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PrimeCare Medical of New York Inc., Re: Proposal for Comprehensive Services - Putnam County, 2018

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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

Table of Contents
ACCEPTANCE OF TERMS AND CONDITIONS OF RFP ................................................... 3
STATEMENT OF THE PROBLEM ........................................................................................... 4
COMPANY PROFILE .................................................................................................................. 5
PRIOR EXPERIENCE ................................................................................................................. 8
MANAGEMENT SUMMARY .................................................................................................... 13
FINANCIAL CAPABILITY ........................................................................................................ 28
CLINICAL OPERATIONAL PLAN .......................................................................................... 29
SCOPE OF WORK ...............................................................................................................29
MEDICAL AUTONOMY........................................................................................................30
ACCESS TO TREATMENT .................................................................................................30
INFORMED CONSENT........................................................................................................30
RECEIVING SCREENING ...................................................................................................30
SUICIDE PREVENTION AND AWARENESS ..................................................................31
DETOXIFICATION ................................................................................................................37
INTAKE HISTORY AND PHYSICAL EXAMINATIONS ..................................................40
NURSING SERVICES ..........................................................................................................40
DAILY SICK CALL / DISPENSARY OPERATION ...........................................................41
PHYSICIAN / PHYSICIAN ASSISTANT / NURSE PRACTITIONER SERVICES ......42
SPECIALTY CLINICS AND CHRONIC CONDITIONS ...................................................43
INFECTIOUS DISEASE .......................................................................................................45
SCHEDULING OF OFF-SITE CONSULTATIONS ..........................................................47
SPECIAL NEEDS HOUSING / INFIRMARY.....................................................................48
HOSPITALIZATION SERVICES.........................................................................................48
MANAGEMENT OF OFF-SITE CARE AND COST CONTAINMENT ..........................49
LONG-TERM CARE .............................................................................................................51
HOSPICE................................................................................................................................51
EMERGENCY TRANSPORTATION ..................................................................................52
NON-EMERGENT TRANSPORTATION ...........................................................................52
PREGNANCY, PRENATAL, AND POSTPARTUM CARE .............................................53
MENTAL HEALTH SERVICES ...........................................................................................53
TELEMEDICINE CAPABILITIES .......................................................................................58
ORAL CARE SERVICES .....................................................................................................59
VISION CARE SERVICES ..................................................................................................60
CONTINUITY OF CARE ......................................................................................................60
PHARMACEUTICAL SERVICES .......................................................................................60
LABORATORY SERVICES .................................................................................................63
RADIOLOGY SERVICES ....................................................................................................64
ECG SERVICES....................................................................................................................65
THERAPEUTIC DIET PROGRAMS ...................................................................................65
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

INFECTIOUS WASTE DISPOSAL .....................................................................................65
INMATE/PATIENT GRIEVANCES .....................................................................................66
RE-ENTRY / DISCHARGE PLANNING ............................................................................66
MEDICAL RECORDS...........................................................................................................67
ELECTRONIC MEDICAL RECORDS SYSTEM ..............................................................68
MEDICAL SUPPLIES AND EQUIPMENT .........................................................................74
INMATE/PATIENT HEALTH EDUCATION .......................................................................74
CRITICAL INCIDENTS AND MORTALITY REVIEW ......................................................75
STAFF WELLNESS PROGRAM ........................................................................................75
EMERGENCY PREPAREDNESS ......................................................................................75
SECURITY REQUIREMENTS ............................................................................................80
ADMINISTRATIVE OPERATIONAL PLAN .......................................................................... 81
HEALTH CARE POLICY AND PROCEDURE MANUAL ................................................82
ACCREDITATION .................................................................................................................82
QUALITY IMPROVEMENT PROGRAM ............................................................................84
UTILIZATION REVIEW & COST CONTAINMENT ..........................................................87
MANAGEMENT INFORMATION SYSTEM ......................................................................89
TECHNOLOGICAL ENHANCEMENTS .............................................................................92
CORPORATE SAFETY COMMITTEE ..............................................................................94
LEGAL, RISK MANAGEMENT & INSURANCE PROGRAMS ......................................94
HIPAA COMPLIANCE ..........................................................................................................95
LIQUIDATED DAMAGES & PERFORMANCE DEFICIENCY ADJUSTMENTS ........96
HUMAN RESOURCES AND PERSONNEL ......................................................................... 96
RECRUITMENT PRACTICES ............................................................................................96
EQUAL EMPLOYMENT OPPORTUNITIES .....................................................................98
DRUG-FREE WORK PLACE ..............................................................................................98
SECURITY REQUIREMENTS ............................................................................................98
EMPLOYEE BENEFITS .......................................................................................................99
EMPLOYEE ASSISTANCE PROGRAM .........................................................................100
STAFF TRAINING AND PERSONNEL DEVELOPMENT ............................................101
STAFFING MATRIX............................................................................................................104
ORIENTATION MANUAL ..................................................................................................105
CREDENTIALING ...............................................................................................................105
TRANSITION PLAN ................................................................................................................ 106
PERT / GANTT CHART .....................................................................................................106
TRANSITION .......................................................................................................................106
CONCLUSION.......................................................................................................................... 111

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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

ACCEPTANCE OF TERMS AND CONDITIONS OF RFP
In accordance with the Request for Proposals, PrimeCare Medical of New York, Inc., a wholly
owned subsidiary of PrimeCare Medical, Inc. (hereinafter, “PrimeCare Medical”) is respectfully
submitting this Technical and Pricing Proposal to provide all services necessary for the provision
of comprehensive health care services to all inmates/patients who are under the care and custody
of the Putnam County Correctional Facility. PrimeCare Medical shall fully comply with all
mandatory terms, requirements, conditions, and specifications contained in the County of
Putnam Purchasing Division’s Request for Proposal (RFP), to include any and all Addendums
issued thereafter. In the event any content of our Technical and/or Pricing Proposal contradicts
any of the specifications contained within the RFP, PrimeCare Medical acknowledges that the
requirements of the RFP shall take precedence.
In accordance with the Request for Proposals, all inmate/patient health care services provided
under this contract for the Putnam County Correctional Facility shall be in accordance with the
standards of the National Commission on Correctional Health Care (NCCHC), New York State
Commission of Corrections (NYSCOC), New York State Code Rules and Regulations, the New
York State Office of Mental Health (NYSOMH), the New York State Health Department
(NYSHD), the Putnam County Correctional Facility’s Policies and Procedures, the Affordable
Care Act, the American Medical Association (AMA), Centers for Disease Control Protocols and
Guidelines, Federal Prison Rape Elimination Act (PREA), State Licensing Board Laws and
Regulations, Federal OSHA Guidelines, and all other applicable Federal, State, and Local laws /
regulations. All required permits, registrations, and licenses needed to perform the services
detailed within this Proposal shall be the responsibility of PrimeCare Medical to acquire and
maintain for the life of the contract.
In accordance with the Request for Proposals, PrimeCare Medical shall coordinate all aspects of
its health care delivery systems, policies and procedures, reporting analysis, quality improvement
/ assurance studies and processes, cost containment programs, and all other requirements of the
RFP with the Putnam County Correctional Facility. Additionally, PrimeCare Medical shall be
available to confer with the Putnam County Correctional Facility at any time concerning any
provisions of this Proposal or any other matters pertaining to the performance of any potential
contract.
In accordance with the Request for Proposals, PrimeCare Medical’s Technical and Pricing
Proposal outlines our operational plan to provide comprehensive health care services to the
Putnam County Correctional Facility. Should Putnam County desire any additional information /
documentation to further support and/or clarify PrimeCare Medical’s Proposal, such additional
information / documentation will be furnished immediately upon request. PrimeCare Medical
understands the fiscal and operational constraints of the Putnam County Correctional Facility and
firmly believes that awarding this comprehensive health care services agreement to PrimeCare
Medical will prove to be the most logical, efficient, and cost-effective strategy for the County of
Putnam.

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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

STATEMENT OF THE PROBLEM
The County of Putnam and the Putnam County Correctional Facility are seeking a highly
qualified and experienced correctional health care corporation to serve as their primary provider
of comprehensive health care services to their inmate/patient population. The respective
correctional health care corporation shall solely be in the business of providing such contracted
services to inmates/patients confined to correctional institutions and shall provide levels of
service consistent with nationally accepted standards, laws, and regulations. All professional
health care services and management of such services shall be under the guidance and direction
of appropriately qualified, licensed, and trained individuals who are experienced and specialize
in the field of correctional medicine.
The main goals and objectives of the Putnam County Correctional Facility, through this RFP
process, are to identify, select, and contract with an established, qualified, and proven
correctional health care firm who has the expertise and ability for delivering the following:
 Provide health care services at a standard consistent with nationally accepted and
community required standards of care (NCCHC), as well as, all applicable State and local
statutes, regulations, and laws.
 Provide health care services in a manner approved by the Putnam County Correctional
Facility, which shall be compliant with Putnam County Correctional Facility’s policies
and procedures.
 Provide health care services in the most cost-effective and operationally efficient manner
possible, consistent with all requirements set forth in the RFP, with full reporting and
accountability to the Putnam County Correctional Facility.
 Develop and implement strategies to minimize health care cost increases during the life
of this correctional health services agreement.
 Operate a comprehensive health care program at full staffing using only appropriately
licensed, certified and professionally trained personnel.
 Partner with the Putnam County Correctional Facility in a joint Continuous Quality
Improvement Program, focusing on process and outcome strategies to achieve the most
appropriate levels of inmate/patient care.
 Provide for the implementation of a comprehensive electronic medical records system for
the Putnam County Correctional Facility.
 Develop relationships with community based partners to coordinate for the necessary
discharge of inmates/patients from correctional facilities and insure their successful reentry back into the community.
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

The Putnam County Correctional Facility is in need of a comprehensive correctional health care
firm who not only possesses the operational ability, but also maintains the financial capability of
providing this level of service to its inmate/patient population. Such a firm will need to possess
the infrastructure and have the necessary resources available to provide for both the
administrative and medical management of such a project, as well as, have the proven ability to
transition a correctional health care contract of this size.
Following your review of our Proposal, we firmly believe that the Putnam County Correctional
Facility will see that PrimeCare Medical not only meets all of the requirements of this RFP, but
far exceeds them; thus, making PrimeCare Medical the ideal solution for the Putnam County
Correctional Facility.

COMPANY PROFILE
PrimeCare
Medical
was
originally
incorporated in the
Commonwealth
of
Pennsylvania as a
business corporation
in 1986 and was then
known
as
Pennsylvania Institutional Health Services, Inc. (PIHS). In
1994, its legal status was changed to a professional corporation
and, four years later, its name was formally changed to
PrimeCare Medical, Inc. That same year, two wholly owned
subsidiaries were created, PrimeCare Medical of West
Virginia, Inc. and PrimeCare Medical of New York, Inc.
PrimeCare Medical is a privately held Pennsylvania
correctional health care corporation that is currently celebrating
thirty-two (32) years in business. Our founder, Dr. Carl A.
Hoffman, Jr., D.O., D.Sc., CCHP, brings over forty (40) years
of hands on correctional / health care experience. PrimeCare
Medical’s Corporate Headquarters is located at 3940 Locust
Lane, Harrisburg, Pennsylvania 17109.

PCM Highlights
 32 years in business –
Established 1986
 Privately held and
operated
 Corporately located in
Harrisburg, PA
 200 years of Correctional
Management Experience
 69 Correctional Facilities
serving over 24,500
inmates/patients
 Largest provider of
correctional healthcare to
the Counties of
Pennsylvania
 Annual revenues in excess
of $120 million

PrimeCare Medical is proud to say that our vision of becoming
one of the region’s most prestigious correctional health care companies has become a reality, due
to the tireless efforts, leadership, and management of our senior Corporate Officers. PrimeCare
Medical’s Executive Vice President, Theresa Marie Hoffman; our Chief Executive Officer,
Thomas J. Weber, Esquire; our Vice President, Todd W. Haskins, RN, BSN, CCHP; and our
Strategic Planning Officer, Francis J. Komykoski Sr., MBA, CCHP; possess over 100 years of
correctional management, mental health, and administrative experience. The combination of this
unparalleled level of experience in the industry permits PrimeCare Medical to possess a unique
insight into the challenges and dynamics of the correctional health field today.
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

PrimeCare Medical currently provides
comprehensive health care services to over 24,500
inmates/patients in sixty-nine (69) adult and
juvenile correctional facilities throughout the
Northeastern United States, totaling in excess of
$120,000,000 in annual revenues for the
Corporation.
Of those clients, we are most proud of the fact that (1) PrimeCare Medical is the “largest”
provider of county correctional health care services in the Commonwealth of Pennsylvania; and
(2) PrimeCare Medical of West Virginia, Inc. has been the correctional health care provider to
the West Virginia Regional Jail Authority since February 22, 1993 and to the West Virginia
Division of Juvenile Services since January 15, 2001. This achievement and our continued
successes have been attainable due to the vision and leadership of Dr. Hoffman, our tested and
proven business model, and the strong partnerships which we have forged with each and every
one of our clients throughout the Corporation. Since our inception, we have strived to be the
“best” in the correctional health care industry and to differentiate ourselves from our competition
through this business philosophy, which was developed to service county jails and state prison
systems, such as the Putnam County Correctional Facility. A complete listing of all current
contracts and professional references, to include facility names, average daily populations, date
original contracts were signed, points of contact and telephone numbers, and accreditation
statuses can be found attached to this Proposal. PrimeCare Medical not only welcomes you, but
encourages you to contact any one of these clients and inquire as to the level of service we
provide.
PrimeCare Medical also supports the National Commission on Correctional Health Care
(NCCHC) and the American Correctional Association (ACA) accreditation processes.
PrimeCare Medical has successfully achieved and maintained NCCHC Accreditation at fortythree (43) of our contracted facilities and has successfully achieved and maintained ACA
accreditation at several other facilities throughout our years of service. We are extremely proud
of these accreditations and of the fact that not only have we achieved accreditation each and
every time that we have applied, but also the fact that we have never lost an accreditation at any
of our contracted facilities.
PrimeCare Medical has a proud history and commitment to correctional health care. The Mission
and Vision of the Corporation is reflective in our many years of success in a difficult and
continuously evolving environment of correctional health care.

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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

PrimeCare Medical currently employs nearly 1,400 health care professionals, as well as, a
multitude of additional health care subcontracted providers, who are managed by a team of
experienced professionals in health care, corrections, risk management, and business. These
health care professionals total over $76,000,000 in annual payroll expense to PrimeCare
Medical. With this wide variety of experience, PrimeCare Medical is capable of providing to all
of its contracts a professional health care TEAM to address any and all situations that may arise
within a correctional setting.
We realize and respect that each individual institution has its own unique policies, procedures
and budgetary constraints. Consequently, at PrimeCare Medical, we are committed to providing
our clients with quality health care programs that are customized to meet specific institutional
needs and fit into existing administrative structures, to include those of the Putnam County
Correctional Facility.
Throughout the years, PrimeCare Medical’s TEAM has built both close personal and strong
professional relationships with many different members of the correctional industry’s
management staffs in the states in which we operate. This network has empowered PrimeCare
Medical to accomplish otherwise impossible tasks. Diversity of relationships, ownership of
challenges, accessibility of personnel, commitment to issue resolutions, and retention of senior
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

staff makes PrimeCare Medical uniquely suited to deal with the medical issues of the Putnam
County Correctional Facility.

“At PrimeCare Medical, we remain committed to
developing the strongest client relationships in the
industry, striving to continuously customizing our
services to satisfy the needs of each of our
correctional institutions. Our level of commitment to
our clients is absolute.”

~ Carl A. Hoffman, Jr., D.O., D.Sc., CCHP
Founder – PrimeCare Medical

PRIOR EXPERIENCE
Over the past thirty-two (32) years, PrimeCare Medical has sustained steady, continual,
purposeful growth and has successfully expanded its business operations throughout the
Northeastern United States. PrimeCare Medical currently provides medical, mental health,
dental, pharmaceutical, radiology, laboratory, chronic disease management, risk management,
and contract oversight for sixty-nine (69) correctional institutions across five (5) states, which
encompasses over 24,500 inmate/patient lives. It is this footprint that has uniquely positioned
PrimeCare Medical to meet the needs of the inmate/patient population of the Putnam County
Correctional Facility and to seamlessly transition this Proposal. This provides PrimeCare
Medical with the required level of resources and flexibility needed to achieve our mutual success
in transitioning the Putnam County Correctional Facility health care system.

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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

and only, health care provider to service to the West Virginia Regional Jail Authority. For over
twenty-five (25) years, PrimeCare Medical has successfully provided for the comprehensive
health care services to the inmate/patient population of the West Virginia Regional Jail
Authority, a single contract consisting of a state-wide correctional system housing over 4,000
inmates/patients. It has been these twenty-five (25) years of service that has made PrimeCare
Medical the longest current standing correctional health
care firm to have partnered with the State of West
Virginia. The West Virginia Regional Jail Authority is
WV & PCM
comprised of nine (9) regional jail facilities. We believe
it is imperative to highlight that through our contract
 Partnership with the State
with the Regional Jail Authority; PrimeCare Medical is
of West Virginia for over
already providing care to many other “state inmates”
25 years
who are currently serving time within the Regional Jail
 Incorporated in the State
system. This unique blending of inmates/patients has
of West Virginia
allowed PrimeCare Medical to experience the vast
 Very first and only health
differences and complexities of health related concerns
care provider for the
that face those inmates/patients facing both short term
Regional Jail Authority
and long term sentences.
 State-Wide Electronic
Health Record (EHR) in
Also in West Virginia, PrimeCare Medical is extremely
all RJA Facilities
proud to say that it has been the contracted health care
 Contracted provider for all
provider for the entire West Virginia Division of
WV Division of Juvenile
Juvenile Services system since 2001, when we were
Services (DJS) Facilities
awarded an emergency services contract at the West
Virginia Industrial Home for Youth. The Division of
Juvenile Services is another multi-facility system
consisting of nine (9) juvenile detention and confinement facilities and PrimeCare Medical is
proud to say that it has again, been the only correctional health care firm to have serviced this
unique and diverse multi-facility system. This is just another example of PrimeCare Medical’s
ability to effectively operate and manage a state-wide correctional system.
In addition to these facilities, PrimeCare Medical is extremely proud to say that it has been
providing comprehensive correctional health care services to the Rockingham County
Department of Corrections, located in New Hampshire, since July 1, 1999, representing a
business partnership that has stood the test of time for over nineteen (19) years. This proven
continuous contract history represents just one (1) example of PrimeCare Medical’s commitment
to developing and maintaining long-term professional partnerships with the counties with whom
we contract with.
Additionally, PrimeCare Medical is very excited and proud to say that we are currently
expanding our business operations throughout the State of Maryland; currently providing
correctional health care services to the Baltimore County Detention Center, Carroll County
Detention Center, Cecil County Detention Center, Charles County Detention Center, Garrett
County Detention Center, and St. Mary’s County Detention Center. Consistent with our proven
business philosophy of steady, purposeful growth and staying focused on remaining the region’s
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

premier correctional health care provider, we are able to maintain our commitment to each of
these clients by bringing a “hands-on” and “personal service touch”. PrimeCare Medical not
only welcomes you, but encourages you to contact each of these facilities to inquire as to the
vast differences in operational ability and managerial commitment between their previous
contracted providers and PrimeCare Medical.
Likely one of the most significant accomplishments we have made in recent years within our
contracted correctional facilities has been the implementation of our completely customized
electronic medical records system, CorEMR. We have already implemented this electronic
medical record system in forty-six (46) sites – accounting for over 23,000 lives. PrimeCare
Medical is currently working towards implementing this system in all contract facilities. The
system currently services PrimeCare Medical facilities ranging in size from 2,600 beds (York
County) to 49 beds (Lancaster Youth Intervention Center) including a multi-site system (West
Virginia Regional Jail Authority). In March of 2011, PrimeCare Medical successfully
transitioned CorEMR into each of the Regional Jail Facilities, making West Virginia one of the
only state-wide regional jail systems in the country to have achieved this milestone. It is this
vast experience that has uniquely positioned PrimeCare Medical to enter into the contract for the
Putnam County Correctional Facility. We believe that through our existing partnerships, we
possess a strategic advantage over each of our competitors to maintain the highest levels of
continuity of patient care for those inmates/patients confined to the Putnam County Correctional
Facility.
PrimeCare Medical, as well as numerous members of our Senior Corporate Leadership Team,
also has many years of experience in contracting with State Department of Corrections / Division
of Corrections facilities. Throughout the years, Pennsylvania and West Virginia have also
routinely housed thousands of their DOC Inmates within their County / Regional Facilities. As
such, we have successfully provided for the ongoing health needs of this critical DOC
population.
It is through these corporate experiences and years of our senior leadership’s personal
experiences in working in correctional health care systems, that has again uniquely and
strategically positioned PrimeCare Medical to seamlessly transition this health services contract
in the most cost effective and efficient manner possible.
Another critical aspect of PrimeCare Medical’s business
model is the “longevity” of our health services contracts. At
PrimeCare Medical, we remain focused and committed to
establishing long term partnerships with our clients.
Typically, once we are awarded a correctional health care
contract, we are never faced with the need to prepare an exit
strategy and transition plan to another health care company. In fact, many of our existing clients
elect to simply “renew” our health care agreements without the desire to even obtain proposals
from other firms. PrimeCare Medical has actually maintained many of our health care contracts
longer than some of our competitors have even been in business. We again encourage you to
contact any one of these clients to learn more about the level of services we provide.
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

PrimeCare Medical is also a strong supporter of the National Commission on Correctional
Health Care (NCCHC) and the American Correctional Association (ACA), as all of our policies
and procedures are based upon their standards. One of the key reasons why we feel so strongly
about these agencies and their accreditation processes is that they provide our clients with an
unbiased, third party evaluation of the level of service PrimeCare Medical provides. Over the
years, PrimeCare Medical has

Successfully achieved accreditation, as well as reaccreditation, from these agencies in 100% of our
audits;
thus, PrimeCare Medical has never failed to achieve and/or maintain continuous accreditation
status from either of these agencies. In West Virginia, we have successfully achieved and
maintained accreditation from the NCCHC for the entire Regional Jail Authority and for the
entire Division of Juvenile Services.
To further illustrate our ability to effectively operate the health services contract for the Putnam
County Correctional Facility, we would like to share some statistics detailing the volume of
health care services provided by PrimeCare Medical on an annual basis.

Total Average Daily Population (ADP)
Total Number of Intake Receiving Screenings Completed
Total Number of Outside Specialty Consultations

24,500+
139,809
16,282

Total Number of Medical Sick Call Visits Completed 300,137
(Nursing, PA's, CRNP's, & Physician)
246,051
Total Number of Mental Health Patient Contacts
27,948
Total Number of Dental Patient Contacts
*Statistics taken from 2017 End of Year Statistical Summary Reports.

PrimeCare Medical has a long-standing, definitive track record of successfully managing all
aspects required for a smooth contract implementation, transition of employees, and continuity of
services. Every new contract is launched using a formal Transition Plan that specifies key
activities within each major functional area, the person(s) responsible for completing these tasks,
and the required dates of completion based on the timeframe available. Implementation
activities focus on smooth transitioning of all management functions and the continuity of all
clinical services required under the contract. Our expertise is further enhanced by PrimeCare
Medical’s extensive experience and working knowledge of the correctional system. Important
for the Putnam County Correctional Facility, PrimeCare Medical has a thorough understanding
of correctional policies and procedures from our years of experience in managing health care
services within the local region. Upon a contract award, PrimeCare Medical will utilize our
experienced managers to implement and initiate the PrimeCare Medical operations plan as
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

detailed throughout this Proposal. Drawing upon thirty-two (32) years of experience in
successfully managing many other contracts, as well as our in-depth working knowledge and
experience specific to local county corrections, PrimeCare Medical can assure the Putnam
County Correctional Facility a smooth and effectively coordinated transition that will insure
continuity of administrative and clinical functions to the Putnam County Correctional Facility.

MANAGEMENT SUMMARY
PrimeCare Medical, since its inception, has been committed to providing the most efficient and
cost effective, quality levels of health care services in the industry. This is accomplished through
a commitment to operating the corporation on a daily basis consistent with nationally accepted
standards. Our proven business model, coupled with our core values, business philosophies, and
continuous desire to be the premier provider of correctional health care services in the
Northeastern United States are what makes PrimeCare Medical a true leader in the correctional
health care industry today and the ideal health care provider for the Putnam County Correctional
Facility.
Due to the unique and diverse composition of our senior corporate leadership, PrimeCare
Medical has the unparalleled capacity to effectively engage in the type of strategic operational
planning, medical/administrative consultation, and rapid response to emergent / client issues
necessary for the proper delivery of medical services to the Putnam County Correctional Facility.
As stated previously, Dr. Hoffman’s vision for PrimeCare Medical has been spearheaded through
the efforts of our Senior Executive Team, who possess over 100 years of experience. These
individuals are further supported by our Junior Vice Presidents, who will each play an integral
role in the transition of the Putnam County Correctional Facility contract. PrimeCare Medical’s
Junior Vice Presidents, to include Marcy E. Hoffman, MHRM, CCHP; Brent W. Bavington,
MBA, CCHP; Derek G. Hughes, MBA, CCHP; Paul W. Navarro, MSN, NP-C, CCHP; and
Kelly A. Ehrich, MBA, BSN, RN, CCHP; possess a combined 100 years’ experience in both
state and county corrections, health care, information technology, human resources and
recruitment, risk management, and correctional medical management. Additional transitional
and managerial support of this project will be further supported by our highly skilled and
experienced Team of Directors, Regional Coordinators, and Assistant Regional Coordinators.
The combination of this level of experience permits the PrimeCare Medical senior leadership to
possess an insight into the problems and dynamics of the correctional medical field today. As
such, this has again provided for another strategic advantage to PrimeCare Medical in
transitioning and managing this contract as we intend to utilize each member of this team at
various levels to successfully transition the Putnam County Correctional Facility health services
contract.
As previously noted, the goal of providing quality health care services to the inmates/patients at
the Putnam County Correctional Facility will continue to be overseen by a multi-disciplinary
team of health care and business professionals. The following listed individuals are PrimeCare
Medical Representatives who will be directly involved in and responsible for the operational
implementation of our business plan for the Putnam County Correctional Facility Contract.
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Putnam County Correctional Facility
Inmate Health Care Services
RFP – 7-18

