STATE OF TENNESSEE DEPARTMENT OF CORRECTION REQUEST … · 2/25/2020 · in RFP 32901-31202,...

RFP # 32901-31202 – Amendment # 12 of 21

STATE OF TENNESSEE DEPARTMENT OF CORRECTION

REQUEST FOR PROPOSALS # 32901-31202 AMENDMENT # Twelve FOR GOODS OR INMATE BEHAVIORAL HEALTH SERVICES

DATE: February 25, 2020 RFP # 32901-31202 IS AMENDED AS FOLLOWS: 1. This RFP Schedule of Events updates and confirms scheduled RFP dates. Any event, time, or date containing revised or new text is highlighted.

EVENT

TIME (central time zone)

DATE

1. RFP Issued August 8, 2019

2. Disability Accommodation Request Deadline 2:00 p.m. August 13, 2019

3. Pre-response Conference 11:00 a.m. August 14, 2019

4. Notice of Intent to Respond Deadline 2:00 p.m. August 15, 2019

5. Written “Questions & Comments” Deadline 2:00 p.m. August 20, 2019

6. State Response to Written “Questions & Comments” Feb. 25, 2020

7. Deadline for Second Round of Written Vendor Questions and Comments March 3, 2020

8. State Response to Second Round of Written Vendor Questions and Comments March 24, 2020

9. Response Deadline 2:00 p.m. April 24, 2020

10. State Completion of Technical Response Evaluations May 8, 2020

11. State Opening & Scoring of Cost Proposals 2:00 p.m. May 11, 2020

12. Negotiations (Optional) May 18-22, 2020

13. State Notice of Intent to Award Released and RFP Files Opened for Public Inspection 2:00 p.m. May 28, 2020

14. End of Open File Period June 4, 2020

15. State sends contract to Contractor for signature June 5, 2020

16. Contractor Signature Deadline 2:00 p.m. June 12, 2020

17. Performance Bond Deadline 4:30 p.m. June 19, 2020

2. State responses to questions and comments in the table below amend and clarify this RFP.

RFP # 32901-31202 – Amendment # 12 of 21

Any restatement of RFP text in the Question/Comment column shall NOT be construed as a change in the actual wording of the RFP document.

RFP SECTION PAGE # QUESTION / COMMENT STATE RESPONSE

1.1 Statement of Procurement Purpose

Page 2 1. The RFP indicates that APNs may provide psychiatric services. Are Physician Assistants with Psychiatric designation allowed to provide psychiatric services under this contract?

Yes. Physician Assistants with Psychiatric designations will be permitted to provide psychiatric services under the contract resulting from this RFP.

Attachment 6.6. Pro Forma, Section A.2. Definitions # 23

Page 3 2. Will the Case Management Coordinator be required to work all hours in the Central Office when not in a site or will he/she have the opportunity to work from the Contractor’s Regional Office?

No. It is the State’s expectation that the Case Management Coordinator will be at the physical location (site) as assigned.

Attachment 6.6. Pro Forma, Section A.9.a. Mental Health Nursing Coverage

Page 23 3. When Inmate Health Services Contractor does not provide required nursing coverage and behavioral health operations are negatively impacted, will Contractor be ensured they will not be held liable for potential liquidated damages occurring as a result of mental health nursing staffing shortages?

The Contractor for Inmate Health Services will be held accountable for any failure to fulfill Contractor obligations. Note that Inmate Health Services is a separate Contract. Each Contractor will be held accountable for their respective responsibilities. The Inmate Behavioral Health Services Contractor awarded through this RFP may elect to provide more staff than delineated in the Staffing Pattern detailed in RFP 32901-31202, Release 2, Attachment Five. Positions listed in the Staffing Pattern as Advance Practice Nurses must be filled by APNs. If a Contractor elects to provide more than the minimum number of employees for any position listed in the Staffing Pattern, they may do so.

Attachment 6.6. Pro Forma, Section, A.9.a. Mental Health Nursing Coverage

Page 23 4. What is number of Mental Health Nurses assigned to each site and what is the staffing/fill rate?

The number of Mental Health Nurses assigned to each facility are defined in the Inmate Health Services Contract Staffing Pattern. The current fill rate is ninety-seven percent (97%).

