM) Services
The Contractor must manage provision of services to avoid unnecessary off-site travel
while insuring that necessary consultations and off-site services are provided.
Therefore, the Contractor must implement an electronic Utilization Management (UM)
Program, which includes nationally accepted criteria, to manage inmate healthcare. The
Contractor shall give read-only and reporting access to the Utilization Management
(UM) system data to the Department.
The Contractor must also manage requests for off formulary medication usage
(formulary exception process). At a minimum, the following information must be
provided to the Department:
•

The Department’s Office of Health Services timely reviews alternative actions and
discusses resultant concerns with the Contractor’s medical director. If an agreement
cannot be reached, the Department’s Office of Health Services’ opinion shall prevail.

24. Telehealth Services
The Contractor will be responsible for the cost of acquiring and maintaining the
necessary telemedicine communication system, equipment and consultations provided
by telemedicine. The Contractor will also be responsible for paying for all telemedicine
service line/data charges for communications related to the provision of health care to
Department inmates. The proposed solution must meet the following minimum
requirements, and shall be approved by the Department’s Office of Information
Technology (OIT):
Platform/Network –
• Browser IE7
• Useable at 1024x768 resolution
• Runs on a 64-bit platform Windows 2003 server & above
• Application runs on Microsoft SQL 2008 or 2005 environment and above
• PC shall have a minimum of MS XP Pro, 512 MB RAM & 1GHz CPU
• Must be Windows Active Directory compliant
• Application supports clients connecting at T1, T3, WAN speed, and 100 mbps
• Must integrate with supporting single sign-on User ID and be centrally managed
• Must support HL7 compatibility as well as other data standards
The proposed solution will be Intranet web-based and users will need Internet Explorer
to access the application. Users will not be required to have a client module on their PC.
Updates (including white papers), patches and fixes must be approved by the
Department’s Office of Information Technology; however, the Contractor will be
responsible for any up-load and install.
Software offered must have the ability to:
Be compliant with the Health Insurance Portability and Accountability Act (HIPAA) and
the HITECH Act. Any service, software, or process that handles and/or transmits
electronic protected health information must do so in full HIPAA compliance and with
encryption provided as a part of the service, software, or process. In addition, the
transmission and encryption scheme supplied by the Contractor must be approved by the

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Department’s Office of Information Technology prior to implementation. Confidential
or personal health information includes but is not limited to, all social security numbers,
all health information protected by HIPAA, and addresses of law enforcement officers,
judges, and other protected classes. Pursuant to Florida Statute 119.071(5)(a)5, social
security numbers are confidential information and therefore exempt from public record
or disclosure.
25. Nursing Services
Nurses must perform the following functions:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

C.

Respond to inmate patients medical needs
Practice within scope of educational preparation and licensure
Restore and maintain the health of inmates with compassion, concern, and
professionalism
Collaborate with other healthcare team members, correctional staff, and community
colleagues to meet the needs of the inmates, which include physical, psychosocial
and spiritual aspects of care
Provide education for disease prevention and health promotion
Maintain responsibility for monitoring and evaluating nursing practice for
continuous quality improvement
Deliver care to all inmates with compassion, empathy, commitment, competency,
dedication, and a positive attitude
Negotiate, problem solve, listen and communicate effectively
Good assessment, organizational, critical decision making and thinking skills
Conduct an appropriate and timely assessment
Collect comprehensive data pertinent to the inmate’s health and condition or
situation
Analyze the assessment data to determine the diagnoses or issues or need for referral
to appropriate discipline
Identify expected outcomes for a plan individualized to the inmate or situation
Develop a plan that prescribes strategies and alternatives to attain expected outcome
Implements identified plan
Coordinates care delivery
Employs strategies to promote health and a safe environment
Evaluates progress towards attainment of outcomes
Enhances the quality and effectiveness of nursing practice
Attains knowledge and competency that reflects current nursing practice
Integrates ethical provisions in all areas of practice
Considers factors related to safety, effectiveness, cost, benefits, and impact on
practice in the planning and delivery of nursing services
Render or secure appropriate healthcare services
Timely, accurate and complete documentation record(s)
Comply with Department Policy Procedure, Health Services Bulletins, Court Orders,
Technical Instructions, Manuals, Federal and State Law, ACA and/or NCCHC
Standards

Dental Services
1. General Overview
The Contractor shall be responsible for all inmate dental services and shall identify,
plan, and provide for all on-site general dental services. This includes all care that is

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normally provided in the dental unit, dental treatment that cannot be performed in the
unit, as well as responding to any emergencies occurring in the dental area until
appropriate medical or mental health providers arrive. The Contractor shall have a
Dental Director responsible for providing clinical oversight of all dental care, both on
and off site, and Dental Utilization Management. The Dental Director will also be
responsible for supervision of all dental staff members.
A standardized program of routine, urgent and emergency dental services is to be
available to all inmates. Emphasis shall be placed on preventative dental practices. All
treatment will be rendered in accordance with Department of Corrections’ rules,
policies, procedures and Health Services Bulletins/Technical Instructions.
Comprehensive dental services will be provided at a minimum constitutionally adequate
level of care. This means all necessary dental care will be provided either routinely,
urgently or emergently as dictated by the need to resolve the issue presenting itself.
Dental treatment shall be provided according to the treatment plan, based upon
established priorities that in the dentist’s judgment are necessary for maintaining the
inmate’s health status.
a. The Contractor shall be responsible for all on-site and/or off-site dental treatments
and all other needed dental specialty care. All dental supplies, dental laboratory fees
and all dental equipment repairs, to include equipment replacements, shall be the
responsibility of the Contractor.
b. Dental sick call shall be performed daily Monday through Friday when a dentist is
present. For emergencies, dental sick call shall be performed on Saturdays,
Sundays, and Holidays by the medical staff on duty. Inmates must be able to signup for sick call seven (7) days a week and the sick call sign-up form shall be triaged
daily by healthcare staff.
c. Inmates experiencing dental care emergencies may request and shall receive
emergency care at any time, if indicated, twenty-four (24) hours a day seven (7)
days a week.
d. Designated institutional dental healthcare staff will be responsible for coordination
with the institutional Health Services Administrator for purposes of coordination and
provision of institutional healthcare. The institutional Health Services Administrator
will be responsible to the institution’s Warden for coordinating and ensuring the
provision of all institutional health care. Questions or issues arising during the
course of daily activities that cannot be resolved at the institution will be referred to
the Contract Manager and/or designee.
Dental medications will be administered/dispensed by the Contractor at the dental clinic
or a prescription will be written for administration of the medication by health care staff.
Prescriptions will be written for dispensing by the assigned pharmacy to be issued by
health care staff.
Note: The DOC Pharmacy currently provides stock medication for dispensing by
dentists (Ibuprofen/erythromycin/etc). DOC Pharmacy does not currently provide other
dental medications (lidocaine injections, etc.).
Inmates cannot dictate dental treatment in any form; however, inmates can refuse dental
care at any time. The contracted dentist will decide the appropriate treatment plan

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individualized for each inmate. The Contractor cannot refuse to treat an inmate seeking
emergent, sick call, urgent or routine dental care.
2. Dental Examinations/Assessments
a. Every inmate shall receive an intake dental examination at a reception center by a
dentist. The intake dental examination shall take place no later than seven (7) days
after reception. Each examination of this type shall include, at a minimum, a visual
clinical exam of the head, neck, intraoral areas for any pathology and charting
consisting of: missing teeth, restorations present, fixed or removable prosthetics,
gingival conditions, deposits, masticating efficiency, treatment indicated
(provisional treatment plan), dental grade, and emergency dental needs.
b. Each inmate shall receive, within seven (7) days of arrival at an institution, an
orientation to dental services, which includes information on available hours of
service and how to access dental care at the institution. The Dental Treatment
Record shall be reviewed for emergency/urgent dental needs or follow-up care. If an
inmate's dental record has not been received within seven (7) days or the inmate has
not had a dental examination in accordance with established policy, one is to be
completed within seven (7) days and a replacement dental record generated where
indicated.
c. Each inmate shall receive a periodic dental examination in accordance with
established policy. Each periodic examination shall consist of a clinical examination
of the head, neck and intra-oral areas, evaluation of urgent dental needs.
d. A dental examination/assessment shall be performed by a dentist on confined
individuals, when determined necessary.
e. Before commencing with routine dental treatment, a diagnosis and treatment plan
shall be derived from the following: a clinical examination, pathology examination,
full mouth radiographs, Periodontal Screening and Recording, plaque evaluation as
appropriate, charting, and health history.
f.

The topical application of fluoride may be included in the dental treatment plan as
deemed necessary by the treating dentist. The topical application of fluoride shall be
included as part of the dental treatment plan for all youthful inmates.

3. Priorities for Dental Treatment
a. Emergency Dental Treatment: Emergency dental treatment will be available on a
twenty four (24) hour basis through the on-duty dental staff during working hours.
In the event a dentist is not available at a facility to treat a dental emergency, the
emergency will be referred to the medical department in accordance with nationally
accepted dental emergency protocols and dental emergency policies which must
provide back-up dental coverage. There is to be no waiting list for dental
emergencies.
Dental emergencies generally include fractured jaw, excessive
bleeding or hemorrhage, acute abscess, and/or other acute conditions.
b. Urgent Non-emergency Dental Treatment: All Department of Corrections’ dental
clinics shall hold daily sick call (five (5) days a week Monday through Friday or
when the dentist is present) to provide dental access to those inmate patients who

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cannot wait for a routine appointment and yet do not meet the criteria for emergency
care. Inmates signing up for dental sick call must be evaluated, triaged and/or treated
a within 72 hours.
Urgent Non-emergency Dental Treatment includes toothaches, chronic abscesses,
fractured teeth, lost fillings, teeth sensitive to hot and cold, broken and/or ill-fitting
dentures, and other chronic conditions.
Dental sick call hours shall be set in accordance with each Senior Dentist's
preference. When dental staff is not present, inmates will be seen in the medical
clinic for sick call issues.
If an inmate is in need of urgent non-emergency dental care and the necessary dental
treatment cannot be completed that day, the inmate is to be treated palliatively and
treatment rescheduled as soon as possible, but in no event longer than ten (10)
working days.
c. Regular or Routine Dental Treatment: This treatment generally includes Partial
and Complete Dentures, Denture Repairs, Dental Radiology, Endodontics, Fixed
Prosthetics, Oral Surgery, Periodontics, Preventive Dentistry and Restorative
Dentistry.
Each inmate may submit a written request to obtain dental care. When a request is
received, the inmate’s name shall be placed on a list of individuals awaiting services
on a first-come, first-served basis. However, those individuals without sufficient
teeth for proper mastication of food, or those deemed by the dentist to be in urgent
need of dental care, are to have a higher priority in the scheduling of appointments.
The appointment waiting time between request for dental care and the treatment plan
appointment shall not exceed six (6) months.
Waiting times between routine dental appointments shall not exceed three (3)
months.
Note: The Contractor shall ensure that dentists and/or their staff are available for
treatment of dental emergencies and shall respond to same within twenty-four (24)
hours of occurrence.
The Contractor shall have back-up dental coverage when the institution’s dentists
are not available. The Contractor’s list of back-up dentists must include a location
for emergent/life threatening care.
4. Levels of Dental Care
Dental services available to inmates are based upon four (4) levels of dental care:
a. Level I
This level of dental care shall be provided to inmates during the reception process.
Level I services shall include, but not be limited to:

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1) An intake dental examination performed by a dentist and development of a
provisional treatment plan.
2) Necessary extractions as determined by the intake dental examination; and
3) Emergency dental treatment including treatment of soft tissue pathology.
b. Level II
This level of dental care shall be provided to inmates with less than six (6) months
of Department of Corrections’ incarceration time. Level II services shall include,
but not be limited to:
1) All Level I care;
2) Caries control (reversible pulpitis) with temporary restorations;
3) Gross cavitron debridement of symptomatic areas with emphasis on oral hygiene
practices; and
4) Complete and partial denture repairs provided the inmate has sufficient
Department-incarceration time remaining on his/her sentence to complete the
repair. In cases of medical necessity, a complete denture(s) shall be fabricated if
the inmate has at least four (4) months of continuous Department-incarceration
time remaining on his/her sentence.
c. Level III
This level of dental care shall be provided to inmates who have served six (6)
months or more of continuous Department of Corrections’ incarceration time. Level
III service shall include, but is not limited to:
1) All Level I and Level II care;
2) Complete dental examination with full mouth radiographs, Periodontal
Screening and Recording (PSR) and development of a dental treatment plan.
3) Prophylaxis with definitive debridement. Periodontal examination as indicated
by the PSR, oral hygiene instructions with emphasis on preventive dentistry;
4) Complete denture(s) provided the inmate has at least four (4) months of
continuous Department-incarceration time remaining on his/her sentence;
5) After the inmate has received a complete prophylaxis with definitive
debridement, he/she is eligible for restorative, amalgams, resins, glass ionomers,
chairside post and cores;
6) Removable Prosthetics
a) Acrylic partial dentures provided the inmate has at least four (4) months of
continuous Department-incarceration time remaining on his/her sentence;
and

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b) Relines and rebases (provided the inmate has enough continuous
Department-incarceration time remaining to complete the procedure).
7) Anterior Endodontics (Canine - Canine), provided the tooth in question has
adequate periodontal support and has a good prognosis of restorability and longterm retention;
8) Posterior Endodontics, which may be performed at either the local facility or by
referral to an endodontist. The tooth should be crucial to arch integrity (no
missing teeth in the quadrant or necessary as a partial denture abutment), have
adequate periodontal support, and have a good prognosis of restorability and
long-term retention; and
9) Basic non-surgical periodontal therapy, as necessary.
d. Level IV (Advanced Dental Services)
This level of dental care represents advanced dental services to be provided to
inmates on an as-needed basis after completion of Level III services and successful
demonstration of a Plaque Index Score of ninety percent (90%) or better for two (2)
consecutive months. If an inmate does not achieve the required Plaque Index Score,
he/she shall be rescheduled in three (3) months for another follow-up plaque score.
If the required ninety percent (90%) plaque score is not obtained, advanced dental
services shall not be considered.
Dental care and follow-up to highly specialized procedures such as orthodontics and
implants placed before incarceration shall be managed on an individual basis after
consulting with the Director of Dental Services.
Dental care and follow-up to oral surgery and pathology-related issues shall be
provided in accordance with appropriate technical instructions.
5. Dental Hygiene and Preventive Dentistry
The Florida Department of Corrections’ Dental Services Program emphasizes preventive
dentistry that strives to restore and maintain the inmate's dentition to an acceptable level
of masticatory function within appropriate departmental guidelines. Preventive dentistry
shall be taught to all inmate patients. This shall be accomplished in two (2) ways:
a. Prevention training with oral hygiene instructions shall be given to each inmate as
part of his/her orientation to the institution. This training is to include instructions in
proper usage of the three (3) essential oral hygiene aids (toothbrush, toothpaste, and
some type of floss).
This training shall be coordinated with the institutional
orientation and may be accomplished either through a direct presentation or any
other method approved by the Department.
b. Personal preventive training with oral hygiene instructions shall be included as part
of an inmate's dental treatment plan. Oral hygiene instructions shall be reinforced
throughout the dental treatment plan.

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In addition, all dental clinics shall obtain Preventive Dentistry/Oral Hygiene posters
and/or plaques for viewing by inmate patients.
6. Dentures/Prosthetics
NOTE (For All Removable Prosthetics): Each inmate is responsible for the loss,
destruction or mutilation of removable prosthetics. Failure to take responsibility for the
removable prosthetics is not justification for replacement at the Contractors expense.
Upon the inmate’s receipt of a denture(s), a Receipt of Provisions Received, shall be
completed and placed in chronological order on the left-hand side of the dental record.
Senior Dentists are allowed discretion to provide replacement removable prosthetics
when it is determined that the original prosthetics were inadvertently lost or damaged.
An incident report and/or additional documentation shall be presented to the dentist
before a replacement is fabricated at no charge to the inmate. In cases where intentional
damage or loss is suggested, the incident shall be considered the same as willfully
damaging state property and shall be dealt with in accordance with existing institutional
policies.
Justification for replacement shall be properly documented in the Dental Treatment
Record.
NOTE: Specifics on clinical dental care are contained in Health Services Bulletin
15.04.13, Supplement C.
7. Dental Radiology
a. Dental radiographs are to be exposed in accordance with established policy. A full
mouth series of radiographs are required to develop a dental treatment plan. A
treatment plan series of radiographs and/or panorex are acceptable for a maximum
five-year period of time. Bitewing radiographs are acceptable for a maximum twoyear period of time. Dental radiographs are to be mounted dot out.
b. Appropriate dental radiology operating and safety procedures must be utilized,
including but not limited to:
1) Use of a lead apron for all intraoral radiographs.
2) All x-ray machine operators must be certified or undergoing radiology training
in accordance with Department of Health (DOH) guidelines.
c. Radiographs exposed for endodontic therapy (minimum of pre- and post-treatment)
shall be mounted in sequence using the same mount.
d. The Contractor shall be responsible for all dental-specific hazardous waste disposal
from radiological developers and lead foil backings from dental x-rays. Hazardous
waste disposal by anyone other than the Contractor shall be coordinated with the
Warden at the respective institution.
e. The Contractor may supply dosimeter for dental staff at the Contractor’s expense.
f.

The Contractor will be responsible for having all dental x-ray machines inspected by
the Department of Health (DOH), and for all costs associated with the inspection.

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The Contractor will ensure all x-ray machines are registered through the Department
of Health (DOH) and a registration certificate is posted near each dental x-ray
machine.
8. Dental Laboratory Services
For dental laboratory services provided under this Contract, the Contractor may use the
PRIDE Dental Lab or may utilize a dental lab of their choice.
a. Routine removable prosthetic appliances can be fabricated by the PRIDE Dental
Laboratory located at Union Correctional Institution. In addition, the PRIDE Dental
Laboratory can perform denture repairs, relines, rebases and other miscellaneous
procedures on removable prosthetic appliances. PRIDE’S address is:
PRIDE Dental Laboratory
Union Correctional Institution
7819 Northwest 228th Street
Raiford, Florida 32026
Partials and dentures with gold and/or gold shell crowns should be sent to an outside
dental lab as determined by the Contractor (not to the PRIDE Dental Laboratory).
b. The Contractor should call the PRIDE Dental Laboratory Supervisor if there is a
question as to whether or not the laboratory can perform the required procedure.
c. The Contractor shall be responsible for all costs related to shipping items to and
from the dental laboratory. All dental prosthetic cases must be disinfected prior to
shipping and marked “Sensitive Item”.
d. PRIDE Dental Laboratory may also provide limited fixed prosthetic services.
D.

Mental Health/Behavioral Health
The Contractor should understand that adjustments in staffing may be necessary if the
required work cannot be accomplished with the initial staffing levels. The Contractor should
also be aware that lowered service levels associated with persistent vacancies in baseline
staffing will be considered grounds for requiring that baseline-staffing levels be increased.
All changes to the approved staffing plan must be approved by the Department.
The Contractor shall provide access to necessary mental health services, which are those
services and activities that are provided primarily by mental health staff and secondarily by
other health care staff for the purposes of:
•
•
•
•
•

Identifying inmates who are experiencing disabling symptoms of a mental disorder that
impair the ability to function adequately within the incarceration environment;
Providing appropriate intervention to alleviate disabling symptoms of a mental disorder;
Assisting inmates with a mental disorder with adjusting to the demands of prison life;
Assisting inmates with a mental disorder to maintain a level of adaptive functioning; and
Providing re-entry mental health planning to facilitate the inmate’s continuity of care
after release to the community.

Access to necessary mental health services are available to all inmates within the
Department, are provided in a non-discriminatory fashion, and are provided in accordance

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with prevailing community and correctional standards of care. All inmates are eligible to
receive mental health screening and psychological evaluation as necessary.
It is the responsibility of the Contractor that all inmates entering the Department have access
to necessary mental health services by ensuring:
•
•
•
•
•

Inmates have access to necessary mental health services commensurate with their needs
as determined by mental health care staff;
There is a comprehensive and systematic program for identifying inmates who are
suffering from mental disorder.
Inmates move between levels of care according to their level of adaptive functioning and
treatment needs;
All inmates receiving mental health treatment have a signed Consent for Treatment
form.
All inmates who are receiving mental health services have an individualized services
plan developed by mental health service providers.

A description of the inmate health classification system and levels of care is in HSB
15.03.13.
1. Intake Mental Health Screening at Reception Centers
All newly committed inmates will receive a mental health screening including
psychological testing, clinical interview, mental health history and psychiatric evaluation
as indicated upon receipt at a Department reception center.
New admissions to the reception center will have an intake screening psychological
testing completed within fourteen (14) days of their arrival at the reception center.
If the intake screening revealed information about past suicide attempts or if the results
of the Beck Hopelessness Scale were nine (9) or higher, form DC4-646 Initial Suicide
Profile shall be completed.
If the newly admitted inmate received inpatient mental health care within the past six (6)
months or received psychotropic medication for a mental health disorder in the past
thirty (30) days, she/he will be referred for a psychiatric evaluation. The screening
medical staff person shall arrange for continuity of such care, until such time as the
inmate is seen by the psychiatrist.
In cases where the WASI score is <76 or the adaptive behavior checklist rating is <35
the Wechsler Adult Intelligence Scale III or other non-abbreviated, reputable,
individually administered intelligence test will be administered.
Requests for past treatment records will be briefly documented as an incidental note on
DC4-642.
2. Inmate Orientation to Mental Health Services
All newly arriving inmates are oriented to mental health services at the receiving
institution in accordance with established policy and procedures.

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Orientation will consist of a written, easily understood explanation (available both in
English and Spanish) and oral presentation of available services and instruction on
accessing mental health services including consent or refusal of mental health services
and confidentiality.
3. Health Record Review and Assessment for Continuing Care at Permanent Institutions
Mental health clinical staff will assess a newly arriving inmate who is classified as S-2
or S-3 within the time frame and guidelines specified in established policy.
Inmates with a current diagnosis of Schizophrenia or other psychotic disorders including
disorders with psychotic features shall be maintained as a mental health grade 3 or
higher.
A newly arriving inmate who is classified as S-3 will be continued on any current
psychotropic medication and assessed by a psychiatric provider prior to the expiration of
the current psychotropic prescription to evaluate the inmate’s treatment needs. Medical
staff will ensure continuity of pharmacotherapy for any newly arriving S-3 inmate until
such time as the inmate can be interviewed by a psychiatric provider.
Case Manager Assignment and Screening for S-2 and S-3 Inmates: All newly
arriving S-2 and S-3 inmates shall have a case manager assigned (with documentation in
the health record).
Record Review for S-2 and S-3 Inmates: Mental health sections of records for newly
arriving S-2 and S-3 inmates, whether received from a reception center or transferred
from another institution, will be reviewed within eight (8) days of arrival by mental
health service providers.
Case Management: Case management services will be provided to inmates who are
receiving ongoing mental health services. Inmates with a mental health grade of S-2 or
S-3 shall have a case manager designated within three (3) business days of arrival at a
permanent institution or admission to CSU, TCU, or CMHTF. Case management will
be conducted at least every 90 days
Based on documentation in the record, the frequency of clinical contacts is sufficient and
clinically appropriate.
Psychotherapy/Counseling: Psychotherapy/counseling is considered an interactive
intervention between the clinician and the patient. Individual and/or group therapy is
provided according to the inmate’s identified clinical needs. Mental health staff will
deliver therapy to best meet the inmates’ identified clinical needs.
Inmate-initiated requests shall be responded to within ten (10) working days of receipt.
4. Consent to Mental Health Evaluation and Treatment
All inmates undergoing treatment and/or evaluation, including confinement assessments
and new screenings, must have a valid Form DC4-663 Consent to Mental Health
Evaluation or Treatment on record. Inmates will be advised of the limits of
confidentiality prior to receiving any mental health services.

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Fully informed consent for pharmacological intervention will be obtained by the
psychiatrist prior to the initiation of such intervention.
When admitted to an IMR, TCU or CSU, a healthcare professional will request that the
inmate give written informed consent to treatment. The inmate may refuse to consent to
treatment, however, the inmate cannot refuse placement.
For inpatient psychiatric admissions, an Inpatient Nursing Assessment shall be
completed within four (4) hours of admission.
All patients shall receive a psychiatric evaluation within 72 hours of admission to a
mental health inpatient unit. The psychiatric evaluation may be completed in lieu of the
admission note if completed within 24 hours.
A risk assessment shall be completed within 72 hours of admission to a CSU by a team
comprised of mental health staff, security staff, and classification staff.
If the inmate’s personal property is removed for reasons of safety, such property
restrictions and the justifications shall be documented in the inmate’s infirmary/inpatient
health record and reviewed at least every 72 hours to determine whether continuation of
the restriction is necessary.
A minimum of 12 hours of planned scheduled services per week shall be available to
each patient in a CSU and a TCU, and a minimum of 15 hours of planned scheduled
services shall be available to each patient in a CMHTF.
Treatment for an inmate in corrections mental health treatment facility (CMHTF) is
suited to his or her needs is provided in a humane psychological environment and is
administered skillfully, safely, and humanely with respect for the inmate’s dignity and
personal integrity.
5. Refusal of Mental Health Services
All inmates presenting for mental health services will be informed of their right to refuse
such services, unless services are to be delivered pursuant to a court order. When an
inmate refuses mental health care services, such refusal will be documented in the
inmate health record.
Refusals of mental health evaluation/treatment will be
documented on Form DC4-711A Refusal of Healthcare Services Affidavit. If the inmate
refuses to sign Form DC4-711A, the form will be completed and signed by the provider
and another staff member who witnessed the refusal.
If an inmate refuses treatment that is deemed necessary for his/her appropriate care and
safety, such treatment may be provided without consent in accordance with Sections
945.40 through 945.49, Florida Statutes (The Corrections Mental Health Act).
6. Confidentiality
The limits of confidentiality will be documented and explained to the inmate.
All information obtained by a mental healthcare provider retains its confidential status
unless the inmate specifically consents to its disclosure by initialing the appropriate
areas listed on the appropriate form.

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7. Individualized Service Plan
Each inmate who receives ongoing mental health services will have an Individualized
Service Plan (ISP) developed. Mental health treatment must be consistent with the ISP.
The ISP will be updated at regular intervals to reflect the patient’s current status. The
ISP shall reflect current psychiatric diagnosis, based on the current version of the
Diagnostic and Statistical Manual of Mental Disorders, and significant functional
problems listed in the Problem Index. The symptoms and history documented in the
Biopsychosocial Assessment (BPSA) shall be consistent with the diagnostic criteria.
The initial ISP shall be completed within 14 (calendar) days of the inmate being
assigned a mental health classification of S-2 or S-3. For inmates with a mental health
grade of S-4 through S-6, the ISP will be initiated and approved by the MDST within 14
days of admission to TCU, 5 days of admission to CSU, and 7 days of admission to
MHTF.
8. Confinement Assessment
Confinement assessments will be completed in accordance with established Department
rules, policy and procedures.
Mental health staff shall perform weekly rounds in each confinement unit.
Each inmate who is classified as S-1 or S-2 and who is assigned to administrative or
disciplinary confinement, protective management, or close management status shall
receive a mental status examination within 30 days and every 90 days thereafter. S-3
inmates shall receive a mental status examination within five days of assignment and
every 30 days thereafter.
For close management inmates, a Behavioral Risk Assessment (BRA), form DC4-729,
shall be completed at the required intervals regardless of mental health grade or housing
assignment, including, when the inmate is housed outside the CM unit in order to access
necessary medical or mental health care.
Close Management inmates shall be allowed out of their cells to receive mental health
services as specified in their ISP unless, within the past four (4) hours, the inmate has
displayed hostile, threatening, or other behavior that could present a danger to others.
Security staff shall determine the level of restraint required while CM inmates access
services outside their cells (reference Chapter 33-601.800 (9) (b), F.A.C.).
9. Psychotropic Medication Management
The Contractor will provide a medication management program in accordance with
established policy and procedures.
A psychiatric evaluation will be completed prior to initially prescribing psychotropic
medications. Required laboratory tests shall be ordered for the initiation and follow-up
of psychotropic medication administration.
Informed consent forms for each
psychotropic medication shall be completed.