Carl A. Hoffman, Jr., D.O., D.Sc., CCHP - Dr. Hoffman is the President and Corporate
Medical Director of PrimeCare Medical and PrimeCare Medical of West Virginia, Inc. With his
forty (40) years’ experience as a correctional physician, he will provide direction medically and
administratively to the Putnam County Correctional Facility. He has been President of
PrimeCare Medical and PrimeCare Medical of West Virginia, Inc. since inception and oversees
the operation of all facilities. He will aid in the recruitment and supervision of all professional
staff for medical operations for the Putnam County Correctional Facility.
Dr. Hoffman is an on-call medical provider for the entire Corporation and is available twentyfour (24) hours per day, seven (7) days per week. He is also available as a resource for all
medical personnel should a question arise. Additionally, Dr. Hoffman participates on the
Utilization Review Committee (URC) in reviewing and case managing all outside treatment for
the Company. He is actively involved in the creation, review and approval of all Policies and
Procedures for the Company. His involvement and experience is unmatched in the industry.
Dr. Hoffman received a Bachelor of Arts Degree from Thiel College. Furthering his education at
the Indiana University of Pennsylvania, he earned a Master’s of Science Degree in Biology. He
then went on to graduate from the Philadelphia College of Osteopathic Medicine with a Doctor
of Osteopathic Medicine Degree. Additionally, Dr. Hoffman has received an Honorary Doctor
of Science Degree from Thiel College. Dr. Hoffman is licensed by the Pennsylvania Osteopathic
Medical Board and West Virginia Osteopathic Board of Medicine, and is certified by the
National Commission on Correctional Health Care (NCCHC) as a Certified Correctional Health
Professional (CCHP).
Theresa Marie Hoffman – Mrs. Hoffman is the Executive Vice President of PrimeCare Medical
and PrimeCare Medical of West Virginia, Inc. A 1981 graduate of Bishop McDevitt High
School in Harrisburg, Pennsylvania, her work experience has included Balaban and Balaban, a
Harrisburg law firm, as well as AMP, Inc., a Fortune 500 Company. She has been in the
forefront of the Company’s efforts to streamline and make more efficient its financial and
staffing operations. Mrs. Hoffman also supervises and directs many of the business operations of
the Corporation, providing direct oversight and management to each of the key departments
within the PrimeCare Medical Corporate Office. Mrs. Hoffman also plays an active role in
supporting various Marketing functions of the Corporation, as well as, being involved in leading
numerous employee appreciation and client relations activities. Her unique ability to identify an
issue and create a solution makes Mrs. Hoffman a valuable resource to the team.
Thomas J. Weber, Esquire – On June 1, 2016, after a twenty-six year career as a private
attorney, Mr. Weber assumed the position of Chief Executive Officer of PrimeCare Medical. As
an attorney, Mr. Weber focused a majority of his energies on health care related legal
matters. He also is the author of numerous articles on health care related legal topics and served
as a frequent lecturer on topics ranging from regulatory compliance, HIPAA and proper record
keeping and retention.
Mr. Weber also served on the Executive Committee of Goldberg
Katzman, P.C., gaining invaluable experience in overseeing company operations. Prior to
assuming the position of Chief Executive Officer, Mr. Weber had served as Corporate Counsel
for PrimeCare Medical, wherein he coordinated the defense of inmate/patient lawsuits, oversaw
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insurance and contractual issues, and supervised the Human Resources Department. Mr. Weber
has his Bachelor of Science (B.S.) from The Pennsylvania State University with distinction and
earned his Juris Doctor (J.D.) from The Dickinson School of Law in 1990 graduating cum
laude. As Chief Executive Officer, Mr. Weber utilizes his legal and managerial experiences to
ensure that PrimeCare Medical is positioned to provide the highest quality correctional medicine
in the most cost effective manner while maintaining the highest standards of ethical and legal
compliance.
Todd W. Haskins, RN, BSN, CCHP – As Vice President of Operations for PrimeCare Medical,
Mr. Haskins has clinical and operational responsibilities for Pennsylvania, West Virginia,
Maryland, New York, and New Hampshire Facilities. He started with PrimeCare Medical as a
Health Services Administrator in 1999 and in May 2006 was promoted to Vice President of
Operations.
As Vice President of Operations, Mr. Haskins ensures clinically sound care is provided by
medical and mental health personnel within all contracted PrimeCare Medical facilities. Mr.
Haskins strives to build and maintain relationships with jail/juvenile administrative members
from all levels of the Corporation, as well as serving as the key liaison and negotiator of
collective bargaining agreements/units for the Company. Mr. Haskins is an essential part of the
Corporate Operations and his cutting edge thinking has enabled PrimeCare Medical to be at the
forefront of clinical and operational systems in correctional healthcare. He was a key developer
in the inception of the electronic medical records system and works aggressively with nurses and
clinicians to continually enhance the features that are offered through CorEMR. He also
developed the Continuous Quality Improvement Program and numerous other operational and
clinical enhancement systems and techniques. Mr. Haskins is also a member of the PrimeCare
Medical Utilization Review Committee.
Mr. Haskins has achieved his Certified Correctional Healthcare Professional (CCHP)
certification from the National Commission on Correctional Health Care (NCCHC). Many areas
of clinical experience can be found in Mr. Haskins’ professional career, to include: telemetry,
trauma, emergency medicine, surgical and medical intensive care, case management, and
correctional nursing and healthcare management.
Francis J. Komykoski, Sr., M.B.A., CCHP - As the Strategic Planning Officer, Director of
Policies and Procedures, and the Director of National Commission on Correctional Health Care
(NCCHC) Accreditations for PrimeCare Medical, Mr. Komykoski oversees the day-to-day
operations of the Corporation in Pennsylvania and New Hampshire.
In his prior significant military employment history, Mr. Komykoski was a twenty-three (23)
year veteran of the United States Navy retiring at the rank of Commander in 2002 with the
designation as a Surface Warfare Officer (SWO). In his final active duty assignment, Mr.
Komykoski served as Commanding Officer, Naval Reserve Center, Fort Dix, New Jersey. He
managed the training and administration for over one thousand (1,000) Naval Reservists and one
hundred (100) active duty Naval Officers and Sailors in the northeastern United States of
America and he was responsible for the yearly implementation and execution of over a
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$1,100,000.00 operating budget. A few noteworthy highlights of Mr. Komykoski’s naval career
include the fact that he was awarded three (3) Meritorious Service Medals, four (4) Navy
Commendations Medals, and three (3) Navy Achievements.
Already a distinguished graduate of the Pennsylvania State University with a Bachelor of
Science Degree in Industrial Arts Education, upon his retirement Mr. Komykoski furthered his
education by earning a Master’s Degree in Business Administration (MBA) with an emphasis in
Health Services Administration from Eastern University in 2005. He also earned his Certified
Correctional Health Professional (CCHP) certification through the National Commission on
Correctional Health Care (NCCHC). He served on the Academy of Health Care Professional
Board of Trustees from 2006 to 2008.
Additionally, Mr. Komykoski is the Director of National Commission on Correctional Health
Care (NCCHC) Accreditation and Director of Policies and Procedures and supervises the
NCCHC Accreditation process for the Corporation.
Paul W. Navarro, MSN, NP-C, CCHP - As a Junior Vice President of Clinical Operations for
PrimeCare Medical, Mr. Navarro assists the Vice President of Operations with the research,
development and implementation of company safety and clinical educational programs. Mr.
Navarro is also a member of the Utilization Review Committee and assists in the day-to-day
clinical operations of the corporation. He is a 2006 graduate of The Pennsylvania State
University with a Bachelor of Science in Nursing Degree. He has been a guest lecturer for
students and faculty at The Penn State School of Nursing, Hershey Medical Center on various
clinical and correctional healthcare topics. Mr. Navarro also serves on the Pennsylvania State
University School of Nursing APG Board of Directors. Mr. Navarro received his Masters of
Science in Nursing Degree in 2010 from Widener University, where he was a member of the
Sigma Theta Tau, Eta Beta Chapter, International Honor Society of Nursing. Mr. Navarro was
first employed by PrimeCare Medical as an EMT in 1999. He has clinical experience in the
Pediatric Intensive Care Unit, trauma, emergency medicine, and infectious disease. Mr. Navarro
is Nationally Certified as a Family Nurse Practitioner by the American Academy of Nurse
Practitioners. He has also achieved his Certified Correctional Health Professional (CCHP)
certification from the National Commission on Correctional Health Care (NCCHC).
Kelly A. Ehrich, M.B.A., B.S.N., R.N., CCHP – As a Junior Vice President of Operations for
PrimeCare Medical, Ms. Ehrich oversees several facilities in Southeastern Pennsylvania with
populations ranging in size from 400 – 2,300 inmates/patients. Ms. Ehrich began with PrimeCare
Medicalas the Health Services Administrator at Lehigh County Prison and was promoted to the
role of Regional Coordinator for the Company. Ms. Ehrich is a graduate of Wilkes University,
where she received a Master’s Degree in Business Administration. She is a Registered Nurse
and received her Bachelor of Science Degree in Nursing at Cedar Crest College. She has
achieved her Certified Correctional Health Professional (CCHP) certification from the National
Commission on Correctional Health Care (NCCHC).
Prior to her employment with PrimeCare Medical, Ms. Ehrich was employed by another
correctional health care firm at the Lehigh County Prison, Allentown, PA, as the Healthcare
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Administrator where she was responsible for the effective delivery of the institutions (1300 bed)
overall health care system. In this role she acted as a liaison between health services and
institutional administration, department heads and security. She supervised all health care unit
budgets including: pharmacy, medical records, nursing, lab, X-ray etc. and actively monitored
financial performance of the contract. Ms. Ehrich developed and implemented all institution
directives and procedures to comply with NCCHC accreditation and maintained a quality
improvement program. She managed all staff related issues including: recruitment and retention,
interviewing and hiring of department heads and staff, scheduling, and performance evaluations.
Ms. Ehrich was also employed by a third correctional health care company within the New
Jersey Department of Corrections in a multitude of roles, including those of Outside
Consultation/Specialty Care Manager, East Area Sr. Financial Analyst, and the New Jersey
Financial Manager. As the Statewide Outside Consultation/Specialty Care Manager she directly
supervised consult coordinators within the prison facilities across the state and coordinated onsite clinics and outpatient services for New Jersey State inmates. Throughout her career with
Correctional Medical Services, she supported the New Jersey contracts in establishing and/or
maintaining accreditation status. She then moved into the role of the East Area Sr. Financial
Analyst, where she analyzed financial data for the correctional facilities of the Eastern Region of
the United States that contracted with Correctional Medical Services. She worked on bid
proposals and helped to support the Main Office Financial Operations Department in St. Louis,
MO. She additionally was appointed as a Focal Point Trainer responsible for training all new
management and administrative employees in various aspects of their contract. She then served
as a Financial Manager where she supported the day-to-day financial operations of the $125
million New Jersey Region and Federal Projects. This position included daily monitoring of
labor to review appropriate utilization of staff relative to approved operational levels,
troubleshooting claim/invoice issues, Ad Hoc reporting/analysis, monitoring utilization trends in
inpatient and outpatient services, quickly identifying the need for corrective action, and to
effectively communicate and resolve any issues related to the financial performance of the
contract to include operational issues that could potentially lead to penalties.
Marcy E. Hoffman, M.H.R.M., CCHP - As the Junior Vice President of Human Resources Personnel, Ms. Hoffman oversees Human Resources operations on a daily basis. She reviews all
disciplinary action and terminations, in conjunction with the Vice President and Chief Executive
Officer of the Company. She maintains all personnel files of each employee in the Company and
also maintains all Company benefits, excluding the 401K Plan. Ms. Hoffman has achieved her
Certified Correctional Health Professional (CCHP) certification from the National Commission
on Correctional Health Care (NCCHC). She holds a Master’s Degree in Human Resources
Management and Industrial Relations.
Brent W. Bavington, M.B.A., CCHP - Mr. Bavington is the Junior Vice President of
Operations, Human Resources (Recruitment and Employment) and Technology. He is a graduate
of Slippery Rock University with a Bachelor of Science Degree in Information Technology with
a Minor in Marketing. He received a Master’s Degree in Business Administration (MBA) from
Eastern University in St. David’s, PA. Mr. Bavington has achieved his Certified Correctional
Health Professional (CCHP) certification from the National Commission on Correctional Health
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Care (NCCHC). He oversees the recruitment process of all new hires. Mr. Bavington sees that
staffing needs are met at all PrimeCare Medical facilities and has operational supervision of
various contracted facilities in Pennsylvania and West Virginia. He also supervises the
Corporate Network Administrator in all technological needs of the Corporation.
Derek G. Hughes, M.B.A., CCHP – As the Junior Vice President of Operations for PrimeCare
Medical, Mr. Hughes assists the Vice President of Operations in the operational management of
the Corporation; primarily having contract oversight for various correctional health contracts in
Central and Northeastern Pennsylvania, as well as managing its contractual operations in New
Hampshire and Maryland. Mr. Hughes actively coordinates with all Pennsylvania, New
Hampshire, and Maryland contracts and assists with the tactical planning and operations with
each. Mr. Hughes is also responsible for the technical writing and preparation of all company
proposals and subcontracting endeavors, as well as his involvement in the Corporation’s
marketing and business development initiatives. He is a 2004 Magna Cum-Laude graduate of
the Shippensburg University of Pennsylvania with a Bachelor of Science Degree in Business
Administration and has earned his Master’s Degree in Business Administration (MBA) from
Eastern University in St. David’s, Pennsylvania. He has achieved his Certified Correctional
Health Professional (CCHP) certification from the National Commission on Correctional Health
Care (NCCHC).
Sandra M. Ulerick, M.B.A., CCHP – As the Director of Risk Management and Privacy
Officer, Ms. Ulerick monitors all lawsuits and coordinates communications between attorneys
and key staff members. Ms. Ulerick reviews all grievances and inmate/patient letters received at
the Corporate Office. She is also responsible for reviewing the daily logs and reporting to the
Corporate Medical Director and Corporate Counsel any potential high-risk issues. Ms. Ulerick is
a graduate of Duquesne University, where she obtained her Bachelors of Science Degree in
Criminal Justice and Forensic Science and has earned her Master’s Degree in Business
Administration (MBA) from Eastern University in St. David’s, Pennsylvania. Ms. Ulerick has
achieved her Certified Correctional Health Professional (CCHP) certification from the National
Commission on Correctional Health Care (NCCHC).
Jennifer Mroz, PA-C, CCHP – Ms. Mroz is a graduate of Kings College and has over 18 years
of medical experience. She started with PrimeCare Medical as a Physician Assistant in 2003 and
in 2013 was promoted to Director of Clinical Operations for the Corporation. She assists in the
day to day clinical operations of the company, is a member of the Utilization Review Committee,
and provides physician assistant services at various facilities throughout Northeastern
Pennsylvania. Ms. Mroz has achieved her Certified Correctional Health Professional (CCHP)
certification from the National Commission on Correctional Health Care (NCCHC).
Pamela Rollings-Mazza, MD – Dr. Rollings-Mazza is a licensed Psychiatrist in the
Commonwealth of Pennsylvania and has been employed with PrimeCare Medical as a staff
psychiatrist since January, 2008. She has recently been promoted to the Director of Psychiatry
for the Corporation. In addition to continuing to provide direct patient care, Dr. Rollings-Mazza
assumes various administrative duties to improve the efficiencies of our mental health care
delivery model, assists with the development of policies and training to ensure PrimeCare
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Medical remains at the forefront of meeting our patients’ mental health needs and overseeing the
consistent application of the company’s procedures. Dr. Rollings-Mazza is available to provide
telepsychiatry for any facility based out of the PrimeCare Medical Corporate Office in
Harrisburg, PA if required to do so. She received her Doctor of Medicine degree from Memorial
University of Newfoundland, Canada in 1996. Dr. Rollings-Mazza is American Board Certified
in Psychiatry and Neurology.
Robert M. Nichols, Jr., Psy.D., CCHP – As Director of Mental Health, Dr. Nichols oversees
the mental health services for PrimeCare Medical. He has over twenty-five years of correctional
experience, including fifteen years as Deputy Warden of Treatment at Berks County Prison. Dr.
Nichols graduated from Elizabethtown College with a Bachelor of Arts degree in Political
Science and History. He received his Master’s Degree in Counseling Psychology from Kutztown
University graduating Magna Cum Laude. Recently he received his Doctor of Psychology
(Psy.D.) degree in Clinical Psychology from Philadelphia College of Osteopathic Medicine. For
nearly two decades, he has practiced as a licensed psychologist in Pennsylvania. Dr. Nichols has
been employed with PrimeCare Medical since January, 2006.
Nathan B. Kalteski, D.M.D. – Dr. Kalteski is the Director of Dental Health Services for
PrimeCare Medical. He is a graduate of Temple University School of Dentistry. He attended
undergraduate school at the University of Scranton. He currently services the Chester County
Prison, Northampton County Department of Corrections, Franklin County Prison, Lehigh County
Prison, Lancaster County Prison, and the Pike County Correctional Facilities for PrimeCare
Medical
Emily M. Scordellis, Psy.D. – As the Regional Mental Health Manager, Dr. Scordellis assists
with the implementation of policies and procedures for mental health services at PrimeCare
Medical locations across Pennsylvania, Maryland and New York. Dr. Scordellis graduated from
Chestnut Hill College with a Bachelor of Arts degree in Psychology and Criminal Justice in 2006
and she earned her Master’s Degree in Clinical and Counseling Psychology from Chestnut Hill
College in 2008. Dr. Scordellis graduated with her Doctorate in Psychology (Psy.D.) from
Immaculata University in 2013. She joined the PrimeCare Medical team upon the completion of
her degree and was promoted to Regional Manager in 2016. Dr. Scordellis is currently licensed
in the states of Pennsylvania, Maryland, New York and West Virginia.
Victoria A. Gessner, M.D. – Dr. Gessner serves as the Assistant Corporate Medical Director
for PrimeCare Medical in the Commonwealth of Pennsylvania. Dr. Gessner is a 1983 graduate
of the Temple University School of Medicine and has over 19 years of experience in the
correctional health care industry. Dr. Gessner has worked as the Medical Director/Physician at
the following facilities: The George W. Hill Correctional Facility, Thornton, PA; Delaware
County Prison, Thornton, PA; Montgomery County Correctional Facility, Norristown, PA; and
SCI Graterford, Graterford, PA. Dr. Gessner began her employment with PrimeCare Medical in
November, 2007. She currently services the Chester County Prison, Berks County Jail System,
Northampton County Prison, and Dauphin County Prison for PrimeCare Medical Prior to
corrections, she worked as a hospitalist in various Philadelphia hospitals and later as a physician
in a private group practice in Abington, PA. Dr. Gessner speaks fluent English and Spanish.
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Denise Gemzik-Jemiola, RN, BSN, CCHP-RN – Ms. Jemiola is a graduate of the Pittston
Hospital School of Nursing and has over twenty-five (25) years of nursing experience. She
began employment with PrimeCare Medical as a Health Services Administrator in 2005 and has
been promoted to Regional Coordinator for Northeastern Pennsylvania and New Hampshire. Ms.
Jemiola has achieved her Certified Correctional Health Professional (CCHP) certification from
the National Commission on Correctional Health Care (NCCHC).
Kelly Rhoads, LPN, CCHP – Ms. Rhoads started her employment with PrimeCare Medical in
1996 as a staff licensed practical nurse and was later promoted through the ranks to Assistant
Regional Coordinator. She currently oversees the operations of multiple adult correctional
facilities ranging in size from 1,000 inmates/patients to over 2,300 inmates/patients, as well as
several juvenile detention centers. Ms. Rhoads achieved her Certified Correctional Health
Professional (CCHP) certification from the National Commission on Correctional Health Care
(NCCHC).
Tiffany Morykan, MBA, CCHP – Ms. Morykan began her employment with PrimeCare
Medical in 2004 as an Administrative Assistant at the Northampton County Prison. Since that
time, she has continued her education and has been promoted through the ranks to Assistant
Regional Coordinator. She is responsible for the day-to-day operations for the Eastern
Pennsylvania and Maryland contracted facilities. She is a graduate of DeSales University where
she received a Master’s Degree in Business Administration. Ms. Morykan achieved her Certified
Correctional Health Professional (CCHP) certification from the National Commission on
Correctional Health Care (NCCHC).
Susan M. Brennan, RD, LDN – Ms. Brennan is a 1989 graduate of the University of Delaware
where she received a BAAS in International Relations. She attended Immaculata University
where she received a MA Candidate/AP4 Certification in Nutrition Education. Ms. Brennan
served in the US Air Force from 1995 to 2004 where she was nominated for the USAF Dietitian
of the Year Award. She has been employed as the Dietitian for PrimeCare Medical since 2011
and is the expert consultant providing comprehensive medical nutrition therapy and menu
reviews to PrimeCare Medical’s contracted correctional facilities throughout the Northeastern
United States. Ms. Brennan is frequently consulted on various dietary issues within PrimeCare
Medical’s contracted facilities.
SUBCONTRACTORS
In addition to PrimeCare Medical’s extensive “in-house” management TEAM, we also provide
various service aspects of this Proposal through already established working partnerships with
our TEAM of subcontracted providers; each of which being experts in their respective fields as
they relate to the correctional health care industry. Subcontractors identified within this Proposal
that we intend to utilize include Professional Care Medical Practice P.C., Professional Care
Dental Services, P.C., Personal Care Registered Professional Nursing P.C., Bio-Reference
Laboratories, Correct Rx Pharmacy Services, Physicians Mobile X-Ray Imaging, Institutional
Eye Care, Infinity Search Group, CorEMR, and Stericycle. Qualifications and descriptions of

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each of these subcontractors are outlined below.
services will be further detailed later in our Proposal.

Each of these subcontracted providers’

 Professional Care Medical Practice P.C., Professional Care Dental Services, P.C., and
Personal Care Registered Professional Nursing P.C. are three New York Professional
Corporations formed and owned by long time PrimeCare Medical employees licensed by
the state of New York to provide medical, dental and nursing care and services
respectfully. They were formed and work exclusively in tandem with PrimeCare Medical
of New York, Inc. to provide the full range of health care services in correctional settings
in the state of New York. The mission of these companies and their employees is to
focus on and provide the professional health care services. PrimeCare Medical of New
York, Inc. in turn handles the managerial and administrative aspects of the contract and
serves as the primary point of contact with the facility and liaison between the facility
and the health care providers.

 Bio-Reference Laboratories, Inc. has been serving the Correctional market for over
fifteen (15) years. Bio-Reference is CLIA Certified, CAP accredited, and properly
licensed. As the largest independent clinical laboratory in the tri-state area, BioReference seeks to offer the best service possible that is personalized to fit the needs of
your facility. Bio-Reference operates a full service clinical laboratory and an andrology
laboratory. Currently, Bio-Reference Laboratories services all PrimeCare Medical
contracted facilities. The direct point of contact for Bio-Reference Laboratories is Sujaya
Swaroop, who may be reached at 481 Edward H. Ross Drive, Elmwood Park, New Jersey
07407; or by phone at 201-218-6530.

 Correct Rx Pharmacy Services, Inc. was established as a Maryland corporation in 2003
and has experienced steady growth year over year. Correct Rx is headquartered in
Maryland, between Baltimore and Washington, and serves more than 200,000 inmates in
42 states in correctional and juvenile facilities, residential treatment programs and senior
care facilities. They are a full service pharmacy available 24 hours a day, seven days a
week, and take pride in providing accurate and timely dispensing and delivery.
Correct Rx is a leader in institutional pharmacy and offers clients a unique value through
their commitment to Clinical Pharmacy. They partner closely with our Healthcare teams
to identify ways to reduce overall healthcare costs while improving patient outcomes.
Correct Rx’s unique business model is based on the practice of clinical pharmacy,
collaborating with other parts of a medical team to manage a patient’s health rather than
strictly filling prescriptions and selling pills. Their goal is to ensure the best possible
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health outcome and the most cost-effective treatment rather than simply fill orders with
the prescribed number of the cheapest pills. Additionally, Correct Rx has expertise in
accreditation and can assist in helping clients get accredited or re-accredited. They
created a robust audit tool which ensures that client’s medication rooms are in full
compliance with all State and Federal regulations including national accrediting bodies
(e.g., NCCHC, ACA, and JC) along with facility specific standards, policies and
procedures.
Correct Rx has the experience you can count on as a client, from the owners of Correct
Rx to our Clinical Pharmacists. Dr. Ellen H. Yankellow is the President and CEO of
Correct Rx and a national leader in the advancement of clinical pharmacy for institutions.
She has over 30 years of experience in the industry. Jill Molofsky, RPh, CCHP, serves as
Vice President and also has over 30 years of operational experience providing pharmacy
services for institutions all across the country. James Tristani, RPh is head of Purchasing
and has 35 years of direct pharmacy business experience. Correct Rx employs the highest
credentialed Clinical Pharmacists to support these clinical initiatives. These Clinical
Pharmacists have Pharm D, post-graduate residency training and are board certified.
Correct Rx has the ability to take on large pieces of business in an organized manner with
no disruption to clients and the inmates they serve. They have transitioned over 390
facilities in the past 12 years. This includes statewide systems, large municipalities like
the Philadelphia Prison System and the Atlanta City Jail and county jails. Correct Rx
currently provides pharmacy services to fourteen of the twenty-three Maryland Counties,
Maryland DPSCS since 2005, and the Maryland Department of Juvenile Services.
Correct Rx is a woman-owned and operated business certified by the Maryland
Department of Transportation (MDOT - Certification No. 03-440) as a Women Business
Enterprise (WBE). In addition, Correct Rx is certified as a Women’s Business Enterprise
by the Women’s Business Enterprise National Council (WBENC – Certification No.
2005125955), the nation’s largest third-party certifier of the businesses owned and
operated by women in the United States. Correct Rx is also classified as a certified small
business through the federal SBA. Correct Rx has a diverse work force as more than
70% of our employees are classified as minorities. We have contracted with several small
local and regional companies on numerous contracts to provide support services that help
us to meet the needs of our clients.
The direct point of contact for Correct Rx is Dr. Ellen H. Yankellow, President and CEO,
who may be reached at 1352-C Charwood Road, Hanover, MD 21076; or by phone at
800-636-0501.

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 Physicians Mobile X-Ray Imaging, Inc. (PMX) was established in 1978 in Western
Pennsylvania. We currently service all of Pennsylvania, Maryland, Delaware, Ohio and
West Virginia. PMX has been providing service to PrimeCare Medical for over 15 years.
PMX is an industry leader providing digital portable diagnostic x-ray, ultrasound, and
cardiac services. Our team of caring professionals uses advanced technology to deliver
prompt and efficient service. We bring our personnel and equipment to the facility and
perform ordered exams. Images are able to be viewed by the patient’s physician at the
time of services. Reports are faxed and available for review on the website following
interpretation. X-Ray and EKG services are available 24 hours a day, 7 days a week.
Ultrasound services are available on a scheduled basis.
The administrative offices of Physician's Mobile X-Ray, Inc. are located at 945 East Park
Drive, Suite 102, Harrisburg, PA 17111. For additional information, please contact Todd
Gelbaugh, C.E.O., at (717) 561-4940.

 Institutional Eye Care, Inc. is the largest vision service provider in the country devoted
solely to inmate eye care. We currently service over 1,000 separate local, county, state
and federal facilities in 45 states. We provide on-site vision services in all 50 states and
began international service in January 2000. Institutional Eye Care’s correctional
experience began in 1983.
Institutional Eye Care will provide on-site optometry and prescription eyeglass services
to meet all specifications set forth in the Request for Proposal. All prescription
eyeglasses will meet or exceed FDA and ANSI Dress Safety standards. Our optical lab
currently turns standard eyeglass orders around in about three business days of order
receipt. We guarantee standard prescription eyeglass shipment within ten days. All
eyeglasses carry a one year warranty against manufacturing defect.
We provide in state licensed and credentialed optometrists. Routine optometric care will
meet all current standards of community care. All services will be provided within the
state’s scope of optometric care and on-site equipment parameters. Services will be
provided at a mutually agreed upon schedule with the facility(s) to meet the requirements
as specified in the Request for Proposal. Currently, Institutional Eye Care services all
PrimeCare Medical contracted facilities. The direct point of contact for Institutional Eye

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Care is Jeffrey Lose, who may be reached at PO Box 366550, Bonita Springs, Florida
34136; or by phone at 866-604-2931.

 Infinity Search Group is comprised of highly successful consultants serving both
healthcare hiring clients and professionals. ISG = “Nationwide Healthcare Recruiters.”
Infinity Search Group (ISG) has been providing placement services for more than eight
(8) years. ISG specializes exclusively in the search and placement of qualified clinical,
managerial, supervisory, and staff healthcare professionals, in the fields of pharmacy and
allied healthcare. Our specialty is recruiting Nurse Practitioners and Physician
Assistants. We’ve recently expanded our platform to include Physician recruiting. We
are scalable and can transition into other disciplines.
Hiring clients utilize our comprehensive placement services on a contingency basis;
contingency searches enable the clients to view the potential candidates at no cost to
themselves. ISG has maintained and developed client relationships with numerous
healthcare-related organizations and institutions, on local, regional and national levels.
All potential healthcare candidates are thoroughly interviewed to ascertain their
motivation, salary expectations, and geographic/location preferences. We desire to work
with only ‘serious’ candidates, and will not refer individuals who are unrealistic and/or
merely “shopping around”. We do not define our own successes by the number of
placements we make, but by the quality of the candidates we help to achieve a rewarding
career path. Our secret!? We listen to all the individuals involved. Employers have
specific needs which they must meet, while potential candidates have certain personal
desires they look to satisfy, in a new position. We listen, understand, and then match
candidates with hiring managers that fulfill the needs of both parties. As a result, there
are no surprises. Just well informed candidates that are pre-screened and well-qualified to
meet the challenges they will face in their new position.
Currently, we service Maryland, Delaware, Pennsylvania, New Jersey, Ohio, Indiana and
Illinois. We are scalable and can transition into other states which we do frequently for
our clients. At ISG, we are committed to finding the best qualified candidates to be an
asset to your team and to building lasting client relationships. Infinity Search Group has
the experience and knowledge to locate and deliver well-qualified clients to the positions
they desire to obtain. The direct point of contact for Infinity Search Group is Ed
Shihadeh, who may be reached at 610-325-9461.

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 CorEMR was founded in 2004 and is the fastest growing Medical Records System on the
market today. CorEMR has emerged as the national leader in providing Electronic
Medical Records (EMR) to the correctional health care industry. CorEMR has more than
155 correctional facility customers in 30 states throughout the country with more than
88,000 inmate lives currently having their medical records kept
within the CorEMR system.
The CorEMR software was designed and developed from the
conception as a Correctional Electronic Medical Records package.
The software was not ported from a Physician Management or
Acute Care software system. The CorEMR software is a true webbased application that does not utilize any middleware to enable it
to be accessed via a web-browser or to make it appear as a thin client. CorEMR’s MAR is
an integrated feature of the EMR, it is not provided by a third-party company.
The CorEMR software is utilized by multiple regional and national Correctional Health
Care providers as well as self-operated County facilities. The CorEMR software is
certified by the ONC-ACB as a 2014 “Complete EHR”.
CorEMR meets the unique needs of correctional medical services by being flexible and
configurable:
 Multi-Facility Support allowing different forms and other configured items at
each facility if required.
 User Configurable Forms – easy migration from current paper forms to electronic
format for Intake forms, Nurse Protocols, Release and Transfers, etc.
 Configurable Security to control user access to support HIPAA requirements
 Scalable to support small and large County Facilities as well as State DOC
facilities
CorEMR has extensive experience in Integrations with other systems using HL7, Web
Services, File Sharing and File Transfer Protocols that include:






Offender/Jail Management
o Demographics
o Housing Location
o Release
Pharmacy
Laboratory
Radiology

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

State Wide Information Exchanges

The direct point of contact for CorEMR is Jonathan Probst, who may be reached at 1173
S. 800 East, Orem, Utah 84097; or by phone at 888-267-3671.

 Stericycle, Inc. specializes in the proper disposal of medical and/or bio-hazardous waste.
Their medical waste management services aid in employee safety, protect the
environment, and reduce compliance risks for those businesses that generate biohazardous waste. Stericycle is a global business-to-business services company. We
provide an array of highly specialized solutions serving healthcare organizations and
commercial businesses of every size. Since our founding over 25 years ago, we have
grown from a small start-up in medical waste management into a leader across a range of
increasingly complex and highly regulated arenas, such as:
•
•
•
•

Brand protection solutions
Environmental and sustainable solutions
Patient and customer communication solutions
Regulated waste management and compliance solutions

Every organization today must comply with increasingly strict regulatory guidelines and
quality controls in the delivery of their core businesses. Large or small, businesses can’t
always do it on their own. They seek out Stericycle to help them. We have the expertise
and passion to take on many complicated and often behind-the-scenes services our clients
don’t always know how to do well but that ultimately make their business better.
Our Purpose is to help our customers fulfill their promise by providing solutions that
protect people and brands, promote health and safeguard the environment. The direct
point of contact for Stericycle is Christine Bleisch, who may be reached at 4357 Ferguson
Drive, Suite 100, Cincinnati, Ohio; or by phone at 513-262-9678.
Given the current financial climate across our Country, we are constantly faced with the
challenging realization that we must learn to “do more with less,” especially in the correctional
health care industry. Being an established local health care provider, we have firsthand
knowledge and a vested interest in ensuring the Putnam County Correctional Facility
successfully accomplishes this task. With the PrimeCare Medical solution, we are ideally suited
to assist the Putnam County Correctional Facility in doing just that. Upon a contract award,
PrimeCare Medical not only can, but will achieve this goal through our already developed
networks of community resources; “bench” of qualified, licensed health care professionals;
established economies-of-scale; and working knowledge of local county inmates/patients.
Additionally, PrimeCare Medical has devoted significant amounts of resources and has made
substantial financial investments into an array of technological based advancements, which have
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taken us to the cutting edge of correctional health care. These investments have enabled us to be
a significant force in a highly competitive market and remain at the forefront of correctional
medicine.
Through the successful development and implementation of these critical
technological programs, PrimeCare Medical has not only improved the provision of overall care
to our inmates/patients, but has also realized substantial increases in operational effectiveness
and staffing efficiencies. PrimeCare Medical’s most significant stride in the technology-medical
industry has been through its complete customization and integration of our electronic medical
record system, CorEMR. The operational efficiencies of this system allows for immediate
implementation of policy changes, enhanced continuity of care, improved inmate/patient
outcomes, and most importantly, prevents inmates/patient from “slipping through the cracks”.
PrimeCare Medical has successfully implemented CorEMR at forty-six (46) correctional
facilities since its inception. A more in-depth review of this
system and the operational efficiencies it will provide to the
Putnam County Correctional Facility can be found in the
Advancements in
Electronic Medical Records section of this Proposal.
Technology
In additional to our electronic medical records system;
 CorEMR –
PrimeCare Medical has developed its own PCM Portal System,
Corrections based
will provides for medical and client staffs’ instant electronic
EMR
retrieval of key information such as policies and procedures,
 PCM Portal
medication formularies, continuing staff / medical education,
 HEALTHsuite by
inmate/patient educational programs, etc. PrimeCare Medical
RAM Technologies –
has also made significant enhancements within our internal
McKesson & Optum
financial management programs, such as our state-of-the-art
Coding
inmate/patient manager program, HEALTHsuite by RAM
 “eConsults” for
Technologies. This integrated claims processing system tracks
offsite care tracking
all inmate/patients in a step-by-step tracking format from the
 PCM NOW
date of an initial consultation request until payment is made to
the treating institution or provider. This program utilizes
McKesson and Optum Coding products to assist with claim
appropriateness and fiscal management of each inmate’s/patient’s interaction with all offsite
providers. With our vision of continuous improvement, PrimeCare Medical has also developed
“eConsults” linking origination of consults within CorEMR with the offsite providers utilizing a
more robust and efficient methodology. PrimeCare Medical has created an instant reporting and
monitoring system. This system, PCM NOW, responds to business/medical issues by
automatically sending alerts or notifications when pre-defined events occur. These alerts can
include anything from certain inmate/patient events (i.e., high blood pressure, low blood sugars,
etc.) to inmates/patients approaching monetary thresholds on their medical claims. Each of these
critical systems will be further addressed in greater detail later in our proposal.
PrimeCare Medical also understands the importance of partnering and collaborating with
uniform collective bargaining organizations. Throughout our corporation, we have successfully
maintained a very low incidence of union activity. PrimeCare Medical does, however, currently
manage one facility, where after assuming the medical services contract from another health care
firm, had made the decision to maintain this facility’s collective bargaining status. PrimeCare
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Medical has formed a true business partnership with this union organization over the years and
has successfully managed the union’s collective bargaining agreement with no adverse relations.
PrimeCare Medical is sensitive to this issue and has made it a priority to collaborate with the
unions, rather than making attempts to avoid and/or create adversarial relations.
It is this combination of PrimeCare Medical’s proven business philosophy in correctional
medicine of over thirty-two (32) years, the vast professional experiences of our multidisciplinary
senior management team, our extensive comprehensive presence in local correctional health care
systems, proven ability to operate state-wide correctional systems, innovation into various
technological advancements, and experience with local unions that makes PrimeCare Medical
the ideal health care solution for the Putnam County Correctional Facility.