Attachment 6.6. Pro Forma, Section A.23.a. Contract Management-Administrator

Page 23 5. Contract indicates Administrator must be a licensed mental health professional. Is this a required credential or a preferred credential?

It is a required credential.

Attachment 6.6. Pro Forma, Section A.23.a—Contract Management-Administrator

Page 23 6. Would it be possible to use an individual with an MBA degree with appropriate management experience?

The State will consider individuals with MBA degrees and the appropriate management experience.

Attachment 6.6. Pro Forma, Section A.23.g—Contract Management

Page 28 7. Section indicates the TDOC Director of Addiction Treatment and Recovery Services has oversight over the Addiction Treatment and Recovery Services Coordinator’s duties and responsibilities. Will the Addiction Treatment and Recovery Services Coordinator also take direction and instruction from the Treatment and Recovery Services Coordinator and/or the Contract Administrator?

Yes. The Addiction Treatment and Recovery Services Coordinator will take direction from the State Director of Behavioral Health Services and appointed designees.

Attachment 6.6. Pro Forma, Section A.23.j—Contract Management—Certified Peer Recovery Specialist Trainer

Page 28 8. Will the CPRS Trainers be required to be fully credentialed as outlined in the contract prior to contract commencement or will there be a grace period post contract commencement to get staff trained per contract requirements?

All Contractor staff shall have the necessary training and/or credentials by the end of the three (3) month transition period prior to the anticipated contract start date of July 1, 2020.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.6. Pro Forma, Section A.24.d—Staffing Requirements—Bilingual Personnel

Page 29 9. Is the state requiring a minimum number of staff in the contract to be bilingual?

Yes. Please refer to Pro Forma Contract Section A.24.d., which reads as follows: A.24.d. Bilingual Personnel. The Contractor shall provide staff who are bilingual in English and

Spanish. The Contractor shall provide translation services to meet the needs of the Inmate population. The Contractor shall ensure that Inmates shall not be utilized as translators for Clinical staff.

For Inmates whose native language is other than English or Spanish, the awarded Contractor is expected to provide classroom materials or live interpreting services in an Offender’s native language. Classroom materials shall be readily available upon award. The awarded Contractor is required to engage the State identified interpreting service, and to reimburse the State for the cost of each interpreting appointment.

The number of interpreters is generally determined by the length of time they are needed. Typically, if an interpreter is needed for more than four (4) hours, more than one (1) interpreter may be required. One (1) interpreter typically can serve up to three (3) Inmates at a time.

Attachment 6.6. Pro Forma, Section A.26.b—Psychiatric Services

Page 31 10. Please clarify as this section does not represent current TDOC policy.

State policies are revised and updated from time-to-time. The policy citation has been revised to TDOC Policy # 113.84 and is reflected in RFP 32901-31202 Release 2, Appendix B.

Attachment 6.6. Pro Forma, Section A.26.c—Psychiatric Services

Page 31 11. Is a “Direct Assessment” considered face-to-face or via tele-health?

The Contractor shall administer Direct Assessments face-to-face and shall not administer Direct Assessments via telehealth.

Attachment 6.6. Pro Forma, Section A.29.b—NWCX Special Education Program

Page 35 12. Services are to be provided within 15 days of the state designating a new program location. Will the state allow enough time for the Contractor to procure staff, if needed, prior to the initial request?

The requirement has been revised to thirty calendar (30) days as detailed in RFP 32901-31202, Release 2, Attachment 6.6. Pro Forma Contract, Section A.29.b.

Attachment 6.6. Pro Forma, Section A.32.f Substance Use Disorder Treatment

Page 37 13. Please review the staffing section as there are differences in the text versus Attachment 5.

RFP Attachment 6.6., Section A.32.f. has been revised to mirror the requirements in RFP 32901-31202 Release 2 Attachment Five. Please note that the staffing levels in Attachment Five encompass all positions TDOC requires the Contractor to provide including and in addition to Section A.32.f. The Staffing Pattern numbers do not have to match Section A.32.f.

Attachment 6.6. Pro Forma, Section A.33.c Annual Review

Page 45 14. Please clarify. Annual Reports have typically been done on the fiscal year not calendar year which would make the annual report due on or before the 15th of August.

RFP Attachment 6.6., Section A.33.c. has been revised accordingly to reflect that the Annual Review is due on or before August 15th each year.