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The initial psychiatric follow-up shall be conducted at least once every two (2) weeks
upon initiation of any new psychotropic medication and for a period of four (4) weeks.
The physician shall include a rationale for any change of medication in her/his progress
notes.
For patients receiving antipsychotic medications, AIMS testing shall be administered
every six (6) months.
All transfers will be coordinated with the Department’s OHS Transfer Coordinator in the
Office of Health Services.
Mental health transfers for inpatient care to TCUs, CSUs, and CMHTF will be
accomplished in accordance with established Department policy, rules and procedures
and sections 945.40 - 945.49, Florida Statutes (The Correctional Mental Health Act) as
applicable.
10. Crisis Intervention and Suicide Prevention
Crisis intervention and management is available at all facilities and includes all
behavioral and/or psychiatric emergencies such as management of a suicidal or decompensating inmate.
The Contractor will ensure its entire staff is trained to recognize and immediately report
warning signs for those inmates exhibiting self-injurious behavior and suicidal ideations.
However, only mental health or in their absence, medical staff, determines risk of selfinjurious behavior, assign/discontinue suicide observation status, and make other
decisions that significantly impact healthcare delivery, such as when to admit/discharge
from a given level of care. All mental health staff shall receive yearly suicide and selfinjury prevention training.
Inmate-declared emergencies and emergent staff referrals shall be responded to within
four (4) hours of notification. Emergency evaluations shall contain sufficient clinical
justification for the final disposition.
For inmates referred to inpatient care, the inmate/patient symptoms/behaviors
necessitating inpatient care shall be consistent and clinically appropriate to the specified
level of care (CSU, TCU, or MHTF).
For inmates placed on Self-harm Observation Status (SHOS), there shall be an order
documented in the infirmary record by the attending clinician. Inmates on SHOS shall
be visually checked by appropriate staff at least once every fifteen minutes.
For inmates housed in infirmary level of mental health care, daily counseling by mental
health staff (except weekend and holidays) shall be conducted and documented as a
SOAP note. The total duration of infirmary mental health care will not exceed fourteen
(14) days before the inmate is discharged to a lower level of mental health care or
referred to a higher level of care.
Infirmary records for inmates whose self-harm observation status (SHOS) was
discontinued contained sufficient clinical justification to ensure that the inmate’s level of
care was commensurate with the assessed treatment needs. Upon discharge from
Isolation Management/CSU/TCU a Discharge Summary shall be completed and placed

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in inmate’s health record. Mental health staff will evaluate the relevant mental status
and institutional adjustment at least at by the seventh (7th) and twenty-first (21st) day
following discharge.
Isolation Management Rooms (IMR) shall be certified as safe housing for inmates who
are at risk for self-harm by authorized mental health personnel. The IMR must have an
unobstructed view for observation by staff to ensure patient safety.
11. Restraint Usage
Any use of force for the provision of mental health care must be in accordance with
departmental policies.
Mental health staff shall evaluate S2/S3 inmates no later than the next working day
following a use of force.
When psychiatric restraints or seclusion are ordered, there shall be documentation that
less restrictive alternatives were considered and the clinical rationale for the use of
restraints shall be recorded in the inpatient record. Physician’s orders shall document
the maximum duration of the order for restraint, the clinical rationale for restraint, and
the behavioral criteria for release from restraints.
12. Aftercare Planning for Intellectually Disabeled and Mentally Disordered Inmates
Continuity of care planning services will be provided to mentally disordered and
Intellectually Disabled inmates to assist with the transition from incarceration to release.
All inmates with a mental health grade of S2-S6 and who are within 180 days of End of
Sentence (EOS) shall have their ISP updated to address Discharge/Aftercare Planning.
Inmates with a mental health grade of S3-S6 or with a diagnosis of intellectual disability
who are between forty five (45) and thirty (30) days of release shall have a copy of DC4661 Summary of Outpatient Mental Health Care or DC4-657 Discharge Summary for
Inpatient Mental Health Care in their health record.
13. Psychological Evaluations and Referrals
Mental health staff is required to provide psychological evaluations for inmates referred
by various program areas or to ascertain a diagnostic disposition. Psychological
evaluations will be conducted only by licensed psychologists in accordance with Chapter
490.
14. Clinical Review and Supervision
All non-psychiatric mental health services provided are supervised by the Senior
Behavior Analyst who assumes clinical responsibility and professional accountability for
the services provided. In doing so, the Senior Behavior Analyst reviews and approves
reports and test protocols as well as intervention plans and strategies. Documentation of
required review and approval takes the form of co-signing all psychological reports,
ISPs, treatment summaries, and referrals for psychiatric services and clinical
consultations.

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A minimum of one hour per week is devoted to direct face-to-face clinical supervision
with each Behavioral Specialist and/or in accordance with guidelines of the Chapter 490
and 491 Boards.
15. Psychology Doctoral Internship and Post-Doctoral Fellowship Programs
The Department has a Doctoral Psychology Internship program that is accredited by the
American Psychological Association (APA) and is a member of the Association of
Psychology Postdoctoral and Internship Centers (APPIC). The internship mission is to
provide training that will produce postdoctoral/entry level psychologists who have the
requisite knowledge and skills for successful entry into the practice of professional
psychology in general clinical or correctional settings and eventually become licensed
psychologists. The internship is organized around a Practitioner-Scholar Model where
scientific training is integrated into the practice training component. The internship
consists of 2,000 hours over a one year period and begins July 1st and ends on June 30th
of the succeeding year. The Florida Department of Corrections funds four (4) interns per
year. Interns work at several facilities during the year and are supervised by at least three
different Florida licensed psychologists.
The Department has a Psychology Post-Doctoral Fellowship program that started in
2012, with the goal of obtaining accreditation by the American Psychological
Association. The mission of the Fellowship will be to prepare the Psychology Residents
for the advanced practice of professional psychology, with an emphasis in correctional
psychology. The Fellowship program will consist of up to four (4) Psychology Residents
and a Training Director, who will also serve as the Internship Training Director, and a
data entry operator, who will also support the internship program.
The Contractor shall fund and incorporate the internship/fellowship training director,
interns, psychology residents, and data entry operator into the mental health service
delivery system in order to satisfy the internship and fellowship requirements. The
Contractor shall enter into separate employment agreements with these persons should
the Contractor decide to become their direct employer.
16. Child and Adolescent Psychologist
The Contractor will ensure a Florida Licensed Psychologist with formal training and
credentials in child and adolescent psychology and approved by the Department is
assigned on a full time basis to one institution designated by the Department to house
youthful offenders.
Note: The Department will allow certain mental health care services to be provided via
Telehealth, under the conditions outlined in Section II., B., 24.
E.

Nutrition and Health Diets
The Contractor shall provide nutritional supplements (inclusive of all required and/or
prescribed maintenance solutions and/or hyper-alimentation products) that are medically
prescribed by a licensed physician. This shall include all soluble, insoluble, and other liquid
or colloid preparations delivered by the way of intravenous or medically prescribed oral,
nasal, and/or percutaneous methods.

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Special diet orders are required to be written by qualified health care personnel. A standard
special medical diet program is established between the health care Contractor and food
services. Any deviation from the special diet orders shall require written authorization from
the Contractor’s Medical Director. The Department shall be responsible for the cost of the
food with the exception of those nutritive supplements described in the paragraph above.
F.

Quality Management/Quality Assurance
The Contractor shall participate in quality assurance activities at the institutional and central
office levels, in accordance with HSB 15.09.01, Clinical Quality Management. These
activities include participation on statewide quality management committees that monitor the
health services provided, including the performance of institution level quality assurance
committees.
The Central Office Quality Assurance (QA) Committee shall review reports from all
institution level quality assurance committees and shall be empowered to consider the
reports from all other committees as appropriate. The QA Committee shall make
recommendations for necessary changes or interventions and review the outcomes of these
practice modifications. The results of mortality reviews shall also be reviewed by the Central
Office QA Committee, which shall meet at least quarterly.
This committee shall also consider the results of quality of care audits, whether carried out
by outside agencies such as the Correctional Medical Authority, ACA and/or NCCHC or by
Department staff.
The Contractor shall participate in external reviews, inspections, and audits as requested and
the preparation of responses to internal or external inquiries, letters, or critiques. The
Contractor shall develop and implement peer review and plans to address or correct
identified deficiencies.
1. Quality Management Activities
a. The health services Contractor shall conduct monthly health care review meetings at
each Department institution. The health services Contractor must maintain minutes
of the meetings and submit them to the institution Warden and the Department’s
Office of Health Services.
b. Infection Control Workgroup: The Infection Control Workgroup shall monitor
surveillance on communicable diseases of concern (see above), the occurrence and
control of nosocomial infections, sterilization, and sanitation practices in the health
care unit, control of any unexpected communicable diseases within the institution,
and other infection-related issues that may arise. The Infection Control Committee
shall meet at least quarterly.
c. Peer Review Workgroup: At each institution, the Contractor shall develop a Peer
Review Workgroup (PRW). The PRW shall be a subgroup of the Quality Assurance
Workgroup and shall insure that all professionals have their work reviewed in
accordance with HSB 15.09.06, Clinical Peer Review. Findings shall be reported to
and reviewed by the Quality Assurance Workgroups.
d. Credentialing and Continuing Education and Certifications: The Contractor
must verify credentials and current licensure of all licensed healthcare professionals.

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Copies of licensure and certifications of the healthcare personnel must be provided
to the Department’s Contract Manager. If licensure or certification is dependent
upon continuing education, the Contractor is responsible to assure conformity with
such requirements. In addition, accrediting agencies require that such credentials and
licensure be maintained in the institution where the individual professional is
performing service.
G.

Medical Disaster Plan
The Contractor will implement the Department’s disaster plan for the delivery of health
services in the event of a disaster, such as an epidemic, riot, strike, fire, tornado, or other acts
of God (contract may be amended to include authorized additional costs). The plan shall be
in accordance with Health Services Bulletin 15.03.06, Medical Emergency Plans, and
Procedure 602.009, Emergency Preparedness, and shall be updated annually. The health
care disaster plan must include the following:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

H.

Communications system
Recall of key staff
Assignment of health care staff
Establishment of a triage area
Triage procedures
Health records - identification of injured
Use of ambulance services
Transfer of injured to local hospitals
Evacuation procedures (coordinated with security personnel)
Back-up plan
Use of emergency equipment and supplies
Annual practice drill, according to Department policy.

Physician Provider Base
The Contractor must have an established provider healthcare base. Contractor shall make
available to the Contract Manager a comprehensive provider healthcare base network having
sufficient numbers and types of contracted providers, hospitals, other health care
professionals as necessary based on industry standards in Regions I, II and III. The system
shall allow inmate access to local, regional and/or national healthcare networks as necessary.
Healthcare networks shall be of sufficient size with numbers and types of providers to
satisfactorily serve the inmate population.

I.

Periodic Health Screening
The Contractor will provide periodic health screening in accordance with Department
directives. This includes “A” and “B” recommendations by the United States Preventive
Services Task Force (USPSTF) as modified for correctional application and includes review
of problem lists and treatment plans for completeness and appropriateness.
The USPSTF updated its definitions of the grades it assigns to recommendations and now
includes "suggestions for practice" associated with each grade. The USPSTF has also
defined levels of certainty regarding net benefit of its recommendations.
Those recommendations and benefits are as follows:

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•
•

Recommendation A - there is a high certainty that the net benefit is substantial.
Recommendation B - there is a high certainty that the net benefit is moderate or there is
certainty that the net benefit is moderate to substantial.

The recommendations are available at:
http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm
At certain points during confinement, charts must be reviewed to insure that necessary
services are being provided. The health record is reviewed during periodic screening,
transfer, and arrival at an institution.
J.

Employee Health
The Contractor shall be responsible for the Contractor’s employee health program which
includes:
•
•
•
•

K.

TB screening and testing;
All vaccinations, to include Hepatitis B immunity by vaccination and/or antibody
confirmation;
Immediate review of exposure incidents (Post-exposure follow-up and care is the
responsibility of the Contractor); and
Appropriate documentation and completion of records and forms (actual records are to
be made available to the Department’s Human Resource office upon verifiable request).

Health Education
As part of primary health care, health education services will be an important and required
component of the total health care delivery system. The Contractor will provide specialized
training to security staff on health care topics (mental health, elderly, etc.). The specifics of
these training events will be determined jointly by the Contractor, the Office of Health
Services, and the Office of Staff Development and Training.
Examples of health education topics include:
1. Healthcare staff education should include routine in-service education for:
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.

First aid training
AED Training for selected staff
Sprains
Psychotic behavior
Casts
Seizures
Minor burns
Dependency on drugs
Health seminar
Lifts and carries
Suicide Prevention and Emergency Response Training
Mandatory annual in-service training on communicable diseases
Universal Precautions
Mandatory Departmental in services as determined by the Office of Staff
Development, in compliance with ACA and/or NCCHC standards.

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This training is not designed to take the place of any medical services offered by the
Contractor, but to augment the medical services provided by the Contractor.
2. Inmate education should include topics such as:
a. Access to health care
b. Communicable disease
• HIV
• Hepatitis A, B, C
• Gastroenteritis
• Syphilis
• Chlamydia
• Gonorrhea
• Human papilloma virus
• Herpes
• Methicillin resistant staphylococcus aureus
• Tuberculosis
c. Care of minor skin wounds
d. Diabetes
e. Personal / oral hygiene
f. Exercise
g. Heart disease
h. Hypertension
i. Infection control for kitchen workers
j. Smoking and smoking cessation.
k. Stress management.
l. Universal Precautions
m. Co-payment for health services
n. How to obtain over-the-counter and prescribed medications
o. Right to refuse medication and treatment
p. Advance directives
L.

Administration
1. Administrative Services
The Contractor must provide for the clinical and managerial administration of the health
care program and attend institutional and administrative meetings. As part of
administrative services, the Contractor shall manage and/or support all programmatic
areas with the health care unit. These services shall include, but not be limited to:
a. The Contractor’s staff shall comply with policies, procedures, and protocols for the
medical unit and staff that are approved by the Department.
b. The Contractor will be responsible for ensuring that its staff reports any problems
and/or unusual incidents to the Warden or designee.
c. The Contractor must ensure that the health care status of inmates admitted to outside
hospitals is reviewed to assure that the duration of hospitalization is no longer than
medically indicated.
d. The Contractor must ensure that its staff documents all health care contacts in the
medical record and in the Offender Based Information System (OBIS).

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e. The Contractor must provide a staffing plan that identifies all personnel required to
perform the services and/or responsibilities under the Contract. All staffing plans
shall be approved by the Department’s Office of Health Services.
f. The majority of outside services should be provided within a forty-five (45)-mile
radius of each of the Department’s secured institutions.
g. The Contractor must provide for the disposal of all bio-hazardous, hazardous and/or
other EPA regulated waste produced in the care, diagnosis, and treatment of the inmate.
2. Administrative Functions
The Contractor must perform the following administrative functions including but not
limited to:
a.
b.
c.
d.
e.

Attendance at monthly contract overview meetings;
Attendance at institution monthly/weekly Wardens meetings;
Attendance at regional meetings scheduled by the Regional Director;
Attendance at statewide meetings scheduled by the Department;
Reporting in compliance with statutes, rules, policies and procedures, court orders,
health services bulletins, court orders, and other contractual requirements set forth
by the Department. (risk management/incident reporting; infection control, quality
management; HIPAA reports, etc.);
f. Attendance by Designated Office of Health Services staff and/or Health Services
Administrator for each institution at all Regional Directors meetings;
g. Participation in statewide Quarterly Pharmaceutical and Therapeutic, and Quality
Management meetings.
h. Provide administrative support for tracking inmate co-payments in the
Department’s Offender Based Information System (OBIS) or through an
Electronic Health Record;
i. Responding to inmate health care requests and grievances;
j. Tracking and responding to inquiries from family members and officials making
inquiry about health care issues on behalf of inmates. This includes referrals from
the Department, the Executive Office of the Governor, and other elected officials.
k. Tracking and providing information in response to public records requests
l. Tracking and providing information in response to requests from the Office of
Attorney General, DOH, AHCA, and CMA.
M.

Computer and Information Systems
1. Corporate Access to the Departments Network
Any access to the Departments network from an outside non-law enforcement entity
must be done via a LAN to LAN Virtual Private Network (VPN). This service is
provided by the Florida Department of Management Services. Once the corporate entity
has made the request thru DMS, the Department will require a copy of their security
policies and a network diagram. After review by the Departments network staff,
Information Security staff, the Chief Information Officer will make the final decision on
granting access.
2. LAN to LAN Connections
Authorized LAN to LAN connections must utilize IPSec security with either Triple DES
or AES and be provided and managed (including software provision and configuration,

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and connection support) by a Department-approved VPN service provider. Outside
entities requesting or using these connections are financially responsible for all required
or related equipment and must adhere to all VPN service provider policies and
procedures as well as Department procedures. The VPN service provider will coordinate
with the outside entity in determining whether to use outside entity equipment to
terminate that end of the VPN connection or provide the necessary equipment.
When LAN to LAN VPN access is requested the requestor must also present an accurate
and complete description of the requestor’s information network, including all
permanent and temporary remote connections made from and to the requestor’s network,
for Department review. Any access or connection to the Department’s network not
approved by the Chief Information Officer or the Department is strictly prohibited.
Outside entity workstations accessing the Department’s information network via a LAN
to LAN VPN must operate Windows XP or later operating system.
Outside entity workstations accessing the Department’s information network via a LAN
to LAN VPN must operate with password protected screen savers enabled and
configured for no more than 15 minutes of inactivity
It is the responsibility of the authorized users with VPN privileges to ensure that
unauthorized persons are not allowed access to the Department’s network by way of
these same privileges. At no time should any authorized user provide their userID or
password to anyone, including supervisors and family members. All users are
responsible for the communications conducted by their workstations through the VPN
connection to the Department.
Any attempt to fraudulently access, test, measure or operate unapproved software on the
Department’s network is strictly prohibited. The use of any software capable of
capturing information network packets for display or any other use is prohibited without
the express consent of the Office of Information Technology.
3. Outside Entity Obligations
It is the outside entities’ and their workforce members’ responsibility to maintain
knowledge of and compliance with relevant and applicable Department procedures.
Notice of planned events in an outside entity’s computing environment that may impact
its secured connection, in any way or at any severity level, to the Department must be
submitted to the Department at least one week in advance of the event.
The Department must receive notice in electronic and written form from an outside
entity when any unexpected event of interest occurs in any way or at any level of
severity within or around the outside entity’s computing environment that may impact
the Department’s information security. Events including but not limited to malware
(virus, trojan, etc) discovery, network or system breaches, privileged account
compromise, employee or workforce member misconduct, etc, are examples of events of
interest to the Department.
Outside entity workstations are not to access any resource or download any software
from the Department’s information network without prior approval.

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Before connection and while connected to a VPN formed with the Department the
outside entity’s computing environment (computing devices including workstations,
servers, and networking devices) must be operating the latest available software versions
and applicable patches, and have the following implemented with supporting policies or
procedures available for review by the Department:
•
•

Active and effective network device, server and workstation operating system and
layered software patch or update processes.
Department approved, up-to-date server and workstation anti-virus/malware
software (all components) installed with active and effective patch or update
processes in place.

Outside entity workforce members with VPN access privileges to the Department’s
network shall not use non-Department email accounts (i.e., Hotmail, Yahoo, AOL), or
other external information resources to conduct Department business, ensuring a reduced
risk to Department data and that Department business is never confused with personal
business.
With regard to VPN connections used by outside entities that are provided by
Department-approved VPN providers, the Department bears no responsibility if the
installation of VPN software, or the use of any remote access systems, causes system
lockups, crashes or complete or partial data loss on any outside entity computing or
network equipment. The outside entity is solely responsible for protecting (backing up)
all data present on its computing and network equipment and compliance with all
regulatory legislation.
4. Contractor’s Network
In addition to the Contractor providing their own data network and connectivity devices,
all associated IT hardware at the local correctional facility level will be provided by and
maintained by the Contractor. This includes, but is not all inclusive, hardware such as
personal computers and laptops (including software licenses), tablet PC’s, thin clients,
printers, fax machines, scanners, video conferencing, switches, and UPS for switches.
The Department’s PCs and printers currently being used by Health Services staff, which
are the property of the Department, are available for use by the Contractor. The use of
Department equipment is the Contractor’s choice. If the Contractor decides to use the
equipment then the Contractor assumes responsibility for the equipment and the
equipment will be treated like other Contractor equipment. The Contractor’s
responsibility for the equipment includes, but is not limited to, configuration,
maintenance, support, upgrade, replacement and other requirements specified within this
Contract. The equipment will not reside on the Department’s network. The equipment
(or its replacement) shall remain the property of the Department upon expiration or
termination of the contract. Other references in this Contract with regard to the
ownership, use, transfer and end of contract and related subjects, for equipment and
property other than PCs and printers still apply.
5. Transmitting Health Information via E-mail
In conducting its mission the Department is required to communicate with parties
outside of its internal email and information systems. These communications include
electronic protected health information (ePHI) or other confidential information

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governed by any of the Health Insurance Portability and Accountability Act (HIPAA),
The Health Information Technology for Economic and Clinical Health (HITECH) Act or
the Florida Administrative Code, Rule Chapter 71-A. These and other regulations
require that electronic transmission of ePHI or confidential information be encrypted.
If the Contractor requires using e-mail to transport ePHI or other confidential health
information it must establish and host an e-mail encryption solution. The solution must
be approved by the Department’s Office of Information Technology (OIT) and meet or
exceed the federal and state regulations mentioned above before implementation.
6. Contractor Data Availability
a. The Contractor shall have the capability for the Department to send data to and pull
data from the Contractor’s provided health service information technology system
via a secure transport method (SFTP, Secure Web Services, etc.); furthermore, the
data format should either be XML-based or delimiter-separated values. It is the
Contractor’s responsibility to provide all necessary documentation to assist in the
integration of data which includes but is not limited to crosswalk tables for code
values, schemas, and encodings.
b. The Contractor and their staff will be held to contractual obligations of
confidentiality, integrity, and availability in the handling and transmission of any
Department information.
1) No disclosure or destruction of any Department data can occur without prior
express consent from the Contract Manager.
2) The Contractor shall timely return any and/or all Department information in a
format deemed acceptable by the Department when the contractual relationship
effectively terminates.
3) The Contractor shall provide certification of its destruction of all Departmental
data in its possession in accordance with DoD 5220.22-M, "National Industrial
Security Program Operating Manual” when the need for the Contractor’s
custody of the data no longer exists.
4) The Contractor must maintain support for its services following an emergency
that affects the facilities and systems it maintains. Following an emergency that
affects the Contractor’s facilities or production systems, the Contractor must
provide access and use of a backup system with the same functionality and data
as its operational system within twenty-four (24) hours. The Contractor must
also guarantee the availability of data in its custody to the Department within
twenty-four (24) hours following an emergency that may occur within the
Contractor’s facilities or systems. Following an emergency that affects the
Department’s facilities or systems, the Contractor must continue to provide
access and use of its production systems once the Department has recovered or
re-located its service delivery operations.
5) The introduction of wireless devices at facilities is subject to prior review and
approval by the Contract Manager. The Contractor is responsible for notifying
the Department before introducing wireless devices into facilities.

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7. Information Security Auditing and Accountability
a. The Contractor will provide the Department audit and accountability controls to
increase the probability of authorized system administrators conforming to a
prescribed pattern of behavior. The Contractor in concert with the Department shall
carefully assess the inventory of components that compose their information systems
to determine which security controls are applicable to the various components.
b. Auditing controls are typically applied to the components of an information system
that provide auditing capability including servers, mainframe, firewalls, routers,
switches.
8. Auditable Events and Content (Servers, Mainframes, Firewalls, Routers, Switches)
a. The Contractor shall generate audit records for defined events. These defined events
include identifying significant events which need to be audited as relevant to the
security of the information system. The Department shall specify which information
system components carry out auditing activities. Auditing activity can affect
information system performance and this issue must be considered as a separate
factor during the acquisition of information systems.
b. The Contractor shall produce, at the system level, audit records containing sufficient
information to establish what events occurred, the sources of the events, and the
outcomes of the events. The Department shall periodically review and update the list
of auditable events.
9. Events
The following events shall be logged:
a. Successful and unsuccessful system log-on attempts.
b. Successful and unsuccessful attempts to access, create, write, delete or change
permission on a user account, file, directory or other system resource.
c. Successful and unsuccessful attempts to change account passwords.
d. Successful and unsuccessful actions by privileged accounts.
e. Successful and unsuccessful attempts for users to access, modify, or destroy the
audit log file.
10. Content
The following content shall be included with every audited event:
a. Date and time of the event.
b. The component of the information system (e.g., software component, hardware
component) where the event occurred.
c. Type of event
d. User/subject identity.
e. Outcome (success or failure) of the event.
11. Response to Audit Processing Failures
The Contractor shall provide alerts to the Department’s CIO or designee in the event of
an audit processing failure. Audit processing failures include, for example:

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software/hardware errors, failures in the audit capturing mechanisms, and audit storage
capacity being reached or exceeded.
12. Time Stamps
The Contractor shall provide time stamps for use in audit record generation. The time
stamps shall include the date and time values generated by the internal system clocks in
the audit records. The agency shall synchronize internal information system clocks on an
annual basis.
13. Protection of Audit Information
The Contractor shall protect audit information and audit tools from modification,
deletion and unauthorized access.
14. Audit Record Retention
The Contractor shall retain audit records for at least 365 days. Once the minimum
retention time period has passed, the Contractor shall continue to retain audit records
until it is determined they are no longer needed for administrative, legal, audit, or other
operational purposes.
15. Compliance Requirements
So as to be compliant with the Health Insurance Portability and Accountability Act
(HIPAA), any service, software, or process to be acquired by or used on behalf of the
Department that handles and/or transmits electronic protected health information must
do so in full HIPAA compliance and with encryption provided as a part of the service,
software, or process. In addition, the transmission and encryption scheme supplied by
the Contractor must be approved by the Department prior to acquisition.
Any service, software, or process used in service to the Department that includes a
userID and password component must ensure said component includes at a minimum
capabilities for password expiration and confidentiality, logging of all UserID activities,
lockout on failed password entry, provisions for different levels of access by its userIDs,
and intended disablement of UserIDs.
Any and all introductions or subsequent changes to information technology or related
services provided by the Contractor in the Department’s corrections environment must
be communicated to and approved by the Department and Office of Information
Technology prior to their introduction. As examples, the implementation of wireless
(Bluetooth, 802.11, cellular, etc) technology or use of USB based portable technology.
Any and all information security technology or related services (e.g. internet monitoring
software) in the Department’s corrections environment are to be provided by the
Contractor unless the lack of these technologies and services is approved by the
Department and Office of Information Technology.
The Department will maintain administrative control over any aspect of this service
within its corrections environment to the degree necessary to maintain compliance with
the U. S. Department of Justice Information Services Security Policy.