FINANCIAL CAPABILITY
PrimeCare Medical has experienced steady growth and financial success since its inception.
PrimeCare Medical has been on The Central Penn Business Journal’s “50 Fastest Growing
Companies” list four (4) times in recent years. PrimeCare Medical has consistently maintained
compliance with all contract obligations, even while continually expanding. In the thirty-two
(32) years PrimeCare Medical has been in business, we have never experienced default or
forfeiture on any performance, payments or other bonding requirement. PrimeCare Medical has
continued to grow each and every year, even while constrictions have occurred within our
market base. The continued financial growth of our Corporation has been achieved through
technological advancements and operational system efficiencies which have resulted in improved
inmate/patient outcomes. PrimeCare Medical has thirty-two (32) years of proven financial
prudence record. This financial awareness allows our company to obtain bonds without issue,
maintain multi-million dollar lines of credit with zero (0) balances, and have the ability to
complete successful negotiations with our contracted vendors for reductions in their pricing
models due to our rapid payment abilities. Currently, PrimeCare Medical only maintains lines of
credit through our primary banking institution, PNC; as such line(s) are rarely used due to the
sound financial condition of our Corporation.
PrimeCare Medical maintains its financial stability through the routine monitoring and review of
all financial accounts. PrimeCare Medical employs a Certified Public Accountant with sixteen
(16) years of experience, who prepares and reviews the Balance Sheet, Income Statement, and all
other financial documents for PrimeCare Medical on a monthly basis. These Financial
Statements are also reviewed periodically throughout the year by an outside accounting firm as
well as quarterly by our banking institution. PrimeCare Medical also conducts the following
meetings on a regular basis to review the financial stability of the corporation:
 Monthly Review of all Outstanding Accounts Receivables
 Weekly Review of all Outstanding Accounts Payables
 Monthly Review of all Cash and Investment Accounts
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 Weekly Financial meetings are held with the PrimeCare Medical Director of Finance
(Certified Public Accountant) and the Vice Presidents of the Company
 Monthly conference calls are held with the staff at the contracted facilities where any
financial issues and or concerns are addressed
 Annual training is held for the Health Services Administrators where any financial
concerns and or issues are discussed
PrimeCare Medical possesses the necessary staff to maintain the financial performance of the
Corporation. We employ experienced staff for each of the following departments: Accounts
Receivable, Accounts Payable, and Payroll. PrimeCare Medical has open communications on
any financial matters with the staff of the various facilities with whom we are contracted.
PrimeCare Medical has Certificates of Good Standing for the following states: Pennsylvania,
West Virginia, New Hampshire, Maryland, Virginia, Ohio, New York and New Jersey.
PrimeCare Medical will meet all the necessary bonding requirements and/or letter of credit
requirement for the contract. PrimeCare Medical possesses the sufficient financial resources (i.e.,
investments, lines of credit, etc.) required to assure service delivery and responsibility to the
Putnam County Correctional Facility.

CLINICAL OPERATIONAL PLAN
SCOPE OF WORK
PrimeCare Medical shall provide comprehensive medical, dental, mental health, and
pharmaceutical services to all inmates/patients of the Putnam County Correctional Facility as
specified within the RFP and as detailed within this Proposal. PrimeCare Medical, since its
inception, has been committed to providing efficient, quality health care. This is accomplished
through a commitment to operating the company on a day-to-day basis by nationally accepted
standards, by consistently monitoring the health needs of our inmate/patient populations, and by
immediately implementing evidence based standards of care when clinically indicated. The
following work plan addresses the major aspects of PrimeCare Medical’s health care delivery
systems and our medical operation, from the initial intake to discharge planning and outlines
services such as transition planning, continuity of care, multidisciplinary provider collaboration,
infectious disease, continuous quality improvement, cost containment strategies, utilization
review, communication / coordination with facility administrative personnel, electronic medical
records systems, risk management, staff and inmate/patient education, policy and procedure
compliance, and accreditation. Below, PrimeCare Medical will provide a detailed overview and
explanation of our proven business model, identifying how our solution will provide for the
provision of comprehensive health care services to the Putnam County Correctional Facility.
Although these critical functions are described separately within this section, our
multidisciplinary management and transition team shall strategically and systematically integrate
each of these functions into our overall work plan; thus, creating a model that will ensure the
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highest level of health care services are provided to the Putnam County Correctional Facility in
the most cost effective and efficient manner possible.
MEDICAL AUTONOMY
It is acknowledged and agreed that, in accordance with NCCHC Standards, decisions and actions
regarding health care services provided to inmates/patients are the sole responsibility of qualified
health care personnel and cannot be compromised for security reasons; thus, all decisions
involving the exercise of medical or other health related judgments are the sole responsibility of
PrimeCare Medical and its health care practitioners.
ACCESS TO TREATMENT
Upon admission, each inmate/patient shall be informed of his or her right of access to health care
treatment. In addition to verbal instruction, each inmate/patient shall receive an educational
sheet which includes information about the Facility’s sick call schedule, the procedures for
registration for sick call, education on dental hygiene, smoking cessation, MRSA prevention,
mental healthcare/suicide precautions, access to health care in the community, and the grievance
procedures concerning medical care. All such instruction is documented within CorEMR. The
medical information and educational packets shall be approved by the responsible physician. All
inmates/patients shall have prompt access to necessary medical, dental and psychiatric care
provided in a reasonable manner by licensed personnel in accordance with applicable standards.
Additionally, initial health consents are signed by the inmate/patient at this time and scanned into
their medical record. Specific consents are also completed during incarceration for certain
physical health, dental care, and mental health services as required by Federal and State Law.
PrimeCare Medical also has specific policies related to obtaining parental consent for juveniles
confined in adult institutions as may be required by law.
INFORMED CONSENT
The informed consent of inmates/patients is necessary for all medical examinations, treatment
and procedures except those required by law (i.e., the treatment of infectious diseases when
public health law requires such treatment, or in the event of an emergency). Informed consent is
the voluntary consent of an inmate/patient to an examination, treatment or procedure after
receiving information concerning the material facts regarding the nature, consequences, risks and
alternative procedures. In the event a minor is admitted, the consent to medical care must be
obtained from a parent, guardian or legal custodian in accordance with state law. Any
inmate/patient refusing to consent for medically required treatment shall be required to document
their refusal in accordance with NCCHC standards and Putnam County Correctional Facility’
policy.
RECEIVING SCREENING
PrimeCare Medical believes that the completion of rapid, effective, comprehensive receiving
screenings are paramount to the clinical success of each inmate/patient entering a correctional
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institution. Many of our inmates/patients have potentially serious, and many times untreated,
health conditions; which if gone untreated, can result in serious medical and/or mental health
concerns. The receiving screening also allows our medical staff the opportunity to not only
assess the newly committed inmate/patient for injuries, illness or mental health related disorders,
but the opportunity to provide education regarding future access to care, even in the community.
Each of the newly received inmates/patients, to include those inmates/patients being transferred
from other correctional facilities, will receive a thorough receiving screening immediately upon
arrival to the Putnam County Correctional Facility, which shall include obtaining a complete
medical, mental health, and dental history and determining the disposition of each newly
committed inmate/patient. All inmates/patients who are admitted will also be screened for
various infectious diseases. In addition to TST testing, all inmates/patients are screened for
diabetes and female patients are screened for pregnancy. Receiving Screenings shall be
performed by an appropriately licensed health care professional as permitted by the RFP. In the
event that this evaluation identifies any medical conditions that require treatment, an appropriate
therapy regimen will be initiated in accordance with accepted protocols.
PrimeCare Medical has developed and implemented specific questions within our receiving
screening tools, which dependent upon how an inmate/patient responds, will automatically
initiate several critical procedural protocols. These pre-established protocols assist our staffs
with safeguarding the inmate/patient and prevent individuals from “falling through the cracks”.
A few examples of when these pre-programmed safeguards are initiated include detoxification
risks, chronic diseases, mental health issues, and PREA related concerns. Additionally,
immediate medical referrals shall be arranged to appropriate clinical providers as indicated.
PrimeCare Medical shall also be responsible for medically “clearing” all inmates/patients into
the Facility, prior to their formal acceptance and booking by security personnel in accordance
with applicable policy. As such, health care personnel shall ensure that inmates/patients who are
unconscious, semiconscious, severely bleeding, mentally unstable, severely intoxicated, in
alcohol or drug withdrawal, or otherwise urgently in need of medical attention are immediately
referred for care and medical clearance at the local community hospital. In such cases, upon the
individual’s return, their admission to the correctional facility shall be predicated upon written
medical clearance from the respective emergency room physician.
SUICIDE PREVENTION AND AWARENESS
Medical staff will be alert for any symptoms of mental illness during the initial Receiving
Screening process, as well as, during all subsequent contacts with the inmate/patient. Medical
Staff and Corrections Staff shall be trained by the PrimeCare Medical Psychologist and/or
Psychiatrist on what symptoms and issues to look for when screening for mental illness.
PrimeCare Medical has worked closely with a National Suicide Prevention Expert, Mr. Lindsay
Hayes, M.S., to further develop and enhance its Suicide Prevention Program(s). Mr. Hayes has
attended PrimeCare Medical’s Health Services Administrators’ Annual Training Seminars,
where he presented an in depth training on updates to suicide prevention policy and protocols.
Mr. Hayes has also visited several of PrimeCare Medical’s contracted facilities to make certain
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all suicide prevention policies remain on the forefront of recognition by our health care and
mental health staffs. One example of this collaborate approach is our usage of the New York
Model Screening Tool, which is used to screen all new commitments to the Facility. The system
utilizes a scoring system on individual questions; when a specific score (8) is reached, the
inmate/patient is placed on suicide precautions and referred to Mental Health staff.
Appropriately trained staff completes the suicide prevention screen questionnaire on all new
commitments. Those who score eight or more are placed on suicidal observation and referred to
mental health staff. Once the referral is received, mental health staff is tasked to evaluate the
inmate/patient as soon as possible. Mental health staff will then conduct an assessment to
determine the inmate’s/patient’s risk for suicide or self-harm and determine the appropriate level
of suicide precautions based upon the assessment.
As part of the suicide risk assessment, PrimeCare Medical utilizes the Columbia Suicide Severity
Risk Scale (C-SRS). The C-SRSS is used extensively in primary care, clinical practice and
institutional settings. It is recommended by the U.S. Food and Drug Administration, World
Health Organization, Joint Commission Accreditation of Healthcare (JCACHO), and the
National Institute of Mental Health (NIMH). The C-SSRS is the only screening tool that
assesses the full range of evidence-based ideation and behavior items, with criteria for next steps
(i.e., referral to mental health professionals); thus, the C-SSRS can be exceptionally useful in
initial screenings.
PrimeCare Medical has also developed a rating system to classify inmates/patients and their
relative mental health needs - the Mental Health Stability Rating Scale (MHSR). The MHSR is a
4-point scale (i.e., A, B, C, D) developed to identify and track patients who receive mental health
treatment services. The scale was derived from the Pennsylvania Department of Corrections and
has been modified for use at all PrimeCare Medical locations. It also informs medical personnel
that the inmate/patient has a history of, or is currently, receiving mental health services at the
facility. The rating scales are as follows:
 A – No Mental Health and/or Intellectual Disabilities (MH/ID) classification made. The
patient has no identified MH/ID needs and/or history of psychiatric treatment for the past
five (5) years.
 B – The patient is placed on the inactive MH/ID roster. This rating scale will include
patients who have a history of treatment at the facility and no longer require mental
health services.
 C – The patient is placed on the active MH/ID roster. This category is for any patient
who is currently active in treatment with the mental health department and includes
patients who are utilizing medication management services and/or have a history of
suicide attempts/psychiatric hospitalizations in the past two (2) years.
 D – The patient is placed on the active MH/ID roster has been diagnosed with a Serious
Mental Illness (SMI) and/or exhibits significant adjustment/behavioral concerns. SMI
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diagnoses include Schizophrenia, Schizoaffective Disorder, Major Depressive Disorder,
Bipolar Disorder, Unspecified Psychotic Disorder and Borderline Personality Disorder in
addition to a significant treatment history in the community. Additionally, patients who
are non-compliant with medications for a period of seven (7) days and who have a history
of institutional misconducts will be placed on this scale.
The MHSR also determines the level of treatment a patient is to receive, such as the frequency
they are seen by psychiatry and mental health staff, housing assignment, etc.
PrimeCare Medical currently utilizes three levels of suicide precaution; Constant Observation,
Level 1 Suicide Watch, and Level 2 Suicide Watch. Only licensed mental health professionals
can modify or discontinue suicide watch levels.
 Constant Observation - This level is reserved for the inmate/patient who is actively
suicidal, either threatening or engaging in self-injurious behavior and would be
considered an extreme risk for suicide or serious self-injury. Facility staff shall observe
such an inmate/patient on a continuous uninterrupted basis and have a clear unobstructed
view of the inmate/patient at all times. Observations shall be documented at ten-minute
intervals.
 LEVEL I – Suicide Watch - This level is for inmates/patients who are not actively
suicidal but a) express suicidal ideation and have a plan to commit suicide, b) have
recently (within 60 days) attempted suicide, c) engaged in serious self-injurious behavior,
or d) demonstrates other concerning behavior (through actions, current circumstances or
recent history) indicating the potential for self-injury. This level of watch is for actively
suicidal individuals, those either threatening or engaging in self-injurious behavior. These
inmates/patients would be considered medium to high risk for suicide. This level may be
utilized whenever staff (i.e., nursing, custody staff) believes an inmate/patient is at
moderate to high risk for suicidal behavior, pending an evaluation by a licensed mental
health professional.
 LEVEL II – Suicide Watch - This level is the default level for an inmate/patient who has
suicidal ideation, but no plan to commit suicide. This level is for inmates/patients who are
not actively suicidal, but express suicidal ideation (i.e., a wish to die without a specific
threat or plan) and/or has a prior history of self-destructive behavior. This also applies to
inmates/patients that deny suicidal ideation, but demonstrates other concerning behavior
(through actions, current circumstances, or recent history) indicating the potential for
self-injury. This level is also used for inmates/patients that score an eight or higher on the
Suicide Screening Form who are not actively suicidal and have had no recent suicide
attempts. Note: inmates/patients charged with any sex offense or those that are highprofile should also be placed on this watch level (unless they meet criteria for Level I)
even if they do not score an eight or higher on the screen. Level II is also used as a stepdown from Level I suicide watch.

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PrimeCare Medical’s mental health staff will participate in the administration of the jail’s
prevention plan as required. All PrimeCare Medical staff receives training in the identification,
assessment, monitoring, and interventions utilized in suicide prevention. Further, it is
recommended that facility staffs who have direct contact with inmates/patients also receive
training in the identification of inmates/patients at risk for suicide and the related policies and
procedures on suicide prevention.
 Identification - The Receiving Screening Form and the Suicide Prevention Screening
Guidelines (NY Model) contain observation and interview items related to an
inmate’s/patient’s potential suicide risk. If either PrimeCare Medical or facility staff
identify someone who is potentially suicidal, the individual is placed on close observation
- suicide precautions and is referred immediately to mental health staff. Further, any staff
member who believes an inmate/patient is suicidal should immediately refer them to
medical staff for evaluation. In such a circumstance, the inmate/patient should be
observed while waiting for evaluation or be placed on constant observation.
 Training - All staff members who work with inmates/patients shall be trained to
recognize verbal and behavioral clues that indicate a risk of suicide, and how to respond
appropriately. Initial training during employee orientation and at least annual training
thereafter will be provided. Training is conducted by an appropriately trained qualified
mental health professional such as a psychiatrist, psychologist, or psychiatric nurse
practitioner. The training will include avoiding negative attitudes to suicide prevention,
research on inmate/patient suicide, why correctional environments are conducive to
suicidal behavior, potential predisposing factors to suicide, high-risk suicide periods,
warning signs and symptoms, identifying suicidal inmates/patients despite denial of risk,
the agency’s suicide prevention policy, the use of the Suicide Prevention Screening
Guidelines – NY Model, and associated liability issues.
 Assessment – A suicide risk assessment will be conducted by a licensed mental health
professional on each inmate/patient that a) screens positive for suicide risk based on the
Suicide Prevention Screening Guidelines and/or other critical risk indicators, b) is placed
on suicide watch by other staff, or c) screens positive for mental illness. The assessment
is conducted in a private setting, not by the cell door, in the dayroom, or other nonprivate locations. The licensed mental health professional will designate the individual’s
level of suicide risk and level of supervision needed. This may include making a
recommendation to petition the court for an involuntary commitment to a state forensic
hospital.
o The suicide risk assessments will include a description of the current
behavior(s) and justification for a particular level of observation and/or
discharge from suicide precautions. The assessment must include a mental
status examination, a listing of both historic and current risk factors, a
listing of protective factors, the determined level of suicide risk (i.e. low,
medium, high), and a treatment plan.

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o Inmates/Patients on suicide watch or identified as at risk of suicide will be
evaluated daily by mental health staff to monitor and document changes in
suicidal ideation, mood, affect, cognition, behavior, stressors, etc. that
affect relative risk for suicidal behavior. Only licensed mental health
professionals can modify or discontinue suicide watch levels. There will
be written justification for each decision documented in the medical chart.
o Individual treatment plans are developed for all inmates/patients held on
suicide precautions for more than 24 hours, on the business day following
the initiation of suicide precautions. The plans describe signs, symptoms,
and the circumstances in which the risk for suicide is likely to recur, how
recurrence of suicidal thoughts are avoided or managed, and actions the
inmate/patient or staff can take if suicidal thoughts do occur.
o Treatment plans include the provision of follow up evaluations for
detainees once they are cleared from suicide precautions. Typically these
are within the first 24 hours, then the following 72 hours, the next week,
and then periodically (i.e., 30 day, 60 day, 90 day intervals) until the
inmate/patient is released from custody.
 Monitoring/Housing – An inmate/patient identified as being at risk for suicide is placed
on constant observation until evaluated by a licensed mental health professional.
Inmates/Patients who are identified as being at risk for suicide are placed in an area
where regularly scheduled observations are made and those observations documented. If
possible, an inmate/patient on suicide watch will not be placed in isolation (or single
celled), they should be housed with another inmate/patient or in dormitory style housing
and checked on an irregular schedule not to exceed 15 minutes. The cell is to be as
suicide proof as possible (without protrusions of any kind that would enable a hanging).
If the potentially suicidal inmate/patient is deemed to be at high risk, constant observation
will occur. Use of other inmates/patients for monitoring will not be permitted.
o All inmates/patients on suicide precautions should be allowed all routine
privileges (i.e., visitation, telephone calls, out-of-cell time unless it is
contraindicated with written justification in the medical chart by a licensed mental
health professional (except in cases where the inmate/patient has lost privileges as
the result of a disciplinary sanctions)).
 Referral – PrimeCare Medical staff or facility staff can refer inmates/patients they believe
may be suicidal to mental health care providers for evaluation.
 Communication - Communication between PrimeCare Medical health care and facility
personnel regarding the status of the inmate/patient will provide clear and up-to-date
information. Communication between transferring authorities (i.e., county facility,
medical/psychiatric facility) and facility personnel will be in written format. At

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minimum, a Doctor’s Order to the Jailer (DOJ) will be issued documenting all changes in
suicide precautions, suicide watch levels, observation, and housing.
 Intervention – All staff that comes into contact with inmates/patients will be trained in
first aid and cardiopulmonary resuscitation (CPR). Any staff member who discovers an
inmate/patient attempting suicide shall respond immediately; survey the scene to ensure
the emergency is genuine, alert other staff to the emergency, call for medical personnel
and begin standard first aid and/or CPR. Staff will never presume that the inmate/patient
is dead, but rather initiate life saving measures until relieved by medical personnel.
Housing units should have appropriate emergency equipment including first aid kits,
rescue tools, and ready access to an automatic external defibrillator (AED) as well as be
trained in its use.
 Notification and Reporting - Procedures are in place stating when facility administrators,
outside authorities, and family members are notified of attempted or completed suicides.
All designated correctional officials will be notified through the chain of command. All
staff that came into contact with the victim prior to the incident will be required to submit
a statement as to their knowledge of the inmate/patient and the incident. PrimeCare
Medical has its own notification procedures that include notification of corporate
personnel.
 Review - There are procedures for medical and administrative review if a suicide or a
serious suicide attempt occurs. Mortality reviews are required to be completed within
thirty (30) days of a completed suicide. As part the mortality review for a completed
suicide a psychological review of records is conducted and its findings included in the
mortality review.
In addition to the suicide prevention screening, all inmates/patients are screened for potential
untreated depression. These depression scales are gender based and if found to be positive, preestablished protocols shall be initiated which assist with the immediate scheduling of referrals to
mental health staff and placement recommendations.
Inmates/Patients processed into the Facility with significant mental health histories and/or
currently taking daily prescribed psychotropic medications and/or exhibiting signs of mental
illness are immediately referred to mental health staff for evaluation. In addition, mental health
records are immediately requested and prescription drug orders are verified through the
inmate’s/patient’s physician or pharmacy. Referrals are also made through appropriate Facility
staff such as Administrators, Counselors, Officers, Work Supervisors, and Medical Staff.
Annual Suicide Prevention / Awareness Training will be provided by PrimeCare Medical in
coordination with the Facility Administration. Education related to access to mental health
services, suicide prevention and what to do if a fellow inmate/patient is discussing suicidal
thoughts is also shared with all new inmate/patient commitments.

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with the Methadone Clinic to continue such treatment. A bridge opiate plan (utilizing
methadone), as recognized by NCCHC, indicates bridge orders are permitted to prevent potential
harm to the patient and/or fetus. In the event such a female inmate/patient is not an established
patient of a methadone program, PrimeCare Medical will contact an “X Waivered” provider to
evaluate and initiate Subutex if clinically indicated. PrimeCare Medical currently employs
multiple providers who are able to prescribe Subutex to prevent withdrawal for this patient
group.
Most recently, with the explosive opiate (heroin and other opiate based pain medications) abuse
epidemic earning national headlines, PrimeCare Medical has invested countless hours and
company resources in ensuring our policies and protocols pertaining to the treatment of these
individuals remain consistent with all applicable Federal and State guidelines. As such,
PrimeCare Medical has begun implementing three (3) new programs within our correctional
facilities to further assist in the prevention of these negative patient outcomes, as further detailed
below.
The inherent danger in treating these individuals occurs with the immense risk of potential
overdose, as well as, the significant health risks associated with their withdrawal; one of the
main concerns within regional and county jails being inmates who are released from custody and
overdosing once they return to the streets. In some of our contracted facilities, we have worked
with the respective facility administrators to develop protocols for actually providing Nasal
Narcan to designated individuals upon their discharge from the facility in an attempt to prevent
such overdosing from occurring. PrimeCare Medical has actually maintained an emergency
stock supply of Narcan within our emergency medication boxes at all of our contracted facilities
for the past two decades. As such, PrimeCare Medical has developed specific training for the
administration of both Nasal Narcan and intravenous / intramuscular injected Narcan, which has
been shared with all of our health care staff. This training can also be made available to
designated correctional staff for use of Nasal Narcan in the event of an emergency situation. In
one of our facilities, all community corrections staff have already received this training.
Additionally, for approximately the past one and a half years, PrimeCare Medical has partnered
with Alkermes, the manufacturer of Vivitrol, to assist our clients with the implementation of
Vivitrol programs upon an inmate’s/patient’s discharge from our institutions. Through this
partnership with Alkermes, they have agreed to provide the initial dosing of Vivitrol to qualified
inmates/patients free of charge.
In an effort to diminish the rise in the number of individuals becoming addicted to prescribed
opiate based medications, the CDC released guidelines for treating patients who are in need of
such pain medications. These guidelines were developed by the CDC’s experts to provide an
additional resource for the respective treating prescribers; the goal being to decrease the risk of
new patients seeking other opiates (such as heroin) once they are no longer prescribed their
opiate based pain medications. PrimeCare Medical has since shared these guidelines with all of
our contracted facilities and health care professionals, encouraging them to follow the guidelines
when rendering care to our incarcerated patients.

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PrimeCare Medical is pursuing each of these efforts in our attempts to remain on the forefront of
this initiative and in the prevention of potential negative patient outcomes.
INTAKE HISTORY AND PHYSICAL EXAMINATIONS
Within ten (10) to fourteen (14) days of arrival, PrimeCare Medical will perform a
comprehensive health assessment (physical) on all inmates/patients in accordance with
applicable standards. During this visit, the inmate’s/patient’s vital signs and weight will be reassessed, as well as, their medical, surgical and mental health history. PrimeCare Medical also
requires several other screenings / testings be completed at this time, such as blood glucose
testing on all inmates/patients to identify any undiagnosed diabetic conditions. The health
assessment will be conducted by the PrimeCare Medical Physician/Physician Assistant/Nurse
Practitioner or Registered Nurse, as permitted by jurisdiction and the RFP. If completed by a
registered nurse or mid-level practitioner, the physician shall review, initial and date the health
assessment. In the event that this evaluation identifies any medical conditions that require
treatment, an appropriate therapy regimen will be initiated in accordance with accepted
protocols. Any inmate/patient identified as having a chronic care condition will be immediately
referred to the appropriate specialty chronic care clinic. All identified infectious diseases shall
be reported to the Public Health Authority in accordance with State and Federal requirements.
Additionally, annual health and mental health assessments shall be conducted on all
inmates/patients being incarcerated for a period of one (1) year or greater in accordance with
applicable standards. The annual health assessment shall also include testing for tuberculosis
and an annual dental examination completed by the contracted dentist.
NURSING SERVICES
Nursing services shall be provided to the Putnam County Correctional Facility as detailed within
the enclosed proposed staffing matrix and shall include completing all tasks as outlined within
this Proposal as permitted by licensure. Responsibilities of the nursing staff shall include, but
are not limited to conducting daily nursing sick call (as permitted by the RFP), dispensing
medications as ordered by appropriate providers, completing initial receiving screenings, and
completing other nursing tasks as directed by the provider staff.
All completed nursing protocol forms are sent to the on-site Medical Director’s electronic
medical record queue for review and signature. Issues that may be identified are directly
addressed with the appropriate staff member. Nursing protocols are reviewed annually by the
Statewide and on-site Medical Directors. They are also reviewed by the Vice-President,
Regional Managers and on-site Health Services Administrators.
Nurses are clinically supervised by the on-site Health Services Administrator and Medical
Director. The Health Services Administrator completes monthly CQI audits that directly
monitor nursing care at the Facility. Issues related to nursing care are addressed at the monthly
staff meeting and on an individual basis if necessary.

