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Alaska Cca Contract 2004 Partc

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Facility Requirements

A.

General Statements

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The facility must be In full compraance with applicable zoning ordinances and
applicable building. fire, and life safety codes. ACA standards must be met in aU
areas to include handicap access.

The facility must provide external security In the form of wall and/or double fence,
razor wire. detector devfces, patrol, and/or towels. can doors In the ~its must be
lockable. Housing may be in for form of cells, rooms. or donnitorles with secUre

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The facility must be able to accommodate prisoners with c:.f(sablllties and meet ADA
compliance. A minimum of 2% of the cells shall be capable of accommodating
disabled prisoners.

B.

safety, S8I)ifation and Health Standards! Life Safety
The contmctor. shall 8n8Ure that safety. sanltalion, . . h8BMh stand8rd8 are· : ,
I11eIIltlaIned at aD Imea for the welfar8 of off8ndets, facility sta«, vI8Iors,' and
to Include:
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10)
11)

4.10

Claaelllcatlon and' PalOle Planning

AFP.iiil iill 454C/CanRcta054981

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A.

The contractor shall assist in the arranging for dassification· and parole hearings
conducted on-site. by audio or video teleconference. Cost of the teleconference
shall be borne by the State.
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Assignment of Prisoners
Prisoners wDl be' assigned to the Facility by the department In accordance with the
Departmenfs dassiflcation and assignment procedures. DOC Policy 735.01
Designation Process for Long Tenn Sentenced Prisoners wID be followed as it
relates to housing conditions. At. the Facility. they wII be housed utilizing the unit .
team concept Unit team members shaU be accessible in the housing units and
avaHabie to the population.

B.

Orientation
Each prisoner shaH receive a facility and prugc8m orientation within 24 hours of his
arrival. The orIeIltation shall Include staff pI888I1taIons 80d a vdten handbook.
The ~ ehaIIlncIude 811 facIily and program rules and ~ ' * as well
88 pReoner "'ill. The orientation shall Include ataIuby provisions for escape fiorn
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SegnJgeted Prisoners

sean.1IIIon

The cOnbacIor must foIow DOC 804.01 ~
and 804.02
. ~1Iive SegregatIon to manage an~ h0U88 segNgBted priaorMn.

E.

Alaska Parole

Process

Contractor shall provide corrections counselors on a staff io prisoner ratio of 1 to
130 who 8f8 . . . . wiIh . . prisoner'a stab. to .1111t
the prisoner'a
appIicatioi'ls for parole and planning for their appl8nince b
the board. case
managers shall contact the DIrecb" of In8IIIuIIMs or
wIIh My ~I8BtIoIl8
I8Ieed by prfsoneI8 regadng ~ d the . . . . be aid . . ~ 8haII provide
requested InfOrm8tIon as.1OOn 88 pos.... 1n " ' n to lte.CD1'f8C1b18 counselor
provided by the contracIDr. at the dIeci.aDn of the StrIte, ComadbnaI 0fftcer8 may
be placed on site.
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At the request of the DOC staff or the Parole Board. contraclor shall provide ,.
prisone(s progress reports for all prisoners within two yeatS of parole eliglbDity.
Generally, reports on Alaska prisoners shall be submitted at six month intervals
summarizing prisoner progress. conduct and recommendation for retention at
contracto(s facility or return to Alaska.
Contractor shall assist in the ananging for parole hearings conducted either on site
or by video or audio teleconferencing. The cost of the conferencing shan be borne
by the State.

4.11

Records and Reporting

A.

Sentence Computation.
Th~

contractor·wII provide to the Department any nec88881Y information for
sentence computation. The Department wBl do aU sentence computation. CopIes
shall be furnished to the COl dlactor and Contract sIaff shaI proW:Ie this to the
prisoner. No prieoner wII be admitted to or released from the Fadlity without
penniseion from the DOC.

B.

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Prisoner RecoRte and Reports

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The FadIty'wII mailtain prisoner recorda at their sole SI. . . . 1n ac:ccR8fiC8"
applicable ~~18I1tf800Id ~ pnlCIIoes and ~: ...,:~.,~ (8~~;~' ..'. '. -~: ..:~

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andtocal"'~tgconldentlality.~hIIIory .. a~"'.'F

receAt.d8isific
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contlBCfor

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htformlllloa syBI.... ~ 1dei1llficalion

M priIonttrs:houljlld at the facIity will be photographed. An infMn..

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be III_I I..... ThiI ayaIem muatlnctude the cuetDdy ..... of ~ ~er, ~ of .
COIWidIon, releaae date. and physical descriptio..... No prisoner 8h8II have 8CC8I1 k)
this system.
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4.12

pnsoner ActMIes and Programs
Note:

Removal d. JXi80ners from contractor provided prqpme·must be done In

accontance wIIh' DOC PolIcy 808.04 Removal From Rehablltatlon Programs.

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ActivftIes
SUfficIent jobs 8Rd programs must be available for a mkJinun.of 90% d

eI8IbIe

PJison... The ~aetor IIIUIt also maltltain 8 mINmum 0!7o-Kt ~ d:tn ....

for worIdng AlBII. prisoners. If CCA Ie not able to rnalIltlift a m1I...m 70%
paI1Jcip8&ton for \1IOl'k or 90% partIdpaIIon for WOfk and ~ combined due to
prisoner,..,.., CCA muIt document In-wriling each ........ I8fu881 to
parttdpate. lnelliia ~ 81'8 those ~ 81"8 I. ul18ble to work due to age or
handicap, or 8M In N8trIc8ve housing. Pri8oner8 shall be productively occupied
out8Ide of........ 1IalJntI quarters fOr four to eight hours per day, . . . d8)tB perWMk·Jn

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work. educational, vocational or rehabUitative programs. Recreation is to be provided
seven days per week. Hobbyctaft shall be available 7 days per week. 6 hours per
day with at least 2 hours at night
Prisoner Work
Prisoner work programs shall be established in aCCOldance with the Contract.
Department Policy 812.01 Prisoner Employment. and state (to Include Alaska) and
federal law. Prisoners have the right to refuse employment Work outside the secure
perimeter (e.g. work crews) must be approved in writing by ~e Director of
Institutions.
Prisoner labor may be used for Facility operations and maintenance; however,
neither the contractor nor any of their empIoyges shall peraonaUy benefit from the
labor of prisoners. No prisoner shall ever be placed In a position of authority fNW
a~e~

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Prisoner wages wi be paid by the confr8ctor In accordance 812.02 CompensaIon
for Prieoner PmIkJc8d Goods and ServiceS forwark performed at the·F&eay. See
,also, Section 4.08F.
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Compel:ts tlonfor.tiilg·priBonenIls to be for aduaf hours worked (not
auIomaIo8IIy 88SYIMd as eight hour8 per day, five d8ys per week).
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Industry PIograms. , .

D.

Winimum edaM alon Pmen!Y'n ~

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l:1Ie ~wiII.~ 'a iniimum of four Irlstrucflcn; of whIct1 two mite

IriiIIrudor8 ~ Povide ~ In theeubject 8188 of ABEIGED, and h'other' two

to.provIde we: miaMi COUI'888 eX the cor*actor'a chooaIng. The following rn....

are requInMI to:b&in.pIece within 90 days after the ServIce ComrnencemeM DetI:
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RiIn&8gratIon program - This must Include In III uchn in,
Ute areas of health.and safety, communication sIdIa. aoaa-cuIIurIlI1M6 .11.
employability akiIIa and tranSitIon planning. The prognun
be. a minimum
of ten hours In duration.

must

2)

ABE and GEO: muat IncIlIde programming In literacy, pr&:GEO 8\d Gal
In8b'udIon and EngIW\ 88 a 8econd Language ImIIructIon (ESl). AMllllrMRt
must be 81taNilhed that determines appropriate pIecement and p" • III .

a)

Student AeesBsment
On progI8II1 entry, at adult 1eam818 YttI be Pf8 .salBed for ...6Ig.
wrtIing. apeakIng, problem soMng, and m&th ... levels. Wf.wI
possible. adult learners will be post allaalad upon . . or ua ,sty. A

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standardized assessment tool endorsed by the U.S. Department of
Education, Division of Adult Education and Literacy, must be used. The
Alaska Department of Corrections, as well as all Adult Learnfng Centers
in Alaska, uses the Test of Adult Basic Education (TABE) and the BaSicOEnglish SkiDs Test (BEST) for assessment of ESL students. The
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education program at the contract facility is expected to utirlZe the TABE '
and BEST. unless adequate justification can be provided for utilizing
other instruments.

b)

Adult Basic Education
The ABE/GED program must offer instruction in basic skHIs and adult
secondary education. Basic skiDs Include Instruction in I'88ding. wrilng.
and mathematics with a grade level equivalency of 81t grade and below.
Adult secondary education includes instruction in pr9p8IIng to take the
GED test and general high school equivalency fnstrucIIon.

c)

Student Records
The minimum Information to be maintained for ABeJGED studentS
indudes:
., Student Idenfiftcation (preferably social security number and ~ of
'1Hrth)
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• Pun.dssioo to use social security number for datil ooIection
purposes only
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Student demOgraphic infqr.maIon
Prior ye&nI of achooIing

• PIKernedt teveI at program 8I*y
• .1niIi8I1eamiag go&I8
• Spedfi&d pre- and PoIt'tedialfj. stucI.ent iRformalon
'.. Entry and updelel9COld8
• AtIendance records

d)

GEDT8IIing
~ Testing policies and procedur8e must observe ~ ~
~ in the GEl) Teat AdmlnistnltIon ~. 88 published by. GED
, T~ S8rv1ce. Inc. and endorsed by the U.S. Department of
Education.

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Vocational and Post-8econdary Academic Programming:

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A minimum of two programs must be offered. Post-68COl1dary and vocational
training must be accredited by the Alaska PosI-Secondary Commission
cornp8f1IbIe body in the state ~ the conInIct Institution is 1ocaIBd. Adult
be8Ic 8IJucation and GED must i:ompIy with aI applicable slate and federal

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4)

VOC8fConaI Education Programs

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Offer a sequence of courses that are directly related to the preparation of .
individuals for employment in occupations not requiring a bachelors or
advanced degree. Vocational programs should Include competency-based
applied learning and instruction in occupation-specific sklls. When
appropriate, vocational training programs may be tied to employment
opportunities within the given institution. Vocational training may also include
Apprenticeship programs which meet the criteria established by the U.S.
Department of Labor, Bureau of Apprenticeship & Training.

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E.

F.

Post-8econdary Aca4em1c Programming:
Prisoners mayacces$ coIlege-1evei academic classes, which may include
correspondence classes, at their own expense. The education program at the
contract facility wII provide remedlallnstnJ*n, on-slte tutorial assistance
and other supplemental Instruction. Existing facility staff as well as qualified
prisoners may provide remedial instruction and tutoring services.

Substance Abuse Program

Reaeation Program

TIme, 8P8C8 and equipment must be provided YtHch enc:otJnlI88S heallhy leisure
aaIvIIes Space must be pIOVided both Inside and outside will ouIIIIde recnJllion
made avaII8bIe at Ie8et 50% of the time. RecaatIon lIRe for prieoRer8 In general

"popgllllon 8h8II be avaitable a minimum of seven hounI per day (daylight
pemlitllllQ). and at least 7 days perweek.

Prisoners In admi1Jstrative segregation and under medical care will receive

rea "on In accordance with ACA Standards. Prisoner8In"punitIlIa aegreg&Uon and

RFP. 2iiiDiOI2ocJo../ 00nIrad12054881

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maximum security, and protective aJstody must be offered one hour per day, 7 dBys
a week, access to out of cell exercise.
Day rooms must be provided for indoor leisure activities and will be equipped with
televisions, furniture, games, etc.

G.

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Hobby Craft Program
Hobby craft programs as defined in DOC policy 815.04 Art & Craft Programs must
be made avaUabie to DOC prisoners. The minimum number of hours for operation
will be subject to written approval by the Director of Institutions. HobbycrBft shall be
av.ailable 1 days per week. 6 hours per day with at least 2 hours at night An
approved outlet or maO order outlet must be offered for purchase of suppDes. In ceH
programs must be offered subject to security considerations. Prisoners may
dispoSe of their products.

H.