Attachment 6.6. Pro Forma, Section A.33.d Data Management Automation

Page 45 15. If the state elects to implement an EHR will the DOC or contracted mental health provider be responsible for network connectivity to the forthcoming EHR?

The State does not currently utilize an EHR system. If the State converts to an EHR system, the Contractor shall require that the Contractor’s subcontractors, such as laboratory, pharmacy, telemedicine, etc., link to the State’s automated hardware/software. The State’s Management Information System (“MIS”) and Strategic Technology Solutions (“STS”) divisions shall handle coordination for compatibility.

If an EHR is adopted by the State, it shall include Direct Secure messaging capability to permit secure exchange of Protected Health Information as needed with entities that do not possess EHR systems.

Attachment 6.6. Pro Forma, Section A.33.d Data Management Automation

Page 45 16. Will the mental health provider have input into the included forms and configurations of the forthcoming EHR?

The Contractor awarded through this procurement may provide input for consideration but final determinations on the content and configurations of the EHR will be made by the State.

Attachment 6.6. Pro Forma, Section C.3.b Payment Methodology

Pages 47-48 17. The payment is based upon the ADP per inmate per day. State DOC ADP have been declining nationwide; however, the Mental Health caseloads have increased. Would the State consider transitioning to a caseload model or an ADP model with a floor?

RFP Attachment 6.3. Cost Proposal & Scoring Guide has been revised accordingly to seek pricing on the ADP and account for fluctuations in the ADP in increments of 5%, 10%, and 15% for both increases and decreases in ADP. It should be noted that any costs associated with Contractor obligations detailed in Attachment 6.6., Sections A.24.g.4. and A.27.a. shall be included in the Respondents quoted pricing.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment Four: Key Performance Indicators Manual

Attachment Four: Key Performance Indicators Manual

18. Several of the “Critical Indicators” do not reflect current policy. Would it be possible to update the “Critical Indicators”?

The Key Performance Indicators Manual (which includes the Critical Indicators) is updated from time to time to conform to TDOC’s most current policies, ACA Standards, and Clinical needs.

Attachment Four: Key Performance Indicators Manual- Telepsychiatry

Attachment Four Key Performance Indicators Manual -Telepsychiatry

19. Specifically how will this item be measured and damages assessed?

If the awarded Inmate Behavioral Health Contractor does not make Telepsychiatry Services available when merited and as measured in the Monthly Operating Report described in Attachment 6.6., Section A.33.b. and as referenced in Attachment Three, Liquidated Damages may be assessed by the State.

Attachment Five: Minimum Staffing Requirements

Attachment Five

20. The staffing matrix seems to reflect the missions of the facilities from 2016 and not current missions. In addition, the Physician FTEs seem under estimated given the number of APN FTEs. Would it be possible to revisit the staffing matrix?

Both the State’s Chief Medical Officer and Director of Behavioral Health Services have confirmed that the Staffing Pattern reflects current missions. Please note that the staffing levels in Attachment Five encompass all positions TDOC requires the vendor to provide including and in addition to A.32.f. The Staffing Pattern numbers do not have to match section A.32.f.

Appendix C Appendix C 21. Please provide a copy of the current contract for inmate behavioral health services, including all amendments.

The current Inmate Behavioral Health contract has been provided in RFP 32901-31202, Release 2, Appendix C. Please note, however, that the scope and staffing patterns that are being requested through this procurement differ from the current contract in scope and Staffing Pattern requirements.

Attachment 6.6. Pro Forma Contract, Section A.33.d. Data Management Automation

Page 45 22. Does the state currently use an electronic health record system? If so, which system is used? If not, is there an anticipated time frame to converting from paper records to an EHR?

The State does not currently utilize an EHR system. There is no definitive timeline for conversion from paper-based records to an EHR system.

Attachment 6.6. Pro Forma Contract, Section A.7 Telepsychiatry

Pages 22-23 23. Will the current telepsychiatry equipment remain on site to be utilized by the contractor awarded the contract?

State owned equipment will remain in place. Any equipment owned by the current Contractor will not be available after current contract expires on June 30, 2020. Please reference the State’s Response to Question 88.

Attachment 6.6. Pro Forma Contract, Section A.36. Employee Transition Process

Page 46 24. How many state employees meet the professional qualifications and are eligible to transfer to the contractor?