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DAILY SICK CALL / DISPENSARY OPERATION
Sick call is the system through which each inmate/patient reports for and receives appropriate
medical services for non-emergent illness or injury. PrimeCare Medical has established sick call
protocols which are system based and have set areas of assessments which should occur based on
the inmate/patient concern. The Sick Call Protocols are reviewed on an annual basis and are
limited within the scope of the practice per state licensure regulations. Per policy, annual
training shall occur, conducted by the facility Medical Director, which reviews these protocols
and assessment techniques. When an inmate/patient who desires to be evaluated for a medical
condition or concern, they will have the opportunity to register via a sick call request slip
(Electronic if so equipped) on a daily basis, which shall be reviewed that day by the health
authority or other person designated by the responsible physician. When the sick call requests are
received in the Medical Department, the following process will occur:
 In accordance with established nursing protocols, an appropriately licensed nurse will
conduct a screening / triage of all sick calls received seven (7) days per week (shall occur
within 24 hours of receipt). Actual sick call clinics shall occur within 48 hours of
submission of the sick call request, or sooner as may be required by the RFP. All such
forms shall be reviewed, signed, dated, and timed by PrimeCare Medical.
 Based on the results of this screening, the nurse will administer appropriate treatment in
accordance with treatment protocols and make appropriate referrals to a Provider Clinic.
 The Physician’s Clinic/Physician Assistant Clinic/Nurse Practitioner Clinic shall be
conducted in the Medical Department on daily basis consistent with the staffing plan
contained within this Proposal, or at other designated locations as required by the Putnam
County Correctional Facility.
 Upon completion of the physician’s clinic, each inmate/patient will have an appropriate
notation made within their electronic record. Any necessary additional laboratory testing
or treatments will be ordered at that time. All of the laboratory, x-ray, and medical tests
performed will be reviewed by the on-site Medical Director/Physician Assistant/Nurse
Practitioner and recommendations for additional medical tests or treatments will be made.
Sick call shall be conducted within the parameters of applicable standards. During normal
operations, sick call will be conducted in the designated medical unit for general population
inmates/patients. Offenders housed in segregated units may be handled within their unit or at
specified times in the medical unit. Regardless of whether a segregated inmate/patient requests
medical service, nursing rounds shall still occur within the segregation units, to include
assessments and appropriate follow-up care. Additionally, mental health staff shall conduct
rounds within these units in accordance with NCCHC Standards. All such segregation round
encounters are documented within the respective inmate/patient medical records. Co-Payment
procedures shall be carried out in accordance with Putnam County Correctional Facility policy, if
applicable. The Putnam County Correctional Facility will coordinate a sick call schedule with

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PrimeCare Medical. Although this schedule will be given priority, the security needs of the
Facility shall prevail.
PHYSICIAN / PHYSICIAN ASSISTANT / NURSE PRACTITIONER SERVICES
PrimeCare Medical shall designate a responsible physician to approve health care policies,
procedures and agreements which may include the use of emergency rooms in local hospitals. A
properly licensed local Physician, Physician Assistant and/or Nurse Practitioner will conduct
providers’ clinic at the Putnam County Correctional Facility, as detailed within the enclosed
Staffing Plan. Physician’s coverage will include on-call availability twenty-four (24) hours a
day, seven (7) days a week for emergency situations. They shall be further supported by Carl A.
Hoffman Jr., D.O., D.Sc., CCHP, Corporate Medical Director; Victoria Gessner, M.D., Assistant
Corporate Medical Director; and various other members of the Utilization Review Committee.
Duties of the Physician / Physician Assistant / Nurse Practitioner shall include the following:
 Conducting inmate/patient physician’s clinic at the Facility on days and at times
scheduled in conjunction with the Facility.
 Examining, diagnosing, and treating inmates/patients referred to the respective provider.
 Reviewing all laboratory, X-ray, and other ancillary reports and documenting the review
in the medical record.
 Examining and rendering initial emergency medical treatment of persons who are injured
or who become ill while on the premises. These persons (other than inmates/patients)
shall be stabilized and referred to their physician for any necessary follow-up care.
 Performing annual and/or employment physical examinations for the Facility, where
contractually applicable.
 Providing minor surgical treatment at the institution as deemed medically appropriate, to
include suturing for minor lacerations.
 Conducting intake and annual physical examinations of inmates/patients.
 Evaluating food handler candidates, inmate workers, trustees, work release
inmates/patients, etc. prior to assignment and periodically thereafter to ensure compliance
with all health regulations.
 Constantly evaluating the need for non-emergency referrals to medical specialists or
outside hospitals as needed for diagnosis or treatment of those inmates/patients with
health care problems which may extend beyond the scope of services provided on-site.
 Documenting all health care contacts in the inmate’s/patient’s health care record.
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 Participating in quality assurance programs, which include, but are not limited to, peer
audit and medical chart review procedures.
 Provide for daily reports including condition, diagnosis, treatment plan, medications,
prognosis, and discharge planning and clinical status / progress on all hospitalized
inmates/patients.
 Be knowledgeable in the treatment of HIV infection, Tuberculosis, Hepatitis and other
communicable diseases, and shall remain current in the treatment of these diseases.
 Physicians’ lines shall not be concluded until all inmates/patients scheduled have been
assessed.
PrimeCare Medical staff will adhere to accepted medical practice in evaluating and monitoring
the medical status of each inmate/patient to ensure that all necessary supporting diagnostic
examinations are provided as needed. All health problems identified will be managed through
appropriate follow-up. All supporting diagnostic/follow-up coordination needs will be managed
by the PrimeCare Medical Health Services Administrator and on-site Medical Director. The
provider shall review and sign all diagnostic test results and off-site treatment records during
their next scheduled visit to the Facility. The physician shall also be responsible for adherence to
PrimeCare Medical’s policy on the use of clinically ordered therapeutic restraints and therapeutic
seclusion, which is based upon NCCHC Standards.
To assist in reducing the frequency of unnecessary transports to local hospitals outside of
PrimeCare Medical professional staffs’ typical working hours, we have developed systems to
provide our clinicians with financial incentives to return to the institution(s) to render care for
certain health related concerns. On average, PrimeCare Medical will compensate our providers
between $200 - $500 per instance, dependent upon the provider’s licensure and specific clinical
situation. Such health related situations include, but are not limited to, clinical assessments,
suturing, etc. Presently, this practice has been instituted in various contracted facilities, which
has proven to be very effective in reducing many off-site transports; thus, resulting in reduced
officer overtime and other unnecessary expenses.
PrimeCare Medical also intends to work with various local residency programs and OB/GYN
groups in the local community in an effort to identify qualified, appropriately trained providers
to assist with providing additional coverage that may be needed at the Putnam County
Correctional Facility.
SPECIALTY CLINICS AND CHRONIC CONDITIONS
NCCHC Standards relating to Special Needs Treatment Plans require close monitoring of
inmates/patients with special needs (i.e., chronically ill, communicable disease, physically
handicapped, disabled, frail elderly, terminally ill, special mental health needs, inmates/patients
in a diagnostic or therapeutic “Pipeline” and the developmentally disabled). PrimeCare Medical
places a major emphasis on chronic care at all of its sites.
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PrimeCare Medical will provide the services of specialists needed for comprehensive medical
services for inmates/patients at the Putnam County Correctional Facility through the contract
hospital, local managed care network and/or the local medical community. During the initial
Receiving Screening process, all inmates/patients are asked questions related to chronic health
conditions. If inmates/patients answer in the positive that they have a chronic condition,
automatically, the respective inmates/patients receive a referral for a rapid assessment during the
next scheduled provider line. During this chronic care assessment, the inmate/patient is ordered
all necessary diagnostic testing and a review of medications shall occur. By rapidly assessing
and providing unfettered access to health care services, we have noted a dramatic reduction in
hospitalizations related to untreated or delayed care for our sickest and highest risk populations.
During this visit, the medical provider will also schedule future appointments.
During the Health Assessment and on a continuous basis, inmate/patients who are chronically ill
are identified and tracked to ensure that they are seen every thirty (30) to ninety (90) days, or less
depending on the severity of their illness, to monitor the chronic condition by the physician,
physician assistant, or certified nurse practitioner. The physician shall be required to complete a
review of these individuals at a minimum of every three (3) months. Additionally, the physician
shall review the care and treatment plans for each of these inmates/patients. A specialized
treatment plan will be developed for each inmate/patient requiring such on-going therapeutic
care through a multidisciplinary team of health care professionals. When seen, preventative
medical maintenance shall be provided and shall include health education and medical services,
such as inoculation and immunization in order to take measures in advance of the onset of illness
and to provide instruction in the self-care of chronic conditions. Treatment plans shall include a
written statement which specifies the particular course of therapy and the roles of medical and
non-medical personnel in carrying out the course of therapy, to include specific instructions
regarding diet, exercise, medication, type and frequency of diagnostic testing, the frequency of
medical follow-up, and adjustment of treatment modality. Such plans shall be individualized and
based on an assessment of the inmate’s/patient’s needs, short and long term goals, and the
methods by which these goals shall be pursued.
PrimeCare Medical shall utilize aggressive case management for all inmates/patients identified
as being at risk for exacerbation of their chronic illnesses related to being incarcerated. It is
PrimeCare Medical’s belief that through aggressive case management, the health needs of the
Facility’s high health risk population will be managed in the most efficient and cost-effective
manner possible; thus resulting in the most favorable inmate/patient health outcomes. Some of
the Chronic Care Clinics which are regularly conducted include the following:

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INFECTIOUS DISEASE
PrimeCare Medical will manage all infectious disease cases identified at the Putnam County
Correctional Facility as clinically indicated. Guidelines and educational procedures will be such
that proper diagnosis, screening, and treatment of these special inmates/patients will be
performed by PrimeCare Medical staff in a timely fashion. HIV testing shall be completed at the
request of the inmate/patient. PrimeCare Medical will strictly adhere to state confidentiality
laws. PrimeCare Medical has successfully managed and implemented many programs to protect
and prevent the transmission of various infectious disease processes within our institutions.
Types of these programs include the successful prevention of Tuberculosis, Multidrug Resistant
Tuberculosis, MRSA, Influenza, varicella infections, etc. We believe education is paramount to
the successful prevention of many infectious disease processes. Through our aggressive
management and rapid detection, we have successfully mitigated and prevented the possible
spread of illness throughout our institutions. PrimeCare Medical collaborates and coordinates
our infection control measures with community, State and Federal public health departments.
The PrimeCare Medical Facility and Statewide Medical Directors will utilize the services of
various infectious disease consultants, on acute infectious disease issues, including treatment
regimens and medication recommendations. Inmate/Patient management shall be provided only
through one or more Board Certified Infectious Disease Specialist(s) or, at a minimum, be
supervised by a Board Certified Infectious Disease Specialist(s). Proper and appropriate
documentation of services and record keeping shall be maintained, including written
recommendations to the Corporate Utilization Review Committee on necessary formulary
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additions with updates as required by advancing pharmacology. If any significant revisions are
made to the current treatment regimens for infectious diseases, the costs of such additional
treatments shall be separately negotiated between PrimeCare Medical and the Putnam County
Correctional Facility.
Additionally, PrimeCare Medical shall evaluate and clear all inmates/patients requesting to work
in the food service areas / kitchen, to ensure they are free of contagious diseases. Additional
diagnostic testing shall be completed as required by the Facility.
 HIV/AIDS MEDICAL CASES: PrimeCare Medical will manage any AIDS or HIV
positive cases identified at the Putnam County Correctional Facility. Guidelines and
educational procedures will be such that proper diagnosis, screening, and treatment of
these special inmates/patients will be performed by PrimeCare Medical staff in a timely
fashion. Treatment for HIV/AIDS shall include: one-on-one counseling, medication
education, medication prescription, monitoring and management, medical treatment,
management of medical needs and coordination with community based agencies for care
and follow-up upon discharge from the Facility. PrimeCare Medical will work closely
with the community HIV Case Management Agency for purposes of continuity of care.
State confidentiality laws will be strictly adhered to.
 HEPATITIS MEDICAL CASES: PrimeCare Medical will provide testing for the
inmate/patient population pursuant to the requirements of the RFP. In addition to the
specialty clinics, immunization and therapeutic treatment regimens will occur in
accordance with Putnam County Correctional Facility policy and procedure. The Facility
Medical Director, in conjunction with the PrimeCare Medical infectious disease
physicians, will evaluate and implement therapeutic treatment regimens for this disease
process.
 MRSA/MULTI-DRUG RESISTENT MEDICAL CASES: PrimeCare Medical will
manage any positive or suspected MRSA or other drug resistant infections identified at
the Putnam County Correctional Facility with community approved clinical treatment
regimens. Guidelines and educational procedures will be such that proper surveillance,
diagnosis, treatment, prevention and monitoring of these special inmates/patients will be
performed by PrimeCare Medical staff in a timely fashion. PrimeCare Medical will
provide prevention education for all inmates/patients currently housed within the Putnam
County Correctional Facility. Strict screening will occur on intake for any signs or
symptoms of CA-MRSA or other multi-drug resistant bacterial infections. All procedures
will be completed in accordance with the State Department of Health and the Center for
Disease Control guidelines.
 INFULENZA-LIKE-ILLNESS (ILI): PrimeCare Medical will manage any suspected or
confirmed ILI cases identified at the Putnam County Correctional Facility. Guidelines
and educational procedures will be such that proper surveillance, diagnosis, treatment,
prevention and monitoring of these infectious inmates/patients will be performed by
PrimeCare Medical staff in a timely fashion. All procedures will be completed in
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accordance with the State Department of Health and the Center for Disease Control
guidelines. All inmates/patients who are housed and or arriving at the Putnam County
Correctional Facility will be screened and receive education on ILI illness. In the event a
new strain or a strain with significant virulence occurs, PrimeCare Medical will
implement its pandemic plan to assist the Putnam County Correctional Facility with
clinical and operational oversight. Our plan focuses on monitoring the State Department
of Health and Center for Disease Control sentinel reporting methods, monitoring national
and international media outlets, monitoring the Center for Disease Control and the World
Health Organization (WHO). Once reported, PrimeCare Medical will increase
surveillance efforts to monitor all sites and regions for any unusual activity. PrimeCare
Medical will work with the State Department of Health to determine if rapid testing is
available. If available, sentinel testing will begin within the Facility. PrimeCare Medical
will immediately work with the Putnam County Correctional Facility to implement rapid
education, increase surveillance efforts, and will recommend any special housing
recommendations. Pertinent information will be shared with all PrimeCare Medical and
Putnam County Correctional Facility employees.
SCHEDULING OF OFF-SITE CONSULTATIONS
PrimeCare Medical shall be responsible for administrative efficiency, quality, and costeffectiveness of any off-site specialty consultation. PrimeCare Medical shall recruit, credential,
develop, and contract with a preferred provider network to provide all covered medically
necessary services, which cannot be provided on-site to the inmate/patient population of the
Facility. PrimeCare Medical shall make all reasonable attempts to develop the preferred
provider network within the closest available proximity to the Facility, keeping in mind the
additional burden placed on security personnel as a result of these off-site transports. Such
outside specialists will be brought on-site to the Putnam County Correctional Facility whenever
possible to furnish services. Upon a contract award, PrimeCare Medical fully intends to
formalize agreements with all other community specialists / members of the existing preferred
provider network and negotiate financial discounts in accordance with applicable state
legislation. PrimeCare Medical shall coordinate all off-site medical, mental health, and dental
referrals to local community specialists as determined clinically appropriate by the respective onsite physician. All scheduling, continuity of care paperwork, and payment coordination shall be
the responsibility of PrimeCare Medical.
All off-site referrals will be reviewed and evaluated for clinical appropriateness by the Statewide
Medical Director and the Corporate Utilization Review Committee and shall be coordinated with
Facility Administration. A Request for Consultation review form will be completed and sent
with the inmate/patient to the respective community provider’s office. PrimeCare Medical shall
endeavor to consolidate the scheduling of appointments and services for inmates/patients with
community physicians, hospitals, and other health care providers. PrimeCare Medical shall
obtain daily updates on all inmates/patients receiving health care services from any off-site
specialty care provider while the inmate/patient is receiving such off-site care. All medical
documentation / findings received from the local provider’s office shall be reviewed by the
physician / physician’s assistant / certified registered nurse practitioner in accordance with
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applicable standards and placed in the inmate’s/patient’s medical record with appropriate orders
for any new treatment and/or medication required. Any non-routine follow-up care that is
recommended by the preferred provider’s office shall be communicated directly with the Facility
Medical Director to determine the most appropriate course of future treatment.
SPECIAL NEEDS HOUSING / INFIRMARY
The PrimeCare Medical Physician / Physician Assistant / Nurse Practitioner will utilize the
infirmary / medical observation unit / special needs housing located in the Facility in lieu of
placement in an outside hospital unless it is medically necessary to do so. Placement outside of
the infirmary / medical observation unit / special needs housing unit will occur only when the
medical condition of the inmate/patient is such that special needs housing is not appropriate
because of the resource level demanded for successful treatment of the inmate/patient
condition. These units shall be utilized to their fullest extent. Prior to inmates/patients with
diagnosed psychiatric or significant medical illnesses are given housing assignments, work
assignments, disciplinary measures or transfers, the Prison Facility’s administrator and the
responsible physician or their designees shall confer to consider any special precautions or
preparations. A list of frequent illnesses which require special arrangements shall be developed.
HOSPITALIZATION SERVICES
PrimeCare Medical will provide outside hospitalization at local hospitals for Putnam County
Correctional Facility inmates/patients. The Health Services Administrator will coordinate with
the security staff for arranging transportation and correctional officer supervision of hospitalized
inmates/patients. Same day surgical services will be encouraged and outpatient treatments,
radiology, and emergency room care will be coordinated with the appropriate local providers.
PrimeCare Medical shall insure that the medical condition of hospitalized inmates/patients is
routinely monitored (daily) to insure that hospitalization is continued only until no longer
medically necessary. The daily monitoring of hospitalized inmates/patients, to include
anticipated treatment plans and discharge plans, shall be coordinated through the Statewide
Medical Director and the Facility’s Medical Director. Such daily reporting shall be
communicated to the Putnam County Correctional Facility. Hospital utilization managers and
discharge planners shall be contacted so that discharges from the hospital are arranged as soon as
clinically indicated.
PrimeCare Medical shall maintain documentation of appropriate licensing and accreditation for
any hospitals, clinics or laboratories which provide services under this contract. A copy of these
certificates will be kept at the Facility, as well as at the PrimeCare Medical Corporate Office.
All applicable Federal and State laws regarding patient confidentiality will be strictly adhered to
for all inmate/patient hospitalizations.
PrimeCare Medical makes all attempts to aggressively negotiate significant discounted rates
through local hospitals and specialty care providers in the community. Significant infrastructure
is available within our corporate offices to assist with processing claims received for in-patient
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and out-patient care. PrimeCare Medical will seek any and all third party available sources (i.e.,
private insurance, federal funding, worker’s compensation, etc.) to assist with off-setting
expenses for out-patient and in-patient care of the inmate/patients of the Putnam County
Correctional Facility. Such alternate payment opportunities shall be utilized to their fullest
extent. PrimeCare Medical staff shall be responsible for the coordination and enrollment of
inmates/patients into any such available programs. Off-site detailed billing summaries shall be
provided to the Putnam County Correctional Facility as required by the RFP.
MANAGEMENT OF OFF-SITE CARE AND COST CONTAINMENT
PrimeCare Medical has various systems and protocols in place to effectively manage the
inmate’s/patient’s health needs on-site at the Putnam County Correctional Facility. However, as
mentioned above, clinical situations do arise where the need for off-site specialty services and/or
hospitalization is required. In such cases, PrimeCare Medical’s Utilization Review Committee,
RN Case Managers, local Health Services Administrators and Medical Directors work
collaboratively together to ensure the need for such service is clinically indicated and that
PrimeCare Medical’s cost containment protocols are enforced. Federal inmates require specific
approvals for such off-site care through the responsible Federal agency.
Typically, when PrimeCare Medical transitions a new medical services contract, we conduct an
initial baseline review and analysis of the current facility / medical operations to determine
necessary and required operational modifications that we believe will lead to increased
efficiencies and cost effectiveness. Based upon these findings, we will strategically and
systematically initiate changes which we believe will help us to achieve these goals. Once
initiated, we will begin to monitor their effectiveness and continue to make slight modifications
to them until the desired outcome is achieved. While many of these operational changes have
assisted us in reducing the clients’ financial liability, many more significant achievements have
been realized which cannot be quantified. PrimeCare not only offers to you, but encourages you
to contact any of our existing clients to validate our performance.
Based upon our review of the Putnam County Correctional Facility’s RFP and historic utilization
statistics, we believe there are several options and efficiencies that we can offer to significantly
reduce the number of outside transports. One component of this is through the use of our
telemedicine clinics, which is further discussed later in this Proposal. Through the PrimeCare
solution, we can offer the Putnam County Correctional Facility with the option of having various
different health care specialists evaluate inmates/patients through the use of telemedicine video
conferencing equipment, thus eliminating the need for these individuals to be transported offsite. Some examples of such specialists include OB/GYN providers, oral care specialists, and
infectious disease physicians. Another component that PrimeCare Medical would suggest to
reduce the number of inmate/patient transports would be by reviewing and evaluating the
Facility’s overall medical operation as it relates to your existing staffing matrix to ultimately
make the determination if modifications / adjustments / increases to the staffing plan could lead
to increased efficiencies related to the provision of patient care. Based upon your statistics, we
believe this could play a critical role in reducing non-emergent after hour transports. PrimeCare
Medical has already made similar staffing adjustments within other correctional institutions,
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which have yielded invaluable results to both our medical team and the facility correctional staff.
For example, in Dauphin County, Pennsylvania, they were experiencing an increase in the
number of off-site consultations and in-patient hospitalizations. As a result, PrimeCare Medical
successfully recruited for a full-time Infectious Disease / Chronic Care Registered Nurse. Since
this position was created, the number of consults and hospitalizations has decreased significantly,
saving PrimeCare and the County financially. In Northumberland County, Pennsylvania, they
were also experiencing a surprisingly high number of off-site referral requests. Again, following
our analysis of their operation, we coordinated for an additional provider clinic one time per
week, which almost immediately nearly eliminated the use of off-site consultation requests.
Another critical aspect of this process, specifically relating to cost containment initiatives, is
spearheaded by our Corporate Utilization Review Committee. Typically, pharmaceutical
expense is the largest variable on-site operating cost in any correctional health care setting.
PrimeCare Medical’s medication formulary, which is detailed later in this Proposal, is the most
significant method by which we adequately and appropriately manage this expense. In the event
a health care provider elects to order a non-formulary medication, prior approval must be
obtained, pursuant to Company policy, from the Utilization Review Committee. Throughout the
years, we have managed to successfully reduce many clients’ pharmaceutical budgetary line
items significantly through this process. Recently, PrimeCare Medical was awarded a
correctional health services contract in Crawford County, Pennsylvania; where in the first year of
our contract alone, we were able to reduce the total pharmaceutical expense by over ninety
(90%) percent.
With regards to off-site care, this is often times another substantial cost to a County’s inmate
health care budget. Again, many of PrimeCare Medical’s initiatives and cost containment
strategies are detailed throughout this proposal, to include utilization review, aggressive case
management, negotiating for significantly reduced billable charges through outside agencies, etc.
Through these efforts we have managed to significantly limit the financial exposure of our
clients as it pertains to off-site consultations and in-patient and out-patient hospitalizations.
Three (3) of the most significant accomplishments PrimeCare Medical is extremely proud to say
is that we played a critical role in developing and the passing of state legislation in Pennsylvania
(Act 22 of 2011), West Virginia (House Bill 2422), and New Hampshire (NH RSA 623-C:1);
which regulate what hospitals and off-site specialists can charge for inmate/patient health care
services. Each of these pieces of legislation capitate billable charges by these organizations at
the Medicaid and Medicare fee structures, thus, resulting in significant savings to the respective
clients.
In Chester County, Pennsylvania, the County is responsible for the health needs of a detainee
prior to their booking into the correctional facility. Through our aggressive negotiation efforts
and network of local community providers, we have managed to save Chester County between
$1.5M to $2.0M over recent years.
In Dauphin County, Pennsylvania, the County had housed two (2) different hemophiliac patients
within the past few years, both of which required extensive in-patient hospitalization. Again,
through our ability to negotiate with the respective hospital organizations, we successfully
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negotiated the first inmate’s charges from $4.4M to only $399,000. The second hemophiliac
patient incurred hospital charges of over $7.0M. In this case, we were able to coordinate with
the hospital’s case management and billing department to have the inmate enrolled in Medicaid,
which ultimately made full payment on behalf of the County.
LONG-TERM CARE
PrimeCare Medical recognizes that long-term care may be required at the Putnam County
Correctional Facility. As such, we will partner with the Facility to provide for the identification,
planning, and care of this critical group of inmates/patients. PrimeCare Medical has proposed
adequate staffing for these services and will follow Putnam County Correctional Facility policy
and applicable standards on long-term care referrals and procedures. The services PrimeCare
Medical will provide include, but are not limited to: skilled care, intermediate care, personal
care, assistance with ADL’s, and specialty medical care (i.e., ventilator, wound care, dialysis,
and extensive rehabilitation).
HOSPICE
PrimeCare Medical will work closely with the Putnam County Correctional Facility to continue
to follow the nationally accepted standards set forth by the NCCHC, ACA, National Hospice and
Palliative Care Organization, and the National Prison Hospice Association. PrimeCare Medical
shall fully cooperate and assist the Putnam County Correctional Facility in the continuation and
enhancement of the comprehensive hospice program for inmates/patients with terminal illness.
A terminally ill inmate/patient is defined as one whose physical condition has deteriorated to the
extent that the prognosis of life expectancy is less than one (1) year. Early release refers to an
inmate/patient being released before expiration of his or her sentence based upon
inmate’s/patient’s terminal condition. PrimeCare Medical is sensitive and understands that some
terminally ill inmates/patients will not be permitted to be released from the custody of the
Putnam County Correctional Facility under these circumstances. In these cases, we will provide
end-of-life care using a holistic approach.
PrimeCare Medical understands the effects that end-of-life care has on an inmate’s/patient’s
physical, psychological, social, and spiritual needs. A hospice program’s focus is on symptom
and pain management, not in attempting to cure the inmate’s/patient’s condition. PrimeCare
Medical staff will receive training in the basic theories and techniques of hospice care. Hospice
Care, according to the National Prison Hospice Association, is an interdisciplinary comfortoriented care that allows seriously ill and dying patients to die with dignity and humanity with as
little pain as possible in an environment where they have mental and spiritual preparation for the
natural process of dying. With the increasing “elderly” inmate/patient population in the Putnam
County Correctional Facility, PrimeCare Medical is poised to handle the medical needs of these
inmates/patients.
As such, PrimeCare Medical proposes to develop this program as a true partnership, through a
multidisciplinary team approach with involvement from custody, health care providers and
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community resources. This type of team approach will aide and support in the Putnam County
Correctional Facility’s and PrimeCare Medical’s goal of providing a holistic approach to care for
inmates/patients requiring the levels of care associated with hospice programs. Hospice care is a
concept that necessitates that the health care provider evaluates and considers all aspects of death
and dying. Palliative care will be available at the Putnam County Correctional Facility if
medically necessary. As noted within our operational plan, PrimeCare Medical will provide a
community based palliative care program to include pain management. These programs will be
implemented with the primary care site physician and the program managers as the primary focal
point. Our goal will be to provide a holistic program and to preserve the dignity of the dying
inmate/patient.
PrimeCare Medical will address needs of the inmates/patients according to the current
Community Standards. Adequate and appropriate pain management will be provided and
documented in the inmate’s/patient’s medical record. When PrimeCare Medical’s Medical
Director determines that care in a community setting is medically preferable or transfer to a
facility that can offer a higher level of care than can be offered at the Putnam County
Correctional Facility, he or she will make a recommendation to the appropriate legal authority
for the inmate’s/patient’s transfer or early release request.
EMERGENCY TRANSPORTATION
PrimeCare Medical will be responsible for ambulance, medic unit ground transportation, and
medically equipped aircraft coverage for emergency life threatening medical conditions of
inmates/patients through contracts or operating agreements with local ambulance companies.
Ambulance services shall be provided in the form of Basic Life Support (BLS) or Advanced Life
Support (ALS) through local contract arrangements. PrimeCare Medical will coordinate these
services when the situation or condition warrants BLS Transportation. ALS services are
requested when medically necessary. The Physician/Physician Assistant/Nurse Practitioner will
determine what type of transportation is needed to transport inmates/patients through
consultation with facility authorities. The Facility will arrange for transportation of the
correctional officers or designee necessary for security coverage of inmates/patients admitted to
the hospital. Emergency care will also be extended to all staff, volunteers, visitors, and vendors
as needed. Treatment for visitors and staff consisting of stabilization and referral to a personal
physician or local hospital shall be provided as required by the Putnam County Correctional
Facility.
NON-EMERGENT TRANSPORTATION
The Putnam County Correctional Facility shall provide and pay for routine non-emergency
transportation of inmates/patients, which may become necessary between the facilities and to
other medical facilities, as PrimeCare Medical may deem medically necessary and appropriate
for the health care of the inmates/patients. All non-emergency transportation of inmates/patients
shall be provided by the Facility or designee. The Facility shall also provide and pay for any
necessary security transportation in conjunction with inmate/patient trips to such medical
facilities.
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PrimeCare Medical recognizes that inmates/patients being transported off-site may place the
security transportation staff at risk. Our staff will be educated to provide the minimum amount
of health information necessary to protect the county transportation staff (i.e., If patient is
suspected of having an illness that could expose the transportation staff, our staff will advise the
transporting staff what personal protection device they should utilize for the transport).
PREGNANCY, PRENATAL, AND POSTPARTUM CARE
PrimeCare Medical shall be responsible for the health of the pregnant female inmate/patient and
the unborn child. PrimeCare Medical will provide timely and appropriate OB/GYN and prenatal
care, specialized obstetrical services, and postpartum care as clinically indicated and as required
by the RFP. Prior to incarceration, many female patients have maintained unhealthy lifestyles,
often times including a history of extensive drug, alcohol, and tobacco use; many also lack
proper OB/GYN prenatal care. Therefore, many inmate/patient pregnancies can be classified as
high risk. In addition, other factors complicate high-risk pregnancies, such as infectious
diseases, poor nutritional status, and mental health concerns. On admission and upon request,
female inmates/patients are tested to determine if they are pregnant. If the pregnancy test is
found to be positive, formal pregnancy counseling will occur; which includes education on
pregnancy options (i.e., delivery, adoption and or termination). In the event complications occur
within any pregnancy, PrimeCare Medical shall refer the inmate/patient to the local hospital, or
other local specialty care clinic, for urgent care needs. Additionally, PrimeCare Medical has in
place policies and procedures regarding care of the pregnant female who report a history of
certain drug abuse, detailing how certain medication maintenance to sustain the viability and
health of the pregnant female and their unborn child, as discussed in greater detail within our
detoxification section of this Proposal. Under such programs, PrimeCare Medical shall be
responsible for maintaining and the accounting of all such medications and any licensing or
training required for distribution of these medications.
Following the February 2012 American Civil Liberties Union (ACLU) Report, Reproductive
Health Locked Up: An Examination of Pennsylvania Jail Policies., the ACLU recognized
PrimeCare Medical as having “excellent” protocols and policies relating to inmate/patient
pregnancies. The ACLU went on to report that “the policies of jails that use PrimeCare as their
medical contractor were more complete than most others in the state. In a sense, PrimeCare is
taking the place of laws or regulations that we believe should be coming from the state
legislators or the DOC. We applaud your efforts to develop comprehensive policies.”(American
Civil Liberties Union of Pennsylvania [ACLU], 2012), (Petraitis, 2012)
MENTAL HEALTH SERVICES
PrimeCare Medical has considerable experience in providing treatment to inmates/patients with
mental illness. PrimeCare Medical and its contracted mental health care professionals
understand the unique challenges and individual needs of this critical population.
Comprehensive Mental Health Services, consistent with all requirements of the RFP, shall be
provided by PrimeCare Medical, mental health professionals, such as psychiatrists, mental health
specialists, and/or other appropriately trained health care personnel as outlined in the proposed
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staffing matrix, which shall meet the minimum staff / credentialing requirements set forth in the
RFP.
Nearly all of PrimeCare Medical’s correctional health care contracts are comprehensive in scope
(i.e., provision of both medical and mental health services), with the only exceptions being a few
small county facilities who have separately contracted with local county offices to provide
mental health services. As such, PrimeCare Medical has unparalleled experience in providing a
comprehensive health care system to the Putnam County Correctional Facility, building upon our
thirty-two (32) years of correctional health experience. Consistent with the Facility’s goal of
improving the integration and communication between medical and mental health care providers,
PrimeCare Medical will ensure this is successfully maintained during the life of this medical
services contract.
PrimeCare Medical has adopted best practices and evidenced based treatment therapies that are
utilized when providing mental health services for inmates/patients. Cognitive Behavioral
Therapy (CBT), an evidenced based treatment, is provided in individual and group modalities.
CBT has been demonstrated as an effective therapeutic treatment for inmates/patients with
depression, anxiety, psychosis, and many other mental illnesses. Staff is also trained to provide
Dialectic Behavioral Therapy (DBT), a specific type of CBT, which has been found very
effective in treating persons with severe personality disorders where a high degree of
emotionality and acting out behaviors are present. Mental health staffs also have expertise in
other more specific treatment strategies, such as addressing anger control and anger
management, and therapies that improve individuals coping skills, socialization skills, and other
behavioral deficits that may be problematic.
Best practices in mental health services are evident in our suicide prevention program, which
meets and exceeds the requirements of the NCCHC and has been reviewed and approved by
Lindsay Hayes, a nationally recognized expert on suicide prevention in corrections. Another
example of best practices is evidenced in our treatment of inmates/patients with serious mental
illness (i.e., schizophrenia, major depression, bipolar disorder, and borderline personality
disorder). Inmates/Patients with serious mental illness receive psychiatric treatment and are
followed by the psychiatrist as often as needed, at minimum once every 90 days, even if stability
has been established. Mental health staff also provide follow-up therapy and supportive care as
needed. Individual treatment plans are developed and specify the frequency and types of
treatment provided by mental health staff (i.e., psychologists, social workers, licensed
counselors, and psychiatric nurses).
Mental Health staff shall communicate effectively and work collaboratively with medical staff to
review and discuss treatment regimens and medication management for the Facility’s mentally ill
population. Qualified mental health personnel will initiate voluntary and involuntary mental
health commitments as clinically indicated. PrimeCare Medical shall not be responsible for the
cost of these proceedings or any mental health treatment at state or community forensic facilities.
PrimeCare Medical understands the unique challenges and needs of mentally ill inmates/patients
who enter your institutions with a wide range of mental disorders, intellectual disabilities, and
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treatment needs. Therefore, PrimeCare Medical will ensure that this population’s physical and
mental health care is provided as an integrated system. This will be accomplished as outlined in
our Collaboration Plan and Continuous Quality Improvement Program. At the facility level,
PrimeCare Medical staff will have weekly team meetings to determine current needs of new and
existing mentally ill offenders with special attention to those with serious mental illness. The
meeting will also include discussion of sentinel events and related protocols that may need to be
changed as a result of the review. A mental health representative shall attend all monthly
Continuous Quality Improvement (CQI) meetings. PrimeCare Medical will also conduct CQI
audits of psychiatric and mental health processes for both mental health care, as well as, care
issues involving coexisting medical and mental health conditions. All audit findings are shared
with on-site mental health staff and the corporate medical and mental health management as
outlined in the CQI program. Indicators found to be below established thresholds require that
corrective action(s) be implemented. These corrective actions are to be monitored and modified
as necessary until the system deficiency is corrected.
Health care integration between medical and mental health providers is also realized through the
use of our electronic medical record system, CorEMR. This occurs immediately at the time of
intake, when the inmate/patient receives a comprehensive health assessment including both the
inmate’s/patients mental and physical condition. Once an inmate/patient is identified as being in
need of mental health services, an immediate referral is generated to a qualified mental health
provider via CorEMR. The qualified mental health provider automatically receives the referral
and is able to review findings in the medical record immediately to utilize the information while
conducting their clinical assessment of the inmate/patient. Once the mental health assessment is
completed (which shall be completed on all new intakes – with specific screenings utilized on
minors as required by the RFP), the qualified mental health provider can then create follow-up
tasks, document relevant information and forward it to medical staff or a specific provider, so
that all medical providers are aware of and actively participating in the ongoing care of
inmates/patients with mental illness.
As discussed previously, medical staff is trained to be alert for symptoms of mental illness
during the Initial Receiving Screening process as well as during all subsequent contact with
inmates/patients. Medical Staff and Corrections Staff shall be trained by the Psychologist and/or
Psychiatrist on what symptoms and issues to look for when screening for mental illness. The
New York Model Suicide Screening Tool will be utilized on all new prison commitments. The
system utilizes a weighted scoring system consisting of individual questions addressing suicide
risk factors. When the screen cut-off score is reached, the inmate/patient is immediately placed
on suicide precautions and referred to Mental Health staff for further evaluation.
Mental health services shall be provided to all inmates/patients under the jurisdiction and control
of the Putnam County Correctional Facility. Inmates/Patients processed into the Facility will
have a mental health assessment completed by a mental health professional, consistent with all
RFP requirements, within fourteen days of admission. Inmates/Patients with high risk indicators
will be immediately referred for a comprehensive psychological assessment and evaluation.
Examples of high risk indicators may include the following, a) a significant mental health history
including psychiatric treatment and hospitalizations, b) a current prescription for psychotropic
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medication(s), c) currently exhibiting symptoms of serious mental illness (i.e., psychosis,
delusions, agitation, suicidal thoughts). PrimeCare Medical will refer inmates/patients through
the electronic medical record system; which provides for immediate referrals and minimizes
delays in assessment and treatment. Mental health records are immediately requested and
prescription drug orders are verified through the inmate’s/patient’s prior physician. Referrals are
also made through appropriate staff such as Administrators, Counselors, Officers, Work
Supervisors, and Medical Staff. Annual Suicide Prevention / Awareness Training will be
provided by PrimeCare Medical in coordination with the Facility’s Administration and/or
Training Officers.
As part of the medical intake process, all inmates/patients are required to sign a general consent
to treatment document prior to undergoing any evaluation or assessment and before receiving
any treatment including medication. When inmates/patients are seen by psychiatric providers,
they must provide informed consent prior to evaluation and treatment. They are informed of the
potential risks and benefits of medication and/or psychotherapy and sign consent forms
acknowledging this understanding prior to their receiving treatment. Information on medication
classes is provided to the inmates/patients at the time that medication is prescribed. All signed
consent forms, and copies of information provided are scanned into the inmate’s/patient’s
medical record.
Inmates/Patients should complete a sick call slip to access mental health services. Those in
segregation units can also verbally request to be seen by mental health staff by speaking with
nursing or mental health staff completing segregation rounds. Security and other facility staff can
also refer an inmate/patient to mental health by contacting the medical department. All referrals
are input as tasks to the appropriate mental health staff to be seen depending on the nature and
purpose of the referral. Once ‘tasked’ to mental health, the referrals will be completed within 24
hours, contingent upon approved contractual staffing plans. Medical staff will also accept
referrals from family members.
Inmates/Patients will be medically cleared as soon as is clinically appropriate to permit transfer
to a mental health or special needs unit. Suicide prevention and reduction of self-injurious
behavior are met through the Collaboration Plan, Continuous Quality Improvement (CQI)
program and orientation/training curriculum. Medical care in mental health units, psychiatric
observation cells and special needs units will be managed daily via rounds and referral
mechanism and weekly via on-site treatment teams.
Mental health staff shall respond to inmates/patients experiencing psychiatric emergencies,
including suicidal behavior, immediately. A psychiatric provider will be contacted when an
inmate/patient is experiencing a psychiatric emergency. If present in the facility, mental health
staff will evaluate the inmate/patient immediately. If no mental health staff is on site at that
time, the on-call psychiatric provider will be called by medical staff for orders. Please refer to
the Suicide Prevention Screening Guidelines discussed earlier in this proposal.
Forced psychotropic medication will only be utilized in accordance with State law, Facility
Policy Directive, PrimeCare Medical policy, and within the scope of professional practice.
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PrimeCare Medical mental health staff shall arrange for the transfer of mentally ill
inmates/patients to an appropriate psychiatric facility based on the current established criteria.
Mental health staff will work with the Putnam County Correctional Facility to complete the
admission process within established requirements for such admissions, to include psychiatric
evaluations, clinical assessments, and required documentation. Further, as required by the RFP,
PrimeCare Medical acknowledges that we may be required to perform forensic evaluations as
required by the courts, through independently contracted psychiatrists and/or psychologists.
Additionally, PrimeCare Medical mental health staff shall be available and cooperate with the
County’s Mental Health Court as required.
Laboratory screening ordered by mental health staff to determine therapeutic drug levels, will be
entered into the electronic medical record system and tasked to medical staff to be drawn.
Psychotropic medication non-compliance is automatically calculated by the electronic medical
record system and mental health personnel will be able to view this critical inmate/patient
information without prompting from medical. This system also minimizes delays in clinical
interventions and allows both medical and mental health staff to spend their time providing
inmate/patient care in a more efficient manner.
Discharge planning, including continuity of care and referrals for community based services is
crucial for effective mental health treatment. PrimeCare Medical is committed to providing
transition services for inmates/patients being discharged and shall adhere to all requirements set
forth in the RFP. Regarding aftercare planning and referrals to community agencies and
psychiatric providers, PrimeCare Medical will continue existing relationships that we have
established and seek additional services and providers in the community. We have found
working closely with the local mental health offices to be the best way to facilitate effective
discharge planning which typically involves securing funding and/or obtaining health care
insurance.
PrimeCare Medical will provide for the purchase, prescription, administration, and management
of psychoactive medications as further detailed within the Pharmacy Section of this Proposal.
Psychotropic medications are prescribed by psychiatric providers after they conduct a clinical
assessment or in the case of new commitments, when it is verified that the inmate/patient had a
valid prescription and was compliant with his psychotherapeutic treatment. Medication
administration is conducted by nursing at the same time as other medications are dispensed.
Stock psychopharmacological medication is maintained on-site and is available when prescribed.
Psychiatric providers shall discuss medications with each inmate/patient they intend to prescribe
medication to during their clinical assessment. The discussion will include the potential risks and
benefits of the medication. Printed literature will also be provided at this time as necessary.
As part of the transition plan to PrimeCare Medical, all current psychotropic medications will be
continued until the inmates/patients can be seen by a psychiatric provider. Whenever possible,
medications will be continued and not modified unless there is a clinical need. If existing
medications are not on our formulary they may be converted to similar medications which are on
the formulary, unless clinically contraindicated. All inmates/patients on suicide precautions or
psychiatric observation will remain on that status and their care will be assumed on the transition
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date. All relevant and current records on inmates’/patients’ mental health care and the services
they received will be reviewed as they are seen for routine follow-ups or referrals. Please see
details on the overall transition plan discussed elsewhere in this Proposal.
TELEMEDICINE CAPABILITIES
PrimeCare Medical will implement and utilize state-of-the-art telemedicine technologies to assist
with the provision of mental health care and certain other specialty health care clinics as
approved by the Putnam County Correctional Facility. Designed for mobility and ease of use at
the point of care, a high-definition video collaboration system with functionality make it ideal for
medical cases ranging from remote inmate/patient consultations to virtual care teams and
medical education. Through these technologies, health care providers can overcome the barrier
of distance, deliver better and timelier care to inmates/patients, and work more productively
through remote face-to-face collaboration in a medical setting. This system will operate in
compliance with PrimeCare Medical’s policies on Telemedicine.
Telemedicine has been utilized as an important adjunct to our facility staff. In some
jurisdictions, PrimeCare Medical has utilized this critical technology for not only emergent
mental health evaluations, but also for unique specialists such as infectious disease certified
physicians. Our technology systems allow these off-site providers to see the inmate/patient,
complete documentation, and issue orders directly in the inmate’s/patient’s electronic health
record. PrimeCare Medical will work with local specialty groups and those currently on staff to
assist when needed to conduct these services. Additional local specialists who may be opposed
to entering the correctional environment, but would be willing to collaborate and evaluate our
inmates/patients through this electronic media will be recruited and retained.
For the End User Equipment, PrimeCare Medical is proposing the “Cisco TelePresence –
Jabber” telemedicine devices. The Cisco Jabber brings the power of telepresence to health care
environments. Designed for mobility and ease of use at the point of care, a high-definition video
collaboration system with functionality makes it ideal for medical use cases ranging from remote
patient consultations to virtual care teams and medical education. This mobile telemedicine
endpoint is part of the Cisco portfolio, which offers a total solution approach including content
sharing, recording, firewall traversal, and management capabilities. Healthcare providers can
overcome the barrier of distance, deliver better and timelier care to inmates/patients, and work
more productively through remote face-to-face collaboration in a medical setting.