L1~ry

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A general library will be maintained consistent wah N;A standards•

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VeIunt8er PrognIm
A YOIunteer: prognKn shall be developed within the Faclity to provide support groups
·and rellgiaus oppoJU1:ilies. Programs should include offerings from Ii ~.of faiIh
and non failh based offerings·presented by indlviituals who have p8S8~.. j;..... ~ .....;:.
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bacIcgro&Rt investlgEh... Groups such as AIcohoIIos AnorJrmoue and'~~ : .
ADor1)tmotIs should be included.
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AIIgIous P.rognuns

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The COI.duDIf' sfUIU ~ one and a half FfE·a..•1IIrina d8dicalad tB A;I ,.d.ten
pri ClMI8·to provide nondeR~ r&IiIb••INces....... <:aM.. . . . . .
faiIh.beeed re8lden~aI ..OQiWil (deacribed below). M costs for the clu;1 J ICY '.
progaam are included in 1he daly per diem rate.
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ChapIIincy seMces are to incIIlc:le worship MrYicest I8Iigious edt'Clitio.. . ~
care and coUnseling, reI:gIous library, saaamenta. ~, other I8IfGiou8 ...
and rellgiolls dieIs. The Chaplain qualifications . . meet·PlIDM.1IonaI
qU8lificatiDns ~ by the AlIlska DOC ChapI&incy. The Chaplain sh8I develop • (I
an adequata program of clergy and lay voIUnteens for different faith groups to assist
In the provision of religious ~

Adequ_ f&c1i1188 must be provided for reUgIoc IS services and counseling for
prisoner, and a Ch8pIain'. oftice spece.
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A Faith-baeed I88idenUaJ program living unit shall be pmvfded for Alaskan prisoners
. based on lie model developed by the AI.lra Dar 5 1i5£snt of Corr8ctIons a.p.ir~y
Coordinator. The living unit wII house only prI80neIlI accap'.d Ink» the program.
Program deveiopment wit be a coIIaboretiv8 procell blue.. the conbacb8
~ program supervisor and the Alaska DOC Chaplaincy Coordinab".

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Program staffing shall be provided commensurate with the size of the living unit and
the requirements of the program design. A program design is avalable upon
request from the Alaska DOC Chaplaincy deparbnent, or by contacting the
Contracting OflIcer listed in Section 1.01.

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Ar.cess to Court and Legal Materials

K.

A law library as defined In DOC 814.02 Law Ubrary. that meets ACA standards must
be provided. The items listed in DOC Policy 814.02 are required to be maintained in
the law library. The contractor will provide a person ~ In law to assist prisoners
and provide legal materials as requested. The cost of the law library Clerk Is i~ed
In the daly per diem rate. .

Materials must be provided 'Within ten to fourteen working days for routine requests.
within three to five working ~~YS when there Is evidence of an ongoing cfvI or
criminal filing with a deadrtne which must be.met and within forty \Wfking hours
when a prisoner has to file a reply memoranda or has a filing deadOne of leis than
five days.
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VIsitaIion may be imIed m immedI8te family metlimeIs·for those prteonens convicted
of a discipIinery 1nfa8Clion. Prisonera ~ punIIive, ~ must be aIIoMKt one
-hour per week contaCt visit unless a determln&tlon has been made that there Is a
security risk.
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Arrangements wiD be made for visits With attorneys per DOC 812.02 VISItation.

4.13 Support ServIces
MaD

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_]Jle~~~~~vtde~Qf~"'~
correepondence in accordance with DOC PolIcy 810.03 Prt80ner Mel. five pieces eX
mal weighing no IIlOI8 than two pounds each A18Y be maled out for indigent
prtsonera per week. ThIs Is not Intended for mal out of property or hobby craft
lema. All costa 8I8OCiated with the maDing of'fndigellt pReoner mal Is included In
the daly per diem rate.
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B.

Commissary

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The contractor will provide a commissary. Charging prisoners a sUrcharge or
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handling fee of no more than 30% will be aHowed. If sul'Ch8fg8S or handling fees are \::I
collected the proceeds wiN be deposited in the Prisoner Welfare Fund (see 4.06
FIscal Management Section). Proceeds from the commissary account may be used
by the contractor for the operation of the commissary, Including payment of
commissary staff salaries. All commissary actions must be done in accordance with
DOC Policy 302.11 Prisoner Commissary and DOC PoIIc;y.,302. 10 PriSoner Welfare
Fund. An accounting of aU Income and expendltur8S for this fund wiH be sent to
Alaska DOC monthly•

. Prisoners wiII·be given the option of ordering from the AJas1can Commissary. .
Contract staff wII assist will facllJtation of these orders. AIl..c osts of shipping, etc.
must be paid tOr by the pi1soner.
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C.

Telephones
. A minIraum of one teIepIhoae per ten prisonet8 is required. PrIeoners must be
8Iewed, Ie make-""
ca. at no expenee. A phone I8CORIIng system Is .
.NIQtInd•.M
~... etc. received teIaIId to prisoner IeI8phone usage
shall NmIIin.~ properly of the contractor.

.t..gm oaII8~ be. t8GOIded or monitored. ~ ~ be made for
~tD~·CIiIII·fromtheiratlomey. '.:'

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-t..a.ndry ......~ "provided consistent wiIh ACA se8Adards.
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".,..".. 0IIhIftg and IIems
The OOIttractor ~ deteiitdne -,e amounts and types of personal clothing and Iteins
pri8onenI818 allowed. Properly lost or dameged when In contlOl of the contractor
wi( remain the·" responeIbiIily of the conIracIDr. •

When ptIoners are I88ued doIhing, three 8818 ........1e8ued. aaIIing wII be
~Iaced when it wears out or if necessary for seaIonaI ch8nges and or special
purpose clothing.

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Food Services
Food' Services ". be provided consistent with DOC PolIcy 805.01 Food 8ervIce
~ 8nd 105.02 Food Service 8afety qnd S8n1i:1Ioo. 'Foad 88rI8d .. to be
aenendIy ~ to food served in Alallca. 11*8 muSt be . . . meals 88Ived at
regular'" durfng each ~ r hour peliod ~ no mont than fourt8en hours
between the evening meal and breakfast. The adueI R1IIIII schedule (or changeB to
the schedule) must be approved by the Diiacb of It'wIIIuIIon8.

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Special diets will be provided to prisoners consistent with DOC policy 805.03
Special and/or Religious Diets or Meals. The menu rotation must be at least every
four weeks.

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A registered dietician must approve all menus and a copy of each new menu
forwarded to the Director of Institutions for approval. Should these be disapproved
the contractor will be notified in writing of necessary changes. A registered dietician
or nutritionist shall review the master menus including modified menus at least
annually or whenever menu changes substantially. The Director of Institutions shall
.receive a copy of annual review rePOrts. Costs associated with providing dieticI8n
services is the responsibDity of the contractor.
During negotiations DOC and the contractor agreed ·to enhance the variety of food
offered to AI8akan prisoners. It is agreed that fresh bit wiI be provided at least 12
times per month. ground beef Instead of turkey least 4 times per month. and
cubed beef at ~ 3 times per month. The cost for this enhanced menu is inctuded
in the daly per diem rate. DOC and the contractor also agree that If meals are
provided to CCA staff it wiR be done at.oo add~ expense to DOC.

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G.

Facility Supplies

the contracIoi' ~ ..pIU'AtJe faciIily $OppIies which incfufiIas general hygiene I8Ins.
~.linens.
.

ofIIc8 ~ buldiOg cteanJng ~.

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The COiltU'ctor • .be.e"·!'Ie.ito·pRWi_·" on~. • ,,~o.

~"'.lIt of PriseReI' HI
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A ; I " •. d\t I ~.. II.
and .n.gentROcIBS8IYiMEIIoaI~deilb:ll.
and mental" &" . , . . WallcJfGlDi ·1
If
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1hoee . .Iable In 1he CQIIIRlUf1itv. The most COld· eiIfdve .m II ltd al1r1!l atI'neN tJ ....
MellllLllry medical Desds ... lie used. hoMMJr the pli.... y". . . . for q medIeIII decillan
shall be medical necessity and not oosl

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I t..., services that are NqUirad to allevlala pain and 8lII'8ring. ~ thoee plWGdUfl88
deemed necal.lryto aid In.Irwa eIlIing the level offundion f1RIUghouttIe ~•• IhlCe
·1IhaI be provided e.G. deBign_d proeIi8IIc.deYIces 88 appRJV'8d ta,... H..... t!kIrWcM
AdminIaLator or darVt8e· ~ Care 8eMc8s to intplOll8 COIfI1IIIc app BIrMCe.-:to II .tnIit
fundioning at kiMIIs not direcIIy related to rehabIIbIfion. services for con .~·tIuIt""lQng
8IandIng prior to ~ and not deemed-necessary to aIIeYiIIte f)BIn and sufl'Mig wit
nof be provided. (See Alaska Prisoner HaaRh Plan - DOC PolIcy 807.02 AttIIduIIent A &hat
defktee these services In detai). Experimental and UIlCOR'fentional
Mt not
perml? i do MedIcal &eMces ~ npt be denied If Itey are O8C1I I lafy to ....... a. ,dlill"" to
psrtIc:\'l E in or benefit from rehaIl8l11ive aervlces.lfthere an! que U)S& orell_ldll .... ~I.
level of eervIoe or auI1ortzatIon fOr aefvIces. Alaska OepaIIIHMt mComtaIon8 p n I • wII
pnwal.

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AI sarvIces provided by health care personnel olier than 8 ~ (Med1c81 Doctor or
o.I.opatNc PhysiclBn). denIIst. psychiatrist. p8)dloIogiat. optom8Irfst. podbLiat, pIt).iden'a
.118k2lt. or advance nUf1l8 pradIIioner. must be perform. panuant tD "'111&1 ad. . . .
Ii j , I r:.2iiiiA5441 Cui bact aJi4i81
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. ~ by personnel authorized and/or licensed to give such orders. Any judgment matters Will be .
referred to the physician.
Medical services and access must be available 24-hours per day. The contractor is
responsible for .@II routine on-site health care costs and procedures. Prisoners are not

authoHzed to pay for their own medical care. All medically necessary care shall be
provided by the contractor. A medical co-pay program Is required consistent with DOC
Policy 807.07, Prisoner Responsibifrty for Health

care.

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}he State shall not be obligated to pay for costs of medical treatment or transPortation due to
contractor error: i.e. retum trips required because contractor faRed to send x-rays or file
information with prisoner the first trip visit or in the case of contractual relationships between
the State and Health Networks through faBure of the contractor to adhere to follow the set out
procedure for notification of appointment cancellations.
.

Except as set out below, no treatment. ~ne examination or procedure may be
undertaken without ftrst obtaining the informed consent of the Prisoner. Informed consent is
the agreement by ~ PrI80ner to the treatment. non-routine examinaIJon or proc:edlw after .
being provided the rriat.eriaI faQts Je08IdIng'the nature. COnsequences, .... and allBm81Mt8
concerNng my proposed tnMdment,.nOn-rouIrie -.amInatIon orprocedule. hibmed coneId
maybetl... _.ellwlh&t~.~I""ef"'tN"'h'·fIU'C8MpRMder..,.the _I.1I
cordUon ar.. PriIDner (i.e., ~) Gr pHbIic he8IIh cOncima '(4 con
dlee. . .) nicJ.*e inuRedi8te int81veIiIon. or ~ the ~R8oner,1ackB.th8 capadIr to Pe
coneent as determined by a ~"'tnfOrmed Md· doCurnei1ted refusal is requIMd
•
nMJp8CtIveIyfor~.~ In ~ h ~'ofthe prisoner may reSJIt In a , .of (j8'" or .').
serious medIc8I consequenoe illrjudged. by a'liceRsed phyaician.
'.

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The conhcIor shill ha¥e In pIfIce, 80 days aIer award, the admInialialve'conrp
Md
operaIionaI JIQIicie8 and ~. . MCeSSBry for conIinuing compI8nce
~ ..
epeeIicaIIonsand ........ lWICeof. . . .'Jllmn8lalus. The ..~.II~noc I
·~
review and approve poRcIas and procedures of the C01'1InIcb' in any 81888 ~ the
performance d its responsIbIities under law.

..