Presently, five (5) State employees meet the professional qualifications and are eligible to transfer to the awarded Contractor as referenced in Attachment Ten.

Attachment Nine Behavioral Health Pharmacy Utilization Reports and Formulary

Attachment Nine

25. Please provide the total cost of psychiatric medication for each of the past three years.

8/1/2016-7/30/2017 - $1,125,719.93

8/1/2018-7/31/2019 - $2,224,100.45

.

Appendix E Liquidated Damages Assessed to Date

Appendix E 26. Please provide the total amount of liquidated damages assessed against the current contractor for each of the past three years.

The data has been provided in RFP 32901-31202 Release 2 Appendix E.


Appendix E 27. Please provide the total amount of staffing paybacks assessed against the current contractor for each of the past three years.

The data has been provided in RFP 32901-31202, Release 2, Appendix E.

RFP 32901-31202 Release 2 Appendix A

Appendix A 28. Please provide a list of current vacant positions for which the state is assessing staffing paybacks.

A list of the current vacancies has been provided in RFP 32901-31202, Release 2, Appendix A.

Attachment Ten TDOC Staff Eligible to Transition

Attachment Ten

29. The RFP references an Attachment 10 but there is no attachment or placeholder. Please provide a copy of Attachment 10.

Attachment Ten has been provided within RFP 32901-31202, Release 2.

RFP # 32901-31202 – Amendment # 12 of 21


Attachments Seven Population Projections, Eight TDOC Statewide Map, and Nine Behavioral Health Pharmacy Utilization Reports and Formulary

Attachment Seven, Eight and Nine

30. Please provide copies of RFP attachment 7-9. Attachments 7-10 are included within RFP 32901-31202, Release 2.

Attachment 6.3. Cost Proposal & Scoring Guide

Pages 27-28 31. What population base will be used to calculate payment to the contractor, the population at the 11 TDOC managed facilities or will the payment population base include the privately managed facilities?

The Population Base at the TDOC managed facilities will be used to calculate payment to the Contractor.

The privately managed facilities are beyond the scope of this RFP and are not included in the population requiring Behavioral Health Services under the awarded contract.

Attachment 6.3. Cost Proposal & Scoring Guide

Pages 27-28 32. Please provide the average daily population on which contract payment is based for each of the past three years.

ADP FY 16-17: 14,053

ADP FY 17-18: 14,421

ADP FY 18-19: 14,298

Attachment Seven Population Projections

Attachment Seven

33. Please provide the projected average daily population on which the contract is based for each of the next five years of the contract.

The projected population has been provided in RFP 32901-31202, Release 2, Attachment Seven.

34. Please provide copies of any audits conducted by TDOC of the behavioral health program for each of the past three years.

Audits for the current Contractor are not germane to this RFP and the contract resulting from this RFP.

Attachment 6.6.Pro Forma Contract, Section A.33.c. Annual Review

Page 45 35. Please provide copies of any annual statistical reports provided by the current contractor for each of the past three years.

A copy of the Annual Review has been provided in RFP 32901-31202, Release 2, Attachment Eleven

RFP Table of Contents 36. Please provide RFP referenced Attachments Seven, Eight, and Nine

Please see the State’s Response to Question 30.

RFP Section 2.1.Schedule of Events

Page 6 37. a. Releasing the State’s responses to questions this close to the response deadline can result in significant and possibly unacceptable financial risk to Respondents. To ensure Respondents have sufficient time to modify and/or amend responses and pricing to accurately reflect answers provided by the State, please confirm the State will release responses at least 10 business days prior to the submittal due date.

b. Will the State allow a 48-hour follow-up question and answer period so that Respondents can ask clarification questions regarding the answers that will be provided on or around October 4?

a. The Schedule of Events has been revised and is provided above for reference. b. If Respondents have follow-up questions regarding State Responses, the RFP Schedule of

Events will be further revised to allow for the State to address any such questions.

RFP Response Requirements Section 3.1.1.2.

Page 7 38. Please confirm that the required 12 point font size applies only to narrative text, and not to tables, figures, captions, call-out boxes, etc.

The twelve (12) point font size applies to narrative text and does not apply to tables, figures, captions, or call-out boxes

Attachment 6.2, Section C—Technical Qualifications, Experience & Approach Items., C.7

Page 26 39. Please confirm the reference to Section A.4. should correctly refer to Section A.5.