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personnel responsible for completing these screenings will be trained by Dr. Nathan Kalteski,
Director of Dental Health Services, or his designee. Basic dental services and treatments will be
performed by the contracted dentist and shall include examinations, extractions, fillings, dental
hygiene instruction, emergency care, provision of all dental prosthetics and lab services, and
provision of maxillofacial surgery services when indicated. All dental evaluations and
treatments shall be documented by the contracted dentists within the PrimeCare Medical
electronic medical record system to ensure continuity of inmate/patient care is maintained at all
times. Arrangements for emergent care through locally contacted oral surgeon offices shall also
be available and coordinated as clinically indicated. The assigned dentist, or a Corporate
Dentist, shall be available on-call twenty-four (24) hours per day, seven (7) days per week for
emergency situations.
VISION CARE SERVICES
Eye examinations shall be performed in accordance with Putnam County Correctional Facility
Policy, as well as being in accordance with NCCHC and ACA Standards. PrimeCare Medical
shall utilize Institutional Eye Care, a Pennsylvania Corporation, for optical services, as well as,
locally contracted eye care providers. These services will include: Regular eye examinations,
Emergency eye care services, Prescribing, Ordering, Dispensing, Fitting of eyeglasses, routine
eyeglass maintenance, routine eye examinations when medically indicated and other eye care
services as required. Contact lenses will only be provided if medically necessary in accordance
with Putnam County Correctional Facility policy.
CONTINUITY OF CARE
PrimeCare Medical will ensure continuity of care is maintained for all inmates/patients at the
Putnam County Correctional Facility, through established communication systems and protocols.
PrimeCare Medical’s electronic medical records system, CorEMR, has been instrumental in
maintaining continuity of care for all health related services, to include provider-to-provider
consultation, inmate/patient follow-up on chronic and/or acute health conditions, off-site health
referrals, hospitalizations, and discharges from Facility custody. As inmates/patients are
continually being discharged from custody while receiving specific treatment regimens, the
health care team to include members from Medical and Mental Health, are responsible for
coordinating appropriate community referrals prior to the time in which the individual is being
released from custody. This effort cannot be successful without the continued collaboration and
communication with facility treatment personnel and local support agencies within the
community. Our Transition Coordinator will design, develop and implement a referral resource
network within the local communities and be responsible for the successful transition of the
inmate/patient back into society.
PHARMACEUTICAL SERVICES
PrimeCare Medical has written policies outlining the proper procedure for medication
administration, documentation requirements on the medication administration record (MAR),
routine provider follow-up evaluations for continued long-term medication orders, and
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counseling / referring of inmates/patients who refuse prescribed medications. Through this
effort, PrimeCare Medical’s goal is to provide safe and cost effective care. All prescriptions are
written in accordance with a formulary, which includes generic drugs approved for substitution
by the Medical Director/Physician Assistant/Nurse Practitioner. Preference is for generic drugs
whenever appropriate. The purpose of this medication formulary is to:
 Promote cost containment/effectiveness without increased risk of adverse consequences
or therapeutic misadventures.
 Promote rational and objective drug therapy.
 Promote appropriate generic drug utilization and use of the lowest cost therapeutically
equivalent drug within a category.
 Work with other state agencies to purchase medications in bulk at the state agency rate.
Our pharmaceutical system shall provide for the ordering, monitoring on-site receipt, and
maintaining an inventory of pharmaceuticals in a safe, secure, and organized fashion. The
responsible physician shall approve written procedures for the distribution, administration,
accounting and disposal of medications. The responsible physician shall also approve a formal
medication log (Medication Administration Record) which shall be maintained for each
inmate/patient receiving medication. The inmate’s/patient’s medication log shall include the
date, time, name of drug and dosage administered. PrimeCare Medical shall also adhere to any
Putnam County Correctional Facility’s keep-on-person limited medication policy as approved by
the Facility and Statewide Medical Director. PrimeCare Medical currently only allows for very
limited usage of keep-on-person medication programs, as most medications are administered in
accordance with Company policy to ensure the appropriate distribution of all such medication
orders. Medications shall be stored in a locked storage area and a list of stored medications shall
be maintained. Medications shall be secured within these areas in both locked cabinets and also
locked medication carts. All drugs are stored under proper conditions of sanitation, temperature,
light, moisture, ventilation, and security. Internal and injectable medications will be stored
separately from antiseptics, drugs for external use, disinfectants, and cleaning supplies.
Persons administering medication shall do so under the supervision of the responsible physician
and shall have received training appropriate to their assignment. They are accountable for
administering medications according to orders as to both frequency and dosage, and for
recording the administration of medications in a manner and on a form approved by the
responsible physician. Training from the responsible physician shall include the medical aspects
of administration or distribution of medication to all individuals involved with the handling,
ordering, or administering of medications. When feasible, once a day or twice a day dosing is
preferred.
Any inmate/patient who refuses medication shall sign a statement to that effect, which shall be
signed by a staff member and filed in the inmate’s/patient’s medical record. Medications shall
be administered only by an appropriately licensed health care professional. When medications
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are taken orally, the person administering the medication shall take appropriate action to verify
that the medication has been swallowed, thereby ensuring proper ingestion of the prescribed
medication. The on-site registered nurse shall be responsible for maintaining the accuracy of the
MAR each shift and that any inaccuracies / errors are corrected. Furthermore, inmate/patient
MAR’s shall be available to the providers during all clinical encounters. PrimeCare Medical
shall provide notifications of contraindications (i.e., drug interactions, drug allergy, or incorrect
dose).
PrimeCare Medical will provide all medical supplies, office supplies, books, periodicals, and
forms necessary to maintain a facility dispensary for the care of the Putnam County Correctional
Facility inmate/patient population. PrimeCare Medical will provide a central pharmacy through
Correct Rx Pharmacy Services, Inc. for prescription services. Through our agreement with
Correct Rx Pharmacy Services, we will ensure that all requirements of the RFP are met, to
include on-site STAT dose capabilities for emergencies, availability of emergency medication
boxes, daily medication delivery in unit dose packs, on-site starter doses of medications,
pharmacy’s provision of alerts and reports to our health care providers regarding drug
interactions and dosage alerts, and quarterly pharmacy audits with written reports completed by a
registered independent pharmacist. PrimeCare Medical shall also contract with local back-up
pharmacy providers within the community, so that any prescribed medications ordered after
hours can be made available to the respective inmates/patients; thus, making pharmaceutical
delivery available seven (7) days per week. Upon an inmate’s/patient’s discharge from the
facility, an adequate supply of medication shall be sent with them in accordance with Putnam
County Correctional Facility’s policy. These services shall be further customized for the
Facility’s needs and will be furnished in compliance with all State, Federal and other applicable
regulations.
Over-The Counter (OTC) Medications and Stock Medications Inventory:
 PrimeCare Medical shall establish a stock supply of commonly utilized medications
(OTC’s, legend and controlled substances) for administration to inmates/patients prior to
receipt of their specific prescription as permitted by State Law and the Putnam County
Correctional Facility.
 Stock medications shall be managed and maintained in a safe and secure environment
with a perpetual inventory tracking system, developed by PrimeCare Medical, to ensure
accountability.
 PrimeCare Medical shall train all involved facility and health care staff that are involved
in the process of their duties and responsibilities, in order to initiate and maintain the
system. The training program shall be approved in advance by the Putnam County
Correctional Facility.
In order to minimize the waste of pharmaceutical and consumable medical supplies, it is the
responsibility of the PrimeCare Medical Health Services Administrator to designate one (1)
individual to be responsible for conducting a weekly inventory and ordering of all supplies and
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one (1) individual, to be responsible for weekly ordering of medications. This will ensure that
physicians have adequate notice to review and renew prescriptions. This specific designation of
responsibility increases accountability and reduces the possibility of double ordering, missed
prescriptions, delay in ordering, lack of supplies when most needed, and premature prescription
changes.
Our electronic medical record system is critical to effective medication management. Physicians
order medications directly through the electronic medical record system and inmates/patients
receive their medications (if available) at the next medication pass. When a clinician orders
medications, the order is sent electronically directly to the pharmacy via the electronic medical
record system. This system allows for faster ordering and processing of medications in all
facilities. This one step process allows for a reduction in staff time and makes transcription
errors less likely. Furthermore, inmate/patient MAR’s are available to the providers during all
clinical encounters.
A Pharmacy and Therapeutics Committee, consisting of at least the on-site Medical Director/
Physician Assistant or Nurse Practitioner, Health Services Administrator, Pharmacist, and
members of the Facility’s Administration will meet as required, but no less than quarterly. This
committee, which will report to the Continuous Quality Improvement Committee, shall be
responsible for considering and recommending additions and deletions to the formulary. The
usage of all pharmaceuticals, including psychotropic drugs, shall be closely monitored and
prescribing patterns identified. The Committee shall also assist with drug utilization audits.
Generic prescription drugs are used whenever possible. Effective, accepted drugs which have
been on the market are provided initially, and only when they are ineffective, are newly
approved drugs prescribed. PrimeCare Medical and the contracted pharmacy vendor shall report
all requested pharmacy statistics required by the Putnam County Correctional Facility.
LABORATORY SERVICES
PrimeCare Medical will contract laboratory services through Bio-Reference Laboratories, Inc.
PrimeCare Medical will ensure that all subcontracted laboratory services meet all state licensing
requirements and shall provide documentation of routine quality control activities as requested.
All specimen results, when received, will be reviewed by the nurse on-duty, with calls placed to
the on-call provider for orders when clinically appropriate. A record of the date and time of this
communication as well as resulting intervention orders is documented in the inmate’s/patient’s
health care record. It shall be the responsibility for the qualified health care professional
receiving the lab results to ensure that appropriate intervention is initiated. The ordering and
completion of STAT laboratory services shall also be available as clinically indicated, either
through Bio-Reference Laboratories or through arrangements with local hospitals; thus,
eliminating the need for off-site transports for the respective inmates/patients. All test results
shall be made available to the facility within twenty-four hours, with abnormal findings being
made available immediately upon interpretation by the provider. PrimeCare Medical will utilize
CareEvolve, a subsidiary of Bio-Reference Laboratories, Inc. to provide on-line access to
laboratory results. CareEvolve provides access to test results as soon as they are available via a

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secure web portal with a unique login and password. Bio-Reference Laboratories is required to
notify PrimeCare Medical immediately by telephone of any critical abnormal results.
Specimens will be picked up, Monday through Saturday, at approximately the same time each
day and delivered to the laboratory as soon as possible. Stat labs will be transported to a local
hospital within one (1) hour.
In order to ensure a high level of quality control, PrimeCare Medical will require the contracted
laboratory to utilize both internal and external systems to monitor the accuracy and precision of
each inmate/patient run for every test performed in the laboratory. In addition, data from
laboratory quality control proficiency procedures is to be available for review upon request. The
on-site Medical Director/Physician Assistant/Nurse Practitioner shall check, initial, and date all
laboratory results within an appropriate time to assess the follow up care indicated and to screen
for discrepancies between the clinical observations and the laboratory results.
RADIOLOGY SERVICES
PrimeCare Medical will provide contracted x-ray and radiological services to the Putnam County
Correctional Facility by utilizing Physicians Mobile X-Ray Services. These mobile radiology
services personnel are appropriately trained, insured, and certified in accordance with State Law.
PrimeCare Medical shall be responsible for providing all necessary supplies and equipment to
complete required on-site radiological services, to include all fees associated with the
transportation of x-ray films and related interpretation readings by a licensed Radiologist. The
ordering and completion of STAT radiological services shall also be available as clinically
indicated. All test results shall be made available to the facility within twenty-four hours, with
abnormal findings being made available immediately upon interpretation by the provider.
Digital and regular radiographs will be conducted Monday through Friday at times designated by
the institutions (regularly scheduled days), unless institutional operational schedules dictate
otherwise, by a registered technician; with interpretations completed by a board certified
radiologist who shall provide a typed and/or automated report to the institution within acceptable
time frames. PrimeCare Medical shall ensure that results of services will be reported no later
than twenty-four (24) hours after service was rendered. When warranted, STAT readings are to
be provided immediately to the institution when findings are significant. PrimeCare Medical
shall be responsible for the maintenance, pulling, filing, and purging of all X-ray films. All such
radiology services shall be fully integrated into the electronic medical records system, which will
provide for the highest levels of continuity of care following such testings. PrimeCare Medical
shall utilize electronic medical records system for the storage, retention, and documentation of
digital images.
PrimeCare Medical shall also be responsible for all other X-rays and diagnostic testing not
available at the institution. The use of on-site mobile ultrasounds, bone mineral density studies,
EKG’s, and digital holter monitoring will be available and utilized as specific inmates’/patients’
needs warrant.
PrimeCare Medical understands that if radiological services cannot be

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completed on-site, the scheduling of radiological services will be coordinated with Facility
Administration to ensure security and transportation requirements.
ECG SERVICES
PrimeCare Medical shall provide EKG services, equipment, and necessary supplies to the
Putnam County Correctional Facility. EKG equipment utilized by PrimeCare Medical will be
provided by Mortara Instrument ECG’s, a world leader in ECG technology. Widely recognized,
Mortara resting ECG interpretation algorithms use gender specific and adult criteria to provide a
silent second opinion for resting ECG interpretation. PrimeCare Medical will be responsible for
the direct interpretation of all electrocardiograms and tracings through an interpretive machine
located on-site. These tracings will become part of the inmate’s/patient’s permanent medical
record with full interpretations performed by a Cardiologist/Internal Medicine specialist. The
ordering and completion of STAT EKG services shall also be available as clinically indicated.
Readings from these machines, as well as their interpretations shall be electronically integrated
through the electronic medical records system. PrimeCare Medical will provide all equipment
and supplies necessary for these specific services.
THERAPEUTIC DIET PROGRAMS
The on-site Physician/Nurse Practitioner/Physician Assistant will be responsible for the ordering,
monitoring, and evaluating of therapeutic diet programs as dictated by applicable standards at the
Putnam County Correctional Facility. Necessary therapeutic diets will be permanently recorded
in the inmate’s/patient’s medical record. These therapeutic diet programs may only be ordered
by the Physician/Physician Assistant/Nurse Practitioner and must be reviewed on a monthly
basis. These diets are the financial responsibility of the Facility. Inmates/Patients who suffer
from diabetes, hypertension, cardiac problems, AIDS, hepatitis, or other nutritionally
complicated conditions, such as pregnancy, may require a therapeutic diet. PrimeCare Medical’s
contracted dietician, Susan Brennan, RD, LDN, shall be available to consult on semi-annual
dietary menu cycle reviews in accordance with applicable standards and complete specific
inmate/patient reviews when therapeutic dietary treatment plans have been ordered for unique
nutritional concerns. The PrimeCare Medical contracted dietician and health care providers shall
educate inmates/patients on the topics of dietary needs, food consumption, and commissary.
INFECTIOUS WASTE DISPOSAL
PrimeCare Medical will be responsible for the custody and approved appropriate method of
disposal of any and all hazardous waste generated by medical care or treatment provided to the
Putnam County Correctional Facility. These disposal methods shall be in compliance with any
applicable standards and/or regulations relevant to the disposal of bio-hazardous waste material.
PrimeCare Medical shall take appropriate measures to ensure that only biomedical waste
material is deposited in the designated contaminated waste containers. This will occur through a
contractual relationship with Stericycle, Inc., who currently provides medical waste disposal
services to all PrimeCare Medical contracted facilities. All certificates of disposal shall be
maintained by PrimeCare Medical
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INMATE/PATIENT GRIEVANCES
Any medical grievances filed by inmate(s)/patient(s) shall be referred to the on-site Health
Services Administrator, who shall review the claim and gather information concerning the
complaint and take appropriate action consistent with institutional grievance procedures. All
grievances received shall be reviewed for patterns and trends at the monthly Continuous Quality
Improvement team meetings. If patterns are noted, plan of actions are developed to improve
inmate/patient satisfaction rates. The Health Services Administrator shall be responsible for
meeting with all inmates/patients who submit a medical grievance. The purpose of this meeting
is to obtain all of the facts regarding the grievance and to provide education when necessary. We
have determined many grievances can be eliminated through this procedure. All grievances
received shall also be reviewed at the monthly health care staff meeting. The review shall
include any corrective action plans developed as a result of patterns or trends noted. All
grievances are further reviewed weekly by the Corporate Risk Manager as a proactive approach
to resolving potential problems at an early stage.
RE-ENTRY / DISCHARGE PLANNING
PrimeCare Medical shall work in cooperation with the Putnam County Correctional Facility
designated Re-entry Coordinators to develop discharge planning services for inmates/patients
being discharged from the care and custody of the Facility. PrimeCare Medical’s discharge
planning process shall adhere to all requirements set forth in the RFP. PrimeCare Medical will
identify continuing areas of concern for re-entry, and make recommendations for changes where
needed in existing re-entry programs, and make recommendations for the development of new
programs to address inmate/patient re-entry needs. Health Care Release Planning is initiated for
each inmate/patient when the medical department is notified of the inmate’s/patient’s pending
release.
Health Care Release Planning consists of several components, to include health
education, self-care instruction, and continuity of care plan development, which includes both
the treatment plan and community agency referrals.
PrimeCare Medical will designate a member of the facility’s Medical Department to serve as a
Health Care Release Coordinator. The work associated with the Health Care Release
Coordinator is accomplished in coordination with various other departments and multiple
disciplines. The duties of the Health Care Release Coordinator include, but are not limited to:
 Review Facility Re-entry Coordinator’s list of inmates/patients eligible for parole and/or
release. Notify the Putnam County Correctional Facility of any inmate/patient with a
serious health condition that will require extensive medical care or who may present
complex medical conditions post-release.
 Discussion with the inmate/patient about discharge.
 Assist assigned correctional counselor(s) with medical information when inmate/patient
has been deemed eligible for Social Security benefits.

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 Coordinate discharge planning of every mental health/mental retardation (MH/MR)
inmate/patient with the designated Mental Health Coordinator.
 Provide information to inmate/patient related to self-care and health education, as well as
education on special needs.
 PrimeCare Medical shall make every reasonable effort to ensure that inmates/patients
have a sufficient supply of medication upon discharge.
 Schedule necessary follow-up visits / consults with local community care providers as
clinically indicated.
MEDICAL RECORDS
Medical documentation will occur on a daily basis to ensure that NCCHC and ACA standards
are consistently maintained. We will guarantee through an internal auditing system that medical
records are complete and contain accurate legible entries. All information acquired shall be kept
confidential in accordance with State Law, the Health Insurance Portability and Accountability
Act (HIPAA), and NCCHC Standards.
PrimeCare Medical shall have access to private and confidential data maintained by the Putnam
County Correctional Facility to the extent required for PrimeCare Medical to carry out the duties
and responsibilities defined in this agreement. PrimeCare Medical agrees to maintain
confidentiality and security of the data made available. PrimeCare Medical shall have full access
to the medical records after the termination of any contract in order to prepare for litigation or
anticipated litigation brought by third persons in connection with the services rendered by
PrimeCare Medical pursuant to this proposal.
Confidentiality of Health Records: Active health care records shall be maintained under secure
conditions and separately from confinement records pursuant to NCCHC Standards. Access to
active inmate/patient records is controlled by the health care authority. PrimeCare Medical shall
not deny Facility Administration or his/her designee access to such records in accordance with
applicable law.
Release of Health Care Information: Detailed health care information shall only be released to
an outside agency upon written authorization from the inmate/patient or in accordance with
PrimeCare Medical Policy on the matter. Exempt from this policy is the pertinent health care
information necessary for any off-site consultation and/or specialty referral.
Transfer of Records: When an inmate/patient receives off-site examination or treatment or is
transferred to another facility or hospital, the inmate’s/patient’s health record or a copy of the
summary shall accompany him or her. In the event that an inmate/patient is transferred to a
correctional facility outside the jurisdiction of the Putnam County Correctional Facility, an
inmate/patient health care summary sheet shall accompany the inmate/patient. Documentation of

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any off-site examination or treatment shall be made in the health record by the physician or other
health professional involved.
Records Retention: PrimeCare Medical shall comply with all applicable Federal and State rules
and regulations, and requirements governing the maintenance of documentation to verify any
cost of services or commodities rendered under this contract by PrimeCare Medical PrimeCare
Medical shall maintain such records a minimum of seven (7) years and make available all
records to the Putnam County Correctional Facility personnel in accordance with applicable
Federal and State rules and regulations.
ELECTRONIC MEDICAL RECORDS SYSTEM
PrimeCare Medical continually updates and improves technology throughout the Corporation. In
2006, PrimeCare Medical signed a contract with “CorEMR”, an Electronic Medical Records
Corporation based in Orem, Utah. CorEMR has designed an electronic medical record (EMR)
system specifically for corrections. In an effort to continue with product improvements,
PrimeCare Medical continuously works with CorEMR to provide further customization to this
software to better serve each of our facilities. We have already implemented this electronic
medical records system in nearly all PrimeCare Medical contracted facilities. A complete listing
of these facilities, to include the Facility Administrator’s contact information, is contained in the
Addenda Section of this Proposal. This system has significantly improved the efficiency of
medical record maintenance, such as the storage, instantaneous access to intake/receiving
screening, current and complete medical information, health assessment, etc. for staff and
increased speed and efficiencies of several processes that used to require a significant amount of
time.
CorEMR brings real time and accurate health records to the treating medical staff in an efficient
and effective manner. Through built in functionality, CorEMR allows for increased
inmate/patient care and overall improved inmate/patient outcomes. This system is a completely
paperless electronic medical record system. It has the ability to interface with OMS, laboratories,
radiology providers, pharmacies, and other outside agencies. The system is continuously
improving and growing. The built in tracking and reporting features are robust and information is
readily available to the end user. Exago or eWeb Reports can mine database information, custom
and ad hock reporting can be produced, saved and reference at any time. It is built on a sound
backbone for expansion and growth. With health conditions of inmate/patient populations
changing and the world of medicine continually evolving, PrimeCare Medical and CorEMR
understand the importance of staying up to date on all national and local trends, medical
protocols and changes within the Putnam County Correctional Facility.
PrimeCare Medical plans to begin its initial implementation of its electronic medical records
system at the Putnam County Correctional Facility immediately upon a contract award so that its
transition / implementation process can begin. PrimeCare Medical’s proposed electronic medical
record system shall be fully implemented at the Putnam County Correctional Facility upon
contract commencement. This implementation period shall be contingent upon the timely
cooperation of all parties involved and the approval of the Putnam County Correctional Facility.
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PrimeCare Medical is proposing the installation of its completely customized electronic medical
records system, CorEMR, to the Putnam County Correctional Facility immediately upon a
contract award.
Included within PrimeCare Medical’s CorEMR system is our proven and proprietary business
model, operational health systems, forms, policies, protocols and procedures. It is this
customization that separates PrimeCare Medical’s CorEMR system apart from the competition.
All upgrades and enhancements are thoroughly tested prior to deployment and any patches/fixes
are done timely. PrimeCare Medical will provide updates to the facility with any new features
and software enhancements on a quarterly basis. We have already implemented this electronic
medical record system in “forty-two” (42) sites – accounting for over “21,000” lives. PrimeCare
Medicalis currently working towards implementing this system in all contract facilities. The
system currently services PrimeCare Medical facilities ranging in size from 2,600 beds (York
County) to 49 beds (Lancaster Youth Intervention Center) including a state wide multi-site
system (West Virginia Regional Jail Authority).
PrimeCare Medical will be the custodian of all medical records in accordance with all Putnam
County Correctional Facility Policies. The records will also comply with all HIPAA rules and
regulations. PrimeCare Medical’s implementation of an electronic medical records system will
reduce the amount of records being produced going forward. PrimeCare Medical will scan
medical charts that it deems necessary to maintain the continuity of care of chronically ill
inmates/patients.
PrimeCare Medical brings the Putnam County Correctional Facility a solution that will service
the inmate/patient population in the most state of the art and high availability model currently
being offered. PrimeCare Medical hosts this solution in a Tier III data center. The virtualized
environment allows the solution to scale as needed and is accessible at all times. The EMR is
continuously replicated to diverse geographical locations and monitored 24/7. CorEMR can be
accessed simultaneously by different users at multiple locations. CorEMR runs through a web
browser, so no extra software is needed. This backbone will ensure availability and security of
medical records compliant with all state and federal regulations.
As previously mentioned, the system is “completely paperless” touching every aspect of medical
services: Intake, Sick Call, Medication Pass, Forms, Reports, Scheduling and much more. When
an inmate/patient is committed to the Putnam County Correctional Facility an intake is
completed by our medical staff – it is at this point they are entered into CorEMR and the process
begins. An individual health care record is created and maintained for every inmate/patient
regarding medical, dental, or mental health services as a result of the inmate/patient screening
process, or for services rendered following assignment to a housing area. CorEMR has a built in
scheduler that will automatically schedule inmate/patient referrals and follow-ups based on
PrimeCare Medical’s proprietary screening. An extensive mental health assessment is also
completed with suicidal risk factors. The system is set up to accept digital signatures as well as
email notifications for risk factors and/or classification purposes.