. The cordracIDr shall be IMpOnIIbIe far 8I18UAng that lis 8Iiafl reports fnf problems andIor
unusual Incidents to the ~MIca DOC medical dRctor or desIgnee.'ThIIIricIud••, but .. nat
••iISd 10 medical. aect.riy-reI.-t and pe11IOIVl8llssues 1hat might adver88tr Inl..enceu,on
the delivery of ~ ~ seMce8. Ih8 contractor shaI notify the
D9C
8ervices AdmInIsIrator or designee wiIhIn 12 hours concerning aI cas. of serious ..,.. or
injury. aI hospitalization and aH deaChs. Contact numbers and meIhods wII be ftnelzed lit the
time of the contract award and wID Include telephone and facslmle numbers 88 well. e-mail
addf88888.

"J."

."11II( .

The cordracIDr shal alsiln a centRII oIIceor regIon8I menagermedlcal pUll I li0nei whe.....
be rwsponeIbIe for monitoring the performance of all health cam personnel rendering , . .ent
care. ThIs peraon 8haI have tbe cbct auIlorIyto solve admlllisbalve and oIherope,tIonaI
problems encountens.

83

(
,

..

•

)

.During negotiations, DOC and the contractor agreed that all decision making related' to
medical services will be made on-site at the lowest level of authority possible. If the decision
must be moved upward to a higher level of authority it will be done as timely as possible•
Contracts & Reimbursement for Off-site Medical Services

1)

Provisions must be made for prisoners who require radiology, consultant and/or
physical therapy services. All contracts for which the State of Alaska is responsible for
payment must be approved by the State's Health ServIce Administrator or designee.
The State reserves the right to negotiate directfy for services with convnunity-based
specialists, hospitals and health "mai~i1ance organizations to obtain the most
favorable rates avaBabie for care. In the event the .State chooses to exercise this
option. the contractor agrees to assume responsibiUly to assure transport and access
88
for these off4e specialized seivices and In-patient hospital care.

requH:ed

AddIIionaIIy, th!t State JhAtII got.be oIIIiaatI!d to reimburse Q1e contractorfor' prooed&lI8S
or consultations deemed -UM8C88Smy ~r ~ based on pnwaIIing
community medical standards. This Includes" 8ft expertmefflBl treatments, non-FDA
approved utlHzaHon of phannac:eutk:aI 8nd oiher medioiaI II trillventions that aN not
-1ppOfteId bY 8\lIdence ~ medicine. ~IIIB ~ IJUt are Rot Ii,,"d to:
AouCine endo8oopic screening for tnNItmciIInt with PIoton pump InhiIIIIIrn. hnJaI
.8CI'88I'Iing' chest x-rays for aaympbnatic IMN80IIB wIIh"prtortlub..ootfordl•• Ii.e ...a
podIve PPO. Ba88I1Ing InIerventIons that occUr ot.!Islde oUbe recommenddona of
Ihe ~ PJawnttw SeryIces TIIkfqpe-(moef I8C8IIt 18ComInencM1b1s) 8Y8Idlla on
the"wortd wide W8b at: ~mpllll!lJllll.. Upon request In
¥ding from the contractor to th8@sH8dh s.vIces ~8101'or DS••llee.
may ~ on a case-by-case review to consider a waiver fortha ~
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intervention and/or medication utirlzation, which may be granted on a discretiO~ary
basis. Both the r8quest and approval s.hall be in writing with a copy to the medical.
record, induding the DOC decision process.
The State agl:8es to reimburse the contractor monthly for the medical services and
expenses for which the State is responsible under this section. The contractor shall
provide invoices to the State for such costs and agrees not to add additional
administrative charges for reimbursed costs. BlUings for medical services are to 1ncIude
diagnosis and explanation of services provided. This Includes in the case of
noncontractual Health NelY«xk billings, "'Proof.:of-Service- documentatiOn consisting 'of
procedure reports. lab and radiology reports, pathology
arid hospital admitting
and dlschalge summaries. El118Ig8ncy Department reports•.etc. These shaU be sent to
the Inmate Health Care section at the Anchorage Central Offtce and fled in the medical
~rt. No paymeat
f8II(jered un8I this InforRl8tion has lIMn receh'ed. In
the instance Qf Contractual Health Network. the contraoIor"U be reaponaIJIe oi1Ivfor
88SUring receipt of the pertinent medical Information and filing it In the medical chart.
They wII not be responsible for pnMdIng copies to the AIBsIai DOC In theee In8bInces.
.
..

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au

rePorts

shall_

Rlfsnal9fthe Priaonerfor~orconsultatiwtaerviceswll
be ~BII.to.\I••ka
DOC g. appraMif . _ ; 3 .~ days of ..reaM. For UPg8IIt (non .........d
.~.I' n:~),.~· •.~l~or:.~~I.·hiU"'.·.~
. .,.

wit·.... '••••.•4:~,

.... ~le'u1arl~.I"'''''''~.Th8
·Prowide:·..··.....ary

.... Its pIioItly f;JIf'" 'niiid8d service

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8I1u!Jb1fi8d medial judgment can be made to appIQY8 ordeAythe
.h~~
.
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iCan ••ilefs...liffICUitY-... $8Cified 8tw1i!1h~.D me .~ ~ ;'. .. ,,1 £:: .' C.)
• &I·i·~i '~tii6Dr i,h-i.jg·~_uDOOC.•
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• lJfvaHt· will need 10 be .seen wIhin one week

3)

•

~ -:".,.. need to be seen within one month.

•

Routine - wII ne8d to be seen
wiIhIn
.
. two monlas.

•

Other - As epaclied by 1he requesting medical per8OI'lIl8I.

•

Prisoner Health Grievance Procedure

~

Prisoners ehaII be aHowed to file health grievances with Ihe contractor's SI8ndaIds
CompI8Aoe 0RIcer. The contracmr shall ensure that ·hlllllh pr.108 forms are
8\iIdDble and that grievance proCedure8 are po!'E.d In aI housing unIIs.

The COIdladDts medical department shall respond 1o
1C88 reg'&Ird11tgllfMl.c:aI
Issues. The ~ctor's 8taAdards CompIIence 0
8hII foo:Bd a . . . .
grievance. the mlMllcal c:teper_ti8i'1t 8ftBr It Is r&COIded In the •. ". l:a Unit PililHer
grievance IogtIook.

65

AliiI~
........:"1

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All prisoner health related grievances must be handled in accordance with DOC .
Poliet 808.03 Prisoner Grievances. 807.02 Access to Health care Services, and
807.07 Prisoner ResponslbHity for Health Care.

4)

Infectious Diseases I Infection Control Program
An infectious disease program must be in place to monitor prisoners with HIV, TB,
Hepatitis (All types), etc. AM instances of reportable conditions ordiseases (DetaIls to
be provided by DOC at the time of contract award) as mandated under Alaska State
Law as reportable to the Alaska Department of Health &. Social Services must be
reported to the Alaska DOC, regardless of the. requirements of the oontracto(s State
Department of Health.
.
HEALTH PHYSICAL PLANT. OPERATIONS & LOGISTICAL SUPPORT

B.

The contractor Shall provide adequate clinical space for the efficient functloniog to provide
care for the number of prisoners housed at the facility. Beds In the Medical S&.gregstion
Unit wi! be incre88ed proportionally as the number of prisoners incr9ases.

!«J

The 8re8ls providing priepner heaIIh must be secured ~ a CQnIroIIed door.
11' .... be
1imIed. NJ~ wIto ~ '.IVled to work in ~~~ ~ ~ . . ~ bifDM
leaving the 8181I. A~ must be In. place to ~ for'.;a co1d1. .Id.
0"

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must".......

.

CorNdionaI staff
to the . . '(i.e. 4sIigneted medicaf , '
medIc!aI staff and ob+",~8Ion di8pe~" ~"'l ~., ._~,
,seady staflfor 1bis ' ~ .... be ~.. ,to - - " ' : eidt alii. schetJUI. rJ . : : : : :..
.~
atIDn. . . . "ri.i ."JIGr_e.QrMIr 1Pd81i••:··
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,Medical 88g18181on UnIt
'.

1)

At. Ii
~1IdIor shall provide for a four (4) bed ~
88gI8gaCfon ,UnI ,~ ,in close prOximity to or . . " ,the primary dIAIc81 aula).
These becIa niU8t have 1he necessary heafth ~ staffing to monIOf: pMoAeis
housed there. Ills not intended that these wiD be uIIIzed on an ~ . . . for
~,iII ~ or those who are chronically disabled. raI1er for alJI.nalon and
short-term i'n8nBgement pre and post procedures and simple stable IImIIed inedical
problems such 88 IV anIIbIotic? administration. Seriously II prisoners requiring regular
24 hour i...,.. monitoring (regular nUfSing. i.e. 2 hour vi&aI . . . Qr 11'1_10
hquency) for mont then 24 hours. shaI be 8S88888d by the •
for
~ of INIInfenenoe In the unit or need ~ trana"~ to a
The
facility must IBM at ....'0n8 (1) negative air pr8S8UI8f iIoIdon R)QIft In the unit. Nt
prIeonens requIIing 3 (Ihree) or more conaecutive days In thiS unit must be repoIt8d to
the HeeIth semc. AdmInJ*ator. An electronic log (I.....SpNalllaheet.or ,......
d.ba8e) of 1r611181Y '.'sUon rilu8t be iR8InIahId 10 1nc:Iude. . name ef pdeoner.
unique idelllllclillon....,..... diagnosis. dates ofstay. and dIspolllon atdI8ctwLge·(J.e.
general population or hoepItaI admission, etc.).

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RFP... 1&-a88-45441 01

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81
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...
Transportation & Security Coverage outside of facility.

2)

The contractor shall provide security and transportation to and from the faality for all
scheduled medical appointments, court appointments, and emergency medical care
(including ambulance and emergency air lifts), at its expense. The contractor shaH also
provide at its expense, security and transportation from the faality to and from a
designated airport utilized for transferring Alaska prisoners to the contractor. Said
airport to be agreed upon by both parties.

0
~

The State shall be responsible for out of facil"lty medical costs in connection with
hospital admissions to a hospital or long-term care facility. The contracb" shall bearthe
~ts for security related to all ER visits and hospitalizations, regardless of duration.
The Slate shall provide transportation from Alaska to and from the designated airport
and shaH be responsible for all costs related to this transport.

If the State enters into a apecific contractual relationship with community heaItIl care
entiUes, the ~ shaII.seIectiveIy utilize U11s line of referral and coordinate care in
the scheduUng and refemd of AIa8ka .prisoners.

..
.
the ~ or aubcon1rac:Ior is working 40 ~

FuII-tIfne Is defined to mean
per week.
These are referred to as a u.time fMIUIvaIctnt (FTE) positions. These hoUrs may be
accoenpUshed on·a ~•.schs. . . to. maximize efIicI8ncy. Contractor 8h8U coverperiods of
abs800B8 caused by vacaUon8. hoIideya. and·1ick leave.

If sIudents orInterns are utilized. they must have direct supervision and not work beyond their
level of training-or abIity. They' may not be' counted as FTEs.
", ~

Mfr*oum S1affing Levels.

The contractor shall provide the fuR complement of the foIowIng
medical. dental•. and mental health staffing levels.
.
.
. The
diem rate ofba8e compensation in this Connct8hallieftlctthe mnmum coqIIement
·of staff as stipuIat8d in Appet" F. ThIS includes the number of F~Tlme EqI h Blellls
(FTEs). the credentials. and fie tMtbution of sIaff. The ooMactDr Is Aleponsible for.....tng
that aI the requIr8d .....81008, "'818 and ~ usocilled" 8Ie opdi I .. 8i8
8CINe and in good sIaIdng, All plDOl'mel supplied by" collbador wII be ",""II Illy
IIoeneed In the state d Jocatfen of AlIi8kan prfaonens. In each case. u.y mull ..... an
"'urwe8tldBd 1Icen8e: l'hI* Indudes but is not IImbd to medical. dental. phy8k_I"i~ t 5. at.

per

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.nurse practitioner. nursing and other licenses. DEA numbers and registration with the
appropriate State Boards. The contractor's contractuall8lationship with physicians. mid-'evefs.
and dentists shall provide for support of Continuing Medical Education (CME) activities either
by direct monetary supplementation or providing paid ·compensatory time-.
The contractor agrees to provide 24 hour. 7 (seven) days per week access to the
contJ'acto(s Medical Di~r and/or designee and the contractor's Regional Administrator
and/or designee.
In the event of a health care vacancy. Contractor will provide the State with the applicable
salary infonnation for the purposes of monetary penalties. Computation of health c8re .
vacancies wiD utilize this information for assessing monetary. liquidated damages. (See
Appendices F and G).