The section reference has been corrected as detailed in RFP 32901-31202, Release 2.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.3., Cost Proposal & Scoring Guide.

Pages 27-28 40. a. The RFP requires pricing be submitted in a per inmate per day format; please provide what ADP should be used for pricing purposes.

i. Given that the compensation received by the awarded contractor will vary with ADP, will the contractor be allowed to reduce staffing if the ADP were to have a sustained decrease?

ii. Please confirm what the ADP has been for the past two years.

b. Please confirm that if awarded, the base contract is for five years.

c. Please confirm if any option periods or extensions are anticipated.

a. Population Projections have been provided within Attachment Seven.

i. The Contractor cannot change the staffing pattern unless there is written approval from the State, even if there are sustained reductions in population.

ii. Please see the State’s Response to Question 32.

b. The anticipated contract term is sixty (60) months or five (5) years.

c. Standard contract terms are sixty (60) months or five (5) years. No extensions are anticipated at this time.

Attachment 6.6. Pro Forma Contract, Section A.4. General Requirements

Pages 20-21 41. a. Please identify and provide copies of any court decisions, court orders, and consent decrees impacting mental or behavioral health care within the TDOC.

b. Are there any court decisions, court orders, or consent decrees relevant to mental or behavioral health services currently pending?

i. If yes, please identify and provide copies.

There are no court orders, court decisions or consent decrees impacting mental or behavioral health care within the TDOC.

There are no court orders, court decisions or consent decrees impacting mental or behavioral health care currently pending.

RFP Attachment 6.6. Pro Forma Contract, Section A.5.

Pages 21-22 42. Please clarify whether the LADAC and the LCSW FTEs in this section are included in or an addition to the minimum staffing identified in Attachment Five.

The LADAC and LCSW FTEs in the section are in addition to the minimum staffing identified in Attachment Five.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.6. Pro Forma Contract, A.6. Additional Requirements

Page 22 43. a. Please describe the TDOC juvenile population’s utilization of behavioral health services.

i. On average, how many juveniles does the TDOC house?

ii. Please provide current juvenile census by facility

b. Please clarify if sex offender treatment programming is currently being provided at TDOC facilities.

i. If so, how many are receiving treatment?

ii. Is this for both male and female offenders?

iii. At which facilities

iv. How many staff are delivering services and what are their qualifications?

c. Please describe the TDOC sex offender population's utilization of behavioral health services.

i. On average, how many sex offenders of each gender does the TDOC house?

a. There are currently one hundred and twenty (120) participants in the Youth Offenders Program. There are no juveniles housed by TDOC at this time.

b. Sex Offender treatment is currently being provided at DSNF. i. Thirty-two (32) Sex Offenders are currently receiving treatment. ii. Currently only male Offenders are receiving treatment iii. Sex Offender treatment is being provided at DSNF. iv. 1.5 FTE staff are providing treatment.

c. Sex Offenders are housed in a self-contained unit. The program is tailored to meet the needs of the Sex Offender population.

i.Current numbers on Sex Offenders housed at TDOC facilities are as follows:

SiteID Sex SexOffenderCount BCCX Female 3 BCCX Male 381 MCCX Male 279 NECX Male 298 NWCX Male 486 RMSI Male 75 SPND Male 140 TCIX Male 300 TPFW Female 19 WTSP Female 45 WTSP Male 75

Attachment 6.6. Pro Forma Contract, Section A.7. Telepsychiatry.

Pages 22-23 44. a. Please confirm which of the 11 program sites have implemented Telepsychiatry.

i. Please confirm on average, how many Telepsychiatry synchronous encounters occur each month?

b. Please identify TDOC’s current videoconferencing systems.

c. Please confirm if desktop and/or laptops are currently being utilized for Telepsychiatry at any of the 11 program sites. If yes, please identify

d. Please confirm which of the 11 program sites currently have a wireless network available.

a. All TDOC sites are currently using Telepsychiatry. i. On average, four hundred and fifty (450) Telepsychiatry synchronous encounters take

place each month. b. TDOC’s current Teleconferencing Systems used by Mental Health Staff are either Polycom or

Tandberg. c. Yes. Computers and laptops are being used for Telepsychiatry at the eleven (11) program sites. d. There are eleven (11) sites none of which have wireless networks. All service is hardwired.