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CorEMR can also integrate with Putnam County Correctional Facility jail management software
and pass inmate/patient demographic and location information on a constant basis. CorEMR can
also send and receive confirmations from a pharmacy provider and other outside agencies. If sick
call requests are submitted through a kiosk or telephonically, a system will be set up so that
CorEMR will also capture this information and task to the appropriate health care worker.
KEY FEATURES:
Certification & Standards Compliancy
 CorEMR v5.0 received ONC Staging 1 Meaningful Use certification in December 2012.
 The software is NCCHC compliant and will assist the facility in reaching and
maintaining NCCHC accreditation.
 The software supports AJA, ACA and NSA standards
Integrations
 Imports patient data from existing Offender Management Systems (OMS). This
integration creates an automatic electronic patient chart. Patient photo and basic
demographic information is automatically captured.
 Sends medication orders to our/your pharmacy provider for shipment or delivery.
 Receives lab results fully integrated with the health record.
 X-ray imaging seamlessly transferred to patient record.
Technology
 Simultaneous access allowed for multiple terminals and users within the facility.
 Web based structure that runs on the facility’s local network or by a server running at one
central location for facilities with multiple locations.
 Built on a SQL back end and is compatible with SQL Server 2005, 2008, 2012 and
MySQL 5.0+.
Medical Forms
 Forms can be configured with “triggers” that automatically create actions (i.e., creating
an active problem for a diabetic or scheduling a task for the nurse on duty to review that
intake form).
 Transfer and release forms configured with triggers that automatically retrieve
information from the patient’s medical chart such as active problem list, current
medications and most recent PPD test results.
 Unique forms creation tool allows users to create customized forms to use throughout the
system. These forms can be categorized as medical, dental or mental health and can be
defined as Intake, Release, Patient Requests, Subjective Interview, Patient History,
Education and Exam Forms (Objective).
 Forms with built in Protocols based on a specific problem or condition.
 Forms can also capture not-examination information, such as administrative and patient
consent forms, refusals, release of information, as well as many others.
 All forms are titled, date and time stamped with an electronic signature attached with the
name and title of each documenter.
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Patient Charts
 Search for a patient’s chart by booking number, last name, Social Security number or
other identifiers.
 Scan and upload patient requests, outside provider visits, or any other non-system
documents to the patient’s chart.
 Flow sheets for vital signs and blood sugar levels can be recorded and logged. Other flow
sheets include: neuro checks, Coumadin log, nebulizer treatments and more.
 Record progress and chart notes for each patient.
 Create “Patient Alerts,” such as suicide watch or recreation restriction, on the patient
chart, which also displays on the dashboard for high visibility to other users. Alerts are
fully configurable.
 The Chart Summary includes: current medical problems, medications, task summary,
intake form summary and recent medical history with links to each section.
 Chronic Care is also part of the inmate’s chart.
 Maintenance of all records will be in compliance with state and federal law and will be
made available to Facility personnel, consistent with HIPAA requirements.
Infirmary Charting
 The software supports distinct and separate charting for inmates/patients that are being
held in the Infirmary, yet maintains a single chart as per NCCHC requirements.
 The software will track doctor ordered level changes (i.e., level 1,2,3, observatory, etc.)
which determines the level of care required while the inmate/patient is in the Infirmary.
 The software will allow for different Forms to be available within the Infirmary Chart as
opposed to the Master Chart, providing a level of separation of the information captured
in the chart.
 The software supports an admission and discharge process that will allow the user to
determine which data related to medications, alerts and problems is shared between the
Infirmary and Master sections of the chart.
Scheduler
 Includes a robust appointment scheduler that can be filtered by task category (doctor,
dentist, nurse, social worker etc.), priority and housing location.
 Tasks and appointments can be viewed by day, week or by month.
 The system can prevent the over scheduling of a user or user type.
 The system will allow an administrative user to configure an unlimited number of Task
Categories or Types.
Sick Call (SOAPe Notes)
 Uses the standard SOAPe note format for Sick Call examination.
 Displays patient summary information such as current medical problems and current
medication compliance on the Sick Call.
 Gives users access to the Subjective, Objective, Action, Plan and Education sections
directly from the Sick Call module, allowing doctors to record orders for later note off or
complete the actions themselves.

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 Available actions include completing interview or exam forms, scheduling future
appointments, ordering lab work, and ordering medications.
 Receive and store scanned documents and electronic files directly into sick calls.
 Allows users to note if Sick Calls (clinic) or medications are billable.
Medication Administration
 Med Pass times are configured by day and Med Pass Prep List is generated accordingly.
 Med Pass lists can be grouped by housing unit or alphabetically by last name.
 Patient’s acceptance or refusal of each dose is recorded. Graphical and detailed MAR
reports can be viewed at any time.
 The system easily accommodates KOP, PRN, injections and stat dosing.
 Optional bar code reader integration to find each patient’s chart, record Med Pass
compliance and synchronize data with the CorEMR server.
 Automatically highlights medication expiration dates and refill notifications.
 Body image shows on Med Pass to indicate injection sites.
 The software will allow for off-line medication administration in facilities that do not
have wireless network connectivity throughout the facility.
 Med Pass data is safeguarded using a Local Save feature that will prevent the Med Pass
from being lost if the laptop being used is accidently powered off or the battery life
would happen to expire.
 The software supports Medication schedule configurations to meet the distribution
schedule.
 The software will support administrative user configuration of multiple Med Passes for a
given day (i.e. 0800,1200, 1600, and 2000)
 The software will allow an administrative user to tie medication frequencies to the
configured Med Pass Times (i.e., BID medications distributed at 0800 and 1600, QD
distributed at 0800, etc.).
 The software will allow reporting on medication compliancy so the providers can make
an informed decision as to continue the medication or discontinue it based on missed
dosages.
Pharmacy Module
 Send orders to and receive confirmations from the pharmacy provider.
 Includes a pharmacy module for ordering, making Med Pass assignments and scheduling
refills.
 Imports the drug list and identifies formulary medication.
 Allows filtering of the drug list by name, analgesic category, form and other criteria.
 Inventory check-in screen when Meds are received from the pharmacy.
 Eliminates the need for double entry of medications into the EMR and also the
Pharmacies on-line ordering system.
 Eliminates potential pharmacy/provider transcription error that can result in medication
errors.
 Provides positive confirmation that the order has been received by the pharmacy.
 Provides for near real-time order status including error reporting on medication orders
(i.e. reorder too soon, requires a signed paper prescription, etc.).
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 Provides positive Prescription identification using the RX number that will allow the
check-in of medications using bar-code scanning
 The software supports STAT medication ordering that will allow for the ordering and
administration of the med in a single step, while updating the MAR appropriately.
Integrated Document Scanning
 Documents can be attached to the inmate/patient chart and categorized for easy retrieval.
 Documents can be attached to the chart, an inmate form, a release form or a sick call
record.
Reports
 Reports include: task reports, prescription (drug by name and patient), prescriptions
ordered by date range, Medication compliance, refusal, and dosing summary reports,
missed doses, infirmary reports and more.
 Captures a large amount of information on each patient to generate Management Reports
and other patient demographic information.
 Includes a User Definable Report Builder that allows facilities to retrieve information for
unlimited customized reports from defined data elements.
 Medical Studies are conducted through our CQI program and CorEMR reporting.
Administration
 Permissions Grid restricts access by user type.
 Ability to manage and edit all forms and form triggers. Includes the ability to create event
triggers (such as automatically create a specific task when a question on a form is
answered a certain way).
 Ability to create Medication Sets—multiple medications configured to be ordered as a
group, for situations like alcohol withdrawal protocols.
 The software can automatically create in inmate/patient chart when a new inmate to the
system is entered into the JMS system minimizing manual data entry of demographic
data.
 The software will update the chart by adding new booking data (Booking Number,
Booking Date and Booking Time) to an existing chart. If two charts exist for the same
patient those charts can be easily merged together to form one complete medical record.
 The system will track the inmate’s/patient’s housing location history to assist with Med
Pass and also disease management due to contagious diseases (inmate/patient proximity
report).
 The system can capture Agency information (i.e., ICE, US Marshal, Fed, etc.) that is
entered into the JMS that can be used to generate billing reports or passed on to the
Pharmacy for billing.
 The system will automatically cancel any future scheduled Task and Discontinue any
medications when the inmate is released from the Jail Management System.
 Non-Inmate activities can be entered into the system to assist with communication
between management and clinical staff.
 Activities can be marked as complete so that they will no longer display.

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As mentioned above, PrimeCare Medical feels that it is uniquely suited with “CorEMR” to
provide the Putnam County Correctional Facility with a “state-of-the-art, completely customized
electronic medical records system”. PrimeCare Medical has built specific efficiencies into
CorEMR and feels that Putnam County Correctional Facility would benefit immensely with the
implementation of CorEMR. PrimeCare Medical’s is confident that we can provide a level of
service that is unsurpassed by our competitors.
MEDICAL SUPPLIES AND EQUIPMENT
PrimeCare Medical shall be responsible for the maintenance, repair, and replacement of
equipment and for acquisition of additional equipment and supplies necessary for the proper
conduct of inmate/patient medical services at the Putnam County Correctional Facility and
remain flexible to the ongoing needs of the Facility. The Purchasing Department of PrimeCare
Medical will receive and process all supply orders for the Putnam County Correctional
Facility. All of these purchases will be acquired within acceptable timeframes. Additionally, the
PrimeCare Medical Purchasing Department will be responsible for coordinating the acquisition
of telemedicine equipment and service contracts for this equipment in collaboration with the
PrimeCare Medical Information Technology Department.
PrimeCare Medical utilizes the following system of on-going Corporate review:
 All supply orders are received by the Director of Purchasing at the Corporate Office for
review and processing. Any significant increase in the number of specific supplies
ordered that cannot be explained by an increase in the inmate/patient population is noted
and questioned by the Director of Purchasing before the order is processed.
 PrimeCare Medical’s Corporate computer capability is such that all supply and
prescription costs can be tracked by facility and any significant increase suggesting waste
will quickly be identified with appropriate instructions to explain or address the situation
provided to the PrimeCare Medical Health Services Administrator.
 The utilization review and contract compliance audit processes noted in this Proposal also
provides a valuable checks and balances mechanism which guards against waste and
unnecessary expenditures.
INMATE/PATIENT HEALTH EDUCATION
PrimeCare Medical has developed, subject to the Putnam County Correctional Facility approval,
an inmate/patient health education program utilizing posters, pamphlets, and individual health
counseling. To further this health education process, formal sessions shall be made available
based on the assessed educational needs of the inmates/patients. Inmate/Patient health education
topics shall include, but, not be limited to, personal hygiene, medication education, sexually
transmitted diseases, chemical dependency, effects of smoking, and communicable diseases.
Such health related topics are also available and provided to health care staff, as well as, facility
security personnel.
PrimeCare Medical’s Continuous Quality Improvement Program’s
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assessment tools require compliance that all patient encounters include education topics related
to the visit. We believe that with continued education, the health care team can effect change in
inmate/patient lives. This improvement in health will not only benefit the inmate/patient, but
will provide for improved patient outcomes and will assist once the inmate/patient is discharged
back into the community.
CRITICAL INCIDENTS AND MORTALITY REVIEW
PrimeCare Medical takes a collaborative approach in responding to any critical incidents that
occur within our contracted facilities through a formal critical incident debriefing process as
defined by NCCHC. This is completed as a joint effort by the Health Services Administrator,
Medical Director, and Mental Health Staff. A formal review of all processes and actions leading
up to the incident are reviewed, with formal action plans developed if any procedural
discrepancies are noted. These individuals also meet with all staff members involved in the
incident immediately following the event. Such services are also made available to facility
personnel if requested (i.e., mental health staff meet with personnel involved if an attempted
suicide occurs within the facility).
Additionally, PrimeCare Medical policy clearly defines appropriate protocols and procedures to
be followed in the event of an inmate/patient death, based upon applicable standards. A formal
mortality review is required to be completed within thirty (30) days of death, which includes
members from Facility Administration, the Health Services Administrator, Medical Director,
Mental Health Staff, Regional Directors, and members of the Corporate Utilization Review
Committee. Should any corrective action plans be required as a result, PrimeCare Medical shall
issue a formal report of such to Facility Administration.
STAFF WELLNESS PROGRAM
PrimeCare Medical will conduct Pre-Employment and Annual Staff physicals examinations in
accordance with Putnam County Correctional Facility policies as required by the RFP. Upon
receipt of staff/employees names requiring either annual or pre-employment physicals,
PrimeCare Medical’s Health Services Administrator or Designee will schedule the examination.
Laboratory and diagnostic studies will be completed as medically appropriate and in accordance
with Facility policy. A physician will review the results and document findings in the
employee’s file. Additionally, PrimeCare Medical will participate in any and all other required
staff wellness program obligations as required by the Correctional Facility.
EMERGENCY PREPAREDNESS
PrimeCare Medical has an established all-hazard medical disaster and contingency plan to
provide for the delivery of medical services in the event of an unexpected event or disaster,
either naturally occurring or man-made. PrimeCare Medical will implement procedures for the
delivery of medical services in the event of a disaster such as fire, tornado, epidemic, riot, strike
or mass arrests. Such procedures will be developed by the Responsible Health Authority, in
cooperation with correctional staff and PrimeCare Medical corporate management personnel.
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All such plans and emergency measures shall be coordinated with the nearest local disaster
agency. The all-hazard medical disaster plan is in compliance with all applicable standards.
Upon a contract award, PrimeCare Medical will implement its already developed disaster plans
and customize them to fit the needs of the Putnam County Correctional Facility, based upon the
Facility’s needs and risk assessments. PrimeCare Medical shall review all findings and disaster
plans on an annual basis and more frequent as systems warrant.
All health care staff shall receive orientation training and yearly mandatory training in their roles
in the event of a disaster or disruption within the context of this plan. PrimeCare Medical utilizes
Tabletop discussions to reinforce specifics of emergency response planning and steps in the
event of a pandemic or disaster. PrimeCare Medical conducts functional and real life exercises
in the form of mass disaster drills and man-down drills; including all appropriate record keeping
and METTAG or California Fire Chief’s Triage Tags system in accordance with all applicable
standards. PrimeCare Medical shall provide the Facility’s Administration with a copy of the
plan, as well as, a contact list for recall of key health care staff and qualified health care
professionals.
Employee training will be facilitated through PrimeCare Medical’s SharePoint Portal. This portal
has been designed for every employee to access information including, but not limited to:
Human Resources, Training, Information Technology, Legal, Policy and Procedures, and
Operations. Through this portal, information can be passed quickly and efficiently to staff
alerting them of emergencies or changes to our already established Disaster Plan.
Several Emergency Management Elements or core components that may be affected in an
emergency have been identified as illustrated below.

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possible with the Putnam County Correctional Facility and any of the local institutions
throughout the State. The EMG consists of all upper management and department heads. Key
members of the EMG are required to be registered with the Putnam County Alert Network and
receive notifications about prison emergencies.
With any Pandemic, staffing is called into question. PrimeCare Medical will utilize its already
established network of correctional healthcare providers and staff. We will also lean on
temporary staffing agencies which we have contracted with. Additionally, PrimeCare Medical
will leverage its technology (use of telemedicine and its electronic medical records system) to
ensure the employees can carry out all essential functions. PrimeCare Medical shall also identify
and utilize internal and external resources, such as the State’s Department of Health and
PrimeCare Medical subcontractors to assist the EMG in the rapid response plan and
implementation of emergency management and recovery procedures and tools.
For example, on January 14, 2015 at 1400 hours, a fire was reported in the Left Wing of the
Northumberland County Prison, located in Sunbury, Pennsylvania. The Prison census that day
totaled 208 inmates; 172 males and 36 females. PrimeCare Medical personnel on-site consisted
of one registered nurse, two licensed practical nurses, and one mental health worker. Within
forty-five (45) minutes of receiving the initial report of the fire, the registered nurse regional
manager arrived at the scene. Due to the severity of the fire, the entire Prison was ordered to
evacuate by Facility Administration. During evacuation, all inmates/patients were examined
exiting the Prison by PrimeCare Medical’s health care personnel upon their arrival at the
evacuation site, and again intermittently while awaiting for bus transport to SCI Coal Township
(males) and SCI Muncy (females). Prior to arriving at the state facilities, a verbal medical report
was provided to both SCI facility medical departments by the PrimeCare Medical RN
administrator. In addition, through the established working relationship we have developed with
the Secretary of Corrections for the Commonwealth of Pennsylvania, both SCI facilities were
granted “Read Only” access to PrimeCare Medical’s electronic medical record system
(CorEMR) for the entire 208 inmate population. This shared access through our EMR system
allowed for seamless continuity of care that included all patients’ medical histories, current plans
of care, and medication records. Additionally, a 30-day supply of prescription medications were
supplied to both facilities through PrimeCare Medical’s pharmacy vendor within eight (8) hours
of evacuation. Although the Prison population provided for multiple medical challenges that day
(pregnant females, and multiple asthma and cardiac patients), only one (1) patient required
transport to the local emergency department for further evaluation; who returned to the Prison
within three (3) hours with a diagnosis of anxiety. The medical department staff later credited
their quick and professional response of that day’s events to the multiple Mass Disaster and Man
Down Drills conducted by PrimeCare Medical throughout the year.
An additional example, on April 26, 2009, the U.S. Department of Health and Human Services
declared a public health emergency as a result of the detection of twenty (20) known cases of
individuals infected with what is now known as 2009 H1N1 pandemic influenza in the United
States. PrimeCare Medical initiated its Emergency Preparedness and pandemic plan immediately
upon this announcement. Within twenty-four (24) hours of the initial notification, detailed
correspondence was disseminated via email to all PrimeCare Medical staff and facility
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administrators identifying key facts and recommendations in preparation for a potential H1N1
pandemic. PrimeCare Medical’s Pandemic Policy and Procedures took effect immediately,
setting off a chain-of-events: Education was provided to all staff and inmate/patient populations,
aggressive surveillance measures were taken to rapidly identify and quarantine patients/inmates
with Influenza-Like Illness (ILI) symptoms, and subcontractors were notified of our needs and a
surplus of necessary emergency supplies began to be immediately stockpiled. PrimeCare
Medical conducted meetings with the State Departments of Health and local Emergency
Response Organizations to assist in the development and identification of further needs and
treatment options. On June 11, 2009, the World Health Organization declared H1N1 to be a
pandemic. Fortunately, due to PrimeCare Medical’s prompt initiatives and support from local
and state health organizations, as well as through the partnerships of our contracted clients, we
were successful in appropriately treating all inmates/patients who presented with signs and
symptoms of H1N1 and avoided any serious outbreaks in any PrimeCare Medical contracted site.
PrimeCare Medical guarantees that, in cooperation with Putnam County Correctional Facility
Staff, it can deliver all medical services in the event of a disaster within a reasonable period of
time. The Medical Disaster Plan includes the following:














Communications system
Recall of key staff
Assignment of health care staff
Establishment of command post
Safety and security of the inmate/patient and staff areas
Use of emergency equipment and supplies
Establishment of a triage area
Triage procedures
Medical records - identification of injured
Use of ambulance services
Transfer of injured to local hospitals
Evacuation procedures (to be coordinated with security personnel)
Practice drills

PrimeCare Medical shall be a participating member of the Putnam County Correctional Facility
response team that provides and participates in post trauma incident debriefings and counseling
services for critical incidents, including disasters and pandemic episodes. Such services are
provided and intended to expedite the recovery process, help foster a better understanding of the
roles and traumas each individual suffered, aid in recovery, and promote a better understanding
and appreciation for the roles played by all those involved.
The on-site Medical
Director/Physician Assistant/Nurse Practitioner will ensure that capable emergency medical
treatment, including the following, is provided:
 In-service education on first aid and emergency procedures for all staff members (both
Medical and Security).

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 Written policies and procedures concerning emergency transfer and transportation of
inmates/patients.
 Emergency 24-hour on-call provider coverage.
 Coordination with security for arrangements when the immediate transfer of an
inmate/patient is indicated.
 Treatment for visitors and staff consisting of stabilization and referral to a personal
physician or local hospital.
SECURITY REQUIREMENTS
A strong working relationship with security personnel is critical to meeting inmate/patient and
staff needs. All medical personnel must be trained in the security operations of each facility
where they work. To build upon the working relationships that already exist, PrimeCare Medical
will continually educate staff on the importance of security, as well as, any other acute issues that
are applicable to the correctional setting. The Health Services Administrator will be responsible
for maintaining positive working relationships and operations of adhering to security
regulations. PrimeCare Medical will work with security staff to develop alternatives when
particular medical orders implicate particular institutional security concerns.
Without exception, it is the responsibility of PrimeCare Medical to ensure that all work areas,
equipment and supplies are kept secure, and information that pertains to security matters and
inmate/patient health care is properly controlled. No inmate/patient or inmate/patient visitor is to
be left unattended or unobserved within any treatment or procedural area at any time. PrimeCare
Medical shall control entry and access into its assigned work areas. Areas that provide for the
storage of medication, instruments, or sharps are to be kept locked at all times. Non-Medical
personnel shall not be left unattended in these areas. Inmates/Patients shall not be permitted
access to these areas. Inmates/Patients will not be notified in advance of the date or time of any
off-site specialty appointments. Privileged information, that is information regarding security in
regard to inmate/ patient care, will be provided only on a need-to-know basis.
PrimeCare Medical will work in conjunction with the security staff of the Putnam County
Correctional Facility. PrimeCare Medical realizes the importance of security at correctional
facilities and pledges full cooperation. Due to the nature of correctional facilities, the following
requirements will be accepted by PrimeCare Medical:
 Personnel will adhere to all security rules of the Putnam County Correctional Facility.
 Submit names, social security number, driver’s license number, race, gender, and date of
birth of all PrimeCare Medical prospective employees providing services to the Putnam
County Correctional Facility. The Facility shall conduct a background check, on each
individual and may prohibit any individual from entering their institutions when in their

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discretion; such individual poses a threat to the security, safety or orderly operation of the
institution.
 The responsibility for scheduling appointments in a manner that causes minimum
disruptions to the daily institutional schedule.
 Will be responsible for maintaining operations during planned/unplanned institutional
lockdowns, state of emergencies, natural disasters, and implementation of Incident
Command Systems (ICS).
 It is acknowledged that the Putnam County Correctional Facility has the right to
investigate any employee or subcontractor of PrimeCare Medical for security reasons.
 Employee breaks, meals, shift changes, etc. will be coordinated with security to coincide
with the Facility’s personnel staff schedules and requirements.
A member of security is requested to attend all monthly CQI meetings. At every staff, CQI and
quarterly meeting; access to medical care is addressed along with a CQI audit that is completed
on the quality of access to medical services. It is important that medical orders are carried out
within each institution. In the event that a medical order cannot be carried out, the Health
Services Administrator and Medical Director are contacted to review the situation, and if
possible, an alternative plan will be developed that meets the medical needs of the inmate/patient
while maintaining security within the institution. In the event that a resolution is not possible at
this level, it shall be addressed up the chain of command within PrimeCare Medical and the
Facility.

ADMINISTRATIVE OPERATIONAL PLAN
PrimeCare Medical’s business model provides for a comprehensive Administrative Operations
Plan (inclusive of management for both clinical and administrative duties), which has been
designed to guide, govern, analyze and support the health care services being provided to our
inmate/patient populations, to include those of the Putnam County Correctional Facility.
PrimeCare Medical, since its inception, has been committed to providing efficient, quality health
care. This is accomplished through a commitment to operating the company on a day-to-day
basis by nationally accepted standards, by consistently monitoring the health needs of our
inmate/patient populations, and by immediately implementing evidence based standards of care
when clinically indicated. The following Administrative Operations Plan addresses the major
managerial aspects of PrimeCare Medical’s health care delivery systems, to include: policies and
procedures, accreditations, continuous quality improvement, utilization review and cost
containment, management information systems, technological enhancements, risk management,
transition planning, staff education and training, and human resources. Below, PrimeCare
Medical will provide a detailed overview and explanation of our proven business model,
identifying how our solution will provide for the provision of comprehensive health care services
to the Putnam County Correctional Facility. Although these critical functions are described
separately within this section, our multidisciplinary management and transition team shall
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strategically and systematically integrate each of these functions into our overall work plan; thus,
creating a model that will ensure the highest level of health care services are provided to the
Putnam County Correctional Facility in the most cost effective and efficient manner possible.
HEALTH CARE POLICY AND PROCEDURE MANUAL
Under the supervision of PrimeCare Medical’s Director of Policies and Procedures, Francis J.
Komykoski Sr., MBA, CCHP, and Carl A. Hoffman, Jr., D.O., D.Sc., CCHP, President and
Corporate Medical Director, the Corporation has successfully completed a year-long review of
our Company Policies and Procedures Manual. The result has been a 650 page Policy Manual
which incorporates the standards of the American Correctional Association (ACA), National
Commission on Correctional Health Care (NCCHC), the American Medical Association (AMA),
Centers for Disease Control Protocols and Guidelines, State Licensing Boards Laws and
Regulations, and Federal OSHA Guidelines. This Policy Manual provides guidance and
direction to all personnel employed by the Corporation, for both clinical and administrative
issues that may arise. Our Policy and Procedures Manual has stood the test of time in not only
providing for clear, concise directives in how to function in a correctional health care setting, but
also in guiding our staffs to provide the appropriate and necessary health related services needed
by our inmate/patient populations and in effectively defending the Corporation from frivolous
medical actions filed against us. Copies of this Manual are present in all contracted facilities’
Medical Departments, with additional copies being furnished to each of our clients. The
PrimeCare Medical Policy Manual represents already developed policies, which shall be further
customized to fit the specific needs of the Putnam County Correctional Facility upon contract
award. These Corporate Policies and Procedures have been further refined within each of our
institutions in the format of local policies, which are routinely updated and revised (at minimum
of annually) at the Facility level, ensuring all applicable State and Facility requirements are
incorporated into our policy manuals. The Facility shall approve all local institutional policies
developed by PrimeCare Medical pursuant to this contract.
ACCREDITATION
PrimeCare Medical is a strong supporter of the
National Commission on Correctional Health
Care (NCCHC) and the American Correctional
Association (ACA) accreditation processes.
Over the years, PrimeCare Medical has
successfully achieved accreditation, as well as
re-accreditation, from these agencies in 100% of
our audits; earning NCCHC Accreditation at
forty-three (43) of our contracted facilities and
ACA accreditation at several others. We are
extremely proud of these accreditations and of
the fact that not only have we achieved
accreditation each and every time that we have
applied, but also the fact that we have never lost
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an accreditation at any of our contracted facilities. The only instance in which PrimeCare
Medical has not applied for and achieved accreditation exists with a few of our smaller
correctional institutions where such accreditation is not required by the client. One of the key
reasons why we feel so strongly about these agencies and their accreditation processes is that
they provide our clients with an unbiased, third party evaluation of the level of service
PrimeCare Medical provides.
PrimeCare Medical has successfully achieved and maintained NCCHC Accreditation an
astonishing one hundred sixty-eight (168) times for those contracted facilities that have requested
NCCHC Accreditation. PrimeCare Medical has also earned the distinguished honor of having
achieved NCCHC Accreditation at two (2) of the first state-wide correctional systems in the
Country; the West Virginia Regional Jail Authority and the West Virginia Division of Juvenile
Services. Additionally, PrimeCare Medical is extremely proud of the fact we have earned the
distinct honor of being recognized by the NCCHC as “Facility of the Year” in 2011 at the Lehigh
County Prison in Allentown, Pennsylvania. Although we have had numerous facilities
nominated for this award throughout the years, this was the first instance in which we received it.
Additionally, PrimeCare Medical is very proud of earning the prestigious honor of being
recognized as the 2016 Program of the Year for its Broad Array of Inmate Health Programs at
the Dauphin County Prison in Harrisburg, Pennsylvania. This is a distinguished honor issued to
only one correctional health care facility in the country each year.
Since our inception, PrimeCare Medical has always provided a guarantee to each of our clients
of our proven ability to successfully manage and operate their institutional health care programs
on a daily basis so that we will not only achieve accreditation from any agency requested, but
also that we will maintain such continuous accreditation for the life of any medical services
contract. Thus, we can state without hesitation that by awarding the Putnam County Correctional
Facility health care contract to PrimeCare Medical, that we will maintain NCCHC Accreditation
at your Facility for the life of this medical services contract. All fees and document maintenance
associated with NCCHC Accreditations shall be the responsibility of PrimeCare Medical.
PrimeCare Medical’s model of correctional health care establishes each individual facility’s onsite Health Services Administrator’s primary responsibility as managing the day-to-day
operations of their Medical Department in a manner consistent with all applicable standards.
The Health Services Administrators’ efforts are further supported by our established regional and
senior level management personnel.
Additionally, we have invested significant amounts of time and energy in developing our
completely customized Continuous Quality Improvement Programs, which are designed to
monitor and analyze all aspects of our health care delivery systems, to include our uniquely
devised Peer Audit Review Program. This program was developed to mirror the NCCHC and
ACA Accreditation programs; all of which are further detailed in the below sections of our
Proposal. It is the combination of these management systems and quality assurance tools that
enables PrimeCare Medical to achieve and maintain a perfect accreditation history.