The following credentials shall be on file with the contractor on-site at the facility housing
Alaskan Prisoners. Access to and Copies ofthe items shaH be provided to the DOC upon

request:

•

Cumri protessionaIlicensure

•

•••IWIC8'Cov8rBge and cui. . '-'1 (pRor 5.~)

• .s-. Controlled Subetance'recJilflaIon and IlEA ~n
• EdIii:....,.., I Training: Medical ~r8duat8 sChOd. intemships~

residencies.

felOlallhip. other clinical bailling, Fon;lign Medical Gr8duate
.'
• 8aafd 'CerU(icdon (Specialty) I ~aIe tnIIninsi CedHicaWs
pradilianer
Data ~.. " .
•' .F~
of StBte M8iItcaI '.,.." , '-. ~ }" '."

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SIgBed
fJomthe _",'.t.
ujH0-dat8 ~ or~ viae .

_.tation

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.

Medical Staffing Vacancies. The contractor
the ...... 19 pain 88 ouIIined ~. . F
~ thirty (30) days of the seMCe ~ date.• The oontIacb" must mall"'''
specified staffing levels throughout I1e term of the contIad. For. 'by'positIons- to 8A8Ut'e the
drlMNy of clinical care which ~ defined as ~ ~~~ ~ DAcWr. ~ '
AdmII_ator at the facility is 1.0'FTE or less, these;JM."Ii'b,. must be covered at aI tinie8 as
reql*ed by the staflilg pattem or by QfI18Itime or loCum lenums. Any vacancy in a Illy
such as that which occurs by.resignatioit or temlhlllon of. person on contracto(s ~. ahaN
be flied by conInIdDr within one hundred twenty days (120) with a peI800 placed on the
contrador's payroll on a pennanent or long-term basis and who is approved by the DOC HeaHh
ServIces AdmJnjstrator.

PoeiIon

Foral either positions ~ clinical care, which are deli led 88 physiCians other'" thoee
In My posIIiona mid I8WIII and nursee. these' po-lions must be covered at all times 88
I8qUIred by the siafti~ pattern or by overtime or by oontnIctor ~ assignments among
other sIsff. ProvIded.~. any vacancy In theM
providing clinical care..ch at
that whidl occurs by resIgiaation or termination of a 1*800 on contracto(s payroll shall be

po'.OilS

ftIed by the contractor within ninety (90) days by a penJOn placed on contractor's payroll on a
permanent. Iong--term or ternpor:ary ba8i8 Md Is approved by the AK-DOC:
88

,"

.'

,

.

As to positions for staff not delivering clinical care, all vacancies such as that which occurs ~
resignation or tenn~nationof a pelS?n on the contractor's payroll ~hall be filled within sixty (60) " "
days. In the meantime. these positions may be covered by overtime. temporary employment. \Jj
or by contractor adjusting assignments among other staff.
If the contractor faDs to fill a position as required or within the speclfled time-frame. the
monetary liquIdated damage shall be equal to one and one-half (1 %) times the dally
value of the salary and benefits for the position for each day the poslU~ Is not flied.

D.

MEDICAL DISASTER

The contractor wfU provide a disaster plan. The Medical Disaster Plan shatllndude. but not
be limited to the following:
•

Communications sysbm1;
RecaH of key staff;
Assignment of health care staff:
establishment of convnand post;
Safety and ~ of'1M patient and staff are 81;
Use Of 8merg'Rcy"'~'ij .•ment and SUpplIee;

•
•
•
•

•

•

Establshli~ Of a tdIige ar88;

•

Triage procedures;

• Medica:I recants -' identili.c Hlon of injured;
Use Of a::&' d?,~ Jle~e.s:

•

"

Tl'IlmIfeI' of Wi d ~ kJcaI hoer'als;
EV8Gu."~.p"u~~&J_ (to be QOOIdilta&ed wilh.aec:tJIIv penJOM8I):
Pr8dc8 drills .
.

•

•
•

.P8r89r. .. at . . oller iR r.'"' !Mons sh8II be ready,.r MOSII8IY, to &lIBilrt the
Iliperiendng"~ICY.

o

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....

insIIII.-on
:

CONTINUOUS QUAuTY IMPROveMENT {cal) .

Eo

The conIrador sMa InsIiIute a program of ContiIwowa Qrnll¥ IrnpRMMnent. (CQI) aud
Professional Peer RevIew at the contract site. which wII indude. but not I;HiIimJled....dits
.-1d medical record nMew. Physician peer r8Yiew.... occur no IeIB ......,.fiii,..
NCCHC standaIds. During negotiations, CCA's CQ~ poIIcywae aPProved. coPIIJl .. ,..~
the requirements described herein. Within six (6) months ofthe service comrnenc:emeilt ~~
the contractor must provide evidence that a CQI PNgiam Is in place to inclUde mtWltlily
meetings of the CQI committee. The COl program must InoIude 11mb DiOC9IIl aNI gfcppA
B!dIII and must .cover sa aspects of care.proWdid. The CQI program must
nUlldi8dpIInafy COI11R'IiIlee8 and must involve aU he8II1 care . . . during the c
year.
Mortdly nMew aild evaluation of off-eile cana must come under 1he scope of the eat
. program.
The contractor shall perform monthly medical evaIuaIons that Dck certain slailies 88
-deflned by the Health'Services AdminIstrator· or dnlgnee. Formal
a
etanctardIzed data entry sheet I1at focuses on ~ q* ! I 18 and CQlIssuSI • oocur

-audits".....

...... '~/centl8Ctjii4ih
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.:thrice (3 times) yeat1y. The parameters and format will be provided following a discussion
between Departmental and contractor administrative health personnel. Fmal approval shafl be
by the Department of Corrections. Parameters evaluated shall indude both process and
outcome measures. Department of Corrections wiD perfonn similar audits at its discretion. In
addition, The contractor shall conduct quality assurance procedures Including chart-reviews
by nursing staff to assure that practitioner orders are taken from the charts by nurses,
necessary follow-up care is provided. and medications are continued as prescribed. A
physician (site or regional medical director) shall conduct chart reviews on a regular basis to
review care provided by mid-4evel practitioners and nurses. At a minimum. the physician shaI
review the monthly percentage required by NCCHC standards/state law (whichevef'is more
stringent) of charts of prisoners attending chronic care clinics that are evaluated by mid-ieveJ
practitioners or who were rendered emergent care by mid-levels.

The contractor shall establish a Ub1ization Management Program foroff-eite referrals including
aub8pecIalty and inpatient sta~. The Program must incfude norH.IIg8Ilt ~ preoertJfication. wgent hospital certification. concurrent review. pmspective denial. discherge

planning and Prior authorization oftalget8d procedures. The lJfiPzetIoh MInIgement progrwn
must demor"all i'! 1hIIt ace'" to seMce8 " appropdaIe Wld...Jl!!*. Included shall be
ael8sIIment ()f apprOpriate follow-up foIowing hospitafl28tions.
.

".1

;.. r. . .·I1I· t%handpNsenUo.the~Bt(8DOCHIII . . SeNi:
iiEra
*V"N di ·'·'~lIn fortin81 appRMII. The Alallra
rmed.8OOft . .
fa iii. I..... ~ ~ 1$.. ItI1!gtRlBIS'gf ciIcuInBnces and nolErfMn 24 heulS .........ul
The.• '

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a heaIIh 9118h1ati:on'af 811 ~~~.' in .:DJ ' •• nee wi1t18Ie
bDmriIsion on Correction8I UeaM" c.. St8'd;;'ds for HI lila serw:e. in

ciliAl:i.Cb..... _

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(88 ftFAIBd). The conIractcN" shIiII proYjde at a

1'IIh1irRum:

All 1ntake8
Physical ecamin8tioI:'. cIirJicaI tasting (~ and as medic ally indIctzted) and
medic8I .-xi dental dasllication aoC:ooIrig to .cOndiIion need end WOlle c:spabMy.
Indud8d wII be the MCOIding ofweight.·helght. blood pte I lure and temperalure.

2)

Intake Saeening I Physical Examinations
Cor*actor
ptQVIde Intake saeening as soon as pc sBibie upon arrival. but not longer
than 72
PhyaicaI exams• • &ppIqJI'i8tIe _ .... eB/ sick CISII i.lues. and
chronic cInic ~ fII1PIOPrial8);'wII be pnMded In ~wIh NCCHC 8IIIndards or
88 dalsSlni..ed by the facility physician. M1ichever s ....d8Id Ie higher.

3)

Emergency Care

Emergency transport must be available within 20 minutes. A written mass casualtf plan
must be established and annual dnlls conducted.

4)

• .

Age-Based & Clinically Indicated Testing

CCA will provide laboratory and ECG testing when indicated, based on evidencedbased medicine. PPD will be given upon intake and annually utilizing the U.S.
Department of Health and Human Services/CDC guidelines, titled: ControHing TB in
Correctional Faalities. The pneumococcal and influenza vaccine wli be given to high
risk prisoners. '
.
5)

Provision of Health Education shall consist of the following:

The contractor shaD develop, subject to Department approv81, a personal ~
education program minimaUy utilizing posters and pamphlets. To fufther this Rteall•.
educaUon proCess, formal sessions shaH be made ~Iable based on the •••••ed
educational needs. AD program materials must be provided at the appropriMe Ikracy
level of the indiYIduef pri8oner. Program materials wi! be provided to 1h8 DOC II1I.1Il
Services AdfUilMator for nMew, upon requesL Salacted topics for Uta. illlii'DnS
may Include, but are not limited 10:
. . .:.,..

• Otielilllllon to It! w.8aMces and acc::ess to heall. care
• ~hygiene;
• Str8a manag8ment;
•.'..
• .Tl.tbcIRUosIs~ hilP.Sr and other infectious and,communicalM·...IJs8seii:;:. ;; .

• P1ouWitioA oftlv IiiedbtJ and.otherseYl1aiy**.JiIed"~ii.lifMI~
•

Diet,•. :;

C)

.."'.:" '.-:' ~

•

.

• J 1)~.·aRd ~.c dil8888;
. . . . '.
..
• ~~._ *:Ot~m UiBe'8nd eff8cts of alcohol and ~ ."drUg 'Use;

• ~ 8ffeds ofPhJak:al adiYity and a haaltlrydlet;

• . p~ qf del. . tn;I periodontal diseue;

G.

Primary MedIcal Cafe
,

The contractor shall provide 0I'Hile primary and preventive heaNh care aervice8 in
accomepep wIIh the NatiOnal CommIssion on Correctional Health cam SIBAd1Ird8 for
HeBlh SeMces in Prisons (2003 EdiIion, as updated) at each insUlution cCMMWf by this
agllSment. The Contractor ahaII provlde on-site primary health care and ~

,

services to include the following:

1)

~

.

Triage and saeening:
The conbacb'a IN!dicaI ~eI (an RN'or higher~ heaIlh plo" BIIDI'" ahaR
8Cl1IMNl ~ requs. for heanh C8f8 within 24' ~ of recefpt of auch recr;e , to
.dlleniJlne wheeher a prisoner needs referral to nUlSlng sick cal or be·8X8InNd If
IndIcatad by a mid-level fDditIooer or a physician. It It is <WermiMd fronltM IIIpw
ecreening oratnU188 sick cal thatth~ priSoner needs an ~ bya ....... . padltb _. such examIn8IDn shall take place wtI*1 72 hours at the AiIC ilp' at the
wrIIen request. or ~ if necessary. The time. dele. and eIgnaIure of. . m.·
1

Ii i .illlUlIOO t&..IIcei..... :IIIS488.
.. ' .

....

,,'

71

..
..

AIiii....... ,·;~...
PI I II, t

.'.OW:"

••

7

•

(

..
•

personnel who perfonned the screening or sick call and any examination shaI be noted
on the Prisoner's written request and the request shall be placed in the prisoner's
medical record.
Any unresolved diagnostic or therapeutic problems shall be referred to a mid-level
provider or to the physician. Any prisoner presenting for the third time with the ~me
unresolved complaint shall be scheduled to see the physician at the next sick caIJ.