Attachment 6.6. Pro Forma Contract, Section A.8. Mental Health Coverage.

Page 23 45. Please clarify what circumstances necessitate coming on-site. Circumstances including, but not limited to, staffing issues, sentinel events, significant injury, significant breach of contract and any other reasonable standards for Behavioral Health Care would necessitate coming on-site.

Attachment 6.6. Pro Forma Contract., A.13., Supervision of Interns.

Page 24 46. a. Please confirm whether TDOC or the current contractor has established collaborative agreements in place with any schools. If so, please identify which schools.

b. What schools have collaborated in the past?

a. TDOC or the current Behavioral Health Contractor has established affiliation agreements with Union University, Vanderbilt University, the University of Tennessee, Belmont University, Lipscomb University, Middle Tennessee State University, Trevecca Nazarene University, Tennessee State University and Bethel University.

b. In times past, either TDOC or the Behavioral Health Contractor has had affiliation agreements with Tennessee State University, Bethel College, Meharry Medical College, Middle Tennessee State University, UT Martin and Vanderbilt University.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.6. Pro Forma Contract, A.23. Contract Management.

Pages 27-28 47. a. Please confirm the above Contract Management personnel are in addition to and not included or associated with any facility in the minimum staffing provided on Attachment Five.

b. Please confirm whether the current contractor utilizes any of the above personnel to meet minimum staffing requirements identified in Attachment Five.

c. Please clarify in what capacity if any these Contract Management personnel may be utilized to meet the minimum staffing requirements identified in Attachment Five.

a. Contract Management personnel are in addition to the minimum staffing requirements detailed in Attachment Five.

b. The primary focus of the Contract Management positions are solely administrative. Contract Management staff may only be used to meet minimum staffing requirements in the event of a critical psychiatric need and an approval by TDOC’s Director of Behavioral Health.

c. In regular instances not detailed in section b above, Contract Management Personnel may not be used to meet the minimum staffing requirements identified in Attachment Five.

Attachment 6.6. Pro Forma Contract, A.26. Psychiatric Services.

Pages 31-32 48. Please confirm whether this pre-approval requirement by the State applies to every psychiatric provider or just medical director level psychiatrists (as is typical).

The pre-approval requirement applies to every psychiatric professional.


Page 31 49. a. The language “may require” is ambiguous. Please clarify the conditions upon which the State “shall” require the above stipulated reviews.

b. Please clarify if this requirement applies to all inmates in any form of restrictive housing or only to those patients on psych medications in restrictive housing.

a. The language has been revised within RFP 32901-31202, Release 2 to read ‘as specified in TDOC policy.’ This requirement applies to inmates in segregation who must be assessed at thirty (30) day intervals as specified by TDOC Policy #113.84 and referenced in Appendix B.


Page 31 50. a. Please clarify by whom the documented physical assessment will be conducted.

b. Please clarify the State’s intent with this requirement. Does this mean that people who have yet to have a physical exam must wait for any/all psychiatric medications, including emergency medications?

a. Documented Physical Assessments may be conducted by a Psychiatrist, an APN, or a PA. b. Psychotropic medications shall not be prescribed until a Physical Assessment has been

conducted. In cases where there is a critical psychiatric need, Inmate Behavioral Health Contractor staff will consult with Inmate Health Services Contractor staff to make sure any such Physical Assessment is conducted as soon as possible.


Page 31 51. Please provide a copy of all TDOC policies referenced in this RFP.

All TDOC policies referenced in this RFP have been provided in RFP 32901-31202, Release 2, Appendix B.

Attachment 6.6. Pro Forma Contract, A.26. Psychiatric Service

Page 31 52. Please clarify the State’s intent with this requirement. Is this testing for illicit drugs (usually more of a forensic function performed by security or medical staff, rather than clinical), or to have a protocol in place for monitoring psychiatric drugs for which lab monitoring is required?

The State’s intent is for Drug Screening to be conducted for Inmates classified as general population, for substance use programs, for saturation in a given unit, and/or for just cause.

Attachment 6.6. Pro Forma Contract, A.27. Pharmaceutical Responsibilities.