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The Contractor must agree to comply to any applicable requirement necessary to the
Department’s compliance with local, state, and federal code or law.
All Contractors must be able to comply with Department procedures that relate to the
protection (maintaining confidentiality, integrity, and availability) of the Department’s
data and its collective information security. Access to Department information resources
will require use of the Department’s security access request application when applicable.
The Contractor must recognize the Department’s entitlement to all Department provided
information or any information related to the Department generated as a result of or in
participation with this service.
No disclosure or destruction of any Department data by the Contractor or its contracted
parties can occur without prior express consent from a duly authorized Department
representative.
The Contractor must provide for the timely and complete delivery of all Department
information in an appropriate and acceptable format before the contractual relationship
effectively terminates.
The Contractor must provide certification of its destruction of all of the Department’s
data in accordance with NIST Special Publication 800-88, Guidelines for Media
Sanitation, when the need for the Contractor’s custody of the data no longer exists.
The Department’s data and contracted services must be protected from environmental
threats (Contractor’s installation should have data center controls that include the timely,
accurate, complete, and secure backup (use of offsite storage) of all Department
information, and other controls that manage risks from fire, water/humidity, temperature,
contamination (unwanted foreign material, etc), wind, unauthorized entry or access,
theft, etc).
The Contractor should be prepared to guarantee availability of Department data and its
service during a disaster regardless of which party is affected by the disaster.
Correctional institutions site plans and plan components (electrical, plumbing, etc) are
exempt from public record and must be kept confidential.
If applicable, the Contractor shall supply all equipment necessary to provide services
outlined in this Contract. Contractor equipment will not require connection to the
Department’s information network.
If applicable, the Contractor will host the Department’s information and/or services
provided in a data center protected by the following:
a. Controlled access procedures for physical access to the data center;
b. Controlled access procedures for electronic connections to the Contractor’s network;
c. A process designed to control and monitor outside agencies access to the
Contractor’s information network;
d. A Firewalling device;
e. Server based antivirus/malware software;
f. Client based antivirus/malware software;
g. Use of unique userIDs with expiring passwords;

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h. A process that involves collection of userID activities and regular review of these
activities for unauthorized access;
i. A process that ensures up to date software patches are applied to all information
resources
The Contractor shall maintain an Information Security Awareness program. This
program will be designed to keep users knowledgeable on information security best
practices.
N.

Health Records
All inmates must have a health record that is up-to-date at all times, and that complies with
problem-oriented health record format, Department’s policy and procedure, and ACA and/or
NCCHC standards. The record must accompany the inmate at all health encounters and will
be forwarded to the appropriate institution in the event the inmate is transferred. All
procedures (including HIPAA and the HITECH Act) concerning confidentiality must be
followed.
All health records both electronic and paper remain the property of the Department.
The Contractor’s physician or designee will conduct a health file review for each inmate
scheduled for transfer to other institution sites. A health/medical records summary sheet is
to be forwarded to the receiving institution at the time of transfer.
Health Records, at a minimum, contain the following information:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

The completed initial intake form
Health appraisal data forms
All findings, diagnoses, treatments, dispositions
Problem list
Immunization record
Communicable disease record
Prescribed medications
medication administration record
Lab and X-ray reports
Dental radiographs
Notes concerning patient’s education as required in paragraph entitled, “Health
Education”
Records and written reports concerning injuries sustained prior to admission
Signature and title of documenter
Consent and refusal forms;
Release of information forms Place, date, and time of health encounters
Discharge summary of hospitalizations
Health service reports, e.g. dental, psychiatric, and other consultations.

All entries must be maintained in a manner consistent with SOAP and/or SOAPE
charting.
All health care records are the property of the Department and shall remain with the
Department upon termination of the Contract. The Contractor will supply upon request of
the Office of Health Services any and all records relating to the care of the inmates who are

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in the Contractor’s possession. A record of all services provided off-grounds must be
incorporated into each inmate health care record. All prior health care records must be
incorporated into each inmate health care record.
All nonproprietary records kept by the Contractor pertaining to the Contract or to services
provided under the Contract, including, but not limited to, those records specifically
mentioned in the Contract, shall be made available to the Department for lawsuits,
monitoring or evaluation of the contract, and other statutory responsibilities of the
Department and/or other State agencies, and shall be provided at the cost of the Contractor
when requested by the Department during the term of the contract or after termination of the
Contract for the period specified beginning upon the date of award of the Contract to begin
services.
The Contractor must follow all State and Federal laws, rules, and Department Policies and
Procedures relating to storage, access to and confidentiality of the health care records. The
Contractor shall provide secure storage to ensure the safe and confidential maintenance of
active and inactive inmate health records and logs in accordance with Health Services
Bulletin 15.12.03, Health Records. In addition, the Contractor shall ensure the transfer of
inmate comprehensive health records and medications required for continuity of care in
accordance with Procedure 401.017, Health Records and Medication Transfer. Health
records will be transported in accordance with Health Services Bulletin 15.12.03, Appendix
J (Post-Release Health Record Retention and Destruction Schedule).
The Contractor shall ensure that its personnel document in the inmate’s health record all
health care contacts in the proper format in accordance with standard health practice, ACA
and/or NCCHC Standards and Expected Practices, and any relevant Department Policies and
Procedures.
The Contractor shall be responsible for the orderly maintenance and timely filing of all
health information utilizing contract and State employees as staffing indicates.
The Contractor shall comply with all HIPAA requirements.
Length of Retention Period
1. Unless otherwise specifically governed by Department regulations, all health records
shall be kept for a period of seven (7) years or for the period for which records of the
same type must be retained by the State pursuant to statute, whichever is longer. All
retention periods start on the first day after termination of the contract.
2. If any litigation, claim, negotiation, audit, or other action involving the records referred
to has been started before the expiration of the applicable retention period, all records
shall be retained until completion of the action and resolution of all issues, which arise
from it, or until the end of the period specified for, whichever is later.
3. In order to avoid duplicate record keeping, the Department may make special
arrangements with the Contractor for the Department to retain any records, which are
needed for joint use. The Department may accept transfer of records to its custody when
it determines that the records possess long-term retention value. When records are
transferred to or maintained by the Department, the retention requirements of this
paragraph are not applicable to the Contractor as to those records.

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4. The records retention program must comply with guidelines established by the Florida
Department of State, Division of Library and Information Services Records
Management program. The Department endorses the following medical record retention
and destruction practices:
5. Records of inmates presently on extended parole will be maintained until release from
such Department of Corrections responsibility. After seven (7) consecutive years of
inactivity, the Department shall authorize destruction/recycling procedures in
accordance with law.
6. Hard copies of health records will be securely stored at the Reception and Medical
Center. All health records received at the record archives will be checked to ensure that
the color-coded year band is properly attached before filing.
O.

340b Specialty Care Program
On October 31, 2008, the Department of Corrections entered into an interagency agreement
with the Department of Health to conduct a pilot project to treat inmates with HIV/AIDS and
other Sexually Transmitted Diseases. Under this agreement, which was approved by the
Federal Centers for Disease Control and Health Resources Services Administration, the
Department pays local County Health Departments to provide medical services at designated
institutions. The County Health Department physicians prescribe the drugs, which are filled
by the Department of Health’s State Pharmacy. The Contractor is responsible for the
screening labs. This model allows the Department to be eligible for Federal 340b drug
pricing.
The pilot project has been converted into a permanent program. To maintain the cost
savings, the Department will continue to provide immunity clinic services through the
participating County Health Departments. The Department reserves the right to
add/delete sites, as well other medical and or mental health services and related drugs that
are covered under the 340b drug pricing program. The Contractor is required to provide
continuity of care in institutions participating in the 340b program.

P.

Coordination of Services with Other Jurisdictions and Entities
1. Interstate Compact Inmates
The Contractor shall assume all responsibility for the coordination and provision of care
for Interstate Compact inmates in accordance with established Interstate Compact
Agreements.
2. County Jail Work Programs
The Department houses inmates in some county jails where they participate in work
programs at the county jail. The Department has the option of returning the inmates to a
correctional institution. Currently, the Department has contracts with county jails, which
include the provision of health care to inmates.
3. Federal Inmates
The Department presently has some federal inmates in our custody and there is no cost
exchanged. The Federal Bureau of Prisons has a number of the Department’s inmates.
The Contractor will be responsible transfer to and from Federal prisons.

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4. Private Correctional Facilities
Currently, there are approximately 10,000 inmates housed in 7 (seven) private
correctional facilities managed under contracts from the Department of Management
Services. The Contractor will be responsible for the provision and coordination of
health care services for all inmates transferred from private facilities to the Department’s
institutions, and for working cooperatively with private facility staff on all transfers to
and from these facilities. The Department will retain final decision-making authority
regarding the transfer of inmates between the Department institutions and private
correctional facilities.
Q.

Discharge Planning
When an inmate with a serious medical and/or mental illness is released from a Department
institution, his medical and mental health conditions must be identified during the prerelease stage to identify community resources to meet the inmate’s needs. Planning should
include at a minimum, continuing medication with a thirty (30)-day supply, which should be
provided at release unless contraindicated clinically or earlier appointments with outside
providers have been scheduled, for follow up care.
The Contractor shall provide adequate staffing to coordinate discharge planning at each
institution. Discharge planning includes making referrals to appropriate community healthcare
settings and participating in the institution discharge planning process to promote continuity of
care, to include referral of released inmates for commitment under Chapter 394, Florida
Statutes (Baker Act) in accordance with section 945.46, Florida Statutes. The Contractor shall
develop, implement, and coordinate a comprehensive discharge plan for inmates with acute
and/or chronic illness who are difficult to place due to their offense and are within six months
of end of sentence. The Contractor shall coordinate inmate release issues with the
Department’s Office of Health Services, Office of Re-Entry, and Bureau of Admission and
Release, to help assist inmates as they prepare to transition back into the community.
In addition, the Department’s Office of Health Services manages two specialty programs that
assist inmates with release planning. The Contractor shall develop and implement a plan for
incorporating these two programs, (HIV Pre-Release Planning and Mental Health Re-Entry /
Aftercare Program) into their overall health care service delivery system.
HIV Pre-Release Planning - The Department offers HIV pre-release planning services to all
known HIV-infected inmates through a grant from the Department of Health. The program
has been in effect since 1999 and is 100% funded through federal Ryan White Title B funds.
The HIV Planners work with inmates and corrections staff in other institutions to coordinate
referrals and linkages to medical care, case management, medication assistance, and other
supportive services. They work with local Ryan White providers to ease the transition postrelease back into the community, and to ensure clients continue to seek necessary care and
treatment.
Mental Health Re-Entry (Aftercare) Program - The Department manages the Mental Health
Re-Entry (Aftercare) Program, which is a collaborative effort between the Department of
Children and Families and the Department of Corrections. The result is an intake
appointment at a Community Mental Health Center for every inmate that consents to receive
outpatient psychiatric care at the time of their release. The program helps maximize the
successful re-entry of inmates returning to their communities.

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The Contractor shall be responsible at each institution for coordinating the healthcare portion
of the Department’s Re-Entry initiative.
R.

Rules and Regulations
1. The Contractor shall provide all healthcare treatment and services in accordance with all
applicable federal and state laws, rules and regulations, Department of Corrections’
rules, procedures, and Health Services’ Bulletins/Technical Instructions applicable to the
delivery of healthcare services in a correctional setting. In addition, the Contractor shall
meet all state and federal constitutional requirements, court orders, and applicable ACA
and/or NCCHC Standards for Correctional healthcare (whether mandatory or nonmandatory). All such laws, rules and regulations, current and/or as revised, are
incorporated herein by reference and made a part of this Contract. The Contractor and
the Department shall work cooperatively to ensure service delivery in complete
compliance with all such requirements.
2. The Contractor shall ensure that all Contractors’ staff providing services under this
Contract complies with prevailing ethical and professional standards, and the rules,
procedures and regulations mentioned above.
3. The Contractor shall ensure Contractor's staff is familiar with and capable of obtaining
and making use of all applicable Department Policies and Procedures, Technical
Instructions (TI's), and Health Service Bulletins (HSB's). The Contractor will be
provided access to the aforementioned documents through the Warden, or designee, at
the corresponding Correctional Institution.
4. The Contractor shall fully comply with the requirements of Section 466.0285, Florida
Statutes, particularly the requirements in Section 466.0285(1), Florida Statutes, that “no
person other than a dentist licensed pursuant to Chapter 466, nor any entity other than a
professional corporation or limited liability company composed of dentists may employ
a dentist or dental hygienist in the operation of a dental office, may control the use of
any dental equipment or material while such equipment or material is being used for the
provision of dental services, whether those services are provided by a dentist, a dental
hygienist, or a dental assistant, or may direct, control, or interfere with a dentist’s
clinical judgment.”
5. The Contractor is required to be in compliance with state and federal law, including the Fair
Labor Standards Act (FLSA). The Contractor will not be utilizing non-exempt health care
workers for more than 40 hours per week without paying overtime, unless legally
authorized. The Contractor has been advised that the United States Department of Labor
believes compliance with the FLSA requires that hours worked by health care workers
working at different facilities be calculated as if all hours were worked at one facility if
operated by the same Contractor. Accordingly, all hours worked by an individual worker
regardless of how many different temporary agencies the worker is associated with must be
totaled to determine the hours worked per week for each individual worker.
6. Should any of the above laws, standards, rules or regulations, Department procedures,
HSB’s/TI’s or directives change during the course of this procurement or resultant
Contract term, the updated version will take precedence

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7. The Contractor shall comply with all applicable continuing requirements as determined
by the Department’s Assistant Secretary for Health Services for reports to and from the
Department, and the Healthcare Contract Monitoring Team.
8. Documentation of licensure and accreditation for all hospitals, clinics and other related
health service providers to be utilized by the Contractor shall be made available to the
Department upon request. All hospitals utilized by the Contractor for the care of
inmates shall be fully licensed and preferably accredited by the Joint Commission on
Accreditation of Healthcare Organizations (JCAHCO). All hospitals utilized by the
Contractor require prior written approval by the Department’s Contract Manager,
identified in Section IV., A., of this Contract.
9. The Contractor shall supply all equipment necessary to provide services outlined in this
Contract.
Contractor equipment may require connection to the Department’s
information network. Should the Contractor’s equipment be required to connect to the
Department’s information network, all Federal, State and Department rules, regulations,
and guidelines for data transfer shall apply.
10. The Department’s data must be protected from all environmental threats. The
Contractor’s computing equipment installation will be protected by the timely, accurate,
complete, and secure backup of data including the use of similarly secured offsite
storage of all Department information and other controls that manage any risks from all
conditions including but not limited to fire, water/humidity, temperature, contamination
(unwanted foreign material, etc), wind, unauthorized entry or access, and theft.
The Contractor must maintain support for its services following an emergency that
affects the facilities and systems it maintains or those maintained by Department.
Following an emergency that affects the Contractor’s facilities or production systems,
the Contractor must provide access and use of a backup system with the same
functionality and data as its operational system within twenty-four (24) hours. The
Contractor must also guarantee the availability of data in its custody to the Department
within twenty-four (24) hours following an emergency that may occur within the
Contractor’s facilities or systems.
Following an emergency that affects the
Department’s facilities or systems, the Contractor must continue to provide access and
use of its production systems once the Department has recovered or re-located its service
delivery operations.
The Contractor must host the computing equipment protected by the following:
a. Controlled access procedures for physical access to all computing equipment;
b. Controlled access procedures for electronic connections to the Contractor’s network;
c. A process designed to control and monitor outside agencies access to the
Contractor’s information network;
d. A Firewall device;
e. Server based antivirus/malware software;
f. Client based antivirus/malware software;
g. Use of unique userIDs with expiring passwords;
h. A process that involves collection of userID activities and regular review of these
activities for unauthorized access;
i. A process that ensures up to date software patches are applied to all information
resources; and

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j.

The Contractor shall maintain an Information Security Awareness program. This
program will be designed to keep users of the system up to date on cyber security
events capable of compromising the system and or network.

The Contractor’s solution must operate to the Department’s satisfaction on its current
personal computer platform, if applicable, which currently is configured with 1Gb of
RAM, a 1Ghz processor, a 100Mb NIC and Windows XP, SP3.
All Contractor activities involved in the support of its Contract and obligations to the
Department must be conducted in full compliance with all applicable HIPAA (Health
Insurance Portability and Accountability Act) requirements, including but not limited to
those in the HIPAA Security Rule, Part 164, Subpart C. Any service, software, or
process to be acquired by the Department that transmits electronic protected health
information must do so with encryption provided as a part of the service, software, or
process. In addition, the transmission and encryption scheme supplied by the Contractor
must be approved by the Department prior to acquisition.
11. The Contractors must comply with Department procedures that relate to the protection of
the Department’s data and its collective information security which include but are not
limited to: 206.007 User Security for Information Systems Office of Information
Technology internal Remote Access and Virtual Private Network procedure; and the
Contractor, its subcontractors, and their staff will be held to contractual obligations of
confidentiality, integrity, and availability in the handling and transmission of any
Department information.
12. The Contractor must guarantee the availability of data in its custody to the Department
during an emergency that may occur at the Contractor or the Department.
13. The Department must retain ownership of all Department provided information or any
information related to the Department generated as a result of or in participation with
this service.
14. No disclosure or destruction of any Department data can occur without prior express
consent.
15. The Contractor shall provide for the timely and complete return of all Department
information in an acceptable format when the contractual relationship effectively
terminates.
16. The Contractor shall provide certification of its destruction of all of the Department’s
data in accordance with NIST Special Publication 800-88, when the need for the
Contractor’s custody of the data no longer exists.
17. The Contractor will be required to maintain full accreditation by the American
Correctional Association (ACA for the healthcare operational areas in all institutions in
which healthcare services are provided.
18. The Contractor shall provide the Department’s Contract Manager with all subcontractor
agreements for healthcare delivery (including pharmaceuticals), all subcontractor
agreements are approved annually by the Department’s Contract Manager and must

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contain provisions requiring the subcontractor to comply with all applicable terms and
conditions of this Contract.
19. The Contractor agrees to modify its service delivery, including addition or expansion of
comprehensive healthcare services in order to meet or comply with changes required by
operation of law or due to changes in practice standards or regulations, or as a result of
legal settlement agreement or consent order or change in the Department’s mission.
20. Any changes in the scope of service required to ensure continued compliance with State
or Federal laws, statutes or regulations, legal settlement agreement or consent order or
Department policy, regulations or technical instructions will be made in accordance with
Section V., CONTRACT MODIFICATION.
S.

Permits, Licenses, and Insurance Documentation
The Contractor shall have and at all times maintain, at their own cost, documents material to
the resultant Contract - including but not limited to current copies of all required state and
federal licenses, permits, registrations and insurance documentation, and bear any costs
associated with all required compliance inspections, environmental permitting designs, and
any experts required by the Department to review specialized medical requirements. The
Contractor shall maintain copies of the foregoing documents which include, but are not
limited to, current copies of the following:
1. The face-sheet of the Contractor’s current insurance policy showing sufficient coverage
as indicated in Section VII., K.
2. Any applicable state and/or federal licenses related to services provided under this
Contract, as applicable.
The Contractor shall ensure all such licenses, permits, and registrations remain current and
in-good-standing
throughout
the
term
of
the
Contract.
Any
additions/deletions/revisions/renewals to the above documents made during the Contract
period shall be submitted to the Contract Manager and the Department’s Assistant Secretary
of Health Services - Administration within fifteen (15) days of said
addition/deletion/revision/renewal.

T.

Communications
1. Contract communications will be in three (3) forms: routine, informal and formal. For
the purposes of this Contract, the following definitions shall apply:
Routine:

All normal written communications generated by either party relating to
service delivery. Routine communications must be acknowledged or
answered within thirty (30) calendar days of receipt.

Informal:

Special written communications deemed necessary based upon either
contract compliance or quality of service issues. Must be acknowledged or
responded to within fifteen (15) calendar days of receipt.

Formal:

Same as informal but more limited in nature and usually reserved for
significant issues such as Breach of Contract, failure to provide satisfactory
performance, assessment of Financial Consequences, or contract

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termination. Formal communications shall also include requests for changes
in the scope of the Contract and billing adjustments. Must be acknowledged
upon receipt and responded to within seven (7) days of receipt.
2. The only personnel authorized to use formal contract communications are the
Department’s Senior Executive Management Staff, Office of Health Services Senior
Management Staff, Contract Manager, Contract Administrator, and the Contractor’s
CEO or Project Manager. Designees or other persons authorized to utilize formal
contract communications must be agreed upon by both parties and identified in writing
within ten (10) days of execution of the Contract. Notification of any subsequent
changes must be provided in writing prior to issuance of any formal communication
from the changed designee or authorized representative.
3. In addition to the personnel named under formal contract communications, personnel
authorized to use informal contract communications include any other persons so
designated in writing by the parties.
4. If there is an urgent administrative problem the Department shall make contact with the
Contractor and the Contractor shall verbally respond to the Contract Manager within two
(2) hours. If a non-urgent administrative problem occurs, the Department will make
contact with the Contractor and the Contractor shall verbally respond to the Contract
Manager within forty eight (48) hours. The Contractor or Contractor’s designee at each
institution shall respond to inquiries from the Department by providing all information
or records that the Department deems necessary to respond to inquiries, complaints or
grievances from or about inmates within three (3) working days of receipt of the request.
5. The Contractor shall respond to informal and formal communications in writing,
transmitted by facsimile and/or email, with follow-up by hard copy mail.
6. A date/numbering system shall be utilized for tracking of formal communication.
U.

Final Implementation Plan and Transition Date Schedule
1. Within three (3) days after the Contract start date, the Contractor shall meet with the
Department to begin the development of the implementation plan to ensure an orderly
and efficient transition to the Contractor. During this transition period, the Contractor
shall have access to all records, files and documents necessary for the provision of
Comprehensive Healthcare Services, including but not limited to inmate records,
maintenance records, and personnel files.
2. The Contractor will submit their Final Implementation Plan for approval within fifteen
(15) days after contract execution date.
3. The Final Implementation Plan shall be designed to provide for seamless transition with
minimal interruption of healthcare to inmates. Final transition at each institution shall be
coordinated between the Contractor and the Department.
4. The Contractor shall commence provision of comprehensive healthcare services to the
Department’s inmates consistent with the approved Final Implementation Plan and
Transition Date Schedule.

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5. The Contractor shall assume full responsibility for comprehensive healthcare service
delivery pursuant to the schedule to be agreed upon by the Parties prior to the Contract
Implementation period begins.
6. Payment of services during the planning and transition period shall be made in
accordance with Section III., A., Payment.
V.

Service Locations and Service Times
1. Institutions/Facility Locations: The facilities to be included under this Contract include
all currently operating institutions and allied facilities as indicated.
2. Add/Delete Institutions/Facilities for Services: The Department reserves the right to add
or delete institutions/facilities receiving or requiring services under this Contract upon
sixty (60) days’ written notice. Such additions or deletions may be accomplished by
letter and do not require a contract amendment.
3. Service Times: The Contractor shall ensure access to comprehensive healthcare services
as required within Section II., SCOPE OF SERVICE, twenty-four (24) hours per day,
seven (7) days a week.
4. The Contractor shall have an administrative office located within the State of Florida.

W.

Administrative Requirements, Space, Equipment & Commodities
1. The Department shall not provide any administrative functions or office support for the
Contractor (e.g., clerical assistance, office supplies, copiers, fax machines, and
preparation of documents) except as indicated in this Contract.
2. Space and Fixtures: The Department will provide office space within each health
services unit. The institution shall provide and maintain presently available and utilized
health space, building fixtures and other items for the Contractor’s use to ensure the
efficient operation of the Contract. The institution shall also provide or arrange for
waste disposal services, not including medical waste disposal which shall be the
responsibility of the Contractor. The Department will maintain and repair the office
space assigned to the Contractor, if necessary, including painting as needed, and will
provide building utilities necessary for the performance of the Contract as determined
necessary by the Department. The Contractor shall operate the space provided in an
energy efficient manner.
3. Furniture and Non-Healthcare Equipment: The Department will allow the Contractor to
utilize the Department’s furniture, and non-healthcare equipment currently in place in
each health services unit. A physical inventory list of all furniture and non-healthcare
equipment currently existing at each institution will be taken by the Department and the
current Contractor before the Institution’s implementation date. All items identified on
the inventory shall be available for use by the Contractor. Any equipment (i.e., copiers)
currently under lease by the Department’s prior vendor will be either removed or the
lease assumed by the Contractor, if acceptable to the Contractor and if permitted by the
leasing company. If the lease is either not assumable by or transferred to the Contractor,
the Contractor is responsible for making its own leasing or purchasing arrangements.
The Contractor shall be responsible for all costs associated with non-healthcare
equipment utilized, including all telephone equipment, telephone lines and service

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(including all long distance service and dedicated lines for EKG’s or lab reports),
existing copy machines or facsimile equipment, and is responsible for all costs,
including installation, of any phone, fax or dedicated lines requested by the Contractor.
The Department will not be responsible for maintaining any furniture and non-healthcare
equipment identified on the Department’s inventory, including repair and replacement
(including installation) of Department-owned equipment. Any equipment damaged or
otherwise found to be beyond economical repair after the Contract start date will be
repaired or replaced by the Contractor and placed on the inventory list. All inventoried
furniture and non-healthcare equipment identified on the inventory sheet shall remain
the property of the Department upon expiration or termination of the contract. All
furniture and non-healthcare equipment purchased by the Contractor, except inventory
list replacements, shall remain the property of the Contractor after expiration or
termination of the Contract.
4. Existing Healthcare Equipment: A physical inventory list of all healthcare equipment
owned by the Department and currently existing at each institution will be taken by the
Department and the current Contractor before each institution’s implementation date.
All existing equipment shall be available for use by the Contractor. All inventoried
equipment shall be properly maintained as needed by the Contractor and any equipment
utilized by the Contractor that becomes non-functional during the life of the Contract
shall be replaced by the Contractor and placed on the inventory list. All inventoried
equipment shall remain the property of the Department upon expiration or termination of
the Contract. “Healthcare Equipment” is defined as any item with a unit cost exceeding
one thousand dollars ($1,000). Any healthcare equipment damaged or otherwise found
to be beyond economical repair after the Contract start date will be repaired or replaced
by the Contractor and added to the inventory list. Within 30 days of implementation, the
Contractor will advise the Department of any healthcare equipment that is surplus to
their needs. In addition, within 30 days of implementation, the Contractor shall provide
the Department with documentation of maintenance agreements for existing
Department-owned equipment.
5. Additional Equipment: Any healthcare service equipment not available in the
institutional health services unit upon the effective date of the Contract that the
Contractor deems necessary to its provision of healthcare services under the terms of the
Contract, will be the responsibility, and shall be provided at the expense of the
Contractor. The Department will permit the Contractor, at the Contractor’s expense, to
install healthcare equipment in addition to the Department-owned items on the inventory
list provided. Any additional equipment purchased by the Contractor shall be owned
and maintained by the Contractor and shall be retained by the Contractor at Contract
termination. Any additional equipment purchased, replaced or modified by the
Contractor shall meet or exceed the Department’s standards for functionality, sanitation
and security as determined by the Department’s Office of Health Services. To ensure
compliance with all Security requirements, the Contractor shall obtain written
authorization from the Contract Manager when repairing or replacing any nonDepartment owned healthcare service equipment.
6. The Contractor is responsible to have adequate computer hardware and software for staff
to perform care, provide required reports and perform functions that equal those of the
Department. All required computer equipment must be maintained by the Contractor to
ensure compliance with the Department information technology standards.

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7. If contracting to provide pharmaceutical services, the Contractor shall inventory all
pharmaceuticals in each regional pharmacy and correctional institution, work camp, etc.
The Contractor shall purchase the medication from the Department at the Department’s
current cost and shall credit the Department by monthly invoice, not to exceed six (6)
months, for the agreed upon reimbursement for the medications.
8. Healthcare Supplies: All supplies required to provide healthcare services shall be
provided by the Contractor. A physical inventory of all healthcare supplies currently
existing at each institution will be taken by the Department on or before the new contract
implementation date. This will be done in coordination between the Department and the
Contractor. Both parties will agree on any costs for supplies that the Contractor wishes
to retain. The Contractor shall strive to have at least a thirty (30) days’ supply of
healthcare supplies upon its assumption of responsibility for service implementation at
the institutions. A physical inventory of all equipment and healthcare supplies will also
be conducted upon the expiration or termination of this Contract with appropriate credit
payable to the Contractor, in the event the Department chooses to purchase then existing
supplies. The term “healthcare supplies” is defined as all healthcare equipment and
commodity items utilized in the provision of comprehensive healthcare services with a
unit cost of less than one thousand dollars ($1,000).
9. Forms: The Contractor shall utilize Department forms as specified to carry out the
provisions of this Contract. The Department will provide an electronic copy of each
form in a format that may be duplicated for use by the Contractor. The Contractor shall
request prior approval from the Contract Manager should he/she wish to modify format
or develop additional forms.
10. The Contractor shall not be responsible for housekeeping services, building
maintenance, provision of bed linens for inmate housing, routine inmate transportation
and security. However, the Contractor shall be responsible for maintaining the health
services unit in compliance with Department policy to include sanitation, infection
control, etc, according to Department policy. The Contractor shall be responsible for
healthcare specialty items utilized in the infirmary including, but not limited to, treated
mattresses, and infirmary clothing.
X.