2)

Sick call
Sick caD must be held daily and conducted by a physician nurse (RN) or mid-mvel (PA
or ANP) within one (1) day'oftheir request and shalt be available exclusively 10 Alaska
Prisoners at specified times which are posted in Alaska housing units. Nurses must
follow estabiished protocols. If pedonned by a nurse and referred to a mld-fevel
provider, they must be seen with three (3) days of the referral. If refen8d to a
physician. they must be seen within iiv8 (5) days of the refemJI. Any prisonerpr8MN1fing
with a peI8Isting or undiagnosed problem or complaint three times to health per8Of1f1~
must be refer'I8d to a physician for evaluation. A process must be in place fer the
prisoner mrequest care as well as a process for referrals from non-medic8I8IiII. AI
prisoners Pl>8BSnting IlI88 (3) timeB with th8 same unresolved COmp&BAl JbII...bsl

au

~"" •. ~ ._ _ 48 (forty4ght)1IounJofthethird ptaseollatioRor.seoner

deperdRg on ~RiD8t: • • ation•

. 1l:l&COidl~~8~~~."'·~""beconduc&8d bya physicianorol1er

qu_ad·"~:WOJmel.TlJ!I ~.miRImums arv: .

,

:):

Sick cal

.. '.

':

.

. ..

·.~-rln"'URe"""".'of"'--•
•

Pil ·i~.•~... .,~ ~.~. fd~·~ • . ·.m~"'··~"{?2ftounsOf"""

PrisoI.. mtMtliJe seen lIy phy8id8n within 1'20 hours Of 19femII.

II"".

Hou8ing wi .. lment8;1JeognIm alllignmeldB, ~"y Mil
and bnlflrsmor
from faelli.8 ftIg8Iding any Prieonerdl~as hIMng a significant medlcld "s••
or condIIon must b8 approved by:responaIbIe heant. care personnel. H8IIIII C8r8
personnel may only disapprove such actions for sound mediaII reasons. SB• .,.aon
for non-medicaIIy YaJid reasons Is not psun:lttect ·AlIDIdiiII S8Q!lQalio..·.... be
recorded in a sepalate log that includes name•. idenIfyIng i11formation. d8teI and
reason for segAIg8tior:J. 'Review and evaJuation of this log shaft be included il1he CQf
program described herein.
3)

Post HospitaIJzation and Emergency Room ~ation

. ~ regardless of cIiftIcIII diIIgnosis who are tIanspoIted to an outIId8 hildh
care facMy on an emergent bI1eIs (eg. EmeIgency Deparlu. . ., ambuIIIIory care
centers. day swgery can'" or hoepiaIl) roost be 8Y8Iunlll d .. soon 88 pc I . " upon
1heIrretum by whomever Is avaIabIe(RN. UP, or~). PriIonef8 being_lllllled
from the hospital must be seen by a ~. and If not seen Immediately they must
be seen at the flr8t avaIabIe appoIntlneftt poI8ibIe. DocumentaIion of this evalUIIIIon Is
mandatory and must dated, timed, and signed by a physician.

72

F1InIM•••1*• •

.

.

·

.
'4)

Non-Medical segregation Units
Procedures must be in place to ensure that prisoners are given a medical evaluation at
the time they are placed in segregation. Thereafter. rounds in areas of segregated
prisoners must be performed daily by medical staff. An area must be avaHabie to
provide direct supervision of segregated prisoners if medical or mental health
conditions warrant Restraints may be used only if authorized by the Warden and the
Facility Health Care Authority. A higher level practitioner (mid-level or physician) must
visit the "Iocked-down- areas of a facility at least once each week.

H.

•

0

SECONDARY MEDICAL CARE SERVICES

The contractor may be required to make referral arrangements with specialists for the
treatment of those prisoners with health care problems that may extend beyond the primary
care services provided on-sfte. Alternatively, the Alaska DOC may opt to contract directty for
these services. The contractor agrees in these instanceS (Direct Alaska DOC - Specialist
contracts) to-seleetively refer and utJHz8 these services. AI specialiSts must be Board CertIfIed
or qualified in their respective specialty.
.

M ~ ..~I;.~. imIoMng any speclllll.O(~"'" or. ~ Wowup'" be
COI1II1IIIftIc' 'It':h l ....b.untheconlltllnh..... pdit&Yca8ph)lfi:ll:n·Jb.tinMt,. 'j_
ot UI8 ~ ~.8dMty.must reauIt in a 'ef;blel1NJOflln the prieoner's rn'edici1II NCOrd
wIIhIn 72 hOurs Of the ~d8r. When a patient is returned to their resident 1netiUiOri, .t;e
contilictor must pI8ce a Wi• • report in the medical record based upon a discussiQn wIIh the
. off-eIIB consultant that contains the foIowing:
•
•
•
•
•
••

Re8son for the coneuJt (subjective)
ApproprtaIB ~ findings (objectiv8)
DIagnosis (assessment) Incfuding specific recommendations
DIscharge plan(s) as appropriate
Follow-up appointment (if necessary).

•

~

.

TER11MY IlE!DtCAL CARE SERVICES

~ .... be rellf)Olllible for assuring ~IiIBS to aI neceesary hoepIIaI and '00I*IIt8nt
I8Mcee for prIson8r8 8CCOIdlng to any agnKWI'Ient that the Ala8ka DOC n&gOtIates will an
outside beaIh enIly. The ,DOC wII be ft8caIy -I'88po..' 8Ibl8 for all hospIaI and ooneuIIant
88rYices. The 00I*acb'''' be r8IIpOn8IJIe for aB traMpOridon and 0« 8iIa security. J:he
~IIne'for _ _, ~..ement must compIywilh the stJpuI8Iions MtvLtMlld
i2ii128ll4IM/0idii..a5iii1
Iiiii~

=

73

,

FIal.... Ill.'III'_

\

..

'.. by the DOC Health Services Administrator or designee orpenalties will be imposed, (Up to tmd
indudlng non-reimbursement for bilHngs that are tendered beyond the 12Q-day limit from
service delivery). When the State has a contractual relationship with the entity providing
elective health services that directly btll the Alaska DOC, the contractor is responsible only for
obtaining pre-8uthorizaUon for services and dlnical foHow-up but not for biUing. The contractor
shaH preferentiaUy negotiate with local health entities in the event that the Department is
unable to do so or maintain a ·prefe(T'ed· provider relationship with a health entity that is in
dose proximity for the purpose of emergency transfers. If it is not possible to negotiate a
competitive rate or other logistical problems occur. the contractor may negotiate with other
health care systems or hospitals providing a simDar level of services. subject to Alaska DOC
final approval.

.

J.

EMERGENCY MEDICAL SERVICES

The contractor shaH be responsible for health care delivery on a 24-hour basis. In the event of
an emergency•. Health Services. staff will be expected to provide on-slte emergency
interventions. All ambulancM u8fizwt shan be equipped with . . support S'jMoms and sh8fI be
operated by personnel trained' In life support that are calfiad by the S1ate. eX location.
COntrador ahaII be
for atf emergency tIansportBIion and security C08I8 and will
000IdfnMB all emergeRCy IRII
with secuttty :.... ·:In any <:Me wh8I8 the Shift

f8SPOI'"

. . . _ I lM _thatan ........... m..... lsnllot18Rd.c.;..ot
baM to tM tnaa6:Jn·•. lnlli.-y•.appIopri8te m~~&Ji.". Le. ~A.Illft8. i1tne
practIIioner or phY*faris·.lIIi i I ·at. render imrnediete heIIIIh care to the prisoner 8t hisIher
CorI.bLR~.or~!

•
..-",

,-)

.

current 1ocI!tIion•.
. .

.•..y

'

1'".

DOC 1IMII'~'_~onsIII& fOr all ·rnedbiI costs and ~ I18t are ~ and nilize
IoCII A!*'JYRl8L
.
.
. '
.
'.
. ,
.
Th8.~"'~.~.~ ~ "1l~7t .~.~ an emeII~~. ~ C?M.in ~ .... Me ..
IllIeryenloAS' dIn 54. . . ·by M.lCili1J11iI CaR:Iiac l.:ife St.pOlt·'fi'ClS) ~ . 1M MelJbll ,
onou or ihe r .,~~II~.
iM must be ~ .CAlU.liI (up-fo-dIIla) and ~ tcensed
. . . QM . . . . . . . .k·OS 'I~LRSuppoitcl2.ed~).Thein .:Ionwll
conduct 8ft lII&1ilounced '"mock Code"' will complete cIocume: tstion at J88IIt quartItty.

'.

"

.'

aattt,1

ContmcIor .... erlSUf8 av8II:bIHty of emergency hata,WWlt through pnMIetennined
arrallgefR&11IIi and ~ dweIop'a plan and agreemenfB with off~ faclilia8 for . . . . . of aU

The

emecgendea 1hat CaRROt be lru'sd on-site. AI ~.de. requiring' a "911 Car or its
equivalent WiI be .~ to h DOC Health 8ervices·Admllli. . . or d• • • • t i l 24
hours with docufn8ntalien that includes the elapsed time bRtlln the cIIiI rar ••• htance and
the arrival of trained personnel. An 0IMlite log of aD such caDs wII be maintained at the facility
for review by the Alaska DOC.
.
'2

NOTE

Required Follow... on Serious' MedIcal Concerns:

"

& prisoners who are hospMaIlzed must be seen by a phyak:I8n. UP or RN km... IIJrupon'
return to the faeRy. If Vle prieOIl8i cannot be'seen ImmediaIIIIY by a ph)Wci&n. he shoukt be
seen by the phy8Icfan at the first avaBabie appolntri1ent posaIbIe.

74

.
.ALL

prisoners sent to the Emergency Department must be evaluated by an RN.
physician as soon as possible upon return to the facility by whomever is available.

K.

LtP or
•

ORAL HEALTH CARE PROGRAM

The contractor shall develop and implement an oral health care program consisting of
diagnostic. preventive. restorative and rehabilitative services. The oral health program shall be
directed by a clinical dentist with proven administrative competence and preferably with
experience in a conectional setting. The Dental Director shall plan. organ~. staff. direct,
evaluate and represent the oral health care program in accordance with the .eveI of care
approved by the Alaska DOC. The oral health program shall provide for the basic oral health
needs of the prisoner population through the diagnosis of existing oral conditions. services for
the relief of pai~ and elimination of infection. preventive measures to avert the need for
restorative procedures. to maintain optimal oral health and to restore adequate ~nction and
rnastfcation. Prt80ners must be screened within fourteen (14) days of intake and provided an
initial exam sixty (60) days after screening. .

care

Emergent services ~ be provided within 14 to n hoUrs and routine
within 60 days of
~ prisone(s reqti ast The provision of these services shaD be priorftized In a
that
8pproxImates the fuIIowing:

•
•
•

'manner

Emergency serwlcea for the relief of pain. b1eediag•. hlfedb1. trauma. etc.
DIagnostic ~ and ~cumentation.
.
Essential ~. rs~ llnices. .
. . '

• 1OOt
CoI1seMiIv8.bjs·'):Qot.oflMperiodonUumto
Include
oral hygiene~~aad
.........-w..'
. •. . • .
. .
.
.. -. - .• - . ,'..,..........

•

•

.'

~:.. ••,'

O·

";'>~~

CortIervaIMt IeIbBIiYe
seMces
employing 8I11IIIgam. composite
and_I'
- "Sis i8t8eI
.
.
.
'
':.
'.
.
crown proceduNs
-. • I . •
Prosthetic-appian;' neaeulJryto replace the jncising and masiiCatif~~.·
'.

;.

~'-"

The contrador &hal be Nepal I~ for maintaining the ~lg oral huIIh 8CIIiFi _.t~:id88I
working order: the -pRMslan d supplies and materials to ~ a functionlliV -_. iiltioo;
ensuring compliance WIb<;>8HA8IBndan:ts: and providing quality services at a level oonsilltarlt
with local commu~ ~dalds for dental care.
.