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Additionally, PrimeCare Medical shall participate in any other required audits / external reviews
that are conducted at the Putnam County Correctional Facility and shall assist the Facility in
obtaining accreditation through the New York State Sheriffs Association and in achieving PREA
Certification. Should any deficiencies be noted, appropriate corrective action plans shall be
prepared and initiated through the Health Services Administrator and Medical Director.
QUALITY IMPROVEMENT PROGRAM
PrimeCare Medical embraces an active Continuous Quality Improvement (CQI) Program within
all contracted facilities. The program takes a multidisciplinary collaborative approach to ensure
that all inmates/patients under the care of PrimeCare Medical receive appropriate, timely and
clinically sound medical treatment. Any existing quality assurance programs being conducted by
the Facility shall also be integrated into this process.
A CQI committee will be formed and is chaired by the on-site Medical Director. The committee
meets monthly and includes a representative(s) from the PrimeCare Medical Corporate Office,
Prison Administration, Security, Treatment, Mental Health, Pharmacy, Dentistry, Medical
Records, and Dietary; as well as the Health Services Administrator. The committee reviews
findings of monthly audits which cover all aspects of the health care delivery system, as well as,
discuss the following mandatory topics: access to medical services, mortalities, inmate/patient
grievances, pregnancies, hospitalizations, infirmary care, dialysis care, outside consultations,
suicide/attempted suicide, adverse patient occurrences, emergency response, infection control,
patient/staff safety, staffing, monthly environmental and kitchen inspections, credentialing,
training, pharmacy, diagnostic testing, diets, health records, dentistry, intake and discharge
planning and mental health concerns. These items are also reviewed for patterns and trends that
may have developed since the last committee meeting.
Audit findings that fall below established thresholds, to include any patterns or trends that have
been identified, are discussed in-depth by the committee, a plan is developed to bring the
indicators into compliance, and the necessary corrective actions are taken by the appropriate
committee member(s). Indicators below the established thresholds are monitored until the CQI
committee determines there to be continued evident compliance. Until such time, continuous reevaluation of the plan and continued corrective action efforts shall occur. This is typically done
through the development and implementation of a Process and Outcome Study based upon the
identified deficiencies. These studies are completed every month for a minimum period of six
(6) months and until the findings exceed the established thresholds for a minimum of three (3)
continuous months. This three (3) month timeframe ensures that a realized compliance is not
merely a one (1) month phenomenon, but rather, that such compliance has been established for
the long term and that true corrective action measures have been adopted as customary practice.
PrimeCare Medical has an established chart review process that is tasked on a monthly audit
calendar. The monthly audit calendar is followed by the Health Services Administrator each
month, which provides the health related topics that are to be studied for the particular month.
At minimum, the PrimeCare Medical Health Services Administrator, or medical staff designee,
is required to conduct monthly chart reviews of at least a five (5%) to ten (10%) percent random
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sample of active charts. During this review, established criteria are applied to each chart and
identified problems are immediately referred to the responsible physician with follow-up by the
Medical Review Committee. In all cases, monthly reviews must be completed on adverse patient
occurrences, acute care hospitalizations, medical emergencies, conditions requiring outside
medical services, and medical grievances. The responsible physician must be able to
demonstrate that inmates/patients are receiving appropriate care and all written orders and
procedures have been properly carried out. Indicators on audits are based on NCCHC Standards.
The Putnam County Correctional Facility practices and protocols will be integrated into this CQI
system upon a contract award.
PrimeCare Medical has also developed a comprehensive Peer Audit Review system, in which
various members of the middle to upper level management TEAM travel on-site to each
contracted Facility every six (6) months to complete an internal review of all systems, policies,
and procedures to verify and validate their respective compliance measures. These Peer Audit
Reviews have been designed around and mirror the NCCHC Accreditation inspection process,
thereby ensuring compliance with all applicable standards. PrimeCare Medical’s goal is to
operate according to policy and procedure/standards at all times. With the peer audit reviews
being completed every six (6) months, it allows on-site staff to be continually educated in the
process of NCCHC Accreditation and ensures medical departments are striving for continued
policy compliance, regardless of when the next accreditation may occur.
Over the years, PrimeCare Medical has also contracted with various other agencies whose
expertise is in the field of correctional health care as part of our continued efforts for continuous
quality service improvement. Most recently, PrimeCare Medical has contracted the services of
Correctional Medical Monitoring and the National Center on Institutions and Alternatives, who
have reviewed, audited, and analyzed different aspects of our health care delivery program; thus,
ensuring that PrimeCare Medical is always striving to provide the most appropriate and cost
effective levels of health care in the industry.
PrimeCare Medical also completes clinical performance evaluations each year on all professional
health care staff. Random samplings of the provider’s charts are pulled and an audit on the
documentation and soundness of clinical judgment is completed by another provider of equal or
greater training in accordance with applicable standards. Findings are documented and discussed
with the individual provider, and if necessary, a confidential plan of corrective action is
developed through the Utilization Review Committee. Any noted deficiencies shall be corrected
in a timely fashion. An unplanned peer review may also be initiated in response to
inmate/patient complaints or inmate/patient care issues. The Peer Review will be conducted by
an individual who does not regularly perform services at the facility being evaluated. Such
auditor shall be of equal or greater training than of the individual being audited. The outcome of
the review is designed to be constructive and provide a learning experience for the provider.
Alternatively, if corrective action is necessary, a Corrective Action Plan will be formulated that
includes timeline for remediation. If the issues are not corrected, recommendations will be dealt
with by the supervisor of the provider and the PrimeCare Medical Utilization Review
Committee.

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The Medical Director, Regional Manager, and Vice-President shall review all reports, minutes,
audits and findings every month for each of their assigned facilities. These individuals will also
attend each of their assigned facilities’ CQI meetings at a minimum of quarterly. This system
allows individual facilities’ accomplishments and deficiencies to be viewed from a more global
perspective and allow for study and analysis of any potential regional trends that may develop.
Relevant findings of the audits and CQI committee meetings are discussed at monthly medical
department staff meetings to teach an understanding of the importance of following policy and
procedure and to continually educate staff in clinically sound care. PrimeCare Medical will also
participate actively on any local or Statewide Quality Improvement Committees.
PrimeCare Medical shall provide quality management services to support the provision of the
comprehensive health service program. PrimeCare Medical shall be responsible for all costs
incurred for these services. Quality management support services shall be system-wide and have
already been established in the existing PrimeCare Medical contracted facilities. PrimeCare
Medical shall provide written documentation to substantiate these services, which shall include
at a minimum, the following:
 Continuous Quality Improvement (CQI) - This is designed to monitor the quality of
health services delivery. This includes such items as chart review by a qualified health
care professional with the appropriate recommendations for corrections of any
discrepancies.
 Infection Control - This is designed to provide surveillance of infections, to institute
preventative measures, and to report those infections in accordance with applicable laws.
Infection control monitoring shall be an on-going process.
 Utilization Management - This is designed to monitor and review all outside
consultations and in-patient services. PrimeCare Medical has a written plan of action
which addresses, at a minimum, the mechanisms which will facilitate timely and
appropriate consultations, specialty referrals, and out-patient and in-patient
hospitalizations.
 Risk Management - This is designed to manage critical incidents.
mortality review procedures.

It shall include

 Safety and Sanitation Inspections - This is designed to monitor institutional food service,
housing and work areas within the contracted facilities. PrimeCare Medical coordinates
monthly safety and sanitation inspections and makes appropriate recommendations for
corrections of any discrepancies.
The intent of the above process is to ensure that problems are found as they occur and
appropriate corrective action is taken immediately. In order to further ensure that corrective
action is taken, all minutes of the Quality Assurance Committee and the Quarterly Tracking
Report are forwarded to both the on-site Medical Review Committee and the Corporate Medical
Review Committee.
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Upon receiving the information at Corporate Headquarters, a Medical and Risk Management
Review is conducted by the Corporate Medical Director and the Director of Risk Management.
The minutes of both the Quality Improvement Committee and the Tracking Report will be
carefully reviewed and, if necessary, on-site visits will be conducted. Throughout the process,
physician and nursing notes will be compared to ensure that there is continuity in the medical
records. Where problems are found, every attempt will be made to educate the physician and
nurse in a positive, constructive manner.
All findings and required reports and chart audits are reported by PrimeCare Medical to the
Putnam County Correctional Facility to ensure the highest quality of inmate/patient health care is
being provided in the most efficient, cost-effective manner possible.
UTILIZATION REVIEW & COST CONTAINMENT
PrimeCare Medical has an effective Utilization Review procedure. All hospitalizations,
outpatient procedures, outside consultations, outside diagnostic procedures, and non-formulary
medication requests are subject to review by the Corporate Utilization Review
Committee. Elective and experimental drugs and procedures are not utilized unless the
immediate health or quality of life of the inmate/patient will be adversely affected. Emergency
issues are handled by the individual facilities’ Physicians, but an immediate report to the
Corporate Medical Director is made once a situation has stabilized. Pre-approval is requested
from the U.S. Marshall’s Service or U.S. Immigrations on all Federal Inmates/Patients. This
Utilization Review procedure shall demonstrate to the Putnam County Correctional Facility that
the use of off-site services is appropriate and that the length of stay, if applicable, is neither
longer nor shorter than medically indicated. PrimeCare Medical’s Corporate Utilization Review
Committee is multidisciplinary in scope and is comprised of the following members:
 Carl A. Hoffman, Jr., D.O., D.Sc., CCHP - President and Corporate Medical Director,
with over forty (40) years of correctional health care experience.
 Victoria Gessner, M.D. - Assistant Corporate Medical Director, with approximately
twenty (20) years of correctional health care experience.
 Todd W. Haskins, RN, BSN, CCHP - Vice President of Operations, with over twentyfive (25) years of correctional health care experience.
 Paul W. Navarro, M.S.N., NP-C, CCHP - Junior Vice President of Clinical Operations
and Nurse Practitioner, with nearly fifteen (15) years of correctional health care
experience.
 Jennifer Mroz, MS, PA-C, CCHP – Director of Clinical Operations, with over thirteen
(13) years of correctional health care experience.
PrimeCare Medical utilizes aggressive case management for all inmates/patients identified as
being at risk for exacerbation of their chronic illnesses related to being incarcerated. It is
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PrimeCare Medical’s belief that through aggressive case management, the health needs of the
Putnam County Correctional Facility high health risk population will be managed in the most
efficient and cost-effective manner possible; thus resulting in the most favorable inmate/patient
health outcomes. This team’s primary responsibility is to aggressively case manage all
inmate/patient hospitalizations, specialty consultations, and acute care inmates/patients;
providing daily progress updates to the Utilization Review Committee.
Additionally, PrimeCare Medical’s Utilization Review Program includes:
 An identified percentage of all cases for medical provider review.
 An identification of whether the determination is such that a medical provider becomes
involved.
 The number of medical provider requests that would be reviewed in a year, identifying
how many were approved for Medical / Surgery, Mental Health, and Dental Services.
 Implementation of a coding system for diagnoses and procedures.
 Develop review criteria and procedures for determining medical necessity for proposed
treatment (including chemical dependency withdrawal), admission to off-sites facilities
and/or the infirmary to include appropriate length of stays; mental health care (in-patient
and out-patient); case management; and out-patient services. Prior authorization from the
Utilization Review Committee is required for all such care, except for in emergent
situations as detailed above. Reviews shall occur within a timely manner, typically
within twenty-four (24) hours of request, to facilitate timely access to care. All such
requests will be reviewed to ensure such care is in accordance with applicable clinical
standards so that the inmate’s/patient’s medical needs are addressed and to quickly
redirect certain cases to the best alternative sources of required treatment.
 The Utilization Review Committee shall have the ability to review and discuss any nonformulary and/or consultation requests with the respective on-site providers / facility
medical directors to ensure the most clinically appropriate care is being provided to the
inmates/patients. All such communication and requests shall be appropriately
documented.
 The system shall accommodate and provide for an appeal process that is quick and that
allows the primary care physician to appeal a case, along with his/her supervisor, to a
committee of physicians overseen by the Corporate Medical Director who shall serve as a
final arbiter in all cases.
PrimeCare Medical shall cooperate and work with the Putnam County Correctional Facility to
assure that its Utilization Review Program staff and Quality Assurance Staff have an effective
means of communication with the Facility regarding all critically ill inmates/patients.

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MANAGEMENT INFORMATION SYSTEM
PrimeCare Medical tracks all statistics relative to the services detailed throughout this Proposal,
to include a staffing analysis, making daily, weekly, monthly, quarterly, and annual reports to the
Putnam County Correctional Facility Administration and/or designee. PrimeCare Medical will
maintain trend analysis charts on key statistical data taken from the monthly reports and, should
an unusual trend occur, the information will be shared with all parties involved. As part of this
process, PrimeCare Medical will:
 Make cost containment information available to the Administrative Office or selected
designee as requested.
 Track all costs related to primary health care services by:
o
o
o
o
o
o
o
o
o

Laboratory Services
Radiology Services
Other Ancillary Services (i.e., physical therapy, clinics, oxygen therapy)
Outpatient Services
Specialty Services - by Specialty
Dental Care
Inpatient Services
Pharmaceutical
Medical Supplies

The above management information system will be capable of providing statistical data
necessary for the evaluation and monitoring of health services. Information gathered by
PrimeCare Medical will be utilized for the preparation of the following documents:
 Monthly reports of services.
 Reports for administrative meetings with Facility officials.
 Annual reports for the analysis of services provided.
 Specifically, PrimeCare Medical shall provide a monthly and an annual report that
includes:
o
o
o
o
o
o
o
o

Inmate’s/Patient’s requests for various services
Inmates/Patients seen at physician’s clinic
Inmates/Patients seen by dentist
Inmates/Patients seen by mental health
Special Needs Unit admission, patient days, average length of stay
Off-site hospital admissions
Medical specialty consultation referrals
Intake medical screening

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o
o
o
o
o
o
o

History and physical assessments
Diagnostic studies
Percentage of inmate/patient population dispensed medication
Inmates testing positive for sexually transmitted diseases
Inmates/Patients testing positive for HIV
Inmate/Patient mortality
Other data deemed appropriate by the Facility’s Administration and/or the Putnam
County Correctional Facility

 Data collection will be monitored by the on-site Medical Director. Monthly reports shall
be generated and presented for discussion at each Quality Improvement Committee
Meeting. Any significant variances in the data will be investigated and discussed during
these monthly meetings. All documents pertaining to health care services will be
forwarded to the Quality Improvement Committee for evaluation.
PrimeCare Medical meets at least quarterly with the Facility’s Administrators / designee(s) to
review and discuss our health care programs at the Putnam County Correctional Facility.
Meeting minutes are kept for all such meetings. Meetings are to be attended by PrimeCare
Medical staff, members of the Facility’s staff, and any other individual deemed appropriate.
Meetings should, as much as possible, be multi-disciplinary in their scope. The chairperson may
determine the specific focus of any meeting. Reports shall be submitted monthly on the health
care delivery system at the Facility. Topics shall include the effectiveness of the health care
delivery system, a description of any environmental factors which may require improvement,
changes effected since the last report, and recommendations for corrective action if needed.
Depending on contractual and jurisdictional requirements, other additional reports may be
required. The Health Services Administrator is responsible for thorough review and knowledge
of the medical services contract and its requirements. Standard reporting requirements of
PrimeCare Medical include the following, which can be further enhanced to meet the specific
needs of the Putnam County Correctional Facility:
 The Quarterly Report shall include an agenda to address at a minimum the following
topics: Minutes from previous Quarterly Meetings, Review of Catastrophic Medical
Expenses, Medical Grievances and Resolutions, Medical Staffing, and Quarterly
Statistical Summary.
 Along with this report, the Health Services Administrator may be asked to submit a copy
of Staff Meeting Minutes, QI/QA tools and minutes, Quarterly Pharmacy Inspections,
Daily Head Count and any other reports that may be required depending on contractual
requirements.
 The Statistical Summary Report shall include morbidity statistics for the quarter. Trends
shall be analyzed to determine if corrective action is needed.
 The Environmental Health and Safety Report is to be completed monthly by the
PrimeCare Medical Health Services Administrator. The Environmental Health and Safety
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Report evaluates the Facility to determine if it is safe and clean in order to promote good
health.
 The Annual Report is typed synopsis of the year’s major events, an overview of the
annual QI/QA review in accordance with PrimeCare Medical Corporate Policy, major
facility achievements for the year, and goals and objectives for the upcoming year.
Additionally, PrimeCare Medical shall meet weekly with Facility staff and the Facility
Administrators to review inmate/patient medical services and to propose corrections of
deficiencies or problems, to identify in-services training needs and to suggest improvements to
the delivery of contracted services. PrimeCare Medical will communicate with the Putnam
County Correctional Facility more frequently as any potential issues are noted or chronically ill
inmates/patients are identified. Furthermore, a daily communication protocol will be developed
between PrimeCare Medical and the Putnam County Correctional Facility. Additionally,
PrimeCare Medical’s executive management personnel shall be available at the request of the
County to meet to discuss any questions or concerns related to the performance of this contract,
as is the standard philosophy of PrimeCare Medical in each of its contracted institutions.
Required PrimeCare Medical meetings include, but are not limited to the following:
 Quarterly Administrative Meetings - PrimeCare Medical Regional Office personnel,
Health Services Administrator and Facility Administrator or designee. Purpose: to
review effectiveness of health care services.
 Monthly Health Service Staff Meetings - PrimeCare Medical administration and medical
staff. Purpose: to disseminate information and problem solving.
 Quarterly Pharmacy & Therapeutics Meetings - Pharmacists, PrimeCare Medical
Administration, Medical Director / Nursing Supervisor. Purpose: to evaluate and monitor
quality care delivery criteria, focus on quality improvement, review the appropriateness
of prescriptions ordered at the Facility and to review any changes to the formulary made
by the Pharmacy and Therapeutics Committee.
 Monthly Continuous Quality Improvement Meetings - PrimeCare Medical selected staff,
Medical Director and Psychiatrist. Purpose: to evaluate and monitor quality care delivery
criteria and focus on quality improvement.
 Quarterly Infection Control Meetings - PrimeCare Medical Health Services
Administrator, Medical Director, Staff Physicians, Nursing Director, Facility Treatment
Staff. Purpose: to report incidence of infectious and communicable diseases and initiate
a way to promote a safe and healthy environment.
 Monthly Medical Administrative Committee (MAC) Meetings – PrimeCare Medical
Health Services Administrator, Facility Administration Staff, and all other parties
requested by Facility. Purpose: to review effectiveness and appropriateness of health
care services, inmate/patient treatment plans, and efficiency of medical operations.
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TECHNOLOGICAL ENHANCEMENTS
PrimeCare Medical has devoted significant amounts of resources and has made substantial
financial investments into an array of technological based advancements, which have taken us to
the cutting edge of correctional health care. These investments
have enabled PrimeCare Medical to be a significant force in a
highly competitive market and remain at the forefront of
Advancements in
correctional medicine. Through the successful development and
Technology
implementation of these critical technological programs,
PrimeCare Medical has not only improved the provision of
 CorEMR –
overall care to our inmates/patients, but has also realized
Corrections based
substantial increases in operational effectiveness and staffing
EMR
efficiencies.
 PCM Portal
PrimeCare Medical’s most significant stride in the technologymedical industry has been through its complete customization and
integration of its electronic medical record system,
CorEMR. The operational efficiencies of this system allows for
immediate implementation of policy changes, enhanced
continuity of care, improved inmate/patient outcomes, and most
importantly, prevents inmates/patients from “slipping through the
cracks”.

 HEALTHsuite by
RAM Technologies –
McKesson & Optum
Coding
 “eConsults” for
offsite care tracking
 PCM NOW

PrimeCare Medical has also made significant enhancements within our internal financial
management programs, such as our state-of-the-art inmate/patient manager program,
HEALTHsuite, created by RAM Technologies. This integrated claims processing system tracks
all inmates/patients in a step-by-step tracking format from the date of an initial claim until
payment is made to the treating institution or provider. This program utilizes McKesson
products to assist with claim appropriateness and fiscal management of each inmate’s/patient’s
interaction with all off-site providers. Through the integration of CorEMR and HEALTHsuite,
medical claims can be monitored and approved in a more simplified approach that increases our
billing efficiencies and accuracies while only paying for appropriately authorized claims. Below
are graphical illustrations of the significant cost savings realized by PrimeCare Medical and our
contracted clients as a result of this proven claims processing program in conjunction with other
applicable federal and state legislation.

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(i.e., high blood pressure, low blood sugars, etc.) to inmates/patients approaching monetary
thresholds on their medical claims. PCM NOW allows for alerts to be sent via email and/or text
in real time. It is configurable through our electronic medical record system to send notifications
on such items as: medical restrictions, specialty diets, suicidal ideations, hospital updates/reports
and other predetermined thresholds and actionable items. This NOW technology gets
information delivered to key decision makers quickly. This technology puts PrimeCare Medical
on the forefront of technology, “NOW”.
CORPORATE SAFETY COMMITTEE
In an effort to promote and foster the safest work environment possible, PrimeCare Medical has
assembled a Corporate Safety Committee to provide continuous assessment and
recommendations with regard to the safe operations of our medical departments in a wide variety
of correctional settings throughout the Company. The Safety Committee has continued to evolve
and is currently composed of nine (9) members who represent the regional interests and issues of
their respective areas of responsibility. These areas include West Virginia, Maryland, New
Hampshire, New York and Pennsylvania. This membership aggregate insures compliance with
all Federal safety regulations in addition to all State and Local safety regulations throughout the
PrimeCare Medical system. PrimeCare Medical’s Safety Committee has a demonstrated ability
to reduce the numbers of work related injuries sustained by our health care personnel and
decrease unnecessary heath related expenses; thus creating a more productive labor force within
our contracted correctional institutions.
Safety Committee Meetings are held on a monthly basis and follow a published agenda. The
agenda is organized into sections that include Old Business, New Business, Review and
Discussion of Workers Compensation Claims and Review and Discussion of Near Misses. This
format allows for interaction and collaboration among committee members and has been an
integral part in developing effective safety related policies. Meeting minutes from each meeting
are generated and maintained in addition to attendance sheets, that each attendee is required to
sign. All records related to the Safety Committee are maintained at the PrimeCare Medical
Corporate Office in Harrisburg, Pennsylvania.
LEGAL, RISK MANAGEMENT & INSURANCE PROGRAMS
PrimeCare Medical will assemble a team of New York and Pennsylvania attorneys to represent
its interests and those of the Putnam County Correctional Facility. Each of these attorneys will
work closely with Thomas Weber, Esquire, Chief Executive Officer for PrimeCare Medical in a
proactive manner to aggressively defend medical operations at the Putnam County Correctional
Facility. This will be done in a cooperative fashion with the Facility and will emphasize working
as a team. PrimeCare Medical always stands with its clients and defends them when
inmate/patient medical lawsuits are filed. Together, this team of legal professionals will defend
against frivolous inmate/patient medical lawsuits, will assist in obtaining court orders for
medications and other interventions that may be necessary to appropriately manage mental health
emergencies, will consult on a variety of medical issues, and will intervene on behalf of the
Putnam County Correctional Facility where medical care is at issue. PrimeCare Medical agrees
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to cooperate with the Facility in all matters under individual or joint litigation. In addition,
PrimeCare Medical will act as a consultant to the Facility upon request in litigation where the
Corporation is not involved.
PrimeCare Medical will furnish the Putnam County Correctional Facility certificates verifying
that it carries insurance for the life of this contract naming the Putnam County Correctional
Facility as an additional insured. The policies will contain a covenant by the company issuing
the same that the policies will not be cancelled by the issuing company unless a thirty (30) day
written notice of cancellation first be submitted to the Putnam County Correctional Facility. All
premiums due upon these policies will be paid by PrimeCare Medical PrimeCare Medical shall
carry and maintain insurance limits in the minimum amounts as required by the RFP.
Professional liability coverage for PrimeCare Medical is underwritten through Syndicates at
Lloyd’s. Lloyd’s specializes in underwriting medical professional liability insurance for clients
with unusual coverage needs. Lloyd’s underwrites under a binder authority on behalf of The
Beazley Group. The Beazley Group is rated A+, XV by A.M. Best. This gives PrimeCare
Medical the substantive financial backing needed in a tight insurance market. General Liability,
Umbrella Liability, and automotive coverages are through Cincinnati Insurance Company, with
Workman’s Compensation coverage provided through Old Republic Insurance Group, which is
rated A+, XII by A.M. Best. The Facility will be named on all general liability and automobile
liability policies as “Additional Named Insured” for the proposed work. All Insurance Coverage
Limits shall meet the minimum limit requirements as set forth in the RFP.
PrimeCare Medical has insurance professionals available to assist in identifying insurance needs
and meeting these needs with state-of-the-art products. These include: Matthew Anderson, Jon
Kirssin, and Clay Foltz.
 Matthew Anderson is a representative of CRC Professional Liability/Healthcare
Insurance and serves as medical professional liability broker and consultant to PrimeCare
Medical He is available to assist on any health care professional liability issue.
 Jon Kirssin is President of Captive Formation Management Corporation. He has been the
focal point in adapting PrimeCare Medical’s coverage’s to changes in the marketplace.
His specialty is alternative markets.
 Clay Foltz is PrimeCare Medical’s consultant on all surety issues, including bid, payment
and performance bonds.
All three individuals are available to the Putnam County Correctional Facility on any insurance–
related issue.
HIPAA COMPLIANCE
As a result of its services in correctional institutions throughout the region, PrimeCare Medical
has diligently fulfilled its obligations to protect all inmates/patients privacy rights, including
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those established under the Health Insurance Portability and Accountability Act (“HIPAA”).
This compliance continues to be monitored and adjusted as the regulations are modified and/or
affected by other provisions, such as HITECH. PrimeCare Medical has a company-wide Privacy
Officer, as well as a Security Officer. Respectively, the Privacy Officer and Security Officer are
charged with the responsibility of overseeing HIPAA compliance. Immediate contact to these
individuals will be made available to all appropriate Facility employees involved with, or
concerned about, inmate/patient privacy matters. In addition, the Privacy Officer and Security
Officer have immediate access to PrimeCare Medical’s Chief Executive Officer, who is well
versed on HIPAA compliance, having written and extensively lectured on the subject matter.
PrimeCare Medical has instituted company-wide training on HIPAA compliance on at least an
annual basis and will continue to do so throughout the term of any health services agreement.
LIQUIDATED DAMAGES & PERFORMANCE DEFICIENCY ADJUSTMENTS
In accordance with Putnam County’s RFP, PrimeCare Medical acknowledges that its
performance under this contract is subject to the County’s performance deficiency adjustments,
and liquidated damages should we fail to meet the terms and conditions set forth by this
agreement, as further detailed within the RFP.