Audits, Investigations and Legal Actions
The Contractor shall notify the Contract Manager in writing (by email or facsimile) within
twenty-four (24) hours (or next business day, if the deadline falls on a weekend or holiday) of its
receipt of notice of any audit, investigation, or intent to impose disciplinary action by any State or
Federal regulatory or administrative body, or other legal actions or lawsuits filed against the
Contractor that relate in any way to service delivery as specified in the resultant contract. In
addition, the Contractor shall provide copies of the below-indicated reports or documents within
seven (7) working days of the Contractor’s receipt of such reports or documents:
1. audit reports for any reportable condition, complaints filed and/or notices of
investigation from any State or Federal regulatory or administrative body;
2. warning letters or inspection reports issued, including reports of “no findings,” by any
State or Federal regulatory or administrative body;
3. all disciplinary actions imposed by any State or Federal regulatory or administrative
body for the Contractor or any of the Contractor’s employees; and
4. notices of legal actions and copies of claims.

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Y.

Security
1. The Department shall provide security for the Contractor’s staff while in the state
facilities. The level of security provided shall be consistent with and according to the
same standards of security afforded to the DC personnel.
2. The Department shall provide security and security procedures to protect the
Contractor’s equipment as well as DC medical equipment. DC security procedures shall
provide direction for the reasonably safe security management for transportation of
pharmaceuticals, medical supplies and equipment. The Contractor shall ensure that the
Contractor’s staff adheres to all policies and procedures regarding transportation,
security, custody, and control of inmates.
3. The Department shall provide adequate security coverage for all occupied infirmaries.
DC shall provide security posts for clinic areas as necessary and determined through the
facilities security staffing analysis and in coordination with the Office of Health
Services.
4. The Department shall provide security escorts to and from clinic appointments whenever
necessary as determined by security regulations and procedures outlined in the Policies
and Procedures
5. The Department will provide the Contractor with access to all applicable Department
rules and regulations. The Department will inform the Contractor of any regulatory or
operational changes impacting the delivery of services to be provided pursuant to this
Contract.
6. The Department will ensure that any inmate receiving treatment pursuant to this Contract
is appropriately restrained, in accordance with the Department’s procedures, at the time
treatment is rendered and that such restraints shall not be removed during treatment unless
the inmate’s health or safety is immediately threatened or removal or repositioning of the
restraints is needed to insure provision of clinically indicated treatment or diagnostic
evaluation. Metallic restraints will be utilized unless the treatment or procedure dictates
the use of non-metallic restraints. Correctional staff shall have sole discretion to determine
whether restraints are to be removed or repositioned.

Z.

Contractor’s Staffing Requirements
1. Conduct and Safety Requirements
When providing services to the inmate population or in a correctional setting, the
Contractor’s staff shall adhere to the standards of conduct prescribed in Chapter 33-208,
Florida Administrative Code, and as prescribed in the Department’s personnel policy
and procedure guidelines, particularly rules of conduct, employee uniform and clothing
requirements (as applicable), security procedures, and any other applicable rules,
regulations, policies and procedures of the Department.
By execution of this Contract, the Contractor acknowledges and accepts, for itself and
any of its agents, that all or some of the services to be provided under this Contract shall
be provided in a correctional setting with direct and/or indirect contact with the inmate
population and that there are inherent risks associated therewith.

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In addition, the Contractor shall ensure that all staff adheres to the following
requirements:
a. The Contractor’s staff shall not display favoritism to, or preferential treatment of,
one inmate or group of inmates over another.
b. The Contractor’s staff shall not interact with any inmate, except as related to
services provided under this Contract. Specifically, staff members must never
accept for themselves or any member of their family, any personal (tangible or
intangible) gift, favor, or service from an inmate or an inmate’s family or close
associate, no matter how trivial the gift or service may seem. The Contractor shall
report to the Contract Manager any violations or attempted violation of these
restrictions. In addition, no staff member shall give any gifts, favors or services to
inmates, their family or close associates.
c. The Contractor’s staff shall not enter into any business relationship with inmates or
their families (example – selling, buying or trading personal property), or personally
employ them in any capacity.
d. The Contractor’s staff shall not have outside contact (other than incidental contact)
with an inmate being served or their family or close associates, except for those
activities that are to be rendered under this Contract.
e. The Contractor’s staff shall not engage in any conduct which is criminal in nature or
which would bring discredit upon the Contractor or the State. In providing services
pursuant to this Contract, the Contractor shall ensure that its employees avoid both
misconduct and the appearance of misconduct.
f.

At no time shall the Contractor or Contractor’s staff, while delivering services under this
Contract, wear clothing that resembles or could reasonably be mistaken for an inmate’s
uniform or any correctional officer’s uniform or that bears the logo or other identifying
words or symbol of any law enforcement or correctional department or agency.

g. Any violation or attempted violation of the restrictions referred to in this section
regarding employee conduct shall be reported by phone and in writing to the
Contract Manager or their designee, including proposed action to be taken by the
Contractor. Any failure to report a violation or take appropriate disciplinary action
against the offending party or parties shall subject the Contractor to appropriate
action, up to and including termination of this Contract.
h. The Contractor shall report any incident described above, or requiring investigation
by the Contractor, in writing, to the Contract Manager or their designee within
twenty four (24) hours, of the Contractor’s knowledge of the incident.
2. Staff Levels and Qualifications
a. The Contractor shall provide an adequate level of staffing for provision of the
services outlined herein and shall ensure that staff providing services is highly
trained and qualified. Additionally, the Contractor shall liaise with and maintain a
good working relationship with the judiciary, criminal justice system, DC staff, and
the community if required to support the Contract.

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b. Staffing Plans: All staffing plans must be approved by the Department. The
Contractor shall submit any proposed revisions to the initial staffing plan that was
provided in their project proposal to the Department within 30 days of Contract
Implementation. The staffing plan is subject to change throughout the life of the
Contract. In the event there are mission changes that impact on health services
functions and responsibilities at institutions covered by this Contract, the
Department shall advise the Contractor of such changes in writing and request an
updated staffing plan. The Department must approve any and all revisions to the
staffing plan.
c. The Contractor shall NOT provide individuals possessing “temporary work visas” to
fill positions under this Contract.
d. All Contractor/subcontractor staff providing services under the Contract shall have
the ability to understand and speak English to allow for effective communication
between Contractor staff and Department staff and inmates.
3. Staff Background/Criminal Record Checks
a. The Contractors’ staff assigned to this Contract and any other person performing
services pursuant thereto, with the exception of persons holding a current Level 2
clearance, shall be subject, at the Department’s discretion and expense, to a Florida
Department of Law Enforcement (FDLE) Florida Crime Information
Center/National Crime Information Center (FCIC/NCIC) background/criminal
records check. This background check will be conducted by the Department and
may occur or re-occur at any time during the contract period. The Department has
full discretion to require the Contractor to disqualify, prevent, or remove any staff
from any work under the Contract. The use of criminal history records and
information derived from such records checks are restricted pursuant to Section
943.054, F.S. The Department shall not disclose any information regarding the
records check findings or criteria for disqualification or removal to the Contractor.
The Department shall not confirm to the Contractor the existence or nonexistence of
any criminal history record information. In order to carry out this records check, the
Contractor shall provide, prior to contract execution, the following data for any
individual Contractor or subcontractor’s staff assigned to the Contract: Full Name,
Race, Gender, Date of Birth, Social Security Number, Driver’s License Number and
State of Issue.
Note: The Contractor shall comply with all provisions outlined in Procedure
208.054, Positions of Special Trust.
b. When providing services within a correctional setting, the Contractor shall obtain a
Level II background screening (which includes fingerprinting to be submitted to the
Federal Bureau of Investigation (FBI)) for those who do not have a current screening
and results must be submitted to the Department prior to any current or new
Contractor staff being hired or assigned to work under the Contract. The Contractor
shall not consider new employees to be on permanent status until a favorable report
is received by the Department from the FBI. The Contractor shall bear all costs
associated with this background screening.
c. The Contractor shall not permit any individual to provide services under this
Contract who is under supervision or jurisdiction of any parole, probation or

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correctional authority. Persons under any such supervision may work for other
elements of the Contractor’s agency that are independent of the contracted services.
d. Note that a felony or first-degree misdemeanor conviction, a plea of guilty or nolo
contendere to a felony or first-degree misdemeanor crime, or adjudication of guilt
withheld to a felony or first-degree misdemeanor crime does not automatically bar
the Contractor from hiring the proposed employee. However, the Department
reserves the right to prior approval in such cases. Generally, two (2) years with no
criminal history is preferred. The Contractor shall make full written report to the
Contract Manager within three (3) calendar days whenever an employee has a
criminal charge filed against them, or an arrest, or receives a Notice to Appear for
violation of any criminal law involving a misdemeanor, or felony, or ordinance
(except minor violations for which the fine or bond forfeiture is $200 or less) or
when Contractor or Contractor’s staff has knowledge of any violation of the laws,
rules, directives or procedures of the Department.
e. No person who has been barred from any Department institution or other facility
shall provide services under this Contract.
f.

Department employees terminated at any time by the Department for cause may not
be employed or provide services under this Contract.

g. The Contractor shall notify the Department, prior to employing any current or
former employee of the Department to provide either full-time or part-time services
pursuant to this Contract.
4. Utilization of E-Verify
As required by State of Florida Executive Order Number 11-116, the Contractor
identified in this Contract is required to utilize the U.S. Department of Homeland
Security’s E-Verify system to verify employment eligibility of: all persons employed
during the contract term by the Contractor to perform employment duties pursuant to the
Contract, within Florida; and all persons, including subcontractors, assigned by the
Contractor to perform work pursuant to the Contract with the Department.
(http://www.uscis.gov/e-verify) Additionally, the Contractor shall include a provision in
all subcontracts that requires all subcontractors to utilize the U.S. Department of
Homeland Security’s E-Verify system to verify employment eligibility of: all persons
employed during the contract term by the Contractor to perform work or provide
services pursuant to this Contract with the Department.
5. Orientation and Training
The Contractor shall ensure Contractor’s staff performing services under this Contract at
institutional sites meets the Department’s minimum qualifications for his/her specific
position/job class. Both the Department’s and the Contractor’s responsibilities with
respect to orientation and training are listed below.
a. The Department will determine what type and duration of orientation and
training is appropriate for the Contractor’s staff. Job specific orientation/training
with regard to particular policies, procedures, rules and/or processes pertaining
to the administration of health care at each institution where the Contractor

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delivers services, shall be coordinated between the Contractor and designated
Department staff.
b. The new employee orientation will be provided by the Department before the
Contractor’s staff begins to provide services on-site. The Contractor shall
coordinate with designated Department staff at each institution the administration
and scheduling of the Contractor’s staff new employee orientation.
c. The Contractor shall track and document all orientation and training as indicated
above. Documentation shall be provided to the Department’s Contract Manager
upon request.
d. The Department is not responsible for any required professional or non-professional
education/training required for the Contractor’s staff to perform duties under this
Contract.
6. TB Screening/Testing
The Contractor shall ensure that all Department and Contractor institutional staff,
including subcontractors and other service providers, are screened and/or tested for
tuberculosis prior to the start of service delivery, as appropriate, and screened/tested
annually thereafter, as required by Department Procedure 401.015, Employee
Tuberculosis Screening and Control Program. The Contractor shall provide the
Department’s Contract Manager, or designee, with proof of testing prior to the start of
service delivery by the staff member and annually thereafter. Documentation shall be
provided to the Department’s Contract Manager upon request. The Contractor shall be
responsible for obtaining the TB screening/testing. The Contractor shall bear all costs
associated with the TB screening/testing.
7. Hepatitis Vaccination
The Contractor shall ensure Contractor’s staff, performing services under this Contract
at institutional sites, is vaccinated against Hepatitis in accordance with the Department
of Health’s guidelines prior to the start of service delivery. The Contractor shall provide
the Contract manager or clinical designee with proof of vaccination prior to the start of
service delivery by any Contractor’s staff.
AA.

Offender Based Information System (OBIS)
All documentation shall comply with applicable Florida Statutes, relevant sections of Florida
Administrative Code, pertinent Department Procedures, court orders, and Health Services’
Bulletins/Technical Instructions. The Contractor shall utilize the Offender Based
Information System (OBIS).
1. OBIS Data Entry
The Contractor shall ensure information is available for input into the Department’s
existing information systems OBIS or Computer Assisted Reception Process (CARP) in
order to record daily operations. Data includes, but is not limited to information or
reports, billing information and auditing data to ensure accuracy of OBIS and CARP
information, plus any other Department system or component developed for Health
Services or any Department system or component deemed necessary for Health Services

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operations. When requested, the Contractor shall provide the Department data that can
be uploaded into the system. The data will meet all the parameters of the Department
and will be provided at no cost to the Department. This data shall conform to all
standard Department, State and/or Federal rules, guidelines, procedures and/or laws
covering data transfer.
2. OBIS Use and Training
The Contractor will make available appropriate personnel for training in the Health
Services’ component of the Offender-Based Information System (OBIS-HS). This
“Train-the Trainer” training, which will be provided by the Department at designated
locations, will provide detailed instruction on the use of OBIS-HS for Medical, Mental
Health and Dental data entry as required by the Department. The Contractor shall be
responsible for maintaining adequate level of trained personnel to comply with the OBIS
data entry requirements. Failure of the Contractor to provide sufficient personnel for
training is not an acceptable reason for not maintaining OBIS information current and as
noted earlier such failure shall be deemed breach of Contract. If there is any reason the
Contractor is directed to access the Department’s information network, each employee
doing so must have undergone a successful level 2 background check as defined in
Chapter 435, F.S.
3. OBIS Cost Reimbursements
All documentation shall comply with applicable Florida Statutes, relevant sections of
Florida Administrative Code, pertinent Department Procedures, court orders, and Health
Services’ Bulletins/Technical Instructions. The Contractor shall utilize the Offender
Based Information System (OBIS) and shall bear the costs for utilizing this system.
Costs are based on transaction usage and/or Central Processing Unit (CPU) utilization.
BB.

Reporting Requirements
1. Format Profiles: The Contractor shall provide a method to interface and submit data in a
format required by the Department for uploading to the Offender Based Information
System or other system as determined by the Department. The Contractor shall also
provide a web-based method for reviewing the reports.
2. The Contractor shall provide the following reports electronically in the time frames
specified with a hard copy to follow, mailed within five (5) business days of the report
due date. All electronic reports shall be downloadable into an excel format, unless
otherwise approved by the Department. After initial reporting for the first month or
quarter of the contract, changes to the report format required by the Department shall be
made by the Contractor. Reports shall be provided to the Contract Manager unless
otherwise specified. All reports shall be developed in such a manner as to be understood
by the Contract Manager or other Department management staff.
3. Monthly Dental Reporting
a. Quarterly Credentialing Report: The Contractor shall provide a Quarterly
Credentialing Report by each institution which includes a summary of any action
taken/conducted/granting of privileges or other credentialing issues at the institution
involving an employee, to include outcomes and recommendations.

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b. Monthly Dental Provider Day Report: The Contractor shall provide to the Director
of Dental Services a Monthly Dental Provider Day Report by institution for all
Dentists and Dental Hygienists providing dental treatment during that month.
c. Monthly Waiting Time Report: The Contractor shall provide to the Director of
Dental Services a Monthly Waiting Time Report for each institution that documents
the current waiting time from receipt of an inmate request until the treatment plan
appointment (Initial Waiting Time) and the current waiting time between follow-up
dental appointments for routine comprehensive dental treatment (Between
Appointment Waiting Time).
4. Monthly Communicable Disease Reporting
a. Weekly Environmental Health and Safety Inspection Report: The Contractor shall
provide a Weekly Environmental Health and Safety Inspection Report (DC2-537) by
each institution in accordance with Environmental Health and Safety Manual
Chapter 3.
b. Weekly Wound Report: The Contractor shall provide a Weekly Wound Report by
each institution in accordance with Infection Control Manual.
c. Monthly Prevalence Walks Report: The Contractor shall provide a Monthly
Prevalence Walks Report by each institution which includes:
•
•
•
•
•
•
•
•
•
•
•

Prevalence Walk Blood Borne Pathogens and Post Exposure Prophylaxis
Form—DC4-788A
Prevalence Walk--Biomedical Waste—DC4-788B
Prevalence Walk—Refrigerators—DC4-788C
Prevalence Walk—Needle Collection Procedures – DC4-788D
Prevalence Walk—Isolation—DC4-788E
Prevalence Walk—Fluid, Disinfectants, Antiseptics, and Medications—DC4-788F
Prevalence Walk—Under Sink Storage—DC4-788G
Prevalence Walk—Environment—DC4-788H
Prevalence Walk—Ice Machines—DC4-788J
Prevalence Walk—Hand Washing Practices—DC4-788K
Prevalence Walk-Hand Sanitizer and Hand Lotion Inventory—DC4-788L

d. Monthly Communicable Disease Report: The Contractor shall provide a Monthly
Communicable Disease Report (“Infection Attack Rates”) by each institution which
includes a summary of any identified communicable disease outbreaks, including
surveillance data and actions to prevent future outbreaks.
e. Monthly EOS HIV Lab Test Report: The Contractor shall provide a Monthly EOS
HIV Lab Test Report by each institution which includes the number of EOS HIV lab
tests completed the previous month.
f.

Monthly Inmate TST Report: The Contractor shall provide a Monthly TST Disease
Report by each institution which includes a summary of TST testing of inmates in
accordance with HSB 15.03.18.

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g. Monthly Employee TST Report: The Contractor shall provide a Monthly TST
Disease Report by each institution which includes a summary of TST testing of
employees in accordance with Procedure 401.015.
h. Monthly Antibiotic Resistant Organism Report: The Contractor shall provide a
Monthly Antibiotic Resistant Organism Report (DC4-546D) by each institution in
accordance with Infection Control Manual.
i.

Monthly Dialysis Infection Control Report: The Contractor shall provide a Monthly
Dialysis Infection Control Report for each institution that provides dialysis in
accordance with Infection Control Manual.

j.

Monthly Vaccine Report: The Contractor shall provide a Monthly Vaccine Report
(DC4-539F) in accordance with Infection Control Manual.

5. Nursing Services Reporting
a. Quarterly Mock Medical Code Blue Critique Report: The Contractor shall provide a
Quarterly Mock Med Code Blue Critique (DC4-677) in accordance with HSB
15.03.22.
b. Quarterly Medical Code 99 Emergency Work Sheet Report: The Contractor shall
provide a Quarterly Med Code 99 Emergency Work Sheet (DC4-679) in accordance
with HSB 15.03.22.
c. Quarterly Impaired Inmate Meeting Report (including meeting): The Contractor
shall provide a Quarterly Impaired Inmate Meeting Report with minutes in
accordance with HSB 15.03.25.
d. Annual Disaster Plan Drill Report: The Contractor shall provide an Annual Disaster
Plan Drill Report in accordance with HSB 15.03.06.
e. Annual Emergency Preparedness Roster: The Contractor shall provide an Annual
Emergency Preparedness Roster in accordance with HSB 15.03.06.
6. Outbreak/Communicable Disease Reporting
a. Summary of Infection Control Investigation Table V Report: The Contractor shall
provide an immediate Summary of Infection Control Investigation Table V Report
(DC4-539) at the conclusion of an outbreak by each institution in accordance with
Infection Control Manual.
b. Infectious Disease Outbreak Worksheet: The Contractor shall provide a daily,
updated Infectious Disease Outbreak Worksheet (DC4-544C) by each institution in
accordance with Infection Control Manual.
c. Summary Tuberculosis INH Information Summary Report: The Contractor shall a
provide Tuberculosis INH Health Information Summary Report (DC4-758) by each
institution completed before end of sentence in accordance with HSB 15.03.18.

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d. Summary HIV/Aids Health Information Summary Report: The Contractor shall a
provide HIV/Aids Health Information Summary Report (DC4-682) by each
institution completed before end of sentence in accordance with HSB 15.03.18.
e. Summary Bloodborne Pathogen Report: The Contractor shall provide a Inmate
Bloodborne Pathogen Report (DC4-798) by each institution in accordance with
Bloodborne Pathogen Manual.
7. Monthly Mental Health Reporting
a. Aftercare Status Report: The Contractor shall provide a monthly Aftercare report in
accordance with HSB 15.05.21.
b. Mental Health Emergency and Admission/Discharge Reports: The vendor shall
provide OHS with monthly reports that include information about mental health
emergencies, incidents of self-harm behavior, admissions/discharges from inpatient
units, and admissions/discharges from infirmary care for inmates on Self-Harm
Observation Status.
c. Outside Medical Care Report: The vendor shall also provide OHS with a written
mental health summary in a format designated by OHS for all inmates who engage
in self-injurious behaviors that result in transportation to an outside medical facility.
8. Monthly Administrative Reporting
a. Monthly Staffing Report: The Contractor shall provide a Monthly Staffing Report by
each institution which includes, but not limited to, position title, staff member’s
name, position number, date of hire, full time, part time or temporary hours, start
date, shift, vacant date and penalty date.
b. Monthly Personnel Action Report: The Contractor shall provide a Monthly
Personnel Action Report by each institution which includes a summary of any
personnel actions, positive and/or negative, taken on an employee. In addition, the
report shall include a summary of FCIC/NCIC/E-Verify conducted on employees
during the month. The report shall not include protective data or any references that
are in violation of federal and/or state law.
c. Monthly Medical Equipment Report: The Contractor shall provide a Monthly
Medical Equipment Report by each institution which includes a summary of any
medical, dental and/or non-medical equipment.
d. Quarterly Inspection/Survey/Certification Report: The Contractor shall provide a
Quarterly Inspection/Survey/Certification Report by each institution which includes
a summary of any inspections/surveys conducted at the institution directly or
indirectly involving health services, to include outcomes and any corrective action
plans.
e. Monthly Inmate Refusal Report: The Contractor shall provide a Monthly Inmate
Refusal Report by each institution which includes a summary of any inmate’s
refusal of healthcare. The report shall not include protective data or any references
that are in violation of federal and/or state law.

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f.

Quarterly Cost Report: The Contractor shall provide a quarterly a report of its
operating costs to include, at a minimum, employee salaries and benefits, ancillary
services, medication, and medical supplies used for each institution. These cost
reports should be submitted in a format approved by the Contract Manager. Any
changes made to this format by the Department during the term of the contract shall
also be made by the Contractor.

9. Utilization Reporting Requirements
a. Monthly Reports: The Contractor shall provide to the Contract Manager a monthly
report by the tenth (10th) business day each month for the preceding month:
1) Daily Inpatient Hospital Reporting by Diagnostic Related Groups
(DRG)/Current Procedural
2) Terminology (CPT) Data Elements
3) Diagnostic Related Grouping Codes for Admission, On-going Length of Stay
and Discharge
4) Inmate procedures report by DRG/CPT Coding, by Facility, by Provider
5) Inpatient Days per Month
6) Average Length of Stay
7) Routine/Urgent Consult Status Reporting to include:
a) Number of days from “request for medical care” (consult) to “seen”
b) Number of cancelled appointments by network provider
c) Number of cancelled appointments by institutions due to security issues
b. Quarterly Reports The Contractor shall provide to the Contract Manager a quarterly
report by the tenth (10th) business day of January, April, July and October reflecting
the following cumulative information gathered over the previous calendar quarter or
portion thereof:
1) Identification of Outliers, Variance/Variability based on DRG to Length of Stay
2) Identification of Patterns of Prescribing and Trends Analysis
3) Data Cost Analysis of services provided and comparative data for indicators
measured with the goal of cost containment.
4) Cost per Day – Inpatient Hospital, Inpatient at RMC, Infirmary Care
5) Cost per Surgical Case and/or Surgical Procedure
6) Cost by Diagnostic Codes, Provider, Facility, Region, and Inmate
7) Summary report of Unauthorized / Disapproved Claims with explanation
10. Other Reporting Requirements
a. Quality Management Reports: The Contractor shall ensure all Clinical Quality
Management Reports as further described in Quality Management series, including
Mortality Review, Risk Management and Infectious Disease reporting, as
applicable, are properly completed and submitted as directed in the respective
Health Service Bulletins, to the Contract Manager and Quality Management section
in Central Office-Office of Health Services.
b. The Contractor shall comply with applicable continuing reporting requirements as
determined by the Assistant Secretary of Health Services or designee for reports to
and from the Department and the Healthcare Contract Monitor.

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c. The Contractor shall provide a quarterly report listing all Contractor-employed
credentialed providers to the Contract Manager. This report will include the
provider name, health care license type and status, job title, privileges granted,
credentialing status, date started at a Department facility and date no longer working
at a Department facility if the Contractor employee started or ceased providing
services during the reporting period.
d. AdHoc Reports: The Department reserves the right to require additional reports,
adhoc reports, information pertaining to Contract compliance or other reports or
information that may be required to respond to grievances, inquiries, complaints and
other questions raised by inmates or other parties. The Contractor shall submit the
report or information in not less than seventy-two (72) hours after receipt of the
request. When time is of the essence, the Contractor shall make every effort to
answer the request as soon as possible so that the Department can respond to the
authority or party making the request.
e. Quarterly Performance Reports: The Contractor shall provide quarterly performance
reports to the Department addressing the Contractor’s compliance with the
performance measures, as applicable, and as stated in Section II., DD., of the
Contract. If issues of non-compliance are identified in the quarterly performance
reports, financial consequences will be assessed in accordance with Section II., EE.,
of the Contract. The quarterly performance reports shall be submitted by the tenth
(10th) day of the month following the end of the corresponding quarter.
CC.

Contract Termination Requirements
If, at any time, the Contract is canceled, terminated or otherwise expires, and a Contract is
subsequently executed with a firm other than the Contractor, or service delivery is resumed
by the Department, the Contractor has the affirmative obligation to assist in the smooth
transition of Contract services to the subsequent Contractor (or to the Department). This
includes, but is not limited to, the development of a Department approved transition plan that
includes health record updates and disposition, identification of hospitalized inmates,
inventories of equipment and supplies (pharmaceuticals, if applicable, etc.), disposition of
employee health and safety training education and immunization records, and final
submission of all required monthly, quarterly, and annual reports. The Contractor shall work
with the Department during that time to coordinate the phase-out schedule, with the
understanding that as institutions are removed from the Contract, the Contractor understands
that its revenue will drop. The Contractor shall make timely provision of all contract-related
documents and information, not otherwise protected from disclosure by law to the replacing
party.
The Contractor shall submit a transition plan to the Contract Manager no less than one
hundred and twenty (120) days prior to intended contract termination by the Contractor
outlining steps for transition of service upon contract expiration or in the event of contract
termination. The plan shall set forth the date and time of transfer of responsibility by the
Contractor to the entity assuming service, with a schedule for each institution as well as a
transfer plan for any inmates in outside hospitals at the time of transition. Failure to timely
submit the transition plan shall result in forfeiture of ten percent (10%) of both final semimonthly payments. In addition, upon the expiration date of the Contract, the Contractor
shall provide inventories of equipment consistent with the levels and types of inventories
provided upon Contractor’s initial assumption of services under the Contract.

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DD.