L

MENTAL I-EAl:rH-SEfMCes

The contractor sh8II 8S8URt that-mental health profeSsional services are avaIabIe and Shall
ensure that if it Ie ~ that a prieoner Is suffering fiom mentsllIness or Is -in need Of~
Immediate mental health care, the prisoner shaH be referred for~and diagno8is by a
cfll1lcal psychoIogIM or psyahiatriat that meets state and/or national eel Ulicatlon. A PsychIabist
shalf be on caR 24·hot~nH:IIIiI¥, seven days a week and present on-siIe on an as needed basis
a minimum of 16 hotN8 per week.
. Mentally 1ft prisoneis . . . be dared psychological or psychiatric tnIaIment If a ·h..... care
provider, exercI8ing onInary .... and care, concIt Idee witt f8BSa--iabIe medical C8I1aInty that
the priBonef'a ~ ....,. a MIious RI8I1ta1 . . . or Injury; tl8etment could cure or
substantially allevtall the.dI•• s . or injury; and deI8y or denial ofcare could 8u'nt8l1lfally
harm the prisoner. A ~ or an employee nil8fioriship muSt be In place with a -tnlIned

.=. •

..

(Board-qu8Iifie or ea..?') ~id to Pf8SCIibe and monitor JM¥:hotropIc rnedk8licne:

FiFP.~/co.

,~,-

75

PIIiin JifIiliI!iIij

FIaI. . . . . . . .18

"

!

j

)

Emergent Care
Emergency requests (from prisoners and staff) for mental health intervention (exhibiting
behavior indicating imminent danger to self or others and/or grave disability) are to be
evaluated by a qualified mental health professional as soon as practicable or within 4 hours of
referral. On-call psychiatric services must be available 24-hours per day to assist medical staff
In the management of acute mental health needs. In lieu of Qn-site evaluation, transport to an
emergency department capable of evaluating and treating acute psychiabic symptoms is an
acceptable alternative.

Ymenteare
Urgent requests for intervention (prisoner GXIlibijs unstable behavior. displays signs and or
symptoms indicating a risk potential ;Or hann to self or others) must be evaluated by a
licensed, qualified mental health professional within 24 hours.

~

RouIne requests for mental heaIh care (stable condition. prisoner requests an
. appoi*aent) are to be evaluated by a qualfied mental health professional wfIhin five (5)
WOItdI
""
,."..19.d
ays . . ·
1)

SUIcide Prevention & Training

2)

ell...,.

If~P8d"inan~~p""8I'tt"prisoner~cauaina"""rytoseiforoilMl.
or dUe to gNlJe
en,apncy medicalioo adH*ilabalun may be auIIorized ~
the psydliaIri8t or, in the aIISDa.dC8 Of the PI¥=f:lHtst, by a medical physician will
"~authodly. This ~ order must be nwi8Wed by the psychiatrist or
~ pSychiBt:ist within 24 hours.

s.-"

Medical staff shaM seek
input on the triage and aSSBlsment of a prisoner prior to
contInuJng that prisoner on irMlIuntaIy psychoIropic medicatlOns. Policies must be
established for the ongoing adminiatI ation and nMew of irNoIuntary rl:edlcatloi'18. M
reports of Alaskan prisoners put on inwluntary medIcaIIons &hall be repot1ed to 1he
DOC Director of COnical PsychiIIIry and/or DIrectorof' InsIItution&I Mental HeaICh within
24 hours.
3)

Mental Health Treatment Plans and MedIcations

78

NIiII. HIM

fiIiliii

Rd.s.... ) ....

•

.

(

At a minimum, monthly treatment teleconferences shall be held between the 'contract
facility mental health staff and that of the State. unless otherwise instructed by the•

State.
4)

()

Therapeutic Restraints
The contractor may only use therapeutic rvstraJnts or seclusion to control prisoners who
have threatened to injure themselves. who exhibit self-destructive behavior. or who
pose imminent danger to themselves or others ~use of their uncontioHed behavior.
, The use oftherapeutic restraints and seclusion together shall only be presaibed when
no acceptable alternative exists. The contractor shall treat all prisoners In the least
restrictive fashion that is consistent with their I9qUlrements for treatment and safety.
.

.

,

The use of physical restraints or segrega~ housing shall not be used in lieu of
counseling or other psychiatric services for a prisoner suffering from a mentallIness
unless ~ of a treatment plan .prescribed and reviewed monthly by a quaHfled mental
health professional. or unless in an emergency.
.
All use of force incidents. Including physical and chemfcaI restraints for ~
purposes. 8hIIIIlMt JIlIPOIted to the DOC DIf8c*)t of In"lIionai Mental Hi'" or '

d ••1gnee within 24 hours.

M.

.

ANCH , MY AND OTHER MEDICAl. CARE SERVICES

'1) , l..IIboIJItory Services

~ ~~. ~

I rt;aatouy
OWr:pRIIC8.NqUied_aliA~8~Y.ervioes.

1lMp oontlador lJU1!lasure <:;InbtI

Thecor*a;b

.

, .'

IrE a auboo *ad 'for aM IabomIory seMce8 that camot be PluWded' 00'. .

-a1ical .

1..aboiaby ~ muM include a pr'O\ilian for "Slat" WOfk and
k Mr.
"iIIInonMIs will ,.. . . PftMded 'i•• ill six (l)'ho!ift .... 118 sp8cimen Is obtliAed.' A
MIten report shall follow.
Concerning subcontracting wiIh a clnicallaboraby the foIIowi:ng shaH apply
concerning services and capablilies:

•
•
•
•

•

Provision of au Laboratory supplies;
Pick-up and delivery on a daily basis. ~sy Ivough Friday;
Printer or computer to provide test results in8taIIed at each Clinical Site;

•

Reporting capability within 24 hours; and
Phlebotomy services as culT8l'ltly pnMded and specified.

Contractor or its subcontJacting laboratOry shaH comply wIh national and State's
recommended analyllcal methoc:IsIproce.

ContracIIDr or Its subcontracting IaboIaIOry ~ be capable of pmvIdIng the level of
f8p0rIIng required for puIpOS8S of quality iInproverrI8'It and uIIization review.
Pttarm8cy S8fvices!
RFPiI ~/Cor*sctiii54ii1

2)

,77

FIrnI-. ...

k
•

.,

•

)

Phannaceutical services will be provided in accordance with the 2003 National
Commission on Correctional Health Care Standards for Health Services in Prisons, as
updated. At a minimum, the contractor shall be responsible for the administering, and
in compliance with State Pharmacy regulations -dispensing- of medications 0fdeIed by
the contractor employees. The contractor shall utilize their formulary that is effective at
the time of contract commencemenl Any future proposed changes to the oontractor's
formulary shaH be submitted to DOC for review and approval prior to Implementation.
In the provision of pharmacy services, the oontractor shall comply witt1 aU state and
federal laws.
.

.

.

The contractor shall be responsible for the procurement, payment. inventory control,
dispensing and disposaf o~aR pharmaceuticals including psychotropic medications. At
the disaetion of the DOC specific medications may be provided by the DOC pharmacy
(this includes both formulary and ~n-formularymedications). The contractor ....aII be
responsible for the administration of these and all medications.
The contractor's pharmacy shaH be able to perform the following funcUons:

•

uailtain Jrwentory, cost. ordering F8COIds for all phannaceutik:. . induding ..
over"e-c nt8r medications ~ _... ~ .

•

patient dft.Ig prcAi.
.
.
IdecdIy ~~ [~".drug ~ for ~ c:aclu&ed dn.Jgs
.
G81'i',; :·'. ....of priSon_ on spedic ~ 8Iid bfprMazll'ng ...........
~iNiioner·Who-ls6l~·jn~~· .. ~~,~..

•

•
•

KeIrp

$

• :~·Otp,t8Qh~·~~i'.,...efi· r Ion.
~·~~j..'ii;," ...= :..~
Ij', II 'j••' . . . . . Jlrsi?tbd Witin~~=:".1iItk· :lii._.,
....I '.':4..0..- . .
.
.
. . ' .•
. ' ...... .'

• QiI"'.fr: If:lilRG of:8te _
•••1 - - .

.

.

~

';1' '......
"'~

.

",' 7

,

• D8u 9t~ 8nd implement a Continuous QuIIIIy Improvement <CQI> piOg.am for
... ~cy progi8rii detrionsIr8ting a knodeltge and focuia on oubxne
nl8B8UN8

and indicaIors.

.

hours after it is ordered for routine prescriptions and within 12 hours for
emergenUy required treatments.

more
.

Policies must be in place to ensure inventory control, appropriate dispersal based on
physician's oa:ters, and safeguards for handling medication. Hours for medication
dispensing will be posted in aU housing units.

•

0

The contractor is responsible for all costs associated with providing medications
identified in the CCA fonnulary at the time of contract commencement The cost for
CCA to provide formulary medications is inciuded in the daily per diem rate. The
formulary will be r9YIewed each year to add items new to the market or are more costeffective, or to delete obsolete or discontinued Items, as d8emed necessary by the
parties.
The DOC will reimburse the contractor for all HIV, Hepatitis C. and non-formuIary
medications. Non-torrnulary medications will not be presafbed without wriU8n approwl
of the DOC. Non-fonnulary nMew and approval or denial must be ac:compRshed '.WIhin
,5 (five) days of submits SiCA fc?r non-emergent medications. If emergent, DOC will &low
the 'contractor to ,~ non-fonnulary medicatiOns prior, to approval, bUt wrfIen
approval frpm DOC wt1181111 be mqulred.

8111rJ'r

A
tiNd fOIBI ... :pIDGldlns wII be eslabAshed for ..... sl'lilg ~
med'c8'ons. ~,formssubmitted10 DOC,. be r8Vie\-.I and acted If)Ofl
wiItUn 5.ca1ender. .'
,

.-ft.

tie ~ ~tPoJl.!J ' ; I Heath care that the toIBI&,~Ifll~d·.'.

Owe,.,.,

's.

>

~ 8 .I,J.;: ~1!.t.~. ~ rnedicalon . .
d.7~"'" ·.,jl·"",excBe~10%,~

."

.',,'

.'. . ".:

'.

't:,FIdi~£
.,..., "

:r"':"'"

: _ ps,,**,",* hi W •
1'equired fortho8e ~,_.we.etniI
the 10% Rrnit was 'II~ !tided,
' r
4)

AdmiItiStwalion ofMedcalloo minimums:
•

PII c:aI munds wII occur 3 times/day, 7 dayslweek
prisoners.

•

'

for.

general popIdsIIon

PIt call rounds wII occur 3 timeslday, 7 dayslweek fo.r aU aegreg8Iion prisoAenL

AD prisoners pni8Crtbed psychotropic medications must be ob8efved at plliine by •'
health personnel unless specificaUy waived by the prescribing psychiatrist for "'Keep
onp~·m~cdng.
'

All J)liIonens iaIdng.medications for a contagJous or ~ Iif&.Ilreatenin
~ ~8 ase wII, have their medications admini8IIer8d as "'DiMcIy c;>bserwd
TherIIpy", (Eg, TuberouIollr. HtV-f8Iated infections and dlaaale. bcIdlIriaI
endocardIis or severe '80ft tissue ceHurdis, os1eomyeIitis. etc.) with aPPrOPrtate
doCumentation.

Over the counter medications wit be rnad8 avaIabIe to prisoners at corMIiI8aIy.
, OTC meclcations \\II ~ be provided by the contractor per the 8PPfOV'8d

tuml'.",

RFP. 3IIOfi~'45441 Cor*w.t.,StI81

79

AM~fIiIIiIiIi
Fbi .. ,f ......

(

,

Over the counter medications will be provided at no cost to the State if OIdered by'a
health care provider or if the prisoner is indigent.

.
...
5)

ECG Services
Routine ECG services shall be provided on-site by the contractor to indude all
equipment and supplies. Services shall include. but not necessarily limited to:
•

•
•

6)

oVer-read by an appropriately qualified physician.
Pnnted report of ECG with strip; and
Equipment maintenance ~nd service within 24 hours.

RadiologJc Services
The contractor shafl be responsible for the provtsion of all OrHIite and 8impIe
radi01ogicai studies. This Indudes plain films of long bones. chest radiographa. tat
plates of the abdomen and skuU fDms. ExpIlciUy excluded am: CAT scanning. Mm.
fluoroscopy. ultrasound and special studies). The oontI'acIor shall 8I'fIlI• • wilt a
radiology group to provide for the ·over-reading- of
~iogI'aph. by a . . . .
certified" radiologist. The contract established muM UIJUIl8 a fIum-aftJuRd
01.72
hours for aI • •1 J8P0ris. For procedures b• • . the ~ of. . " •• MiEd:

an

on-site. the plllilint shall be RJferred to an off"beIItJ1 care faclity.
7)

.