HUMAN RESOURCES AND PERSONNEL
For over thirty-two (32) years, PrimeCare Medical has had the pleasure of partnering with an
amazing multitude of hard working and dedicated health care professionals. Our commitment to
preserving jobs for locally qualified individuals is foremost to our hiring practices as our
employees are the driving force behind our continued success. At PrimeCare Medical, we
recognize the need to employ qualified, well-trained and appropriately licensed individuals that
share the same core values as our Corporation. It is these hard working employees who are on
the front lines of our correctional health care delivery systems and continue to impress and carry
out our Company’s mission. These dedicated employees are paramount to our continued success
as an industry leader in the field of correctional health care.
PrimeCare Medical shall provide sufficient staffing services to appropriately fulfill the needs of
the Putnam County Correctional Facility as detailed within our proposed staffing matrix. Any
vacant positions that should occur shall be the responsibility of PrimeCare Medical to secure
appropriate coverage. Due to PrimeCare Medical’s existing footprint in the local region, we are
uniquely suited to access a large network of health care staffs who are currently employed and
licensed in the State of New York, as well as, providers and other necessary resources to assist
with staffing vacancies.
RECRUITMENT PRACTICES
PrimeCare Medical’s current recruitment practice was formulated in response to the tight labor
market for health care personnel as an adaptation to the realities of today’s marketplace.
PrimeCare Medical employs a Junior Vice President Operations and Recruitment to coordinate
recruitment activities at every PrimeCare Medical facility. The position oversees two (2)
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recruitment specialists, in addition to other duties in the Operations Department. Both
recruitment specialist are full-time and are dedicated to staffing. They will assist, through proven
techniques that have been proven as effective recruiting/hiring tools, including: local advertising,
online, job fairs and professional conferences, national and regional professional publications,
and direct mailings. PrimeCare Medical recognizes the unique issues of staffing in a correctional
environment and has identified resources for each designated region. PrimeCare Medical has a
proven track record in recruiting and retention; currently recruiting, hiring and retaining
employees in the State of New York. PrimeCare Medical has also identified the need for use of
several staffing agencies to assist with staffing in emergent situations as staffing issues may
arise.
PrimeCare Medical shall employ only such personnel who are qualified by training, education
and experience for the positions they hold; and who meet all applicable licensing and
certification requirements for practice in the State of New York. PrimeCare Medical is
committed to using medical personnel residing and paying taxes in New York and shall make all
reasonable attempts to retain existing medical staff, as long as they are appropriately licensed
and otherwise qualified to provide quality medical services. All members of the existing health
care staff shall be given priority as to scheduling of interviews and offering of positions with
PrimeCare Medical. We will ensure strict compliance with federal immigration law. In
accordance with Facility policy, all potential applicants are required to successfully complete a
criminal background screening, as well as other required screenings to include fingerprinting and
urine drug screen, prior to being offered a position at the Facility. The Facility’s Administration
shall have the right of approval for all employees and prospective employees to be utilized by
PrimeCare Medical at the Putnam County Correctional Facility. The Facility’s Administrators,
or designee, shall also be involved in the interview and selection process for the Medical
Director and Health Services Administrator(s).
Not only does PrimeCare Medical recruit competent
nursing and health care personnel, it also utilizes a preemployment screening which is EEOC compliant and
designed to assess key job-related characteristics and
identify predictable hiring mistakes.
It produces
employees with higher levels of workforce productivity
in such areas as work ethic, care-giving attitudes,
reliability, retention, integrity, and client service.
PrimeCare Medical’s hiring process starts with
applicant identification and moves through a series of
steps from self-survey screenings to face-to-face
interviews, which ultimately can result in an offer of employment letter and institutional
placement. Through our paperless onboarding and self-service module, we have made the new
hiring and orientation processes more efficient and more attractive for our employees; thus,
resulting in a more stable workforce.
All PrimeCare Medical personnel at the Putnam County Correctional Facility shall comply with
all current and future federal, state, and local laws and regulations, court orders, administrative
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regulations, administrative directives, and policies and procedures of the Facility. All such
personnel are subject to removal from the Facility if the Facility’s Administration determines an
individual has engaged in illegal, unprofessional, or threatening behavior, or has violated the
terms of the contract. PrimeCare Medical and the Facility shall consult on all personnel matters
prior to terminations / separations from employment occurring.
PrimeCare Medical also takes a proactive approach to retaining employees. We believe hiring
the right person from the start is the best way to reduce turnover. Traditionally, we have enjoyed
below average industry standards in turnover rates. PrimeCare Medical also has systems in place
for annual employee review programs, which are completed each year on all professional health
care staff. Through a comprehensive recruiting and screening process, a thorough orientation
program, and on-going commitment to continuing education in-services, PrimeCare Medical
believes that the health staff at the Putnam County Correctional Facility can be appropriately
managed and the turnover rates can be minimized.
EQUAL EMPLOYMENT OPPORTUNITIES
PrimeCare Medical is committed to equal employment opportunity and maintaining a workplace
free from harassment or hostility. PrimeCare Medical does not discriminate against employees,
contractors, or job applicants on the basis of race, religion, color, sex, age, national origin,
ancestry, or on any other basis prohibited by law. This nondiscrimination policy applies to all
terms and conditions of employment. To assure the existence of such a workplace, PrimeCare
Medical requires all employees, contractors, and job applicants to read, sign, and abide by its
Policy on Equal Opportunity and Sexual Harassment. It has become a part of our professional
credentialing package.
DRUG-FREE WORK PLACE
PrimeCare Medical acknowledges and certifies its understanding that the following acts by
PrimeCare Medical, its employees or agents performing services pursuant to this Agreement are
prohibited: (1) The unlawful manufacture, distribution, dispensing, possession or use of alcohol
or other drugs; and (2) Impairment from the use of alcohol or drugs (except the use of drugs for
legitimate medical purposes as directed by a physician). PrimeCare Medical shall further comply
with any Facility policy regarding initial and/or random employee drug screening as part of a
joint effort to provide for a drug-free work place environment.
SECURITY REQUIREMENTS
PrimeCare Medical will work in conjunction with the security staff of the Putnam County
Correctional Facility. The Company realizes the importance of security at a correctional facility
and pledges full cooperation. All staff employed by PrimeCare Medical are subject to the same
security requirements, to include obtaining and maintaining a security clearance to the Facility,
as all correctional personnel. PrimeCare Medical will inform the Putnam County Correctional
Facility if any applicant or employee requires ADA accommodations. PrimeCare Medical
understands the nature of essential job functions and requirements of staff, to include:
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negotiating stairway, mobility and movement around interior compound, lifting of
inmates/patients, written and oral communication to inmates/patients and staff and standing for
long periods of time. PrimeCare Medical provide coverage for any employee who is unable to
perform their assigned duties in a reliable manner, demonstrates an uncooperative attitude or is
deemed to be unsatisfactory by the Administrator of the Facility in which he or she is employed.
PrimeCare Medical follows a progression discipline policy for corrective action. PrimeCare
Medical’s employees are classified as essential employees and understand it is expected to report
to work even when other state agencies are closed for emergencies.
EMPLOYEE BENEFITS
Employees currently established as full-time with the current vendor and retained through the
transition process will be permitted to waive the waiting period for benefits. Typically, when
county correctional facilities transition between health care providers, especially when existing
health care personnel are either county employees or part of a collective bargaining unit, their
existing benefit packages cannot be matched by the incoming health care provider (i.e., insurance
premiums, retirement options, legacy costs, etc.). As such, when PrimeCare Medical transitions
this type of program, we will traditionally attempt to off-set these differences through various
other types of financial incentive programs, such as offering higher starting wage rates,
additional financial bonus programs, higher leave accrual rates; which has proven to be an
extremely effective recruiting function for our Corporation. Most recently, with our transition of
the Monroe County Jail (New York) health services contract, the health staff had been employed
by a competitor prior to PrimeCare Medical transitioning the contract, similar to the current
situation in Putnam County. Upon contract award, PrimeCare Medical had aggressively began
its recruiting process of existing health care personnel, offering similar type financial incentives
to offset the existing benefit programs, as detailed above. The result, an extremely smooth and
efficient transition of most all health care staff. All full-time employees receive the following
benefits.
 Health Insurance - Provided by Highmark / Blue Shield, including a prescription
drug plan. Dental and vision coverage will be provided through Highmark / Blue
Shield.
 Health Savings Account – Those employees participating in a qualified high
deductible plan may elect to participate in a health savings account. Currently,
the accounts are administered through Bank of America. Employees may elect a
monetary deduction, pre-pay, from their paycheck to be deferred into the account.
Qualified medical expenses, as defined by the Internal Revenue Service, may be
paid for using money from the account. Funds will roll-over from year to year
and the account is portable.
 Life Insurance / Disability Insurance – This includes a term life insurance policy
in which the employee names their beneficiary. The employee can purchase
additional life insurance at reduced group rates. A short-term twenty-six (26)

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week disability policy is also an insurance voluntary option. Voluntary long term
disability is available at a significant reduction in premium.
 Retirement Plan – The Company has a 401(k) Plan in place for all employees who
are with the Corporation for a minimum of one (1) year, attain the age of twentyone (21), and work at least one thousand (1,000) hours per year. The Company
also provides a discretionary match for each participating employee.
 Jury Duty / Military Leave / Bereavement – available per written PrimeCare
Medical policy.
 Leave – Leave is considered as any time for which an employee is paid for time
while not working. Paid leave is available to full-time employees only. Leave is
any time off. Since PrimeCare Medical is a twenty-four (24) hour, 365 day per
year operation, no holidays, whether legal or religious, are granted as leave. All
time taken off during regularly scheduled working hours is considered leave time.
Full-time employees are granted leave as follows:
o Start date through conclusion of first year employment – 0.50 days (4
hours) for each payroll period worked (thirteen (13) days for first year
worked).
o Second year of employment – 0.615 days for each payroll period worked
(sixteen (16) days per year).
o Third year of employment – 0.769 days for each payroll period worked
(twenty (20) days per year).
o Fourth year of employment – 0.846 days for each payroll period worked
(twenty-two (22) days per year).
o Fifth year of employment – 1.0 days for each payroll period worked
(twenty-six (26) days per year). Any waiver of this provision must be in
writing and signed by the President and Executive Vice President.
EMPLOYEE ASSISTANCE PROGRAM
PrimeCare Medical’s Employee Assistance Program (EAP) is provided as part of the Company’s
health insurance plan, where full-time employees may utilize covered visits for both Outpatient
Psychiatric and Outpatient Substance Abuse treatments. They may also utilize the plan for
covered visits for both Inpatient Psychiatric Visits and Inpatient Substance Abuse
treatments. Employees who are in need of assistance that cannot be covered by Highmark or
who may not be part of the plan shall be referred to appropriate local providers.

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STAFF TRAINING AND PERSONNEL DEVELOPMENT
PrimeCare Medical shall be responsible for providing educational services for all health services
staff and non-clinical staff employed pursuant to this Proposal. PrimeCare Medical’s contractual
relationship with qualified health care professionals shall provide for support of continuing
education activities required for maintenance of licensure. All qualified health care professionals
are required to participate in annual continuing education. PrimeCare Medical has an established
comprehensive continuing education program for all institutional health care staff as well as
PrimeCare Medical staff. Staff employed by PrimeCare Medical pursuant to this RFP shall
successfully complete all required hours of annual in-service training. Tools are in place for
tracking and retention of individual staff training verification.
PrimeCare Medical requires all of its practitioners to submit an Out Service Training Request
(OSTR) for off-site continuing education training. All OSTR requests enter an approval process.
PrimeCare Medical strives to reduce the number of off-site trainings for its practitioners through
its E-learning and continuing education programs. PrimeCare Medical is committed to
continuing education for its staff. All staff members who successfully complete the exam for
Certified Correctional Healthcare Professional (CCHP) are fully reimbursed for examination
expense by the Corporation. Staff requesting attendance at NCCHC and/or ACA conferences,
are given fair consideration.
Additionally, PrimeCare Medical shall assist the institution in providing preventative health
education for the inmate/patient population. As described within our Training Section, each
training agenda will be developed with the institutional health care staff on mutually identified
topics and tailored to the Facility’s needs.
Staff is encouraged to continue their education and PrimeCare Medical periodically provides
information bulletins to field staff to keep them informed about topics of interest. PrimeCare
Medical utilizes a variety of community resources (i.e., hospital, education programs, Red Cross,
Department of Health, specialty doctors and nurses), as well as an internal pool of Corporate
staff and field staff to provide in-service education programs. PrimeCare Medical pays for a
variety of continuing education programs. Staff attending these programs, are then eligible to
teach other staff. All staff at the Putnam County Correctional Facility will be eligible to attend
Medical In-services at no expense to the Facility.
To date, in-service trainings have addressed the following topics:









Basic and Advanced CPR
Mental Health Education / Emergencies
Basic and Advanced First Aid
Disaster Planning
Drug Abuse Education
HIV/AIDS Education
In-house Pharmaceutical Prescription (with drug interaction education)
Management of the Mentally Ill Offender

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help in the day-to-day operations. The cornerstone for building a receptive user community is the
ability to accurately align training courses, roles, and individuals.
The Putnam County Correctional Facility needs a training strategy that prepares personnel to be
proficient in their roles starting immediately with the Putnam County Correctional Facility
orientation training delivered at the inception of the contract, ongoing continuing education, and
recurring recertification and retraining opportunities. We designed our training program taking
into consideration training effectiveness as well as project schedule.
The PrimeCare Medical Team has the expertise and resources to support the training effort
required to transform and maintain the skills of the Putnam County Correctional Facility
professional staff, as well as our own staff being brought in to provide the health care services
requested through this RFP. Specifically, PrimeCare Medical will staff the training team with
individuals possessing in-depth medical knowledge and extensive experience in developing
comprehensive training programs, creating customized training content, and delivering
expansive training curriculums to a diverse user group. PrimeCare Medical also understands its
obligation to have its staff comply with all Facility training requirements. Knowing how to
deliver effective training to meet these challenges is paramount to the project’s success and helps
minimize disruptions that an implementation of this size and scope has on staff, business
partners, and other stakeholders.
Career Advancement Paths - It is the policy of PrimeCare Medical to promote from within
whenever possible. All openings are posted throughout the entire company before anyone is
recruited from the outside.
Licensing / Certification Requirements - PrimeCare Medical shall be responsible for assuring
and verifying that all the required registrations, licenses, board certifications, and credentials
associated with the operation are active and in good-standing. This includes, but is not limited
to, physicians, physician assistant (PA), nurse practitioner (NP), nursing, optometry, radiology,
and other licenses, DEA registration, as well as registration with appropriate State Boards.
PrimeCare Medical shall provide the Putnam County Correctional Facility with current resumes
and licenses, required by statute, on all applicable qualified health care professional employees
as well as those subcontracted, if applicable. All qualified health care professionals shall possess
unrestricted licenses. All physicians will be monitored by PrimeCare Medical through a National
Physician Databank for any actions which would cause practice concerns while practicing in
other jurisdictions. This databank will be used as part of the credentialing process for all current
and newly recruited practitioners.
PrimeCare Medical is responsible for all taxes as well as the acquisition of and all costs
associated with licensures, taxes, fees, bonds, permits, Workers Compensation, accreditation and
all other costs associated in the fulfillment of this contract. PrimeCare Medical shall maintain
documentation of the appropriate licensing and accreditation for and hospitals, clinics or
laboratories which provide services under this contract.

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Duties And Responsibilities - PrimeCare Medical shall ensure the duties and responsibilities of
medical personnel shall be governed by written job descriptions approved by the responsible
physician and the facility administrator. Verification of current credentials and job descriptions
shall be kept on file. Written job descriptions shall include qualifications required and the
specific role in the health care delivery system of that position.
PrimeCare Medical intends to use an automated time keeping system at the Putnam County
Correctional Facility for payroll and reporting purposes. The current automated time keeping
system utilized by PrimeCare Medical is a hand / finger scan device, which is provided through
our contracted payroll company, ECI. Further, PrimeCare Medical shall comply with any
required Facility sign-in / sign-out procedures.
STAFFING MATRIX
Putnam County Correctional Facility
Position

Mon

Tue

Wed

Thu

Fri

Sat

Sun

Hrs/Wk

8

8

40

2

4

DAY SHIFT
Health Services Administrator (RN)

8

Medical Director/Physician
Certified Registered Nurse
Practitioner
Psychiatrist

8

8

2
2

2

4

3

3

Registered Nurse
Licensed Clinical Social Worker

8
8

8

8

Dentist
Administrative Assistant

8

8

8

40

2
8

8

8

16
2

8

8

40

8

8

8

8

56

8

8

8

8

56

EVENING SHIFT
Registered Nurse

8

8

8

NIGHT SHIFT
Registered Nurse
Total Hours Per Week

8

8

8

261

Professional Services contracts dictate that services shall be provided within a reasonable amount
of hours proposed. These hours may fluctuate dependent upon the medical services provider;
and the medical services provider never leaves the facility until all of his/her work is completed.
Also, the medical services provider and the Health Services Administrator are typically not
required to be on-site at the Facility during Federal Holidays. Furthermore, all professional
medical services providers shall be available on-call, twenty-four (24) hours per day, seven (7)
days per week. PrimeCare Medical’s Facility Medical Directors, if requested by Putnam County
Correctional Facility, shall make all reasonable attempts to arrange for courtesy privileges for
use of local hospitals for admitting, monitoring, and discharging inmates/patients being
hospitalized. Copies of staff schedules shall be provided to the Facility’s Administration on a
monthly basis, with a bi-weekly staffing analysis (daily if required) also being submitted, as
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required by the RFP. PrimeCare Medical currently completes similar staffing analyses for
several of our other contracted client facilities.
Relief Factor to account for combined leave is based upon the PrimeCare Medical’s full time
employee’s employment status and longevity. It is the policy of PrimeCare Medical to ensure
that all full-time employees are provided with a sufficient amount of leave to permit time away
from work, consistent with facility staffing needs. The leave accrual process starts when an
employee is hired full-time. Part-time or PRN staff do not earn combined leave.
Calculating relief factor is based upon the average employee with three years in a full time
employment status of 20 days per year of earned leave. The 20 days per years adds an additional
160 work hours (8 hours per day x 20 days) to the employees normal work year or 2080 hours
(40 hours per week x 52 weeks per year) for a total of 2240 work hours per year (2080 hours +
160 hours). The additional 20 days years calculates out to an additional 3.08 or 0.077 full time
equivalents (FTE) (160 hours per year / 52 weeks) hours per work week as a relief factor on
average to account for the full time employees’ accrued leave. Typically the relief factor is
covered by part-time and PRN staff. To illustrate with a FTE compliment of 15 this represents on
average an additional 1.16 FTE per week (15 FTE x 0.077 relief factor); however, PrimeCare
Medical does not limit the number of part-time or PRN staff at a facility to only the calculated
value for the weekly relief factor.
The Facility Administrator shall have the right of approval for all employees and prospective
employees to be utilized by PrimeCare Medical under this contract. This right may be exercised
at any time, but such approvals shall be withheld for valid security reasons only. PrimeCare
Medical recognizes the requirements of the Putnam County Correctional Facility and its security
clearance procedures.
ORIENTATION MANUAL
PrimeCare Medical offers a comprehensive Orientation Manual which provides direction and
guidance into key Corporation policies and procedures. The Orientation Manual is designed to
be utilized for each new staff member. The period of orientation shall be approximately eighty
(80) hours. Orientation shall commence on the first day of hire and should be completed within
the first month of employment. An Orientation to the respective Correctional Facility (Security
Policy and Procedures) for each new employee is required to also occur within the initial
Orientation Period. PrimeCare Medical will be responsible for the orientation of all clinical and
non-clinical staff (Employees and Subcontractors).
CREDENTIALING
PrimeCare Medical shall provide to the Putnam County Correctional Facility a current
accounting of all required credentials for professionally licensed and certified staff. Our current
system maintains capabilities of storing, retrieval, reporting, and auditing for all staff
credentials/license renewals, first aid and CPR expirations, and malpractice insurance criteria.
Qualified health care professionals shall not possess restricted licenses as designated by the
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appropriate State Board. The Facility maintains the right to disqualify individuals from
providing service based on prior work history and security concerns.

TRANSITION PLAN
PrimeCare Medical guarantees a comprehensively coordinated and seamless transition of the
Putnam County Correctional Facility’s medical services contract, which shall commence
immediately upon a contract award. PrimeCare Medical’s “Transition TEAM” shall be
spearheaded through the leadership of Todd W. Haskins, RN, BSN, CCHP, Vice President of
Operations; and Kelly Ehrich, MBA, RN-BSN, CCHP, Jr. Vice President of Operations.
Additional Corporate support of this critical transition shall be provided by Francis J.
Komykoski, Sr., MBA, CCHP, Strategic Planning Officer; and Brent W. Bavington, MBA,
CCHP, Junior Vice President of Operations and Recruitment. A synopsis of PrimeCare
Medical’s transition plan, to include key transitional components designed specifically for the
Putnam County Correctional Facility can be found below.
PERT / GANTT CHART
The project management methodology used by PrimeCare Medical for the transitioning of
contracts is the Program Evaluation and Review Technique (PERT) and Gantt Charts system.
Through the use of the PERT and Gantt management tools, PrimeCare Medical is able to process
data representing the major, finite accomplishments essential to achieve transitioning of our
systems into the Putnam County Correctional Facility. This is obtained through the processing
of data to achieve end-objectives; the inter-dependence of those events; and estimates of ranges
of times necessary to complete each activity between multiple successive events.
The Gantt chart utilized by PrimeCare Medical can be found within our Addenda Section to this
Proposal and demonstrates in a graphic format, all tasks and timelines required to accomplish
transitioning. While the Gantt chart is a comprehensive approach to project management,
PrimeCare Medical has expanded its focus on system requirements and assignments of those
systems into the development of its PERT. The PrimeCare Medical standard transition
methodology is to assign key staff members responsibility for each task, from high level
administrative positions to facility level members to insure ownership and accountability of
actions.
Empowered department heads and other key personnel are held accountable for
implementation of assigned tasks, who assure successful collaboration in team projects.
The PERT and Gantt Charts provide for versatility of additions, changes, and flexibility when
required. Based on PrimeCare Medical’s extensive correctional health care experience and focus
on continuous improvement, the PERT and Gantt Charts will be used to communicate and
document any necessary changes.
TRANSITION
The PrimeCare Medical model of transition management has been refined and proven effective
for contract implementation for over thirty-two (32) years. PrimeCare Medical has developed an
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organizational structure for managing the fundamental components common to every transition
that clearly delineates authority, responsibility and accountability of key positions/functions
necessary for effective management.
Large projects can be most effectively managed if they are broken down into smaller segments
and implemented by key personnel who are at the facility level. This implementation can only
occur if the culture of the implementation team remains sensitive to the daily operational
concerns of the facilities where the implementation is occurring. The implementation team
works not to make changes to the correctional facility, but merges our corporate mission
statement into the existing culture within the each institution. Our transition program is
streamlined with less focus on layers of administrative management and increased focus on
visibility, accessibility, and service delivery.
Our specific organizational approach on transition implementation reflects the Putnam County
Correctional Facility’s operational scope, cost accountability and assures continuity of
management. Drawing upon our extensive expertise in managing correctional health care
contracts, we have created a management structure to insure an appropriate level of supervision,
monitoring and accountability of staff functions. A cost-effective and accountable deployment
of resources to the Putnam County Correctional Facility will begin immediately upon notice of
contract award. Recognizing the critical importance of implementing programs with minimal
service and management disruption, PrimeCare Medical presents a comprehensive transition
plan tailored to the unique requirements of the Putnam County Correctional Facility’s contract,
detailing how PrimeCare Medical will manage the transition in a responsive and timely manner.
As mentioned above, our PERT and GANTT Charts outline specific activities, goals, responsible
parties and projected completion dates.
PrimeCare Medical has developed its transition plan based upon a full completion within a thirty
(30) day implementation period beginning with the date of contract award, with an additional 30day review and compliance monitor, which can be further modified based upon the Facility’s
needs. PrimeCare Medical will communicate and coordinate directly with the Putnam County
Correctional Facility to facilitate the transition to assure continuity of care and a seamless
delivery of services and is fully prepared to start this contract on a date to be determined by the
Putnam County Correctional Facility. Over the past thirty-two (32) years, PrimeCare Medical
has successfully started or transitioned over sixty (60) jails, prisons, state-wide correctional
systems and juvenile detention centers.
To demonstrate our ability to effect an uninterrupted and smooth transition, PrimeCare Medical
has prepared a written description of our approach, identification of dedicated personnel and
resources followed by our PERT and GANTT Charts, which illustrates the specific task, person
responsible and time line for completion. We have also included our plans for deactivation,
should the need ever arise.
As explained in the Management Summary, PrimeCare Medical is proposing an innovative,
integrated management structure that will frame our approach to health care delivery subject to
approval by the Putnam County Correctional Facility. The Transition Plan requires an initial
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series of meetings with the Facility’s administrative personnel, where we will collaborate on the
approach to re-engineer staffing patterns, designate health care unit missions, review the
inmate/patient medical classification system, and work toward program consolidation. While the
transition planning will begin immediately, it is a process of innovation and system changes that
must be collaborative and evolve over time.
Upon a contract award, the Transition Vice President and project leadership personnel will meet
with the appropriate Putnam County Correctional Facility representatives to review the
Transition Plan. At that time, all aspects of the transition plan will be prioritized and the
initiation and/or completion dates and responsible parties will be confirmed. It is imperative that
the Putnam County Correctional Facility key staff be involved with all aspects of this transition,
to ensure a safe, timely, and efficient transition for all parties involved. Simultaneously, since
this will be a very concerning time period for the current staff, PrimeCare Medical will notify all
such personnel through all media channels available of this change and offer informational
workshops to ease their concerns of this transition process.
This approach to health care delivery is population-based and systems-oriented. It is an
approach that this management team has experience in implementing and has been used to meet
the needs of other large facilities and state systems, including the West Virginia Regional Jail
Authority, the West Virginia Division of Juvenile Services, York County Prison, Bucks County
Department of Corrections, Montgomery County Correctional Facility, Lehigh County
Department of Corrections, Berks County Prison, Lancaster County Jail System, etc.
The PrimeCare Medical approach to program management implementation, developed and
refined with our experiences over time, combines the following major elements:
 Use of a structured plan that details the specific tasks, timeframes and individuals
responsible for a seamless transition as detailed in our PERT and GANTT Charts.
 Designation of a 'transition team' composed of representatives from operations, human
resources, clinical services, pharmacy, network development, information systems,
finance and other areas with a clear understanding of tasks and transition challenges.
 Transition Team members at the Putnam County Correctional Facility to work side-byside with key members of the medical staff and correctional administrators to insure
successful integration of the transition implementation.
 Close proximity of our Corporate Offices based in Harrisburg, Pennsylvania.
 Communications, orientation, education and coordination around all aspects of employee
transition issues.
 Holding a series of meetings with the Putnam County Correctional Facility to obtain,
from their prospective, a checklist of their needs related to the corrections division. Based

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on the areas of concern(s), the PrimeCare Medical Transition Team will collaborate and
provide an explanation how the transition program implementation can be initiated.
 Reviewing and evaluating the status of the current health services program for primary
care and on/off-site specialty care to insure access to care.
 Developing needs assessment procedures designed to insure we meet chronic care clinic
requirements.
 Development of unique medical programs to meet the needs of the inmate/patient
population for on-site specialty services.
 Verifying medication requirements and needs for chronic care inmates/patients are met.
 Intensive network development/provider contracting, technology applications, pharmacy,
claims and other support systems implementation.
 Development and deployment of the Transition Plan model in collaboration with the
Putnam County Correctional Facility.
PrimeCare Medical understands the uncertainty and anxiety that will result in any contract
transition and PrimeCare Medical will do everything possible to ease the transition of the current
staff. All current employees will be interviewed and given first priority for available positions
for which they are qualified. As needed, PrimeCare Medical will initiate recruitment efforts
locally, within PrimeCare Medical’s base of 1,000+ affiliated professionals and support staff, as
well as nationally, if needed to fill any vacancies or new positions. PrimeCare Medical will
schedule timely information sessions introducing key team members. As part of our transition
process, PrimeCare Medical will meet with Putnam County Correctional Facility staff to
determine your preferred location for these meetings. Key employee informational documents
will be provided; clearly describing the PrimeCare Medical approach, benefit packages, and
relevant contact personnel. The PrimeCare Medical Transition Teams will have members from
our Human Resources Department who are intimately familiar with all Human
Resources/Employee Benefit functions, as well as, the concerns and issues which will need to be
addressed with current employees. Coordination of all matters related to employee transition and
this administrative process will be managed through the PrimeCare Medical Human Resources
Department.
PrimeCare Medical maintains a comprehensive plan to retain and recruit Medical Providers,
Mid-Level Practitioners and Management Staff at all contracted correctional facilities.
PrimeCare Medical values the knowledge and loyalty of existing staff within a facility and will
strive to retain those individuals within their existing positions. PrimeCare Medical will launch
all efforts to reach out to those existing employees to discuss retention upon immediate notice of
a contract award. For any outstanding vacancies, PrimeCare Medical will initiate a variety of
recruiting techniques to include advertisement in various local periodicals, professional
organization publications, job fairs, online and other media outlets such as television and radio,
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direct mailings and referral bonus programs. PrimeCare Medical has a team of recruiters whose
experience totals over thirty (30) years in all aspects of Human Resources, which includes two
(2) Master’s Level Practitioners.
Each candidate will be interviewed and be given an opportunity to review the job description for
the position they wish to hold. Upon successful completion of the interview, a telephone
psychological screening test will be administered as well as information forwarded to Facility
Security Personnel to ensure that the candidate is eligible to work in a correctional facility. A
series of reference checks will occur as well as a credentialing procedure, if applicable. Once
these items have successfully been completed, each candidate will be offered a job both verbally
and in writing through an Offer of Employment Letter. They will then be transferred to the
Orientation and Training Modules.
The management process of planning, organizing, actualizing, and controlling is most effectively
and successfully accomplished by those closest to the work. We are anxious to share our vision
with the Putnam County Correctional Facility should we be awarded the Putnam County
Correctional Facility contract and look forward to collaborating on a new and improved model
for correctional health care delivery.
PrimeCare Medical has successfully transitioned numerous contracts for medical services. Our
tested systems and team approach to the specific requirements of each client assures that nothing
is overlooked and your particular concerns are addressed timely and professionally. PrimeCare
Medical is confident that our experience in managing this important process, coupled with our
sensitivity to these issues, will result in uninterrupted service to the inmates/patients confined to
the Putnam County Correctional Facility. PrimeCare Medical is able to fully commit the scope
and focus of key personnel and regional based company resources needed to insure a timely,
smooth start-up and continuity of services. It is these personalized services and commitment to
excellence that makes PrimeCare Medical a true competitor.
Deactivation Plan - If, for any reason, PrimeCare Medical is not retained at the conclusion of this
contract term, or if it were to be terminated at any point prior to the expiration of the contract
term, PrimeCare Medical will be fully cooperative and communicative with the Putnam County
Correctional Facility, institution staff and incoming provider(s) to assist with a smooth transition
to a new vendor. Continuity of care with minimal inconvenience to the institution and its
inmates/patients will be the primary consideration. A deactivation plan will be initiated as soon
as notification is received that there will be a new provider. The Vice President will implement a
definitive plan through consultation with the Putnam County Correctional Facility and institution
staff as appropriate. The final plan will elaborate on the actions to be completed by designated
individuals and defining specific time periods. PrimeCare Medical will continue with our
existing policy to utilize exit surveys designed to identify deficiencies or shortcomings during
the deactivation process.
Tasks required to assure continuity of care upon expiration of the contract include the following:
 Meet with incoming vendor regarding continuity of care and specific needs.
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 Confirm contract completion with subcontractors and provide written notification.
 Inventory medical supplies and discuss levels of stock (i.e., supplies and medication
required for transition period).
 Bookkeeping review of any outstanding accounts payable and accounts receivable and
establish formalization of accounts.
 Insure that the quality of health care services is maintained up to termination of services.
(Insure arrangements for orderly transfer of medical documentation (i.e., pending
referrals and scheduled outside trips).
 Insure all employees are advised as to their rights and benefits with the contract
termination. Wherever possible, PrimeCare Medical will actively assist employees in
exploring other job opportunities within our Company and/or the new vendor.

CONCLUSION
It is this combination of PrimeCare Medical’s proven business philosophy in correctional
medicine of over thirty-two (32) years, the vast professional experiences of our multidisciplinary
senior management team, our extensive comprehensive presence in local correctional health care
systems, proven ability to operate state-wide correctional systems, innovation into various
technological advancements, and experience with local unions that makes PrimeCare Medical
the ideal health care solution for the Putnam County Correctional Facility.
Due to the unique and diverse composition of our senior corporate leadership, PrimeCare
Medical has the unparalleled capability to effectively engage in the type of strategic operational
planning, medical/administrative consultation, and rapid response to emergent / client issues
necessary for the proper delivery of medical services to the Putnam County Correctional Facility.
As one of the largest providers of comprehensive correctional health care services to the local
region, PrimeCare Medical has positioned itself to seamlessly transition the Putnam County
Correctional Facility in the most cost effective and efficient manner possible.
PrimeCare Medical will not only meet, but far exceed all levels of services presented in this
proposal. The Company is highly qualified to implement this proposal, which is designed
specifically to service the health care delivery systems for the Putnam County Correctional
Facility. The result is the best possible health care package for the inmate/patient and the most
cost effective delivery system for the Putnam County Correctional Facility.

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ADDENDA
LETTER
RECEIPT OF CONFIRMATION ---------------------------------------------------------------------------------------- A
RELATIONSHIP TO PUTNAM COUNTY ---------------------------------------------------------------------------- B
CERTIFICATION OF COMPLIANCE WITH THE IRAN DIVESTMENT ACT ---------------------------- C
CERTIFICATE OF GOOD STANDING ------------------------------------------------------------------------------- D
CONSENT OF SURETY --------------------------------------------------------------------------------------------------- E
INSURANCE ----------------------------------------------------------------------------------------------------------------- F
TRANSITION PLAN -------------------------------------------------------------------------------------------------------G

ADDENDA
LETTER
RECEIPT OF CONFIRMATION ---------------------------------------------------------------------------------------- A
BISINESS REFERENCES ------------------------------------------------------------------------------------------------- B
BISINESS REFERENCES – EXPIRED CONTRACTS (2013-2018) --------------------------------------------- C
COMPANY POLICY OPERATION MANUAL TOC --------------------------------------------------------------- D
COMPUTERIZED MEDICAL RECORDS (COREMR) SCREEN SHOTS ------------------------------------ E