Performance Measures
The Department has developed the following Performance Measures which shall be used to
measure the Contractor’s performance and delivery of services.
The Contractor shall comply with all contract terms and conditions upon execution of the
Contract. The audit will be performed by the Department’s Office of Health Services to
ensure that contract requirements are being met.
1. Performance Outcomes, Measures, and Standards
The Department’s Office of Health Services will monitor Contractor’s performance in a
continuous and ongoing effort to ensure compliance with requirements of the Contract
commencing 90 days after the Contract Implementation period begins. These
requirements and/or expectations will be based on the current ACA Standards for Health
Care Performance Based Standards and Expected Practices and/or NCCHC Standards,
the Contract specifications, and the Department’s Policies and Procedures. The
Contractor will provide the Department’s Office of Health Services with all medical,
dental and mental health records; logbooks; staffing charts; time reports; inmate
grievances; and other reasonably requested documents required to assess the
Contractor’s performance. Actual performance will be based on a statistically-significant
sample compared with pre-established performance criteria. An audit by the Department
will be performed quarterly to assess contract compliance. The following is a summary
of general performance indicators. These indicators do not represent the complete
description of the Contractor’s responsibility. The Department reserves the right to
add/delete performance indicators as needed to ensure the adequate delivery of
healthcare services. Performance criteria include, but are not limited to, the following
contract deliverables:
Listed below are the key Performance Outcomes, Measures and Standards deemed most
crucial to the success of the overall desired service delivery.
a. MEDICAL SERVICES
1) Access to Care
Inmates have access to care to meet their serious medical, dental, and
mental health needs.
Outcome: Inmates have access to care in a timely manner with referral to an
appropriate clinician as needed.
Measure: Documentation by DC4-698B, DC4-698A, and the Call Out Schedule
(OBIS).
Standard: Achievement of outcome must meet one hundred percent (100%) of
chart reviews.
Reference: Procedure 403.006, HSB 15.05.20 and HSB 15.03.22.
2) Refusal of Health Care Services
Process for refusal of health care services by inmates and the documentation of
inmate-initiated decision to decline a procedure/treatment that a health care
clinician has indicated is medically necessary.

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Outcome: Inmates are provided a process for refusal of health care and the
documentation thereof.
Measure: Refusal noted in OBIS; Documentation by DC4-711A
Standard: Achievement of outcome must meet ninety percent (90%) of record
and OBIS reviews.
Reference: Procedure 401.002
3) Reception, Transfers and Continuity of Care
a) All inmates receive an initial intake screening by a nurse.
Outcome: All inmates have an Initial Intake Screening completed by a
nurse upon entry.
Measure: Complete documentation in health record via Computer-Assisted
Reception Process (CARP)
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Procedure 401.014
b) A proper medical health appraisal is provided to inmates upon
reception
Outcome: Every newly committed inmate will receive a complete medical
health appraisal within fourteen (14) days of arrival at the reception center.
Measure: Completed DC4-707
Standard: Achievement of outcome must meet one hundred percent (100%)
of record reviews.
Reference: Procedure 401.014 and Health Services Bulletin 15.01.06
c) Transfer/Arrival Summary: Continuity of care is provided when
movement/transfer of inmates occur through the transfer of inmate
comprehensive health records, confidential maintenance of health
information, and required medications.
Outcome: Transfer section is completed by the sending institution and the
Arrival Summary is completed by the receiving institution upon arrival.
Measure: Completed DC4-760A
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: Procedure 401.017, 401.014
d) Inmates have continuity of prescribed medication.
Outcome: Inmates that have a current prescribed medication/s when
arriving to the new institution have continuity of medication.
Measure: Completed DC4-760A and DC4-701A
Standard: Achievement of outcome must meet one hundred percent (100%)
of records reviewed.
References: Procedure 401.017

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e) Medication Administration
i.

Outcome: Inmates are administered medication as ordered by the
Clinician
Measure: DC4-701A
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Procedure 403.007 Medication Administration and Refusals

ii. Outcome: Medications are documented on the DC4-701A Medication
and Treatment Record. Each dose of medication not administered is
circled and an explanation written on the back of the DC4-701A.
Measure: DC4-701A
Standard: Achievement of outcome must meet ninety percent (95%).
Reference: Procedure 403.007 Medication Administration and Refusals
4) Pre-Release Planning
All Inmates are offered HIV testing prior to End of Sentence (EOS)
Outcome: All inmates are offered an HIV Test prior to the EOS Date unless the
inmate has a previous positive HIV Test Result on file.
Measure: Documentation of an HIV test result, signed consent or refusal in
medical record.
Standard: Achievement of outcome one hundred percent (100%).
Reference: Section 945.355, Florida Statutes
5) Specialized Medical Care
a) Inmates who need specialized care that cannot be provided by the
Contractor will receive a specialty consultation appointment as
clinically indicated.
Outcome: Provide specialty consultation appointments.
Measure: A completed Consultation Request/Consultant Report Form “DC4702” in the record and a log that reflects appointments are made in accordance
with established guidelines for routine, urgent and emergent care.
Standard: Achievement of outcome ninety-five percent (95%).
Reference: HSB 15.09.04
b) Follow up care after Specialty Consultation
Outcome: Inmates seen by a specialist will have the Consultant Report
reviewed by the clinician. The clinician will either approve recommended
procedure/treatment or recommend alternative clinically appropriate
treatment options and discuss them with the inmate.
Measure: Completed Consultation Request/Consultant Report Form “DC4702” Chronological Record “DC4-701 for entry by clinician of clinically
appropriate procedure/treatment and communication with inmate record
review for procedure/treatment implementation.
Standard: Achievement of outcome one hundred percent (100%)
Reference: HSB 15.09.04.

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6) Hunger Strikes
Outcome: The Chief Health Officer at the institution is responsible for the
treatment of inmates on hunger strike.
Measure: Documentation of appropriate medical interventions as outlined in
Procedure 403.009, Management of Hunger Strikes.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Procedure 403.009
7) Chronic Illness Clinics
Inmates with a Chronic Illness will be seen in a Chronic Illness Clinic (CIC) at
the appropriate interval as determined by the HSB and physician.
Chronic illness clinics include, but are not limited to:
Immunity
Cardiac
Gastrointestinal
Endocrine
Neurology
Respiratory
Oncology
Miscellaneous
a) Outcome: Inmates will be assigned to the appropriate chronic illness clinic
based on clinical need.
Measure: DC4-701F
Standard: Achievement of outcome ninety five percent (95%)
Reference: HSB 15.03.05
b) Outcome: Inmate in chronic illness is seen by the clinician in accordance
with HSB and clinical need.
Measure: DC4-701F
Standard: Achievement of outcome ninety five percent (95%)
Reference: HSB 15.03.05
8) Lab testing and results
a) Outcome: Clinician reviews results of diagnostic test.
Measure: Results are initialed by a clinician indicating review
Standard: Achievement of outcome must meet ninety five percent (95%)
Reference: HSB 15.03.05; TI 15.03.39, HSB 15.05.20
b) Outcome: Clinician orders and implements plan of care for abnormal
diagnostics.
Measure: Documentation of plan and implementation on the DC4-701.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.05; TI 15.03.39 and HSB 15.03.24
c) Outcome: Lab results and diagnostics are available to the clinician prior to
appointment.
Measure: Documentation that lab results were available in the health
record, DC4-701.
Standard: Achievement of outcome (100%)
Reference: HSBs 15.03.24, 15.03.04

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9) OB/GYN Care
a) Outcome: All pregnant inmates will be offered HIV testing.
Measure: HIV test result or signed refusal DC4-711 A in the Health
Record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Section 384.31, Florida Statutes, Rule 64D-3.019 Florida
Administrative Code, TI 15.03.39
b) Outcome: All pregnant inmates will have a hepatitis B (HBsAg) test at the
initial prenatal visit and at twenty eight (28) weeks to thirty two (32) weeks
gestation.
Measure: Hepatitis B test result or signed refusal DC4-711A in the Health
Record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Section 384.31, Florida Statutes, Rule 64D-3.019, Florida
Administrative Code, TI 15.03.39
c) Outcome: All pregnant inmates will have a syphilis test at the initial
prenatal visit and at twenty eight (28) weeks to thirty two (32) weeks
gestation.
Measure: Syphilis test result or signed refusal DC4-711A in the Health
Record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Section 384.31, Florida Statutes, Rule 64D-3.019, Florida
Administrative Code, TI 15.03.39
d) Outcome: All pregnant inmates will receive counseling including a
discussion concerning the risk to the infant and the availability of treatment
for HIV, hepatitis B and syphilis prior to testing.
Measure: Documentation that counseling, discussion or a signed refusal
DC4-711A is in the Health Record
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Section 384.31, Florida Statutes, Rule 64D-3.019, Florida
Administrative Code, TI 15.03.39
e) Outcome: Breast examination self-examination, and professional
examination are in accordance with those of the United States Preventive
Services Task Force (USPSTF).
Measure: Complete documentation on DC4-686 in the Health Record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: HSB 15.03.24
f)

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Outcome: Routine screening mammograms are performed in accordance
with policy.
Measure: Mammogram result or signed refusal is in the Health Record.
Standard: Achievement of outcome must meet ninety five percent (95%).
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g) Outcome: Mammography shall be performed on all inmates with suspicious
breast masses or lumps.
Measure: Mammogram result or signed refusal is in the Health Record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.24
h) Outcome: Complete routine Pap smear per policy.
Measure: Completed DC4-686 or signed refusal in the Health Record.
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: HSB 15.03.04
10) Sick Call hours/Access to care
a) Sick Call Request process
i.

Outcome: Sick call request is triaged by a nurse daily and prioritized as
(1) Emergent, (2) Urgent or (3) Routine.
Measure: Documentation by nurse on sick call request form DC4698A and DC4-698B.
Standard: Achievement of outcome must meet ninety five percent
(95%)
Reference: Procedure 403.006

ii. Outcome: The inmate’s sick call request is scheduled and followed up
according to priority. All emergencies are seen immediately.
Measure: DC4-698A, DC4-698B, DC4-683 Series
Standard: Achievement of outcome must meet ninety five percent
(95%)
Reference: Procedure 403.006
11) Specialty Care
a) Wound prevention and care
Outcome: Prevention of and care for inmate’s wounds in accordance with
the Wound Program in the Infection Control Manual Chapter XXII.
Measure: Complete documentation DC4-683W, DC4-804, DC4-803, DC4805, DC4-701A
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: Infection Control Manual Chapter XXII
b) Palliative Care
Outcome: Provide palliative care for inmates when clinically indicated.
Measure: Palliative Care provided as outlined in 15.02.17
Standard: Achievement of outcome must meet one hundred (100%).
Reference: TI 15.02.17

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12) Emergency Services, Emergency Plan and Training
Outcome: Training for emergency care of inmates will be provided to all health
care staff
Measure: Documentation on DC2-901, DC4-678, DC4-677, First Aid Training,
CPR/AED Certification
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: HSB 15.03.22
13) Prison Rape and Elimination Act
Outcome: All Medical Staff receives training on the Prison Rape and
Elimination Act Procedure and associated Health Services Bulletin.
Measure: Documentation on file that Medical Staff had training in PREA;
compare employee roster with training documents
Standard: Achievement of outcome must meet one hundred percent (100%) of
record reviews.
Reference: Federal Senate Bill 1435, Prison Rape Elimination Act (PREA),
Florida Statute 944.35, Florida Administrative Code Chapter 33-602 and
Sections 33-208.002 and 33-208.003, Prison Rape: Prevention, Elimination and
Investigation 108.010 and Post-rape Medical Action, 15.03.36, DC4-683M.
14) Alleged Sexual Battery/Post-Rape Medical Action
Outcome: Medical Staff delivers care as outlined per policy to inmates who
state they are the victim of an alleged sexual battery.
Measure: Completed DC4-683M
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Procedure 108.010, HSB 15.03.36, DC4-683M
15) Infirmary services
A separately defined medical area/infirmary shall be maintained that provides
organized bed care and services for patients admitted for twenty-four (24) hours
or more and is operated for the expressed or implied purpose of providing
nursing care and/or observation for persons who do not require a higher level of
inpatient care.
a) Outcome: Physician infirmary rounds made on a daily basis (Monday –
Friday), except holidays.
Measure: Completed DC4-714A
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.26
b) Outcome: The initial nursing admission is completed with 2 hours of
admission.
Measure: DC4-684
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.26

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c) Outcome: Nursing rounds are made every two hours in the infirmary.
Measure: DC4-717
Standard: Achievement of outcome must meet ninety-five percent (95%).
Reference: HSB 15.03.26
d) Outcome: A discharge summary for an admitted inmate completed within
48 hours of discharge.
Measure: Completed documentation on DC4-713B (DC4-657 for a mental
health patient) completed by the physician (or designee) within 48 hours of
discharge.
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: HSB 15.03.26
e) Outcome: Nurse will perform Infirmary Patient Assessment per policy.
Measure: Completed documentation on DC4-684 three times a day unless
order more frequently by clinician.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.26, DC4-684
16) Periodic screening
Periodic screening provides evaluation and documentation of inmate/patient’s
health status and preventive health maintenance.
Outcome: Inmates receive a periodic screening.
Measure: Completed Periodic Screening DC4-541 in accordance with schedule
outlined in Health Services Bulletin 15.03.04.
Standard: Achievement of outcome must meet ninety five percent (95%)
Reference: HSB 15.03.04
17) Pre-release Screening
Provide evaluation and documentation of inmate/patient’s health status at time
of release.
Outcome: Inmates receive screening by a clinician prior to release to Customs
Enforcement, parole, placement in a work release facility or community
correctional center.
Measure: Completed Pre-release DC4-549 original in medical record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: HSBs 15.03.04 and 15.03.29
18) Impaired inmate services, including inmate assistants for impaired inmates
a) Outcome: Inmates with impairments are placed in settings that can
adequately provide for their healthcare treatment needs.
Measure: Inmate impairment grade in record matches the Institution’s
impairment designation.
Standard: Achievement of outcome must meet one hundred percent (100%)

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Reference: Procedure Transfer for Medical Reasons 401.016, Health
Services Bulletin Impaired Inmate Services 15.03.25
b) Outcome: Inmates who are assigned to assist impaired inmates will receive
required training.
Measure: Complete documentation DC4-526
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Health Insurance Portability and Accountability Act, Florida
Administrative Code 33-210.201 and 33-401.701, Procedure 403.011
19) Special Housing
a) Outcome: Inmates in special housing receive a Pre-Confinement Physical.
Measure: Completed Special Housing Appraisal or Pre-Confinement
Physical “DC4-769”
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Procedure 403.003, DC4-769
b) Outcome: Nursing staff make daily rounds in special housing.
Measure: Documentation of daily rounds on Nursing Special Housing
Rounds “DC4-696”
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Procedure 403.003, DC4-696
20) Post Use of Force
Outcome: A post use of force physical examination will be performed by
nursing staff with notification and/or referral to a clinician as clinically
indication.
Measure: Complete documentation on the Emergency Room Record “DC4701C”, Diagram of injury “DC4-708” and referral to clinician.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Rule 33-602.210, Florida Administrative Code (“Use of Force”)
21) Medical Isolation for Suspected Communicable or Infectious Disease
Inmate is placed in an isolation cell if suspected of having a communicable or
infectious disease such as Tuberculosis, Chickenpox, etc.
Outcome: Any inmate diagnosed or suspected of having a communicable or
infectious disease shall be isolated until rendered noninfectious.
Measure: Isolation precautions will be documented in the medical record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Infection Control Manual Chapter XIII
22) Immunization Administration and Documentation
a) Outcome: During the reception process inmate’s immunization history will
be assessed and documented.

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Measure: Immunization history documented on the Immunization Record
“DC4-710A”.
Standard: Achievement of outcome must meet ninety-five percent (95%)
Reference: HSB 15.03.30
b) Outcome: Inmates will receive immunizations in accordance with
established policy.
Measure: Completed signed consent or refusal and documentation of
Immunization on DC4 710-A.
Standard: Achievement of outcome must meet ninety-five percent (95%)
Reference: HSB 15.03.30.
23) Tuberculosis Program
a) Employee Tuberculosis Screening
Outcome: All Department employees whose duties are expected to bring
them into contact with inmates and for contract employees, who perform
their duties in institutions, must be screened/tested for tuberculosis upon
application or hire, as appropriate and screened/tested annually thereafter.
Measure: Review monthly report DC4-782B for percentage of compliance
of TST including results.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Procedure 401.015
b) Inmate Tuberculosis Screening
Outcome: All inmates are screened for Tuberculosis with the Tuberculosis
Symptom Questionnaire “DC4-520C.”
Measure: Documentation on the Tuberculosis Symptom Questionnaire
“DC4-520 C” is complete.
Standard: Achievement of outcome must meet ninety-five percent (95%)
Reference: HSB 15.03.18
c) Inmate Tuberculosis Skin Testing
Outcome: Inmates with no history of a previous positive Tuberculosis Skin
Test (TST) results will have TST per schedule outlined in Health Services
Bulletin 15.03.18.
Measure: Documentation that scheduled TST’s were noted on the
Immunization record “DC4-710 A” results read in 48-72 hours and
documented in millimeters (mm) of induration.
Standard: Achievement of outcome must meet ninety-five percent (95%)
Reference: HSB 15.03.18
24) Infection Control Surveillance and Monitoring
a) Bloodborne Pathogens
i.

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Outcome: All bloodborne pathogen exposure incidents must be
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Measure: Review of DC4-798 (Bloodborne Pathogens Exposure –
Screening Incident) and DC4-799 (Inmate Bloodborne Pathogen
Exposure Report).
Standard: Achievement of Outcome must meet one hundred percent
(100%).
Reference: Infection Control Manual Chapter XIX and Bloodborne
Pathogen Exposure Control Plan
b) Chest x-rays
Outcome: Chest x-rays (CXR) are completed on inmates who have
tuberculosis symptoms or a documented positive TST conversion within the
last two years and have either not received or completed treatment.
Measure: Documentation that CXR was completed within seventy two (72)
hours of completion of DC4-520C and CXR reports
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.18
c) Treatment of Latent Tuberculosis Infection
Outcome: Treatment of latent tuberculosis infection shall be considered for
all inmates who have a positive skin test when active disease has been ruled
out and there are no contraindications to treatment.
Measure: Review of DC4-710A Immunization record and DC4-520C
Tuberculosis
Symptom
Questionnaire,
DC4-719
Tuberculosis
INH/Treatment for Latent TB Infection (LTBI) Follow-up Visit
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.18
d) Monthly monitoring Tuberculosis Clinic
Outcome: Monthly monitoring by the nurse or clinician if clinically
indicated is to be initiated within two (2) weeks after the inmate has been
started on INH or TB medications.
Measure: DC4-719 Tuberculosis INH/Treatment for Latent TB Infection
(LTBI) Follow-up Visit, MAR(Medication Administration Record
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.03.18
e) Tuberculosis Contact Investigation
Outcome: A Tuberculosis contact investigation is initiated on all infectious
cases of Tuberculosis. Final results of the contact investigation must be
reported to Department of Health Bureau of TB and Refugee Health within
one year of start date.
Measure: Completed TB Contact Investigation documentation.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: 15.03.18

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f) Bloodborne Pathogen Exposure
i.

Outcome: Filled sharps containers is sealed and discarded as
biomedical waste when three- fourths (¾) full or filled to the “FULL”
line (if present) on the side of the container.
Measure: Inspection of sharps containers during site visit (DC4-788D)
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Bloodborne Pathogen Exposure control Plan

ii. Outcome: All institutions will have Post Exposure Prophylaxis
medications available on site.
Measure: During site visit nurse will check for the presence of
antiretroviral therapy for possible Human Immunodeficiency Virus
(HIV) exposure and Hepatitis B vaccine for possible Hepatitis B
exposure.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: Bloodborne Pathogen Exposure Control Plan
25) Dialysis Services
a) Pre-dialysis patient assessment
Outcome: Conduct pre-dialysis assessment of patient’s vital signs, body
weight, edema, and mental status.
Measure: The assessment data must be documented onto the patient’s
medical record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Nephrology Nursing Standards of Care
b) Post-dialysis patient assessment
Outcome: Conduct post-dialysis assessment of patient’s vital signs, body
weight, edema, and mental status.
Measure: The assessment data must be documented onto the patient’s
medical record.
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Nephrology Nursing Standards of Care
b. MENTAL HEALTH SERVICES
1) Access to Care (Mental Health)
a) Inmate Requests
Outcome: Inmate-initiated requests are responded to in accordance with the
timeframe specified in HSB 15.05.18 Outpatient Mental Health Services.
Measure: Documentation of incidental note on DC4-642 Chronological
Record of Outpatient Mental Health Care and DC6-236 Inmate Request in
the health record.

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Standard: Achievement of outcome must meet ninety-five percent (95%).
Reference: HSB: 15.05.18 Outpatient Mental Health Services, Section V, A.
b) Inmate-Declared Emergencies/Emergent Staff referrals
Outcome: Inmate-declared emergencies and emergent staff referrals are
responded to as soon as possible, but must be within the timeframe specified
in Procedure 404.001 Suicide and Self-Injury Prevention.
Measure: Documentation on DC4-642G Mental Health Emergency
Evaluation, DC4-683A Mental Health Emergency Protocol, in the health
record, and DC4-781A, Mental Health Emergency Log.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB: 15.05.18 Outpatient Mental Health Services, Section V.
A. Procedure 404.001 Suicide and Self-Injury Prevention, Section (1) (b).
2) Reception Center Services
a) Continuity of Care – Psychotropic Medications
Outcome: If the inmate was taking psychotropic medication immediately
prior to transfer from the county jail, the screening medical staff person
arranges for continuity of such care, until such time as the inmate is seen by
psychiatric staff.
Measure: Documentation on DC4-701A Medication Administration Record
in the health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: 15.05.17 Intake Mental Health Screening at Reception Centers,
Section V. A.
b) Psychiatry Referral – Past History
Outcome: If the inmate received inpatient mental health care within the past
six (6) months or received psychotropic medication for a mental health
disorder in the past thirty (30) days, a psychiatric evaluation is completed
within 10 days of referral.
Measure: Documentation on DC4-655 Psychiatric Evaluation in the health
record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: HSB 15.05.17 Intake Mental Health Screening at Reception
Centers Section V.A.; Procedure 401.014 Health Services Intake and
Reception Process Section (3) (a-b).
c) Intake Screening – Psychological Testing
Outcome: Intake screening psychological testing is completed within the
timeframes specified in HSB 15.05.17 Intake Mental Health Screening at
Reception Centers, for all new admissions to a reception center.
Measure: Documentation on DC4-644 Intake Psychological Screening
Report in the health record.

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Standard: Achievement of outcome must meet ninety percent (90%).
Reference: HSB 15.05.17 Intake Mental Health Screening at Reception
Centers, Section IV. B.
3) Treatment Planning
a) Outpatient Individualized Service Plan
Outcome: The initial individualized service plan is completed within the
timeframe specified in HSB 15.05.11 for the inmate being assigned a mental
health classification of S-2 or S-3.
Measure: Documentation on DC4-706 Health Services Profile, DC4-643A
(Parts I, II, and III) Individualized Service Plan in the health record.
Standard: Achievement of outcome must meet ninety percent (90%).
Reference: HSB: 15.05.11 Planning and Implementation of Individualized
Mental Health Services, Section V. A.
b) Inpatient Individualized Service Plan
Outcome: An Individualized Service Plan (ISP) is initiated and approved by
the MDST within the respective timeframes specified in HSB 15.05.11 for
admission to TCU, 5 days of admission to CSU, and 7 days of admission to
CMHTF.
Measure: Documentation on DC4-643A (Parts I, II, and III) Individualized
Service Plan; DC4-714B Physician Order Sheet in the health record or
inpatient health record.
Standard: Achievement of outcome must meet ninety percent (90%).
Reference: HSB 15.05.11 Planning and Implementation of Individualized
Mental Health Services
4) Outpatient Mental Health Services
Level of Care
Outcome: Inmates with a current diagnosis of Schizophrenia or other
psychotic disorders including disorders with psychotic features are
maintained as a mental health grade of S-3 or higher.
Measure: DC4-706 Health Services Profile and DC4-643A (Parts I, II, and
III) Individualized Service Plan in the health record.
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: HSB: 15.05.18 Outpatient Mental Health Services, Section VII. D.
5) Suicide and Self Injury Prevention
a) Self-Harm Observation Status Initial Orders
Outcome: For inmates placed on Self-harm Observation Status, there is an
order documented in the infirmary record by the attending clinician.
Measure: Documentation on DC4-714B Physician's Order Sheet in the
infirmary health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).

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Reference: Procedure 404.001 Suicide and Self-Injury Prevention, Section
(1) (d).
b) SHOS/IMR Observations
Outcome: Observations are completed and recorded by nursing according to
the interval specified by the Clinician.
Measure: Documentation on DC4-650
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: Health Service Bulletin 404.001 Suicide and Self Injury
Prevention; Health Service Bulletin 15.05.05 Inpatient Mental Health
Services
c) Daily Counseling
Outcome: Daily counseling by mental health staff (except weekend and
holidays) is conducted and documented as a SOAP note.
Measure: Documentation on DC4-714A Infirmary Progress Record in the
infirmary record.
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: Procedure 404.001 Suicide and Self-Injury Prevention, Section
(4) (b) 10; HSB 15.03.26 Infirmary Services, Sections V. D. 1 and VII. D.
d) Post-Discharge Continuity of Care
Outcome: Mental health staff evaluates relevant mental status and
institutional adjustment as required by Procedure 404.001 Suicide and SelfInjury Prevention.
Measure: Documentation on DC4-642 Chronological Record of Outpatient
Mental Health Care in the health record.
Standard: Achievement of outcome must meet ninety five percent (95%).
Reference: Procedure 404.001 Suicide and Self-Injury Prevention, Section
(4) (e) 2.
6) Inpatient Mental Health Services
a) Psychiatric Evaluation at Intake
Outcome: All patients receive a psychiatric evaluation within the
timeframes as specified in HSB 15.05.05 Inpatient Mental Health Services.
Measure: Documentation on DC4-655 Psychiatric Evaluation in the
inpatient health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.05 Inpatient Mental Health Services, Section IV. B.
4. g.
b) Planned Scheduled Services
Outcome: Out-of-cell structured therapeutic services are offered to each
patient in a CSU, TCU and a CMHTF, in accordance with HSB 15.05.05
Inpatient Mental Health Services.

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Measure: Documentation on DC4-664 Mental Health Attendance Record or
DC4-711A Affidavit of Refusal for Health Care in the inpatient health
record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.05 Inpatient Mental Health Services.
c) Assessments
Outcome: Nursing observations are documented in accordance with
established policy.
Measure: Documentation on DC4-530, DC4-531, DC4-692, DC4-642
Standard: Achievement of outcome must meet ninety percent (90%)
Reference: Health Service Bulletin 15.05.05 Inpatient Mental Health
Services
7) Psychiatric Restraints
a) Physician Orders – Duration
Outcome: Physician’s orders document the maximum duration of the order
for restraint.
Measure: Documentation on DC4-714B Physician’s Order Sheet.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.10 Inpatient Mental Health Services, Section XI. D.
b) Psychiatric Restraints – Nursing Observations and Assessments
Outcome: Pertinent observations and assessments are completed by nursing
in accordance with established policy
Measure: Documentation on DC4-650A, DC4-642F, DC4-781J (restraint
log)
Standard: Achievement of outcome must meet one hundred percent (100%)
Reference: HSB 15.05.10 Psychiatric Restraint, DC4-650A Restraint
Observation Checklist, DC4-642F Chronological Record of Inpatient
Mental Health Care
8) Psychotropic Medication Management
a) Psychiatric Evaluation Prior to Initial Prescription
Outcome: A psychiatric evaluation is completed prior to initially
prescribing psychotropics.
Measure: Documentation on DC4-655 Psychiatric Evaluation and by DC4714B Physician’s Order Sheet in the health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.19 Psychotropic Medication Use Standards and
Informed Consent, Section III. F.

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b) Informed Consent
Outcome: Informed consent forms for psychotropic medications are
completed.
Measure: Documentation by DC4-545 form series (Specific to psychotropic
prescribed) in the health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.19 Psychotropic Medication Use Standards and
Informed Consent, Section III. I.
c) Required Labs - Initial
Outcome: Required laboratory tests are ordered for the initiation of
psychotropic medication administration.
Measure: Documentation on DC4-714B Physician’s Order Sheet in the
health record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.05.19 Psychotropic Medication Use Standards and
Informed Consent, Section III. F. 5.
9) Use of Force
Mental Health Evaluation
Outcome: Medical staff, upon completing the medical examination following a
use of force, makes a mental health referral for each inmate who is classified S-2
or S-3 on the health profile and sends it to mental health staff, which evaluates
S2/S3 inmates no later than the next working day following a use of force.
Measure: Documentation on DC4-529 Staff Request/Referral and DC4-642B
Mental Health Screening Evaluation in the health record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Administrative Rule: 33-602.210.
10) Confinement/Special Housing Services
a) Confinement Evaluations (S3)
Outcome: Each inmate who is classified as S-3 and who is assigned to
administrative or disciplinary confinement, protective management, or close
management status receives a mental status examination within five days of
assignment and every 30 days thereafter.
Measure: Documentation on DC4-642B Mental Health Screening
Evaluation in the health record.
Standard: Achievement of standard must meet ninety five percent (95%).
Reference: HSB 15.05.08 Mental Health Services for Inmates who are
Assigned to Confinement, Protective Management or Close Management
Status, Section II. G.