Optometry & Ophthalmologic ServIces

.

IMI"i1i.·'" :'fi1l¥9f
the~L ....m~"ft88dfOr:alf._
..~,~ .' ~~.-.:.=
·.P~'I;;I~ntt.t.··.,
1ndHdB·. . -«p".".·
~
.;..a:-'
·_:MF.·· .. .~
diat9lcaO ,;., ..,,~ .illlDii: ..:
;:: .~ "~.' ::. :"!:~ . {&~ . :<..
~ ofoo4i&eOjlbU.8IRAqJIc8GI": r~~itMt,. . .
1 d' . Y<

......

<.

ACA9 ·and "'.M DOC StanU:ds of c.:e.. 'A"q::r'fafl optcImelllilhihiil·.'1iI'.18
prisonenI with specific compJainIs. with refel.aI to an·OphIhsIrnoIogia ~

""."11

The d.~y of'8n on 1111 aptoIR8tIy program rJUJt ilClllde aI meclcllly MIaln"'Ery
eyeglasses. Prisoners who have 20140 vision or better and at JeMt OM' •
uncorrec*Kl with neither eye being less than 20140 COl1'9Cted wit not be gMIri gllZ••
unless they are pi a,sElIIy'wearing glaSSBS or' have worn glasSes during the last two (1)
years. PriMx1ers nwst.be evaluated for eye exams yearJy upon requeSt. EIedtve. nonurgent seMces must be provided within 60 d8)'8 afthe prisone(s requeSt. Gjz~zell
must be provided within tIwe (3) weeks of ~ examination.
Prisoners requiring the care of an ophthalmologist shall receive that level of C8f8 as
medically necessary. An indication of need for further examination would be if the
vIsu'aI acuIy is not at least 20140. or If the Intraocular presat.U8 is above 20. FLKIwr. if a
disease process such 88 diabetes requRs addiIonaI follow-up or b.z
0phtha1moiogic evaluation this wiI be done. AD diabetics must be 9Y8IuaIed .by a
practiIIoner eel IRed to perform a full dilated funduscopic 'exam and ctJ8Ino*
retinopaIhy.
Should therapy such as laser treafmant be required. only an
ophthalmologist can perform such treatment

.w

8)

Physical Therapy & RehabllltatiYe Medicine
80

The contractor shall provide a fuB range of physical therapy and rehabUitatlOn s~
to prisoners as needed. Preferably. the care shall be rendered on-site. but in cases Irequiring higher-levet servic&s. appropriate referral and utilization of community based
resources may be necessary.
9)

0

Medical Records
Medical records will be provided and m~naged In accordance with the National
Commission on Correctional Health Care Standards for Health Services in Prisons.
The contractor shall be responsible for the maintenance, retention·and the timely
transfer of a complete. standardized ·ProbIem Oriented Med;cal Record.· The -SOAP"
fonnat for progress notes shall be used for all prisoner records. Additionally, the
contractor shan maintain medical records in accorda~ with prevaiBng medical
regulations for confldentiaHty, retention and access. Anyalt8mative must be approved
by the Corrections Department and med'1CSI records wli be OIlJ8nizsd and mailtalned In
accordance with Alaska DOC poI"lCies 81d procedures. The system must be overseen
by the oontractor's Health ServIces Administrator who is responsible for assuring 1he
system and Departmental needs 818 mel
.
Standards for Medical Records

The contracmr shall maintaiR medical f9COIda on p8p8I' aAdIor in eIecIronic format
(subject to Department appRMII}1UIt is set forth In a timety,legibIe. cunent. 0fgMiZBd
fD8M8I'. and which permits 8ffedhIe Md conlldenlial piiliant C8I'8 and qu;1Iy nMew;

..

'

.... ~ '.

'~'.

,,-

n.. .~*-*'" shaII.have r!'eii'-'·~ conldenl I.,. . . . . . . pmoedur8s 1het

1n4.ainent the I9qLIiremenIs 9f 8IIIIB and Fedend law and PQIrI¥ and thisAtJ a In~~ .

(~)

1'he ~ shaIIestiEWl, aIId . . . requk81ts pnJdIIiGoeatto hBYe. . . .11 ~
medical t8COId keeping system and staAdaros for the avaIabWy at rnecIcaI iecotds
appPOpdete 1b ~ practice Sfte;

.The COIaCracb' shall provide ~ aooess k) all prisoner medical records for
purposeaof quality nwIews to be conductBd by Haslat DOC or agents thereof, and hit
the medical records be avaIabIe to health C819pt"1d1ioners for each clinical encounter.
MedIcal Records will include. but 818 not IimIed 10:
• Problem list;
•
• CompIeIed I9C8Mng screening fOrm;
• Health appraisal data fonn and flow sheets;
• All findinga. diagnoses. treatments, cHspoeIIIons;
• Prescribed·medIcations and their admInist.ratfon;
• LaboratDry. x-ray and diagnostic sIUdIes;
• SigMtI.n and. tile of-each doaJmented;
• Con8ent and refusal forms;
• Release of Infor1neIon forms;
• Place. date. and time of health encoUnters;
• Discharge summaries of hospIeIizatJons and off. . . procedul'98 and consultant

reports;

81

" .

c

.

,

•

.;
•

•
•

Health service reports, e.g. dental, psychiatric and other consultations;
Medical classification transfer sheet

All health care records prepared pursuant to this Agree~tshall be the property of the
Alaska DOC but shall be maintained in the sole possession, custody and control of
contractor. Contractor shan .not deny to the Inmate Health Services Administrator, or
designee access to such records for examination and photocopying at no additional
cost to the State. Requests to the contractor for medfcal records and/or information
shall be made by the Deparbnent's representative(s), counsel for the Department,
.Alaska Attorney Generars office, or the Department Health Services Administrator.
Requests to the contractor for. medical records must follow confidentiality requirements.
At the expiration of this Agreement or when prisoners are released from institutional
supervision, all such records shall be delivered by the contractor to the Department.
The contractor may make copies of those records at contractor's request and expense.
Medical records Indude those recorded on paper, micro graphics, compu&er
electronics, audio tapes, film, photographs, videotapes and any other recording

niedlum.

B

MentalllaaNh Records

,. .

.

Mental Hellllh records must be kept In a Iocktd area wIIh c0ntr0lied access. Records
must be Iftaintained in a .manner consistent with oomrnunIty and' PIMa ssioAal
MIIndaRts,IndudIng compliance with federal regulations (HIPPA). Providers of·mentaI
heBlth: aeMces wII use DOC-approved fonns for documenting cllnicBl conlullatb"
with AI••I'IIft pri8oners. CopIes of these consults shall be sent to the M8I1IaI IleBlth
dlpailutent.at Anchorage Central Office at least monthly. A complete copy of the
mental he8Ih record shaD accompany the prisoner upon return to Alaska.
11)

EJedlOI~ AccJ8ss to

Inmate Health care

The 00Idf8ck)r \¥II. be a Beta • for the 10.0 upgrade to the AlleafptsfTouchwtvks
8Ofti,.e1lHclh Is being used at the CCA Florence C0rrectlonaI C8nt!ir. This upgrade
wII permit the ~1Ote eIectronlc transrnieIIm ofille inrnatB heaHh recoot. 8CCIiBlltythe
ODe for 811 AI••ka inmate health recorda. and particlpallon by I'Ie ADOC medical
dln~ctQ( and selected medical staff In the non-formuIary and off-48 appn)vaJ
proca.SB. The vendor ~ to hIwe the product In Beta testing In July 2004 will a
~ roII-out by the end of 2005. CCA wHI keep the DOC apprIeed of the
RfP. 2111'" tU4/ ODiilluct 12054881
82

,......,. PMiir
FIlnRce. htmc.

J

implementation and unless the vendor is not able to meet the time lines, CCA ~Id
expect to have remote access available to the DOC by January 2005. A hard copy of all
electronic infonnation will be made and placed in the DOC file when an inmate
releases, transfers. or returns to Alaska.
(])

.

N.

SAFETY, SANITATION, AND INFECTION CONTROL

The contractor is responsible for training its staff and implementing the proper methods of
. handling, storage and disposal of biomedical hazardous waste. This includes needles.
syringes and other materials used in the treatment of the prisoners. The conlractor shaD be .
responsible for maintaining complial:lce with all federal. state, and local infection control
policies, procedures. guidelines and standards. The contractor shall be responsible for staff
training, staff and patient protection devices, and other requirements mandated by law, rules,
.and regul~.
.
' ,.

..

Infection Control: An InfecUon program shall be implemented by the contlacl8r. whidllncludes:
concurrent survellence of patients and staff, prevention techniques, and 'tnNltrllent and
reporting of Infecllons In accordance with local and state laws. Ssfe&y Md. 8anitaCion
Inspections: caclillCtor shall partidpate in I11Ot1thIy safety and san.lUlon·...pedioos of the
institution food .ervioe, housing and WOIk 8ANIS.. Alaska DOC personnel. ptd8~at the
depattnl8nta• • •I •. CoI*actorshall
approfJIiaIe ~.forcorrections
of d1screpancies.

maa.

O.

SPACE.
EIGI'-«
AND COMMODITIES
.
0..
.

.

o

. The contractDr... 'proWte a medical library to include at a minimum a cunni medical
dictionary, .PhyKIIII's. Deek Rater8nce (PDR), Pharmacology Reference. NcaiC a1d ACA
standards. Joint eomrnll"on on the Accreditation of HeaII1 care 0rganIzaI0ns (JCAHO)
Ambulatory
S&and8lds and other cutI'8Ilt (pubIicaIJon wiItlin the 1ast-4 yernlmedlcal
texis and books or joulftllls as I8COfM'l8nded by the 001 oommillee.
.

en

..

The contractor.... a88UI'8 coi'npIiance wittI all OSHA guidelines and oller State and Fect.aI
statutes ~ Jnfedion control and handfing of infectious materials.
.
•
P.
TELEMEDICINE

~

Telemedlcine ~ ~ an opportunity to restructure the mamerin -"Ich access
speciaity conmllilian is provided to prisoners. As the potenIIaI ber.alla of teIemecIcine
become ~ the ocn*acb shall be expected to cooperat8 with the Department in the

t)

uIIization of this technology dependent upon. local a~.

Q..

DEPARlTIENT RE8PONSI8IUTY CONCERMNG PRISONER HEALTH

During the term of this contract.
, the Alaska DOC shall:
83

t'

.•

•
0/..

.

.11 .
(.

Provide contrador with infonnation concerning each prisoner as appropriate.

2. Compensate the contractor as detenniried in final contract.

D

3. Monitor the effectiveness of contractor's Continuous Quality Improvement (CQI) program.

•

4. Provide for review and adjudication of prisoner grievances.
5. Provide data elements for contractor reporting.
6. Monitor data submitted ~ the contractor.

Note: Perfonnance by the coatractor shall not be contingent upon time availability of
Ajaska DOC persOAl18l or ....ourcee with the exception of specific ....ponslblllllee
stated In this contract and the nonnal cooperation that can be expected In such a
contractual Agreement. The contractor's access to Alaska DOC personnel shall be
gI1II1ted as freely as po88IbIe. .However, the compet8Rcy or sufftclency of Alaska DOC
sI1IIf shaH not be NaOn for relieving the contractor of any responsibility for failing to
Meet requlntd deadlfftes or producing unacceptable "'verabIes.
R.

HEALTH SEfMCES CON1ftACT ADt.-IS I ~~

.

The Health SeMces ~ is. and hist1ler SUCCSIIlJr ~ be. designated by, "
COliwilSDter of DeperIment d ~s. Th8 ~ . . . nof.ify the conInIGiw.~
any'dIIiftges 1ft h ltiei·.Y.~'~"·11'I'.1 ~ ~~.
1.1.1IIIh.·• .;~'.1

A* **tillkJria~~ .5

_aM_.",.

n:-e

rJ_"'¥ji.~~.toIlI·

I l l I j . -"'.

In·

::.U;:,:,':'w:=~~~
the:iillltOOtyto 8meild:"_."l...n.tr.. . aNiii~jQi:!i ·Hri.....