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b) Confinement Evaluations (S1/S2)
Outcome: Each inmate who is classified as S-1 or S-2 and who is assigned
to administrative or disciplinary confinement, protective management, or
close management status receives a mental status examination within 30
days and every 90 days thereafter.
Measure: Documentation on DC4-642B Mental Health Screening
Evaluation in the health record.
Standard: Achievement of standard must ninety five percent (95%).
Reference: HSB 15.05.08 Mental Health Services for Inmates who are
Assigned to Confinement, Protective Management or Close Management
Status, Section II. H.
c) Confinement Rounds
Outcome: Mental health staff performs weekly rounds in each confinement
unit.
Measure: Documentation on DC6-229 Daily Record of Segregation.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB: 15.05.08 Mental Health Services for Inmates who are
Assigned to Confinement, Protective Management or Close Management
Status, Section II. D.
d) Behavioral Risk Assessments (BRA)
Outcome: The BRA is completed at the required intervals regardless of Sgrade or housing assignment, including when the CM inmate is housed
outside the CM unit in order to access necessary medical or mental health
care.
Measure: Documentation on DC4-729 Behavioral Risk Assessment in the
health record.
Standard: Achievement of outcome must meet ninety percent (90%).
Reference: FAC 33-601.800 Close Management
11) Sex Offender Screening and Treatment
Outcome: All identified sex offenders at a permanent institution whose current
sentence is a sex offense has a completed sex offender screening as a part of
their medical record.
Measure: Documentation on DC4 647 Sex Offender Screening and Selection in
the health record and/or review of OBIS (DC26 MH07 screens)
Standard: Achievement of outcome must meet ninety percent (90%).
Reference: HSB: 15.05.03 Screening and Treatment for Sexual Disorder,
Section II. A.
12) Re-Entry Services
Initiation of Re-entry Services
Outcome: All inmates with a mental health grade of S-2 through S-6 who are
within 180 days of End of Sentence (EOS) have an updated Individualized
Service Plan to address Discharge/Aftercare Planning.

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Measure: Documentation on DC4-643A (Parts I, II, and III) Individualized
Service Plan in the health record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: HSB: 15.05.21 Mental Health Re-Entry Aftercare Planning
Services, Section VII. A.
c. DENTAL SERVICES
1) Access to Dental Care
a) Outcome: Any dental emergency is evaluated and/or treated within twenty
four (24) hours by the dentist, or in the event the dentist is not available, by
referral to the medical department or local dentist/hospital.
Measure: Review available documentation such as the OBIS-HS computer
system for dental emergencies, along with the DC4-724, Dental Treatment
Record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
b) Outcome: Dental sick call is conducted on a daily basis when the dentist is
present to provide dental access to those inmates who cannot wait for a
routine dental appointment and yet do not meet the criteria for emergency
dental care. In the event the dentist is absent for more than seventy two (72)
hours medical staff are to evaluate and triage the inmate according to
established protocols.
Measure: Review available documentation such as the OBIS-HS computer
system, inmate requests, DC4-724, Dental Treatment Record and DC4-701,
Chronological Record of Health Care.
Standard: Achievement of outcome must meet One hundred percent
(100%).
Reference: HSB15.04.13
2) Wait Times
a) Initial Waiting Times for Routine Comprehensive Dental Care
Outcome: The initial wait after request for routine comprehensive dental
care does not exceed six (6) months for any inmate.
Measure: The amount of time between request for dental care and delivery
of routine comprehensive dental care for all inmates. Review dental request
logs and the DC4-724 Dental Treatment Record.
Standard: Achievement of outcome must meet or exceed ninety-five
percent (95%).
Reference: HSB 15.04.13
b) Wait time for Dental Appointments Between the First Appointment and
Follow-Up Appointment
Outcome: Inmate waiting times between dental appointments do not exceed
three (3) months.
Measure: Review DC4-724, Dental Treatment Record.

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Standard: Achievement of outcome must meet or exceed ninety-five
percent (95%).
Reference: HSB 15.04.13
3) Development of the Dental Treatment Plan for Routine Comprehensive
Dental Care
Outcome: A documented complete dental examination is done to develop an
individualized Dental Treatment Plan.
Measure: Review DC4-734, Dental Health Questionnaire, DC4-764, Dental
Diagnosis and Treatment Plan, DC4-724, Dental Treatment Record, and full
mouth radiographs.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
4) Oral Hygiene Treatment
Outcome: A prophylaxis and oral hygiene instructions are included as part of
the comprehensive dental treatment plan.
Measure: Review the DC4-764, Dental Diagnosis and Treatment Plan and
DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
5) Restorative Dentistry
a) Outcome: Decay reaching the DEJ radiographically is diagnosed for
restoration.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment
Plan and DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
b) Outcome: Restorations and bases are appropriate for the caries noted.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment
Plan, DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
6) Endodontics
a) Outcome: Anterior endodontic treatment is diagnosed if the tooth in
question has adequate periodontal support and has a good prognosis of
restorability and long term retention.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment
Plan, DC4-724, Dental Treatment Record
Standard: Achievement of outcome must meet or exceed ninety five
percent (95%).
Reference: FAC Rule 33-402.101, HSB 15.04.13

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b) Outcome: Posterior endodontic treatment is diagnosed if the tooth is critical
to arch integrity (there are no missing teeth in the quadrant or necessary as a
partial denture abutment), has adequate periodontal support and has a good
prognosis of restorability and long term retention.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment
Plan, DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet or exceed ninety five
percent (95%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
7) Minor Periodontics
Outcome: Periodontal charting is done when indicated by the radiographs,
periodontal examination and/or PSR (Periodontal Screening and Recording).
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment Plan,
DC4-724, Dental Treatment Record, DC4-767, Periodontal Charting.
Standard: Achievement of outcome must meet or exceed ninety five percent
(95%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
8) Complete Dentures
Outcome: Complete dentures are diagnosed and provided for all edentulous
inmates requesting them.
Measure: DC4-764, Dental Diagnosis and Treatment Plan, DC4-724, Dental
Treatment Record, Inmate Requests for Dental Care and Referrals for Dental
Care.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
9) Removable Partial Dentures
Outcome: A removable partial denture is diagnosed when seven (7) or less
posterior teeth are in occlusion.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment Plan,
DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: FAC Rule 33-402.101, HSB 15.04.13
10) Other Specialized Dental Care as Needed
Outcome: Inmates are referred to other dentists/dental providers for treatment
planned dental care not available at the institution.
Measure: Review radiographs, DC4-764, Dental Diagnosis and Treatment Plan,
DC4-724, Dental Treatment Record and dental consult/referral logs.
Standard: Achievement of outcome must meet or exceed ninety five percent
(95%).
Reference: FAC Rule 33-402.101, HSB 15.04.13

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11) Oral Pathology Consults/Referrals
Outcome: Appropriate consults for oral pathology referrals are generated and
forwarded within five (5) calendar days of the encounter generating the need for
referral.
Measure: Review the consult/referral logs, radiographs, DC4-724, Dental
Treatment Record and DC4-702, Consultation Request.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Community Standard of Care
12) Oral Surgery Consults/Referrals
Outcome: Appropriate consults for oral surgery referrals are generated and
forwarded within ten (10) calendar days of the encounter generating the need for
referral.
Measure: Review the consult/referral logs, radiographs, DC4-724, Dental
Treatment Record and DC4-702, Consultation Request.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Community Standard of Care
13) Trauma/Cancer
Outcome: Inmates presenting with head and neck trauma or cancer are
immediately treated and/or referred to an appropriate provider for follow-up
care.
Measure: Review DC4-724, Dental Treatment Record, DC4-702, Consultation
Request, consult/referral logs and radiographs/lab reports.
Standard: Achievement of outcome must meet one hundred percent (100%).
Reference: Community Standard of Care
14) Dental Radiography
a) Outcome: Each x-ray machine is registered through the State of Florida and
the registration certificates are posted near the machines.
Measure: X-Ray machine registration certificates.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.04.06, HSB 15.04.13, FAC Rule 64B5-9
b) Outcome: All x-ray machine operators are certified in dental radiology
theory and technique in accordance with Florida Board of Dentistry Rules.
Measure: Dental Assistant radiology certificates.
Standard: Achievement of outcome must meet one hundred percent
(100%).
Reference: HSB 15.04.06, HSB 15.04.13, FAC Rule 64B5-9
c) Outcome: Dental radiographs are of diagnostic quality.
Measure: Review radiographs, DC4-724, Dental Treatment Record.
Standard: Achievement of outcome must meet or exceed ninety five
percent (95%).
Reference: HSB 15.04.06, HSB 15.04.13, FAC Rule 64B5-9

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d. MEDICATION MANAGEMENT/ PHARMACY SERVICES
1) Medication Therapy Review
Outcome: All medications are dispensed for the appropriate diagnosis and in
therapeutic dosage ranges as determined in the most current editions of Drug
Facts and Comparisons, Physicians’ Desk Reference, or the package insert or
pursuant to an approved DER.
Measure: Review medication regimen therapy
Critical Standard: Achievement of outcome must be ninety-five percent
(95%).
Reference: TI 15.14.04 app A; Procedure 403.007; HSB 15.05.19; 64B1627.810 F.A.C.; 64B16-28.501 F.A.C.; 64B16-28.502 F.A.C.; 64B16-28.702
F.A.C.
2) Medication Administration Review (MAR) Clinical
Outcome: Drug therapy indicated on Medication Administration Review
(MAR) is appropriate as indicated or pursuant to an approved DER.
Measure: Review drug therapy indicated on the Medication Administration
Review (MAR)
Critical Standard: Achievement of outcome must be ninety-five percent
(95%)
Reference: Current editions of Drug Facts and Comparisons, Physicians’ Desk
Reference, or the package insert.
3) Pharmacy Inspections
Outcome: Deficiencies in previous Consultant Pharmacist Monthly Inspection
Report are corrected.
Measure: Review monthly Consultant Pharmacist inspections
Critical Standard: Achievement of Outcome must be ninety percent (90%)
Reference: TI 15.14.04 app A; 64B16-28.501 F.A.C.; 64B16-28.502 F.A.C.;
64B16-28.702 F.A.C.; 465 F.S.
4) Inventory control
a) Narcotics Control
Outcome: Narcotic perpetual inventory are maintained.
Measure: Compare actual narcotic counts with perpetual inventory sheet.
Critical Standard: Achievement of Outcome must be one hundred percent
(100%).
Reference: TI 15.14.04 app A; TI 15.14.04 app A; 465 F.S.
b) Narcotic Key Control
Outcome: Narcotic keys are controlled per HSB 15.14.04.
Measure: Review narcotic key control documents
Critical Standard: Achievement of Outcome must be one hundred percent
(100%)
Reference: TI 15.14.04 app A; TI 15.14.04 app A; 465 F.S.

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c) Legend Drug Stock Control
Outcome: Each legend drug stock item has a perpetual inventory system.
Measure: Compare actual counts with perpetual inventory sheets
Critical Standard: Achievement of Outcome must be ninety percent (90%)
Reference: TI 15.14.04 app A; TI 15.14.04 app A; 465 F.S.
NOTE: Should the Contractor be responsible for pharmaceutical services, the
Contractor shall also be responsible for the achievement of the following
performance standards:
5) Dispensing requirements
a) New regular prescription orders.
Outcome: All new regular prescriptions and orders are dispensed and
delivered within twenty-four (24) hours or the next day from the time-oforder to time-of-receipt at the ordering Department Institution, excluding
weekends and holidays.
Measure: Date-of-order as compared to date-of-receipt.
Critical Standard: Achievement of Outcome must be ninety-eight percent
(98%)
Reference: HSB 15.14.03
b) Refill prescription orders.
Outcome: All refill prescriptions and orders are dispensed and delivered
within forty-eight (48) hours or the second day from the time-of-order to
time-of receipt at the ordering Department Institution, excluding weekends
and holidays.
Measure: Date-of-order as compared to date-of-receipt.
Critical Standard: Achievement of Outcome must be ninety-eight percent
(98%)
Reference: HSB 15.14.03
c) New non-formulary prescriptions.
Outcome: All new non-formulary prescriptions and orders are dispensed
and delivered within forty-eight hours (48) or the second day from the timeof-order to time-of-receipt at the ordering Department Institution, excluding
weekends and holidays, once an approved Drug Exception Request (DER)
has been approved and received.
Measure: Date-of-order as compared to date-of-receipt.
Critical Standard: Achievement of Outcome must be ninety-eight percent
(98%)
Reference: HSB 15.14.03
d) Drug Exception Request (DER) for non-formulary drugs.
Outcome: All non-formulary drugs have an approved Drug Exception
Request (DER).
Measure: Review drug reports with approved Drug Exception Requests
(DER)

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Critical Standard: Achievement of Outcome must be ninety-five percent
(95%)
Reference: HSB 15.14.03
e) Stat Orders
Outcome: STAT orders and prescriptions are administered from stock
immediately.
If not available, the prescription will be filled and
administered within 4 hours.
Measure: Review STAT orders and prescriptions
Critical Standard: Achievement of Outcome must be one hundred percent
(100%)
Reference: HSB 15.14.03
f) Adherence to state and federal statutes, administration rules, and
regulations
Outcome: All prescriptions dispensed adhere to State and Federal Statutes,
administrative rules and regulations.
Measure: Review dispensed prescriptions
Critical Standard: Achievement of Outcome must be one hundred percent
(100%)
Reference: HSB 15.14.03
6) Licenses and Drug Pedigree
a) Possession of Pharmacy Licenses
Outcome: Possession and display of pharmacy licenses.
Measure: Document that pharmacy licenses are displayed
Critical Standard: Achievement of Outcome must be one hundred percent
(100%)
Reference: TI 15.14.04 app A; 499.01212 F.S.; 64B16-28.501 F.A.C.;
64B16-28.502 F.A.C.; 64B16-28.702 F.A.C.; 465 F.S.
b) Drug Pedigree
Outcome: State of Florida drug pedigree requirements met (Florida Statutes
499-01212).
Measure: Document State of Florida drug pedigree requirement
documented
Critical Standard: Achievement of Outcome must be one hundred percent
(100%)
Reference: TI 15.14.04 app A; 499.01212 F.S.; 64B16-28.501 F.A.C.;
64B16-28.502 F.A.C.; 64B16-28.702 F.A.C.; 465 F.S.
e. ADMINISTRATIVE RESPONSIBILITIES
1) Timely Submission of Corrective Action Plans
Outcome: All Corrective Action Plans shall be timely submitted within
timeframe in Section II., EE., .3.

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Measure: Date of receipt of Contractor’s Corrective Action Plan as compared to
date of receipt of monitoring report.
Critical Standard: Achievement of outcome must meet one hundred percent
(100%) on a quarterly basis.
2) Timely Corrections of Deficiencies per Timeframes Established in the
Corrective Action Plan
Outcome: All deficiencies addressed in a Corrective Action Plan shall be timely
corrected.
Measure: Date of correction of deficiency as compared to date for correction
indicated in Contractor’s Corrective Action Plan.
Critical Standard: Achievement of outcome must meet one hundred percent
(100%) on a quarterly basis.
3) Timely Submission of Required Reports
Outcome: All required reports submitted in accordance with contractual
requirements.
Measure: The date quarterly reports are received by the Contract Manager.
Standard: Achievement of Outcome must meet or exceed ninety five percent
(95%).
Reference: Section II., BB., Reporting Requirements.
4) Inmate Requests, Informal and Formal Grievances
Outcome: All inmate requests, informal and formal grievances are responded to
in accordance with established rules, policies and procedures.
Measure: Review of inmate requests, and informal and formal grievance logs.
Standard: Achievement of Outcome must meet or exceed ninety-five percent
(95%).
Reference: Chapter 33-103, F.A.C.
5) Operating Licenses and Permits
Outcome: All operating licenses and permits are current, on hand and posted
appropriately at each institution in accordance with statutory requirements and
policy.
Measure: Visual review of licenses and permits (on site), and/or copies
provided through desk review
Standard: Achievement of Outcome must be one hundred percent (100%).
References: Florida Statutes and Rules
6) Health Record Maintenance
Outcome: All clinical information significant to inmate health is filed in the
health record within 72 hours of receipt.
Measure: Random Sampling of encounter forms, labs, etc., corresponding
health care records and OBIS data (or approved electronic health record).
Standard: Achievement of Outcome must be ninety-five percent (95%).
Reference: HSB 15.12.03

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7) HIPAA/HITECH Compliance
Outcome: The Contractor safeguards Protected Health Information in
accordance with the terms and conditions outlined in the Business Associate
Agreement.
Measure: Review of HIPAA reports and medical records to confirm that a
release of information was obtained for all protected health information that was
disclosed.
Standard: Achievement of Outcome must be one hundred percent (100%).
Reference: Business Associate Agreement
8) Staffing
Outcome: Supervision of staff is provided in accordance with statutory
requirements for medical, nursing, dental, mental health and pharmacy.
Measure: Review of qualifications of supervisory staff to verify appropriate
licensure and certification, and documentation of any required supervision.
Standard: Achievement of Outcome must be one hundred percent (100%).
Reference: Chapters 458, 459, 464, 466, 490 and 491, Florida Statutes.
9) Quality Management
a) Compliance with Credentialing Standards
Outcome: Credentialing records shall comply with all requirements
established by the Department.
Measure: Review of credential records compared to Department standards.
Standard: Achievement of Outcome must meet one hundred percent
(100%).
Reference: Health Services Bulletin 15.09.05, Credentialing and Privileging
Procedures.
b) Mortality Review
i.

Mortality Review Forms
Outcome: Mortality Review meeting occurs and appropriate paperwork
is completed in accordance with policy.
Measure:
DC4-502, Institutional Death Summary, DC4-503,
Institutional Mortality Review Case Abstract and Analysis, DC4-504,
Institutional Mortality Review Team Signature Log, DC4-508,
Institutional Mortality Review Findings/Conclusions and Federal Report
Form.
Standard: Achievement of Outcome must be met one hundred percent
(100%).
Reference: HSB 15.09.09.

ii. Autopsy
Outcome: The institution requests an autopsy, if performed, from the
Medical Examiner’s Office and sends it to the Central Office Mortality

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Review Coordinator. If an autopsy is not performed there should be a
statement indicating the cause of death from the Medical Examiner.
Measure: The date the autopsy results or statement indicating the cause
of death are received by the Central Office Mortality Review
Coordinator.
Standard: Achievement of Outcome must be met one hundred percent
(100%).
Reference: HSB 15.09.09.
10) Information Technology
a) Data Exchanges
Outcome: Proper transmission of data exchanges with related agencies and
vendors.
Measure: Scheduled transfers to be verified by recipient.
Standard: Achievement of Outcome must be met one hundred percent
(100%)
b) Repeated Outages
Outcome: There will be no instances of outages occurring for the same
reason as a previously detected outage.
Measure: Repetition of unplanned outages or major problems.
Standard: 99% of unplanned outages will be resolved in such a way that the
root cause of the problem is determined, and a fix is in place to prevent it
from happening again in the same day.
c) Recovery Time
Outcome: Services will be returned to operation within performance target
timeframe while still ensuring the outage will not reoccur in less than five
minutes.
Measure: The amount of time from an unplanned outage of a service until
the service is again available to its users. This shall be measured on a fiscal
year basis.
Standard: In 98% of unplanned outages the service will be available in less
than one hour after being reported as unavailable.
d) Minimum Acceptable Monthly Service Availability
Outcome: Services will be returned to operation within performance target
timeframes.
Measure: The amount of time the Contractor’s system is available for use
outside schedule availability.
Standard: On a monthly basis, the systems are available for use a minimum
of 99.99% of the time.

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2. Other Contract Requirements
The Department shall monitor the Contractor’s performance to ensure that all other
terms and conditions of the Contract, not included in Section II., DD., 1., Performance
Outcomes, Measures, and Standards, are complied with at all times by the Contractor.
Failure to comply with Other Contract Requirements will subject the Contractor to
financial consequences per Section II., EE.,
EE.

Financial Consequences
By execution of this Contract, the Contractor hereby acknowledges and agrees that its
performance under the Contract shall meet the standards set forth in Section II., DD. 1.
Any assessment of Financial Consequences and/or subsequent payment thereof shall not
affect the Contractor’s obligation to provide services as required by this Contract.
The Department’s Contract Manager will provide written notice to the Contractor’s
Representative of all Financial Consequences assessed accompanied by detail sufficient for
justification of assessment.
The Contractor shall forward a cashier’s check or money order to the Contract Manager,
payable to the Department in the appropriate amount within forty (40) days of receipt of a
written notice of demand for Financial Consequences due, or in the alternative, may issue a
credit in the amount of the Financial Consequences due on the next monthly invoice following
imposition of damages. Documentation of the amount of Financial Consequences assessed
shall be included with the invoice, if issuing credit. Financial Consequences not paid within
ninety-five (95) days of receipt of notice will be deducted from amounts then due the
Contractor.
1. The financial consequences listed below are effective September 1, 2016.
a. The Contractor shall pay the following sums per month for positions listed in
Attachment #2 (excluding those addressed in EE.1.b. below) that are vacant for
more than 45 days.
•
•
•

$600.00 for Group I positions
$300.00 for Group II positions
$200.00 for Group III positions

b. If for any facility in Attachment #3, the total hours provided is less than 90% of the
contracted hours for the position groups below, the Contractor shall pay the
following sums per month. The position groups are CNA, RN, LPN, Mental Health
RN, Mental Health LPN, and Mental Health Professional.
•
•
•

$600.00 for Tier I facilities
$300.00 for Tier II facilities
$200.00 for Tier III facilities

c. A position will not be considered vacant if it is filled for 90% of the full amount of
approved hours by either permanent Contractor staff, temporary Contractor staff,

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temporary staff hired through a staffing agency, or existing staff utilizing overtime
hours.
2. Monitoring Performance Outcomes, Measures and Standards – Effective September 1,
2016, the Contractor’s performance shall be monitored in accordance with Section II,
FF. Should the Contractor fail to achieve compliance with the performance standards in
a minimum of 80% of the applicable standards for each health services discipline
(Medical, Mental Health, Dental, Pharmacy, and Administration), a reduction of the
payment of the monthly invoice of $1000 per discipline per monitoring review will be
assessed. This reduction will apply to each health services unit, including main units
and annexes.
3. Failure to Cure Monitoring Findings – The Contractor is required to cure all monitoring
findings in accordance with timelines outlined in the approved corrective action plan
(CAP). For each monitoring finding that is not cured in accordance with the timelines
outlined in the CAP, a reduction of the payment of the monthly invoice in the amount of
$250 per finding shall be assessed.
FF.

Monitoring Methodology
The Department may utilize any or all of the following monitoring methodologies in
monitoring the Contractor’s performance under the Contract and in determining compliance
with contract terms and conditions:
•

•
•
•
•

desk review of records related to service delivery maintained at Department facilities
serviced by the Contract (shall include any documents and databases pertaining to the
contract and may be based on all documents and data or a sampling of same whether
random or statistical);
on-site review of records maintained at Contractor’s business location, if applicable;
interviews with Contractor and/or Department staff;
review of grievances filed by inmates regarding Contractor’s service delivery; and
review of monitoring, audits, investigations, reviews, evaluations, or other actions by
external agencies (e.g., American Correctional Association and/or National Commission
on Correctional Health Care, Department of Health, etc.).

A Contract Monitoring Plan has been developed and administered by the Department’s
Office of Health Services in accordance with the requirements in this contract. The
monitoring tool will be utilized in review of Contractor’s performance.
1. Monitoring Plan
The Department utilizes a risk-based approach to contract monitoring. The Office of
Health Services conducts an annual risk assessment of all institutions, and assigns
institutions to one of three Tiers based on the results of this risk assessment, as follows:
Tier I institutions – High risk; monitored quarterly, at a minimum
Tier II institution – Moderate risk; monitored twice per year
Tier III institutions – Low risk; monitored once per year
The contract monitoring plan is dynamic in that institutions can and will change their
assigned Tier based on monitoring results and assessed risk factors.

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2. Monitoring Performance Outcomes, Measures, and Standards
Performance will be continuously monitored for contract compliance and measured
against the requirements as contained in this Contract and all other applicable standards
in accordance with Department policies. The Department’s Office of Health Services
will conduct site visits, for the purpose of monitoring contract performance and
compliance. The nature and frequency of these visits will be published in the Office of
Health Services Monitoring Plan. Performance shall be measured beginning no sooner
than the ninety-first (91st) day after services have been implemented.
The Department will publish a monitoring report via an informal Contract
communication in accordance with Section II., T., Communications.
The Contractor will be provided through the monitoring report information-specific to
any issue(s) of non-compliance. The Contractor will be given sixty (60) days, a
reasonable time frame to create and implement a corrective action plan.
The Contractor shall have an opportunity to respond to and request a review of the
Department’s Office of Health Services findings of non-compliance within ten (10) days
of receipt of the written notice. The Assistant Secretary will make a final decision on
the corrective action within thirty (30) days of the review.
Corrective action shall be completed within the time frames set forth in the Monitoring
Plan. Should the Contractor fail to cure an issue of non-compliance to the reasonable
satisfaction of the Department, the Department reserves the right to seek damages it is
entitled to under law and/or termination of this Contract.
Notwithstanding the above, financial consequences shall be assessed as prescribed in
Section II., EE.
3. Rights to Examine, Audit and Administer Resources
The Contractor will permit online and onsite visits by Department’s authorized
employees, officers, inspectors and agents during an administrative or criminal
investigation. The process can begin with either declaration of a computer security
incident (CSIRT) from the Department's CIO or Information Security Officer or directly
from the Department’s Inspector General.
The Contractor will make available any and all operating system computer logs
generated by the mainframe, servers, routers and switches as requested. If requested the
Contractor will provide the Department with administrative level on-line access to the
server console interfaces and logs.
Right to Audit: The Contractor will permit and facilitate both physical and virtual
access to the mainframe, servers, intrusion prevention system, firewalls, routers and
switches by the Department’s authorized audit staff or representatives. Such access may
include both internal and external security scans of those resources.
In certain criminal investigations it may be necessary for the Department to seize control
of the mainframe or servers for the purpose of evidentiary control, pursuant to Sections
20.055 and 944.31, Florida Statutes.

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4. Monitoring Other Contract Requirements
Monitoring for Other Contract Requirements, identified in Section II., DD., 2., will be
conducted as determined necessary, but no less than annually, beginning no sooner than
the ninety-first (91st) day after services have been implemented. A Contract Monitoring
Plan will be developed by the Department’s Office of Health Services. The Monitoring
Plan will be utilized in review of the Contractor’s performance. Such monitoring may
include, but is not limited to, both announced and unannounced site visits.
To ensure the Contract Monitoring process is conducted in the most efficient manner,
the Department has established a Contractor’s Self-Certification of Compliance
checklist, which will be incorporated as an attachment to the Contract Monitoring Plan
to be developed. The Self-Certification of Compliance will be retained in the Contract
Manager’s file and the official Contract file. The Contractor shall complete the SelfCertification of Compliance checklist within thirty (30) days of this Contract
Implementation and forward the original to the Contract Manager.
The Department’s Contract Monitor or designee will provide a written monitoring report
to the Contractor within three (3) weeks of a monitoring visit. Non-compliance issues
identified by the Contract Manager or designee will be identified in detail to provide
opportunity for correction where feasible.
Within ten (10) days of receipt of the Department’s written monitoring report (which
may be transmitted by e-mail), the Contractor shall provide a formal Corrective Action
Plan (CAP) to the Contract Manager (e-mail acceptable) in response to all noted
deficiencies to include responsible individuals and required time frames for achieving
compliance in conjunction with the Monitoring Plan. CAP’s that do not contain all
information required shall be rejected by the Department in writing (e-mail acceptable).
The Contractor shall have five (5) days from the receipt of such written rejection to
submit a revised CAP; this will not increase the required time for achieving compliance.
All noted deficiencies shall be corrected within the time frames identified in the
Monitoring Plan. The Contract Manager, Contract Monitoring Team, or other
designated Department staff may conduct follow-up monitoring at any time to determine
compliance based upon the submitted CAP.
The Department reserves the right for any Department staff to make scheduled or
unscheduled, announced or unannounced monitoring visits.
During follow-up monitoring, any noted failure by the Contractor to correct deficiencies
for Other Contract Requirement violations identified in the monitoring report within the
time frame specified in the CAP shall result in the assessment of financial consequences
as specified in Section II., EE.
5. Repeated Instances
Repeated instances of failure to meet either the Performance Outcomes and Standards or
Other Contract Requirements Outcomes and Standards or to correct deficiencies thereof
may, in addition to the assessment of Financial Consequences, result in determination of
Breach of Contract and/or termination of the Contract in accordance with Section VI.,
TERMINATION.

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GG.

Performance Guarantee
The Contractor shall furnish the Department with a Performance Guarantee in the amount of
twenty-seven million dollars ($27,000,000.00) that shall be in effect yearly for a time frame
equal to the term of the Contract.
The form of the guarantee shall be a bond, cashier’s check, or money order made payable to
the Department. In addition, an irrevocable direct draw letter of credit in the amount of
$27,000,000 for the benefit of the Department, and from a financial institution acceptable to
the Department, may also be used. The guarantee shall be furnished to the Contract
Manager within thirty (30) days after execution of this Contract. No payments shall be made
to the Contractor until the guarantee is in place and approved by the Department in writing.
Upon renewal of the Contract, the Contractor shall provide proof that the performance
guarantee has been renewed for the term of the Contract renewal. The performance bond
shall specifically state that it will pay for any financial consequences assessed under the
Contract.
Based upon Contractor performance after the initial year of the Contract, the Department
may, at the Department’s sole discretion, reduce the amount of the bond for any single year
of the Contract or for the remaining contract period, including the renewal.

HH.

Deliverables
The following services or service tasks are identified as deliverables for the purposes of this
Contract:
1. Appropriate health care services for inmates consisting of deliverables listed under
Section II., DD., 1., Performance Outcomes, Measures, and Standards.
2. Reports as required in Section II., BB., Reporting Requirements.
3. Compliance with contract terms and conditions.

III.

COMPENSATION
A.

Payment
Compensation under this Contract shall consist of two components: reimbursement of actual
expenses; and a percentage of actual expenses to cover administrative expenses. The amount
of reimbursement for these components shall not exceed $267,968,000 annually.
1. Reimbursement for actual expenses – The Contractor shall be reimbursed for actual
expenses incurred under this Contact, including but not limited to:
•
•
•
•
•
•
•

Salaries, wages and benefits for all staff assigned to this contract, including
institutional staff, statewide/regional oversight staff and corporate oversight staff;
Inpatient and outpatient hospital expenses;
Physician’s fees;
Therapeutic and diagnostic ancillary services;
Medical and office supplies;
Medical equipment;
Computer equipment;

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•
•
•
•

Licenses and permits;
Non-formulary and emergency medications and therapeutics;
Background checks; and
Premium and retention costs of insurance.

Administrative Fee – The Contractor shall be reimbursed an administrative fee to cover
corporate supports costs (including, but not limited to, oversight of recruiting, human
resources, clinical operations/utilization management, payroll, and information
technology) and profit. This administrative fee shall be calculated at 13.5% of the actual
expenses outlined in Section III., A., 1., above.
Other costs that may be included in the Administrative Fee:
•
•
•
•

Corporate office rents and facility cost;
Corporate office supplies and maintenance;
Corporate office telephone; and
Corporate office equipment and cell phones.

Invoice Adjustments: In addition, adjustments to the monthly invoices shall include, but not
be limited to, the following:
•
•

A deduction for Department contract monitoring costs. This will be the Contractor’s
portion of statewide FDC monitoring costs, based on the percentage of total FDC
inmates served under this contract.
A deduction for income received from the fee schedule for services at Reception and
Medical Center Hospital RMC Hospital, from Wexford Health Sources and Private
Correctional Facilities, pursuant to Section II., B., 13.

Payment shall be subject to the timely submission and acceptance of all deliverables outlined
in Section II., HH.
B.

MyFloridaMarketPlace
1. Transaction Fee Exemption
The State of Florida has instituted MyFloridaMarketPlace, a statewide eProcurement
System (“System”). Pursuant to section 287.057(22), Florida Statutes, all payments
shall be assessed a Transaction Fee of one percent (1.0%), which the Contractor shall
pay to the State, unless otherwise exempt pursuant to Rule 60A-1.032, F.A.C.
The Department has determined that payments to be made under this Contract are not
subject to the MyFloridaMarketPlace Transaction Fee pursuant to Rule 60A-1.032(1),
Florida Administrative Code (F.A.C).
2. Vendor Substitute W-9
The State of Florida Department of Financial Services (DFS) requires all vendors that do
business with the state to electronically submit a Substitute W-9 Form to
https://flvendor.myfloridacfo.com.
Forms
can
be
found
at:
https://flvendor.myfloridacfo.com/casappsp/cw9hsign.htm.
Frequently
asked
questions/answers
related
to
this
requirement
can
be
found
at:

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https://flvendor.myfloridacfo.com/W-9%2ofaqs.pdf. DFS is ready to assist vendors with
additional questions. You may contact their Customer Service Desk at 850-413-5519 or
FLW9@myfloridacfo.com.
C.

Submission of Invoice(s)
The Contractor agrees to request compensation on a periodic basis for services rendered
through submission to the Department of properly completed invoices covering all
institutions/facilities serviced. The Contractor shall submit separate invoices for staffing
costs, medical claims cost and all other costs. The invoice for staffing costs will be
submitted bi-weekly based upon the payroll processing cycle. The invoices for medical
claims cost will be submitted bi-weekly and all other costs will be submitted monthly within
fifteen (15) days following the end of the month. The 13.5% administrative fee will be
applied separately to each invoice submitted. The Contractor shall submit invoices
pertaining to this Contract to the Contract Manager. Invoices will be reviewed and approved
by the Contract Manager and then forwarded to the appropriate Financial Services’ Office
for further processing of payment. The Contractor’s invoice shall include the Contractor’s
name, mailing address, and tax ID number/FEIN as well as the Contract Number and date
services provided. Every invoice must be accompanied by the appropriate supporting
documentation as indicated in Section III., D., Supporting Documentation for Invoice.

D.

Supporting Documentation for Invoice
Invoices must be submitted in detail sufficient for a proper preaudit and postaudit thereof.
Invoices will only be approved after receipt of the following supporting documentation:
1. Payroll register documenting the employee based cost, overtime, on call, and shift
differential cost per employee per institution along with proof of payment. Time sheets
may be required upon request by the Department.
2. Invoices for payroll benefits such as health insurance, dental insurance, workers
compensation, unemployment compensation along with proof of payment such as
cancelled checks or EFT report.
3. System-generated disbursement registers will be provided for all medical claims.
Supporting documentation, such as CMS-1500 claim forms and proof of payment, will
be supplied upon request by the Department.
4. System-generated disbursement registers will be provided for all other allowable
expenditures. Supporting invoices and proof of payment will be supplied upon the
request of the Department.

E.

Official Payee
The name and address of the official payee to whom payment shall be made is as follows:
Centurion of Florida, LLC
P.O. Box 956883
St. Louis, MO 63195-6883

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F.

Travel Expenses
The Department shall not be responsible for the payment of any travel expense for the
Contractor that occurs as a result of this Contract.

G.

Contractor’s Expenses
The Contractor shall pay for all licenses, permits, and inspection fees or similar charges
required for this Contract, and shall comply with all laws, ordinances, regulations, and any
other requirements applicable to the work to be performed under this Contract.

H.

Annual Appropriation
The State of Florida’s and the Department’s performances and obligations to pay for services
under this Contract are contingent upon an annual appropriation by the Legislature. The
costs of services paid under any other Contract or from any other source are not eligible for
reimbursement under this Contract.

I.

Tax Exemption
The Department agrees to pay for contracted services according to the conditions of this
Contract. The State of Florida does not pay federal excise taxes and sales tax on direct
purchases of services.

J.

Timeframes for Payment and Interest Penalties
Contractors providing goods and services to the Department should be aware of the
following time frames:
1. Upon receipt, the Department has five (5) working days to inspect and approve the
goods and services and associated invoice, unless this Contract specifies otherwise. The
Department has twenty (20) days to deliver a request for payment (voucher) to the
Department of Financial Services. The twenty (20) days are measured from the latter of
the date the invoice is received or the goods or services are received, inspected, and
approved.
2. If a payment is not available within forty (40) days, a separate interest penalty, as
specified in Section 215.422, Florida Statutes, will be due and payable, in addition to the
invoice amount, to the Contractor. However in the case of health services contracts, the
interest penalty provision applies after a thirty-five (35) day time period to health care
Contractors, as defined by rule. Interest penalties of less than one (1) dollar will not be
enforced unless the Contractor requests payment. Invoices, which have to be returned to
a Contractor because of Contractor preparation errors, may cause a delay of the
payment. The invoice payment requirements do not start until the Department receives a
properly completed invoice.

K.

Final Invoice
The Contractor shall submit the final invoices for non-claim or litigation-related payment to
the Department no more than forty-five (45) days after acceptance of the final deliverable by
the Department or the end date of this Contract, whichever occurs last. If the Contractor
fails to do so, all right to payment is forfeited, and the Department will not honor any request

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submitted after aforesaid time period. Any payment due under the terms of the Contract
may be withheld until all applicable deliverables and invoices have been accepted and
approved by the Department.
L.

Vendor Ombudsman
A Vendor Ombudsman has been established within the Department of Financial Services.
The duties of this individual include acting as an advocate for vendors who may be
experiencing problems in obtaining timely payment(s) from a state agency. The Vendor
Ombudsman may be contacted by calling the Department of Financial Services’ Toll Free
Hotline.

M.

Electronic Transfer of Funds
Contractors are encouraged to accept payments for work performed under this Contract by
receiving Direct Deposit. To enroll in the State of Florida’s Direct Deposit System the
Contractor must complete a direct deposit form by contacting the Florida Department of
Financial
Services,
Bureau
of
Accounting,
Direct
Deposit
Section
at
http://www.myfloridacfo.com/aadir/direct_deposit_web/index.htm or by phone at (850) 4135517.

N.

Subcontract Approval
As stipulated in Section VII., N., Subcontracts, no payments shall be made to the Contractor
until all subcontracts have been approved, in writing by the Department.

IV.

CONTRACT MANAGEMENT
A.

Department’s Contract Manager
The Contract Manager for this Contract will be:
David Randall, Senior Management Analyst Supervisor
Office of Health Services-Administration
Florida Department of Corrections
501 South Calhoun Street
Tallahassee, Florida 32399-2500
Telephone: (850) 717-3279
Fax: (850) 922-6015
Email: Randall.David@mail.dc.state.fl.us
The Contract Manager will perform the following functions:
1.
2.
3.
4.

maintain a contract management file;
serve as the liaison between the Department and the Contractor;
evaluate the Contractor's performance;
direct the Contract Administrator to process all amendments, renewals, and termination
of this Contract; and
5. evaluate Contractor performance upon completion of the overall Contract; this
evaluation will be placed on file and will be considered if the Contract is subsequently
used as a reference in future procurements.

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The Contract Manager may delegate the following functions to the Local Contract
Coordinator:
1. verify receipt of deliverables from the Contractor;
2. monitor the Contractor’s performance; and
3. review, verify, and approve invoices from the Contractor.
The Local Contract Coordinator for this Contract will be:
Beverlyn Elliott, Operations Review Specialist
Office of Health Services-Administration
Florida Department of Corrections
501 South Calhoun Street
Tallahassee, Florida 32399-2500
Telephone: (850) 717-3289
Fax: (850) 487-8082
Email: elliott.beverlyn@mail.dc.state.fl.us
B.

Department’s Contract Administrator
The Contract Administrator for this Contract will be:
Operations Manager, Contract Administration
Bureau of Contract Management and Monitoring
Florida Department of Corrections
501 South Calhoun Street
Tallahassee, Florida 32399-2500
Telephone: (850) 717-3681
Fax: (850) 488-7189
The Contract Administrator will perform the following functions:
1. maintain the Contract administration file;
2. process all Contract amendments, renewals, and termination of the Contract; and
3. maintain official records of formal correspondence between the Department and the
Contractor.

C.

Contractor’s Representative
The name, title, address, and telephone number of the Contractor’s representative
responsible for administration and performance under this Contract is:
Steven Wheeler, CEO
Centurion of Florida, LLC
1593 Spring Hill Road, Suite 610
Vienna, Virginia 22182
Telephone: (703) 7494600
Fax: (703) 749-1630
Email: swheeler@centurionmcare.com

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D.

Contract Management Changes
After execution of this Contract, any changes in the information contained in Section IV.,
CONTRACT MANAGEMENT, will be provided to the other party in writing and a copy of
the written notification shall be maintained in both the Contract Manager’s and Contract
Administrator’s files. The Contract Manager shall be responsible for ensuring that copies
are provided to the Contract Administrator.

V.

CONTRACT MODIFICATION
Unless otherwise stated herein, modifications to the provisions of this Contract, with the exception of
Section II., V., 2., Add/Delete Institutions/Facilities for Services; Section III., C., Submission of
Invoice(s); Section III., D., Supporting Documentation for Invoice; and Section IV., CONTRACT
MANAGEMENT, shall be valid only through execution of a formal contract amendment. If cost
increases occur as a result of any modification of the Contract, in no event may such increases result
in the total compensation paid under the Contract exceeding the amount appropriated for this project.
A.

Scope Changes After Contract Execution
During the term of the Contract, the Department may unilaterally require, by written order,
changes altering, adding to, or deducting from the Contract specifications, provided that such
changes are within the general scope of the Contract.
The Department may make an equitable adjustment in the Contract prices or delivery date if
the change affects the cost or time of performance. Equitable adjustments may be made due
to an award under competitive procurement or for changes in the standard of care, treatment
modalities, pharmacy costs, patient base, consent or other court orders that materially impact
the cost of providing services to the Contractor; such equitable adjustments require the
written consent of the Contractor, which shall not be unreasonably withheld.
The Department shall provide written notice to the Contractor thirty (30) days in advance of
any Department required changes to the technical specifications and/or scope of service that
affect the Contractor’s ability to provide the service as specified herein. Any changes that
are other than purely administrative changes will require a formal contract amendment.
All changes will be conducted in a professional manner utilizing best industry practices. The
Department expects changes to be made timely and within the prices proposed.

B.

Other Requested Changes
In addition to changes pursuant to Section V., A., state or federal laws, rules, and regulations
or Department rules and regulations may change. Such changes may impact Contractor’s
service delivery in terms of materially increasing or decreasing the Contractor’s cost of
providing services. There is no way to anticipate what those changes will be nor is there any
way to anticipate the costs associated with such changes.
Either party shall have ninety (90) days from the date such change is implemented to request
an increase or decrease in compensation or the applicant party will be considered to have
waived this right. Full, written justification with documentation sufficient for audit will be
required to authorize an increase in compensation. It is specifically agreed that any changes

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to payment will be effective the date the changed scope of services is approved, in writing,
and implemented.
If the parties are unable to negotiate an agreed-upon increase or decrease in rate or
reimbursement, the Assistant Secretary of Health Services shall determine what the resultant
change in compensation should be, based upon the changes made to the scope of services.
VI.

TERMINATION
A.

Termination at Will
This Contract may be terminated by either party at will, including due to an award under
competitive procurement, upon no less than sixty (60) written calendar days’ notice. Notice
shall be delivered by certified mail (return receipt requested), by other method of delivery
whereby an original signature is obtained, or in-person with proof of delivery.

B.

Termination Because of Lack of Funds
In the event funds to finance this Contract become unavailable, the Department may
terminate the Contract upon no less than twenty-four (24) hours’ notice in writing to the
Contractor. Notice shall be delivered by certified mail (return receipt requested), facsimile,
by other method of delivery whereby an original signature is obtained, or in-person with
proof of delivery. The Department shall be the final authority as to the availability of funds.

C.

Termination for Cause
If a breach of this Contract occurs by the Contractor, which is left uncured after the
expiration of thirty (30) days’ written notice by the Department, the Department may, by
written notice to the Contractor, terminate this Contract upon twenty-four (24) hours’ notice.
Notice shall be delivered by certified mail (return receipt requested), in-person with proof of
delivery, or by another method of delivery whereby an original signature is obtained. If
applicable, the Department may employ the default provisions in Chapter 60A-1, Florida
Administrative Code. The provisions herein do not limit the Department’s right to remedies
at law or to damages.

D.

Termination for Unauthorized Employment
Violation of the provisions of Section 274A of the Immigration and Nationality Act shall be
grounds for unilateral cancellation of this Contract.

VII.

CONDITIONS
A.

Records
1. Public Records Law
The Contractor agrees to: (a) keep and maintain public records that would ordinarily and
necessarily be required by the Department to perform the contracted services; (b) allow
public access to records in accordance with the provisions of Chapter 119 and Section
945.10, Florida Statutes; (c) ensure that public records that are exempt or confidential

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and exempt from public records disclosure requirements are not disclosed except as
authorized by law; (d) meet all requirements for retaining public records and transfer to
the Department, at no cost, all public records in the Contractor’s possession upon
termination of the contract and destroy any duplicate public records that are exempt or
confidential and exempt from public records disclosure requirements. All records stored
electronically must be provided to the Department in a format that is compatible with the
Department’s information technology systems. The Contractor’s failure to comply with
this provision shall constitute sufficient cause for termination of this Contract.
2. Audit Records
a. The Contractor agrees to maintain books, records, and documents (including
electronic storage media) in accordance with generally accepted accounting
procedures and practices which sufficiently and properly reflect all revenues and
expenditures of funds provided by the Department under this Contract, and agrees to
provide a financial and compliance audit to the Department or to the Office of the
Auditor General and to ensure that all related party transactions are disclosed to the
auditor.
b. The Contractor agrees to include all record-keeping requirements in all subcontracts
and assignments related to this Contract.
3. Retention of Records
The Contractor agrees to retain all client records, financial records, supporting
documents, statistical records, and any other documents (including electronic storage
media) pertaining to this Contract for a period of seven (7) years. The Contractor shall
maintain complete and accurate record-keeping and documentation as required by the
Department and the terms of this Contract. Copies of all records and documents shall be
made available for the Department upon request. All invoices and documentation must
be clear and legible for audit purposes. All documents must be retained by the
Contractor at the address listed in Section IV., C., Contractor’s Representative, or the
address listed in Section III., E., Official Payee, for the duration of this Contract. Any
records not available at the time of an audit will be deemed unavailable for audit
purposes. Violations will be noted and forwarded to the Department’s Inspector General
for review. All documents must be retained by the Contractor at the Contractor’s
primary place of business for a period of seven (7) years following termination of the
Contract, or, if an audit has been initiated and audit findings have not been resolved at
the end of seven (7) years, the records shall be retained until resolution of the audit
findings. The Contractor shall cooperate with the Department to facilitate the
duplication and transfer of any said records or documents during the required retention
period. The Contractor shall advise the Department of the location of all records
pertaining to this Contract and shall notify the Department by certified mail within ten
(10) days if/when the records are moved to a new location.
B.

State Objectives
Within thirty (30) calendar days following award of the Contract, the Contractor shall submit
plans addressing each of the State’s four (4) objectives listed below, to the extent applicable
to the items/services covered by this Contract.

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(Note: Diversity plans and reporting shall be submitted to the MBE Coordinator, Bureau of
Procurement and Supply, Department of Corrections, 501 South Calhoun Street,
Tallahassee, FL 32399-2500. All other plans shall be submitted to the Contract Manager or
designee as specified.)
1. Diversity in Contracting: The State of Florida is committed to supporting its diverse
business industry and population through ensuring participation by minority-, women-,
and service-disabled veteran business enterprises in the economic life of the state. The
State of Florida Mentor Protégé Program connects minority-, women-, and servicedisabled veteran business enterprises with private corporations for business development
mentoring. We strongly encourage firms doing business with the State of Florida to
consider this initiative. For more information on the Mentor Protégé Program, please
contact the Office of Supplier Diversity at (850) 487-0915.
The state is dedicated to fostering the continued development and economic growth of
small, minority-, women-, and service-disabled veteran business enterprises.
Participation by a diverse group of Vendors doing business with the state is central to
this effort. To this end, it is vital that small, minority-, women-, and service-disabled
veteran business enterprises participate in the state’s procurement process as both
Contractors and sub-contractors in this Contract. Small, minority-, women-, and
service-disabled veteran business enterprises are strongly encouraged to contribute to
this Contract.
The Contractor shall submit documentation addressing diversity and describing the
efforts being made to encourage the participation of small, minority-, women-, and
service-disabled veteran business enterprises.
Information on Certified -Minority Business Enterprises (CMBE) and Certified ServiceDisabled Veteran Business Enterprises (CSDVBE) is available from the Office of
Supplier Diversity http://dms.myflorida.com/other_programs/office_of_supplier_diversity_osd/.
Diversity in Contracting documentation should identify any participation by diverse
Contractors and suppliers as prime Contractors, sub-contractors, vendors, resellers,
distributors, or such other participation as the parties may agree. Diversity in
Contracting documentation shall include the timely reporting of spending with certified
and other minority/service-disabled veteran business enterprises. Such reports must be
submitted at least monthly and include the period covered, the name, minority code and
Federal Employer Identification Number of each minority/service-disabled veteran
vendor utilized during the period, commodities and services provided by the
minority/service-disabled veteran business enterprise, and the amount paid to each
minority/service-disabled veteran vendor on behalf of each purchasing agency ordering
under the terms of this Contract.
2. Environmental Considerations: The State supports and encourages initiatives to protect
and preserve our environment. If applicable, the Contractor shall provide a plan for
reducing and or handling of any hazardous waste generated by Contractor‘s company.
Reference Rule 62-730.160, Florida Administrative Code. It is a requirement of the
Florida Department of Environmental Protection that a generator of hazardous waste
materials that exceeds a certain threshold must have a valid and current Hazardous
Waste Generator Identification Number. This identification number shall be submitted
as part of Contractor‘s explanation of its company’s hazardous waste plan and shall
explain in detail its handling and disposal of this waste.

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3. Prison Rehabilitative Industries and Diversified Enterprises, Inc. (PRIDE): The State
supports and encourages the use of Florida correctional work programs. The Contractor
agrees that any articles which are the subject of, or are required to carry out this
Contract, shall be purchased from PRIDE, identified under Chapter 946, Florida
Statutes, in the same manner and under the procedures set forth in Subsections
946.515(2) and (4), Florida Statutes. The Contractor shall be deemed to be substituted
for the Department in dealing with PRIDE, for the purposes of this Contract. This
clause is not applicable to subcontractors, unless otherwise required by law. Available
products, pricing, and delivery schedules may be obtained by contacting PRIDE.
4. Products Available from the Blind or Other Handicapped (RESPECT):
The
State/Department supports and encourages the gainful employment of citizens with
disabilities. It is expressly understood and agreed that any articles that are the subject of,
or required to carry out this Contract shall be purchased from a nonprofit agency for the
blind or for the severely handicapped that is qualified pursuant to Chapter 413, Florida
Statutes, in the same manner and under the same procedures set forth in Section
413.036(1) and (2), Florida Statutes; and for purposes of this Contract the person, firm,
or other business entity carrying out the provisions of this Contract shall be deemed to
be substituted for this agency insofar as dealings with such qualified nonprofit agency
are concerned." Additional information about the designated nonprofit agency and the
products it offers is available at http://www.respectofflorida.org.
C.

Prison Rape Elimination Act (PREA)
The Contractor will comply with the national standards to prevent, detect, and respond to
prison rape under the Prison Rape Elimination Act (PREA), Federal Rule 28 C.F.R. Part
115. The Contractor will also comply with all Department policies and procedures that
relate to PREA.

D.

Procurement of Materials with Recycled Content
It is expressly understood and agreed that any products or materials, which are the subject of
or are required to carry out this Contract, shall be procured in accordance with the provisions
of Section 403.7065, Florida Statutes.

E.

Sponsorship
If the Contractor is a nongovernmental organization which sponsors a program financed
partially by State funds, including any funds obtained through this Contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: “Sponsored by
Centurion of Florida, LLC, and the State of Florida, Department of Corrections.” If the
sponsorship reference is in written material, the words “State of Florida, Department of
Corrections” shall appear in the same size letters or type as the name of the organization.

F.

Employment of Department Personnel
The Contractor shall not knowingly engage in this project, on a full-time, part- time, or other
basis during the period of this Contract, any current or former employee of the Department
where such employment conflicts with Section 112.3185, Florida Statutes.

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G.

Non-Discrimination
No person, on the grounds of race, creed, color, national origin, age, gender, marital status,
or disability, shall be excluded from participation in, be denied the proceeds or benefits of,
or be otherwise subjected to discrimination in the performance of this Contract.

H.

Americans with Disabilities Act
The Contractor shall comply with the Americans with Disabilities Act. In the event of the
Contractor’s noncompliance with the nondiscrimination clauses, the Americans with
Disabilities Act, or with any other such rules, regulations, or orders, this Contract may be
canceled, terminated, or suspended in whole or in part and the Contractor may be declared
ineligible for further Contracts.

I.

Contractors Acting as an Agent of the State
In the Contractor’s performance of its duties and responsibilities under this Contract, the
Contractor shall, at all times, act and perform as an agent of the Department, but not as an
employee of the Department. The Department shall neither have nor exercise any control or
direction over the methods by which the Contractor shall perform its work and functions
other than as provided herein. Nothing in this Contract is intended to, nor shall be deemed to
constitute, a partnership or joint venture between the parties.

J.

Indemnification for Contractors Acting as an Agent of the State
The Contractor shall be liable, and agrees to be liable for, and shall indemnify, defend, and
hold the Department, its employees, agents, officers, heirs, and assignees harmless from any
and all claims, suits, judgments, or damages including court costs and attorney’s fees arising
out of intentional acts, negligence, or omissions by the Contractor, or its employees or
agents, in the course of the operations of this Contract, including any claims or actions
brought under Title 42 USC §1983, the Civil Rights Act, up to the limits of liability set forth
in Section 768.28, Florida Statutes.

K.

Contractor’s Insurance for Contractors Acting as an Agent of the State
The Contractor warrants that it is and shall remain for the term of this Contract, in
compliance with the financial responsibility requirements of Section 458.320, Florida
Statutes, and is not entitled to, and shall not claim, any exemption from such requirements.
The Contractor also warrants that funds held under Section 458.320, Florida Statutes, are
available to pay claims against the State in accordance with Section VII., J., Indemnification
for Contractors Acting as an Agent of the State.
Centurion shall maintain, at its expense, the established levels of insurance as shown below
for Workers’ Compensation, Professional Liability, Comprehensive General Liability and
Property Insurance.
•

Workers’ Compensation: statutory

•

Professional Liability: $2,000,000 per occurrence and $6,000,000 in the aggregate
annually

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•

Comprehensive General Liability: $2,000,000 per occurrence and $6,000,000 in the
aggregate annually

Insurance certificate shall identify the Agreement and contain provisions that coverage
afforded under the policies shall not be canceled, terminated or materially altered. All
insurance certificates will provide coverage to the Department as an additional insured.
Upon the execution of this Contract, the Contractor shall furnish the Contract Manager
written verification supporting such insurance coverage. Such coverage may be provided by
a self-insurance program established and operating under the laws of the State of Florida.
The Department reserves the right to require additional insurance where appropriate.
Centurion shall ensure that all subcontractors performing healthcare services under this
Agreement meet the insurance requirements listed in this Section.
L.

Disputes
Any dispute concerning performance of this Contract shall be resolved informally by the
Contract Manager. Any dispute that cannot be resolved informally shall be reduced to
writing and delivered to the Department’s Assistant Secretary for Health Services. The
Assistant Secretary for Health Services or designee shall decide the dispute, reduce the
decision to writing, and deliver a copy to the Contractor, the Contract Manager, and the
Contract Administrator.