. protIlems. conceme or I9QU8stl ~ this Agreem8nt8h811 be' reported' by the COilbacb to
the HI It.. 8erYices AdniuisbilkJr.
S.

CONTRACT MODIfICATION

. In the event that ch8nges In Federal or State statute. ~n. rules. poHcy. or dlanpe In
Federal or State 8f'JPIOPflPalOO<a)orolwrc:ircumstanc.sl1lqUke·a challge in the WIIit
DOC manages Its medical progiWfi.·. . AgleementshEIII be -ill;ecttosubetantialmoollic ~Ion
by amendment. Sooh ale ction shaI be effected by the Department sending written nOIce to
the contraeIor. The Ala. . DOCs decielon as to 8le ~ for change in the scqIe of
the program shaH be final and binding. Th", amendment(s) shall ~ implemented by
Agreement through re-negotiation In accordance with 3.18 Contract Changes - Anticiplile d
Amendments•

.'1."08

. If It Is determined.that compensaIion Is required for the contradorto Implement the dIrectIYes
policy changes. the compensation may be In the 10"" of an increase In the percRem rate or
a one-time lump sum payment. The oonfrador shaH not be ~ to supply addIIIonaI
aeMces at addiUonaI costs unIIl1e paries have reached 8 mutually aati8fadoIy agI&ement
regan:IIng Jnaealsd compenaaIion. DOC shall requfre a reducIon In the per diem raIe If new
poIicie8 or dIrecIives are Implemented or any change In poIIcIee or directives .... in fie

or

RFP" 2G054lIOO-4644/ Coi....... f2054181

NdI. ....... ....,
f1IRRce," '
I ..

~

J

•

•

. ,

...

~reduction of services.

Such a reduction shall'be negotiated between the parties. Prior.y
Increase in per diem or request for lump sum payment, DOC must approve.
. .~

T.

,

SUBCONTRACTS CONCERNING PRISONER HEALTH

The contractor is solely responsible for fulfillment of the Agreement with the Alaska DOC.

•

The contractor shall remain solely responsible for performance by any subcontractor under
such subcontrad(s).

•

The Alaska DOC may undertake or award other agreements for work related to the task
desaibed In this document or any portion therein If the contractor's time avaHable and/or
priorities do not allow such work to be provided by the contractor. The contractor shaH fuRy
cooperate with such other contractor and Alaska DOC In aft such cases. Alaska DOC reserves
the right to withhold payment for such services from the contrBctor.

Subcon1ractlng Requirements - The contractor may.subcontract to a qualftied in~uaI or
organization for the provision of any service defined In the.scope of wort.. The Alaska DOC
reserves the right to review an subcontracts and/or any ~lficant modiIications to
pnMously approved suboontracts to ~U18 compIi8nce wIIh law, policy, and reqt.*8laen!s.
The conncb' ts MqUired to gtve the Dep8rtrRent,priar.OOIIice will ~ t) ill Intlnt to . .
aubc:onAct certain siIr.-cant CXlillact ~ 1MItilw. but nat la. M II ·W::,. ..;'
credenIiaIing, uM'dion ,.,..", and claims proc •.II.•'U ~danIIaJing tie" ·reeqis;. ":' The
COI'lIracmr mu8t ~ "leiIs. aad.pIOC8fJurW.·.~·I\at1hec:11;.. rJ1;.J~'ils
providers and tIiJboOJ.. re· n ·tR88t..,picabie 811Ft ,. . . . .,1IIUd In "~~JWOI1t.
See aIeo 8ecIioIi 1.14 for ~••dlilg. .
' ~t.:, i,1-';"
7 ••

ReWew ReqI..tIr&Rmnts - The. conIndor muat
,eubcontracts. which 819 acc888lble mthe Depa

a ~

executed·OfiIInaI

of

'.

..

0_.

an

.'Minimum Requhmenfs - SuboontnIcts must contain at· least the faIowing provisions:

SUbcontrads must be
policies and rules;

~

In accordance wIIh aM applicable state laws, regulations,

8ubcontnIcts ~ ~ the parties of the subc:onIJact and their legal basis of opeialion in

the State of location;
Subcontracts must include the procedures and speciIIccritefia for terminating the ~
Subcontracts must identify the services to be perfonned by the subcontractor and those
aervlces perfonned ui1der any othersuboonfl8ds(a). SUbooritracls must Include pnMsIon(s)
de8ciibing how Services provided under the termS. of tI}e subconfJact are accsssed by

.

~;

. ~ must include the reimbursement rates and risk assumption, If applicable;

'Subc0ntract0r8 must maintain an records relating to seMcee provided to prieoneI8 fora six (6)
year period and shall make an prison"s medIcar records 8Y8IabIe for the purpoee of quality
'revIew conducted by the Alaska DOC or is designated ~;
RFP "2OO5aOO-45M1

Cui."....

1

85

AIIIIIt'" f8iiIii
FIoI-. At

1181

.

~

.•

,

•

t

I

..-

J

,

~ubcontracts must require that prisoner information be kept confidential, as defined by state
law;

,

Subcontracts must include a provision that authorized representatives of the Alaska DOC have
l88SOOable access to facilities and records for fiscal and medical audit purposes;
Subcontracts must include a provision for the subcontractor to release any information
necessary to perfonn any of its obligations;
The subcontractor must comply with aU applicable State and Federal statutes, laws, rules, and
~&ms;

.

SubcontracIB shall Include provision'fortermination for any violation ct applicableAlaska DOC,
Stale or Federal requirements; The contractor shall not conJract wIh an individual provider. an
entity, oran entJtywith an Individual who is an officer, dif8dor, agent. ormansgerwho owns or
has a conIroIUng Interest In the entitY, which has been COI'lYicMd of any felony offense.

In lIB SUbconCnIcts, the contractor shalensur& that subcontnlclors agr88 to hold h&nnIe8s the
AI',,. DOC irI the event that the ~ carmot"orwll not pay for services performed ,by
. . . . . ~. . . . .~ to the auboonIiact. The hold hai g•••• PRMston shaI
the
. . . . . . . . .i.gIllltDn of lie COI1tIlIdorisUbcoIdlador coMectilraulllOltmd services
1IIId
"nor to the 18rminaIion of the contract, I9Q8fdIess offhe cal. . giving rise to terrilation and
.... be.construed to be for the bene&t of the pri8oners.
'

::.,.

u. '

RECOftDS Ale AUDITS

The oontraokH: shell ~ detailed timed r8COIds, 'WIUch Indicate the date, .... and
nature of 88NIce8 r&nder8d. These recoIds shall be subjeCt to inapectIon bylhe Stale
of Haaka" the Department of AdminieIraIIon, DiwteIon d Finance, the stat8 AudIor
Mdlor any authorized Stale entity and shal be retained for tine (3) year8. The Alaska
DOC or18 de8ignee'shal have the right to audI batgsbolh Wore and afterpayment.
~ under this Agraement . . . ROt fonIcIoM tile right of state of All
to
1'8COV8I'~ IDegaI payrnelds as wei as InI8nMd, ~fees and cost8lnooned

.'ta

In such 18COY8IY.
2)

Other Records

The contractor shall retain all prisoner medical f8CORI8, collected data, and oIher
InformsIipn subject to ~ of AlBa, State of roc..n...... and Federal' reporting or
rnonRoring requIrBrnents for three (3) years. 1'1.- records . . . be subjeCt to
In8pedioR by Stale of AJaska. the Department of ~ Md' Ada*d&flatlun and/or
any autI10rImd State or Federal entity and shall be r8IaIned for three (3) y88f8 after

contact exphallor..
~~------

~ ~(MEIH~
RFfi. _ _ 4544/ cOnnetl.2054l81

•

•
~.

•

l

• The contractor shall be wholly at risk for all covered services. No additional payment sl\an be .
made by the Alaska DOC. nor shan any payment be collected from an prisoner for any reason
except for prisoner -co-pay" fee for service program. Covered services do not include elective
or experimental treatments or procedures. In the event of disagreement as to the elective or
experimental nature of a treatment or procedure. the Alaska DOC Health Services
Administrator shaD review the case and make the final detennioation. Concerning organ
transplants, (exclusive of corneal transplants). medicaJ necessity and decision to transplant wli •
be on a -case-by-case- basis as determined by the Alaska DOC Health Services Adminisln:dor
following full review of the medical information and in consultation with the contractor's Medical •
Director and any appropriate medical consultants. Contractor wAl not be reqUired to provide
...
-experimental- transplants.

0

-

The contractor is solely responsible for ensuring that it issues no payments for services for
which it is not faable under this Agreement Alaska DOC shall accept no respOOsIbIIly for the
refunding to the contractor of any such excess payments. This provision shaD not be COMIrued
to prohibit Contractor from filing a complaint with the court once It has exhau8fed the
administrative remedies set forth herein.

W.

CONFlOEtmAUTY

88

..-

or:

Any confidentiaIlnfonnaIIon.
d8Ined In saat& law. code. n.d88 1WlJl..:I:i.....,~
nnJlcal)le by the Code dEWes. NgaI'ding Alaska DOC .. prisoners pRW
~
by the contrador and Is .auboonINcbs shall .,at. be made 8\. . . . . . to
.
. ..,er
0IgIII'Ii:mI0n by the oonInIdrJr and Its subcontractors wiIlQut the pdor 'Mill .i·
,
.

MluOOC.

·.i

Thecontl8dorandita~

:":'."~'3"'~·
I8CdDr8W811811t"Ihey~~·. '"

.

.~... ( )

".

AlB'" DOC. and
1IM or dlldcse "-it to ~ ~" .,
.
penni.liOn Of AJeaka DOC~._·'" every empbyeeef1h8 oonb
'" . . .
has 8II8CUt&d a binding AII-liat.--.t to the same effeCt The COi
aiId
recognize fMt IrNparabIe MIrm CM be occasioned to AlaRica DOC and .....!iI••• ;by
dIedoeure ofirlforrnalon ,...11118 to their busii1ess and. accordII'QIy. MI•• DOC II ajrJi' f ira
or enjoin such disclosure. and the conIracQand its aubconItactons. . . be soIeiy.itpaji.la
forany~ns.
.
.

ion. ....

The cor*ackH' ah&II (1).r noIify AJeeka DOC prompIIy of any u ~ posI•••
kr)owIedge. or atIempt thend. of Alaska DOC 's data flea or other oonIdeIdIII1 ilb• .,ian;" .
and (2). promptly fumish Alaska DOC full de1aiIs of the unauthoiiz8d poeee.aioR. :. .. Of
I<naMedge or attemPt thereof. ~ assist investigating or preventing the r&CUII'8nC8 ~..

•

In order to protect the confidentiality of prisoner infonnation and records:

The ~rshall ~and impIem8ntwrilten confidentiaIity~ and pocedures. Which
conform to F~ and Stale laws and regulations:
The conllado(s contradB wIIh practitJonerB and other providers ah8II expIidIIy state
expectiItions about the confidentiality of prisoner information and "'CCIId8;
The oontraotor shall afford prIsonens and/or legal guardians the opporUIIly to appRJ\I8 or....y
.the reI.aae of identifiable personal Information by the contradDrto a peraon or agency•
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• ,~lf)f the contractor. except when such release is required by law. State regulation. or quality
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When release of infonnation is made in response to a court order. the contractor shall notify
the prisoner and/or legal guardian of such action in a timely manner;

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. The contractor shaD have specific policies and procedures. which direct how confidential
infonnation gathered or learned during th~ investigation. or resolution of a complaint is
maintained. including the confidentiality of the prisone(s status as a complainant
The contractor must comply with all HIPPA. Federal and State regulations regarding the
management and exchange of medical Information.

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the conlJaclor. except when such I8/ease is required by law, Slate regulation, or quality

standards;

When release of infonnation is made In response to a court order, the contractor shall notify
the prisoner and/or legal guardian of such action in a timely manner.
The contractor shall have specific policies and procedures. which direct how confidential
information gathered or learned dUring the Investigation, or resolution of a complaint is
maintained, including the confidentiality of the prisone(s status as a complainant

The oontractor must comply with all HIPPA, Federal and State regulations regarding the
management and exchange of medical information.

RFP .. 2005-20CJ0..4644/ COilbact '1#2054181
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