M.

Copyrights, Right to Data, Patents and Royalties
Where activities supported by this Contract produce original writing, sound recordings,
pictorial reproductions, drawings or other graphic representation and works of any similar
nature, the Department has the right to use, duplicate and disclose such materials in whole or
in part, in any manner, for any purpose whatsoever and to have others acting on behalf of the
Department to do so. If the materials so developed are subject to copyright, trademark, or
patent, legal title and every right, interest, claim or demand of any kind in and to any patent,
trademark or copyright, or application for the same, will vest in the State of Florida,
Department of State for the exclusive use and benefit of the State. Pursuant to Section
286.021, Florida Statutes, no person, firm or corporation, including parties to this Contract,
shall be entitled to use the copyright, patent, or trademark without the prior written consent
of the Department of State.
The Department shall have unlimited rights to use, disclose or duplicate, for any purpose
whatsoever, all information and data developed, derived, documented, or furnished by the
Contractor under this Contract. All computer programs and other documentation produced as
part of this Contract shall become the exclusive property of the State of Florida, Department of
State, with the exception of data processing software developed by the Department pursuant to
Section 119.083, Florida Statutes, and may not be copied or removed by any employee of the
Contractor without express written permission of the Department.
The Contractor, without exception, shall indemnify and hold harmless the Department and
its employees from liability of any nature or kind, including cost and expenses for or on
account of any copyrighted, patented, or un-patented invention, process, or article
manufactured or supplied by the Contractor. The Contractor has no liability when such
claim is solely and exclusively due to the combination, operation, or use of any article
supplied hereunder with equipment or data not supplied by the Contractor or is based solely

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CONTRACT #C2869
and exclusively upon the Department's alteration of the article. The Department will provide
prompt written notification of a claim of copyright or patent infringement and will afford the
Contractor full opportunity to defend the action and control the defense of such claim.
Further, if such a claim is made or is pending, the Contractor may, at its option and expense,
procure for the Department the right to continue use of, replace, or modify the article to
render it non-infringing. (If none of the alternatives are reasonably available, the
Department agrees to return the article to the Contractor upon its request and receive
reimbursement, fees and costs, if any, as may be determined by a court of competent
jurisdiction.) If the Contractor uses any design, device, or materials covered by letter, patent
or copyright, it is mutually agreed and understood without exception that the Contract prices
shall include all royalties or costs arising from the use of such design, device, or materials in
any way involved in the work to be performed hereunder.
N.

Subcontracts
The Contractor is fully responsible for all work performed under this Contract. The
Contractor may, upon receiving written consent from the Department’s Contract Manager,
enter into written subcontract(s) for performance of certain of its functions under this
Contract. No subcontract, which the Contractor enters into with respect to performance of
any of its functions under this Contract, shall in any way relieve the Contractor of any
responsibility for the performance of its duties. All subcontractors, regardless of function,
providing services on Department property, shall comply with the Department’s security
requirements, as defined by the Department, including background checks, and all other
Contract requirements. All payments to subcontractors shall be made by the Contractor. All
subcontractors shall meet the insurance and indemnification requirements set forth herein,
If a subcontractor is utilized by the Contractor, the Contractor shall pay the subcontractor
within seven (7) working days after receipt of full or partial payments from the Department,
in accordance with Section 287.0585, Florida Statutes. It is understood and agreed that the
Department shall not be liable to any subcontractor for any expenses or liabilities incurred
under the subcontract and that the Contractor shall be solely liable to the subcontractor for
all expenses and liabilities under this Contract. Failure by the Contractor to pay the
subcontractor within seven (7) working days will result in a penalty to be paid by the
Contractor to the subcontractor in the amount of one-half (½) of one percent (1%) of the
amount due per day from the expiration of the period allowed herein for payment. Such
penalty shall be in addition to actual payments owed and shall not exceed fifteen percent
(15%) of the outstanding balance due.

O.

Assignment
The Contractor shall not assign its responsibilities or interests under this Contract to another
party without prior written approval of the Department’s Contract Manager. The
Department shall, at all times, be entitled to assign or transfer its rights, duties and
obligations under this Contract to another governmental agency of the State of Florida upon
giving written notice to the Contractor.

P.

Force Majeure
Neither party shall be liable for loss or damage suffered as a result of any delay or failure in
performance under this Contract or interruption of performance resulting directly or

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CONTRACT #C2869
indirectly from acts of God, accidents, fire, explosions, earthquakes, floods, water, wind,
lightning, civil or military authority, acts of public enemy, war, riots, civil disturbances,
insurrections, strikes, or labor disputes.
Q.

Substitution of Key Personnel
In the event the Contractor desires to substitute any key personnel, either permanently or
temporarily, the Department shall have the right to approve or disapprove the desired
personnel change in advance in writing.

R.

Severability
The invalidity or unenforceability of any particular provision of this Contract shall not affect
the other provisions hereof and this Contract shall be construed in all respects as if such
invalid or unenforceable provision was omitted, so long as the material purposes of this
Contract can still be determined and effectuated.

S.

Use of Funds for Lobbying Prohibited
The Contractor agrees to comply with the provisions of Section 216.347, Florida Statutes,
which prohibits the expenditure of State funds for the purposes of lobbying the Legislature,
the Judicial branch, or a State agency.

T.

Verbal Instructions
No negotiations, decisions, or actions shall be initiated or executed by the Contractor as a
result of any discussions with any Department employee. Only those communications that
are in writing from the Department’s staff identified in Section IV., CONTRACT
MANAGEMENT, of this Contract shall be considered a duly authorized expression on
behalf of the Department. Only communications from the Contractor’s Representative
identified in Section IV., C., which are in writing and signed, will be recognized by the
Department as duly authorized expressions on behalf of the Contractor.

U.

Conflict of Interest
The Contractor shall not compensate in any manner, directly or indirectly, any officer, agent,
or employee of the Department for any act or service that he/she may do, or perform for, or
on behalf of, any officer, agent, or employee of the Contractor. No officer, agent, or
employee of the Department shall have any interest, directly or indirectly, in any contract or
purchase made, or authorized to be made, by anyone for, or on behalf of, the Department.
The Contractor shall have no interest and shall not acquire any interest that shall conflict in
any manner or degree with the performance of the services required under this Contract.

V.

Department of State Licensing Requirements
All entities defined under Chapters 607, 617, or 620, Florida Statutes, seeking to do business
with the Department, shall be on file and in good standing with the State of Florida’s
Department of State.

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CONTRACT #C2869
W.

MyFloridaMarketPlace Vendor Registration
All vendors that have not registered with the State of Florida shall go to
http://vendor.myfloridamarketplace.com/ to complete on-line registration, or call 1-866-3523776 for assisted registration.

X.

Public Entity Crimes Information Statement
A person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid or proposal to provide any goods
or services to a public entity, may not submit a bid or proposal to a public entity for the
construction or repair of a public building or public work, may not submit bids or proposals
for leases of real property to a public entity, may not be awarded or perform work as a
Contractor, supplier, subcontractor, or consultant under a contract with any public entity, and
may not transact business with any public entity in excess of the threshold amount provided
in Section 287.017, Florida Statutes, for Category Two for a period of thirty-six (36) months
from the date of being placed on the Convicted Vendor List.

Y.

Discriminatory Vendors List
An entity or affiliate who has been placed on the Discriminatory Vendors List may not
submit a bid or proposal to provide goods or services to a public entity, may not submit a bid
or proposal with a public entity for the construction or repair of a public building or public
work, may not submit bids or proposals on leases of real property to a public entity, may not
perform work as a Contractor, supplier, subcontractor or consultant under a Contract with
any public entity, and may not transact business with any public entity.

Z.

Scrutinized Companies List
Pursuant to Chapter 287.135, F.S., an entity or affiliate who has been placed on either the
Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List is ineligible for and may not bid on,
submit a proposal for, or enter into or renew a contract with an agency or local governmental
entity for goods or services of $1 million or more.
In executing this contract and any subsequent renewals, the Contractor certifies that it is not
listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized
Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to
section 215.473, Florida Statutes. Pursuant to section 287.135(5), F.S., the Contractor agrees
the Department may immediately terminate this contract for cause if the Contractor is found to
have submitted a false certification or if Contractor is placed on the Scrutinized Companies
with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran
Petroleum Energy Sector List during the term of the contract. Additionally, the submission of
a false certification may subject company to civil penalties, attorney’s fees, and/or costs.

AA.

Governing Law and Venue
This Contract is executed and entered into in the State of Florida and shall be construed,
performed, and enforced in all respects in accordance with the laws, rules, and regulations of
the State of Florida. Any action hereon or in connection herewith shall be brought in Leon
County, Florida.

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CONTRACT #C2869
BB.

No Third Party Beneficiaries
Except as otherwise expressly provided herein, neither this Contract, nor any amendment,
addendum or exhibit attached hereto, nor term, provision or clause contained therein, shall
be construed as being for the benefit of, or providing a benefit to, any party not a signatory
hereto.

CC.

Health Insurance Portability and Accountability Act
The Contractor shall comply with the Health Insurance Portability and Accountability Act of
1996 (HIPAA) (42 U. S. C. 1320d-8) and all applicable regulations promulgated thereunder.
Agreement to comply with HIPAA is evidenced by the Contractor’s execution of this
Contract, which includes and incorporates Attachment #1, Business Associate Agreement,
as part of this Contract.
In addition to complying with HIPAA requirements, the Contractor shall not disclose any
information concerning inmates, specifically concerning inmate transfers/referrals, to parties
outside the Department.

DD.

Reservation of Rights
The Department reserves the exclusive right to make certain determinations regarding the
service requirements outlined in this Contract. The absence of the Department setting forth a
specific reservation of rights does not mean that any provision regarding the services to be
performed under this Contract are subject to mutual agreement. The Department reserves
the right to make any and all determinations exclusively which it deems are necessary to
protect the best interests of the State of Florida and the health, safety, and welfare of the
Department’s inmates and of the general public which is serviced by the Department, either
directly or indirectly, through these services.

EE.

Cooperative Purchasing
Pursuant to their own governing laws, and subject to the agreement of the Contractor, other
entities may be permitted to make purchases in accordance with the terns and conditions
contained herein. The Department shall not be a party to any transaction between the
Contractor and any other purchaser.
Other state agencies wishing to make purchases from this agreement are required to follow
the provisions of Section 287.042(16), F.S. This statute requires the Department of
Management Services to determine that the requestor’s use of the Contract is cost effective
and in the best interest of the State.

FF.

Cooperation with Inspector General
In accordance with Section 20.055(5), Florida Statutes, the Contractor, and any
subcontractor, understands and will comply with its duty to cooperate with the Inspector
General in any investigation, audit, inspection, review, or hearing.

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CONTRACT #C2869

Waiver of breach of any provision of this Contract shall not be deemed to be a waiver of any other breach
and shall not be construed to be a modification of the terms of this Contract.
This Contract contains all the terms and conditions agreed upon by the parties
IN WITNESS THEREOF, the parties hereto have caused this Contract to be executed by their undersigned
officials as duly authorized.

CONTRACTOR:
CENTURION OF FLORIDA, LLC

SIGNED
BY:

• _7'
_lJ._'-LI
...
'4J
.V

NAME:

Steven H. Wheeler

TITLE:

CEO

DAT E:

1/29/1 6

FEID #:

81 -0687470

L

Approved as to form and legality, subject
to execution.

FLORIDA DEPARTMENT OF CORRECTIONS

SIGNED
BY:
NAME:
TITLE:

DATE:

k

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- Ju1,_...,._,..,
i .......,...._
Jo: s-_,_.,....,.,.,,._
Secretary
Department of Corrections

1IJ4/;v
I

_

SIGN ED
BY
NAME j'~
TITLE:

DATE:

Page 113 of 120
MO DEL DOCU MENT REVISED 07/0 1/ 15

1 /)~

i--JLC/1

J

A

'- /V\

I~a-, /

General Counsel
Department of Corrections

((2cr/ th

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Vj

Case 3:20-cv-00036-BJD-LLL Document 63-2 Filed 06/23/20 Page 115 of 121 PageID 595

BUSINESS ASSOCIATE AGREEMENT

CONTRACT #C2869
Attachment #1

This Business Associate Agreement supplements and is made a part of this Agreement between the Florida
Department of Corrections ("Department") and Centurion of Florida, LLC ("Contractor"), (individually, a "Party"
and collectively referred to as "Parties").
Whereas, the Department creates or maintains, or has authorized the Contractor to receive, create, or maintain
certain Protected Health Information (“PHI,”) as that term is defined in 45 C.F.R. §164.501 and that is subject to
protection under the Health Insurance Portability and Accountability Act of 1996, as amended. (“HIPAA”);
Whereas, the Department is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45
C.F.R. Part 160 and Part 164, Subparts A, C, and E, the Standards for Privacy of Individually Identifiable Health
Information (“Privacy Rule”) and the Security Standards for the Protection of Electronic Protected Health
Information (“Security Rule”);
Whereas, the Contractor may have access to Protected Health Information in fulfilling its responsibilities under its
contract with the Department;
Whereas, the Contractor is considered to be a “Business Associate” of a Covered Entity as defined in the Privacy
Rule;
Whereas, pursuant to the Privacy Rule, all Business Associates of Covered Entities must agree in writing to certain
mandatory provisions regarding the use and disclosure of PHI; and
Whereas, the purpose of this Agreement is to comply with the requirements of the Privacy Rule, including, but not
limited to, the Business Associate contract requirements of 45 C.F.R. §164.504(e).
Whereas, in regards to Electronic Protected Health Information as defined in 45 C.F.R. § 160.103, the purpose of
this Agreement is to comply with the requirements of the Security Rule, including, but not limited to, the Business
Associate contract requirements of 45 C.F.R. §164.314(a).
Now, therefore, in consideration of the mutual promises and covenants contained herein, the Parties agree as
follows:
1.

Definitions
Unless otherwise provided in this Agreement, any and all capitalized terms have the same meanings as set
forth in the HIPAA Privacy Rule, HIPAA Security Rule or the HITECH Act. Contractor acknowledges
and agrees that all Protected Health Information that is created or received by the Department and disclosed
or made available in any form, including paper record, oral communication, audio recording, and electronic
display by the Department or its operating units to Contractor or is created or received by Contractor on the
Department’s behalf shall be subject to this Agreement.

2.

Confidentiality Requirements
A.

Contractor agrees to use and disclose Protected Health Information that is disclosed to it by the
Department solely for meeting its obligations under its agreements with the Department, in
accordance with the terms of this agreement, the Department's established policies rules,
procedures and requirements, or as required by law, rule or regulation.

B.

In addition to any other uses and/or disclosures permitted or authorized by this Agreement or
required by law, Contractor may use and disclose Protected Health Information as follows:

Revised 06/24/10

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(1)

C.

CONTRACT #C2869
Attachment #1
if necessary for the proper management and administration of the Contractor and to carry out
the legal responsibilities of the Contractor, provided that any such disclosure is required by
law or that Contractor obtains reasonable assurances from the person to whom the information
is disclosed that it will be held confidentially and used or further disclosed only as required by
law or for the purpose for which it was disclosed to the person, and the person notifies
Contractor of any instances of which it is aware in which the confidentiality of the information
has been breached;

(2)

for data aggregation services, only if to be provided by Contractor for the health care
operations of the Department pursuant to any and all agreements between the Parties. For
purposes of this Agreement, data aggregation services means the combining of protected
health information by Contractor with the protected health information received by
Contractor in its capacity as a Contractor of another covered entity, to permit data analyses
that relate to the health care operations of the respective covered entities.

(3)

Contractor may use and disclose protected health information that Contractor obtains or
creates only if such disclosure is in compliance with every applicable requirement of
Section 164.504(e) of the Privacy relating to Contractor contracts. The additional
requirements of Subtitle D of the HITECH Act that relate to privacy and that are made
applicable to the Department as a covered entity shall also be applicable to Contractor and
are incorporated herein by reference.

Contractor will implement appropriate safeguards to prevent use or disclosure of Protected Health
Information other than as permitted in this Agreement. Further, Contractor shall implement
administrative, physical, and technical safeguards that reasonably and appropriately protect the
confidentiality, integrity, and availability of Electronic Protected Health Information that it creates,
receives, maintains, or transmits on behalf of the Department. The Secretary of Health and Human
Services and the Department shall have the right to audit Contractor’s records and practices related
to use and disclosure of Protected Health Information to ensure the Department's compliance with
the terms of the HIPAA Privacy Rule and/or the HIPAA Security Rule.
Further, Sections 164.308 (administrative safeguards). 164.310 (physical safeguards), 164.312
(technical safeguards), and 164.316 (policies and procedures and documentation requirements) of
the Security Rule shall apply to the Contractor in the same manner that such sections apply to the
Department as a covered entity. The additional requirements of the HITECH Act that relate to
security and that are made applicable to covered entities shall be applicable to Contractor and are
hereby incorporated by reference into this BA Agreement.

D.

Contractor shall report to Department any use or disclosure of Protected Health Information, which is
not in compliance with the terms of this Agreement as well as any Security incident of which it
becomes aware. Contractor agrees to notify the Department, and include a copy of any complaint
related to use, disclosure, or requests of Protected Health Information that the Contractor receives
directly and use best efforts to assist the Department in investigating and resolving such complaints. In
addition, Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to
Contractor of a use or disclosure of Protected Health Information by Contractor in violation of the
requirements of this Agreement.
Such report shall notify the Department of:

Revised 06/24/10

1)

any Use or Disclosure of protected health information (including Security Incidents) not
permitted by this Agreement or in writing by the Department;

2)

any Security Incident;
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CONTRACT #C2869
Attachment #1

3)

any Breach, as defined by the HITECH Act; or

4)

any other breach of a security system, or like system, as may be defined under applicable
State law (Collectively a “Breach”).

Contractor will without unreasonable delay, but no later than seventy-two (72) hours after
discovery of a Breach, send the above report to the Department.
Such report shall identify each individual whose protected health information has been, or is
reasonably believed to have been, accessed, acquired, or disclosed during any Breach pursuant to
42 U.S.C.A. § 17932(b). Such report will:
1)

Identify the nature of the non-permitted or prohibited access, use, or disclosure, including
the nature of the Breach and the date of discovery of the Breach.

2)

Identify the protected health information accessed, used or disclosed, and provide an exact
copy or replication of that protected health information.

3)

Identify who or what caused the Breach and who accessed, used, or received the protected
health information.

4)

Identify what has been or will be done to mitigate the effects of the Breach; and

5)

Provide any other information, including further written reports, as the Department may
request.

E.

In accordance with Section 164.504(e)(1)(ii) of the Privacy Rule, each party agrees that if it knows
of a pattern of activity or practice of the other party that constitutes a material breach of or
violation of the other party’s obligations under the BA Agreement, the non-breaching party will
take reasonable steps to cure the breach or end the violation, and if such steps are unsuccessful,
terminate the contract or arrangement if feasible. If termination is not feasible, the party will report
the problem to the Secretary of Health and Human Services (federal government).

F.

Contractor will ensure that its agents, including a subcontractor, to whom it provides Protected
Health Information received from, or created by Contractor on behalf of the Department, agree to
the same restrictions and conditions that apply to Contractor, and apply reasonable and appropriate
safeguards to protect such information. Contractor agrees to designate an appropriate individual
(by title or name) to ensure the obligations of this agreement are met and to respond to issues and
requests related to Protected Health Information. In addition, Contractor agrees to take other
reasonable steps to ensure that its employees’ actions or omissions do not cause Contractor to
breach the terms of this Agreement.

G.

Contractor shall secure all protected health information by a technology standard that renders
protected health information unusable, unreadable, or indecipherable to unauthorized individuals
and is developed or endorsed by a standards developing organization that is accredited by the
American National Standards Institute and is consistent with guidance issued by the Secretary of
Health and Human Services specifying the technologies and methodologies that render protected
health information unusable, unreadable, or indecipherable to unauthorized individuals, including
the use of standards developed under Section 3002(b)(2)(B)(vi) of the Public Health Service Act,
pursuant to the HITECH Act, 42 U.S.C.A. § 300jj-11, unless the Department agrees in writing that
this requirement is infeasible with respect to particular data. These security and protection
standards shall also apply to any of Contractor’s agents and subcontractors.

H.

Contractor agrees to make available Protected Health Information so that the Department may
comply with individual rights to access in accordance with Section 164.524 of the HIPAA Privacy
Rule. Contractor agrees to make Protected Health Information available for amendment and
incorporate any amendments to Protected Health Information in accordance with the requirements

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CONTRACT #C2869
Attachment #1
of Section 164.526 of the HIPAA Privacy Rule. In addition, Contractor agrees to record
disclosures and such other information necessary, and make such information available, for
purposes of the Department providing an accounting of disclosures, as required by Section 164.528
of the HIPAA Privacy Rule.
I.

3.

4.

The Contractor agrees, when requesting Protected Health Information to fulfill its contractual
obligations or on the Department’s behalf, and when using and disclosing Protected Health
Information as permitted in this contract, that the Contractor will request, use, or disclose only the
minimum necessary in order to accomplish the intended purpose.

Obligations of Department
A.

The Department will make available to the Business Associate the notice of privacy practices
(applicable to offenders under supervision, not to inmates) that the Department produces in
accordance with 45 CFR 164.520, as well as any material changes to such notice.

B.

The Department shall provide Business Associate with any changes in, or revocation of, permission
by an Individual to use or disclose Protected Health Information, if such changes affect Business
Associate’s permitted or required uses and disclosures.

C.

The Department shall notify Business Associate of any restriction to the use or disclosure of
Protected Health Information that impacts the business associate’s use or disclosure and that the
Department has agreed to in accordance with 45 CFR 164.522 and the HITECH Act.

Termination
A.

Termination for Breach - The Department may terminate this Agreement if the Department
determines that Contractor has breached a material term of this Agreement. Alternatively, the
Department may choose to provide Contractor with notice of the existence of an alleged material
breach and afford Contractor an opportunity to cure the alleged material breach. In the event
Contractor fails to cure the breach to the satisfaction of the Department, the Department may
immediately thereafter terminate this Agreement.

B.

Automatic Termination - This Agreement will automatically terminate upon the termination or
expiration of the original contract between the Department and the Contractor.

C.

Effect of Termination
(1)

Termination of this agreement will result in termination of the associated contract between
the Department and the Contractor.

(2)

Upon termination of this Agreement or the contract, Contractor will return or destroy all
PHI received from the Department or created or received by Contractor on behalf of the
Department that Contractor still maintains and retain no copies of such PHI; provided that
if such return or destruction is not feasible, Contractor will extend the protections of this
Agreement to the PHI and limit further uses and disclosure to those purposes that make the
return or destruction of the information infeasible.

5.

Amendment - Both parties agree to take such action as is necessary to amend this Agreement from time to
time as is necessary to comply with the requirements of the Privacy Rule, the HIPAA Security Rule, and
the HITECH Act.

6.

Interpretation - Any ambiguity in this Agreement shall be resolved to permit the Department to comply
with the HIPAA Privacy Rule and/or the HIPAA Security Rule.

Revised 06/24/10

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7.

8.

CONTRACT #C2869
Attachment #1
Indemnification - The Contractor shall be liable for and agrees to be liable for, and shall indemnify,
defend, and hold harmless the Department, its employees, agents, officers, and assigns from any and all
claims, suits, judgments, or damages including court costs and attorneys' fees arising out or in connection
with any non-permitted or prohibited Use or Disclosure of PHI or other breach of this Agreement, whether
intentional, negligent or by omission, by Contractor, or any sub-contractor of Contractor, or agent, person
or entity under the control or direction of Contractor. This indemnification by Contractor includes any
claims brought under Title 42 USC § 1983, the Civil Rights Act.
Miscellaneous - Parties to this Agreement do not intend to create any rights in any third parties. The
obligations of Contractor under this Section shall survive the expiration, termination, or cancellation of this
Agreement, or any and all other contracts between the parties, and shall continue to bind Contractor, its
agents, employees, Contractors, successors, and assigns as set forth herein for any PHI that is not returned
to the Department or destroyed.

CONTRACTOR:
CENTURION OF FLORIDA, LLC
SIGNED BY:
NAME:
TITLE:

C6c:>

DATE:

Revised 06/24/ I 0

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CONTRACT #C2869
Attachment #2

GROUP I II AND III POSITIONS
Group I
DENTAL DIRECTOR
DENTIST

Group II
LPN
BEHAVIORAL HEALTH SPECIALIST

Group III
DATA ENTRY OPERATOR F/C
CLERK TYPIST SPECIALIST F/C

PSYCHIATRIST

SENIOR BEHAVIORAL ANALYST/
MENTAL HEALTH PRACTITIONER

DENTAL ASSISTANT - F/C

PSYCHOLOGIST
PSYCHOLOGICAL SERVICES DIRECTOR

DENTAL HYGIENIST
MEDICAL RECORDS SUPERVISOR/HIS

HEALTH SUPPORT TECHNICIAN-F/C
HEALTH INFORMATION SPECIALIST F/C

ADVANCED REGISTER NURSE PRACTITIONER
(MH)

MENTAL HEALTH TECHNICIAN

MENTAL HEALTH CLERK

PHYSICIANS ASSISTANT (MH)
MENTAL HEALTH DIRECTOR
MENTAL HEALTH REGISTERED NURSE
HEALTH SERVICES ADMINISTRATOR
REGISTERED NURSE

PHARMACY TECHNICIAN
MASTER SOCIAL WORKER
LABORATORY TECHNICIAN
MENTAL HEALTH INTERN
CLINICAL COORDINATOR

SECRETARY SPECIALIST
SENIOR CLERK F/C
ADMINISTRATIVE ASSISTANT
DATA ENTRY CLERK
CERTIFIED NURSING ASSISTANT

ADVANCED REGISTER NURSE PRACTITIONER/
PHYSICIANS ASSISTANT (Med)

QUALITY ASSURANCE COORDINATOR
- RMCH

MEDICAL RECORDS CLERK

PHYSICIAN

DIRECTOR OPERATIONS - RMCH

STAFF ASSISTANT

PHYSICIAN - HOSPITALIST

ASSOCIATE REGIONAL MEDICAL
DIRECTOR

SCHEDULER

MEDICAL DIRECTOR/CHO

LABORATORY MANAGER

INVENTORY COORDINATOR

UM - MEDICAL DIRECTOR

LEAD INVENTORY COORDINATOR RMCH

CLERK

DIRECTOR OF NURSING
ORAL SURGEON
OPTOMETRIST
PHARMACIST - REGIONAL OR DIRECTOR
RADIOLOGY MANAGER
CLINICAL RISK MANAGER

MEDICAL TECHNICIAN - INF/CHEMO
RESPIRATORY THERAPIST
RN - EDUCATION
RN - INFUSION/CHEMOTHERAPY
X-RAY TECHNICIAN
NURSE MANAGER

Page 119 of 120

ACTIVITY TECHNICIAN
INPATIENT SUPERVISOR
LABORATORY ASSISTANT
MEDICAL BILLING CLERK
PATIENT SITTER
RE-ENTRY SERVICES CASE MANAGER
TRANSCRIPTIONIST
PHLEBOTOMIST

Case 3:20-cv-00036-BJD-LLL Document 63-2 Filed 06/23/20 Page 121 of 121 PageID 601
CONTRACT #C2869
Attachment #3

TIER I II AND III FACILITIES
Region I

Tier I

Region II

Region III

Apalachee

Columbia

Central Florida Reception Center

Jefferson

Florida Women's Reception Center

Lake

Northwest Florida Reception Center

Lowell

Santa Rosa

Reception and Medical Center

Taylor

Suwannee
Tomoka
Union

Tier II

Calhoun

Baker Re-Entry

Hernando

Century

Cross City

Sumter

Franklin

Florida State Prison

Zephyrhills

Gulf

Hamilton

Jackson

Marion

Liberty

Mayo

Wakulla

Tier III

Gadsden Re-Entry

Baker

Avon Park

Holmes

Lancaster

Polk

Okaloosa

Lawtey

Walton

Madison
Putnam

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