Pages 31-32 53. a. Please provide what the total psychotropic pharmaceutical spend has been (and what the state’s portion has been) for the past two years.

b. On average, what percentage of TDOC inmates are prescribed psychotropic drugs each month?

c. Please provide copies of the following documents:

i. The current mental health/psychotropic formulary.

ii. A current pharmacy/formulary management report.

a. 8/1/2016-7/30/2017 - $1,125,719.93

8/1/2018-7/31/2019 - $2,224,100.45

The State reimburses the Contractor for fifty (50) percent of the cost of all psychiatric medications.

b. Seventy percent (70%) of the Behavioral Health population is receiving Psychotropic Medications. c. i. The State’s current formulary has been included in RFP 32901-31202, Release 2, Attachment

Nine. ii. The State is unable to provide this information.

Attachment 6.6. Pro Forma Contract, A.28. Psychological Services

Pages 33-34 54. How many Special Education Evaluations were completed last year?

Fewer than ten (10) Special Education Evaluations were completed last year.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.6. Pro Forma Contract, A.29. Northwest Correctional Complex (NWCX) Special Education Program

Pages 34-35 55. a. Please confirm the number of patients in the special education program at NWCX in the last year.

b. Please confirm the number of beds set aside for such programming.

c. Please confirm there is designated space to provide programming for this population.

d. Please clarify the services required within the 15-day timeframe noted.

a. There were ten (10) Special Education Students at NWCX last year. b. There were ten (10) students in 2018, twenty (20) students in 2017, and twenty-two (22) students

in 2016. There have been as many as thirty (30) Special Education students in the past. c. The Special Education teacher has access to two (2) separate classrooms plus inclusion

classrooms. There is space to provide programming. d. Due to the federal guidelines for Special Education Placement, the Psychological Evaluation was

completed within fifteen (15) days.

Attachment 6.6. Pro Forma Contract, A.32. Substance Use Disorder Treatment.

Pages 36-44 56. Please confirm over what period these programming hours must be provided.

Programming is typically provided for no more than three (3) hours per day, during a minimum of ten (10) weeks with the possibility of a maximum of twelve (12) weeks.

Attachment 6.6. Pro Forma Contract, A.32. Substance Use Disorder Treatment. Section in its entirety.

Pages 36-44 57. a. The total number of beds identified in this section add up to 1,508; however, Section A.32. j. states the Contractor shall provide 2,118 treatment beds. Please clarify which number is correct.

b. Please confirm the number of patients by facility that are currently receiving SUD Treatment Services.

a. The total number of beds has been revised to two thousand one hundred and eighteen (2118) as this is correct.

b. Therapeutic Community TCOM capped at ninety-seven percent (97%) of capacity. Group Therapy capped at eighty-eight percent (88%) of capacity.

Attachment 6.6. Pro Forma Contract, A.32. Substance Use Disorder Treatment.

Pages 36-44 58. a. Please clarify who conducts the urinalysis for the patients in the SUD program.

b. Please clarify who makes the determination that a urinalysis should be conducted on a patient.

a. Urinalysis for patients in the SUD program is conducted by the State’s Drug Test Coordinator at each site.

b. The determination that a Urinalysis should be conducted on a patient may be made by the State or Contractor Clinical staff, Inmate Health Services Contractor staff, Behavioral Health Services Contractor staff, State Correctional staff, or the State’s Behavioral Health Program Director if there is reasonable suspicion.

Attachment 6.6. Pro Forma Contract, A.36. Employee Transition Process.

Page 46 59. a. Please provide the above referenced Attachment Ten.

b. Please clarify whether the minimum FTE’s identified in Attachment Five includes these state employees, or if the state employees are in addition to the minimum staffing identified in Attachment Five.

c. Please confirm that the vacant mental health state positions referenced above are limited only to those positions identified in the referenced Attachments.

i. If no, please confirm that the awarded contractor’s compensation may be increased for any state position vacated that becomes a contract position.

d. Please clarify if there are services currently being provided by the state that will now become contract services.

i. If yes, please identify these services.

e. Given that the awarded contractor must offer state employees 120% of their current pay and benefits equal to no less than what they are currently receiving, please provide the following information for each state employee who may transition to the contractor:

i. current rate of pay

ii. current benefit plan

a. Please see State’s response to Question 29. b. The FTEs detailed in Attachment Five shall be provided by the Contractor, and do not include

State employees. c. The vacant positions noted in Attachment Five are in reference to the current contract’s

Behavioral Health Services Staffing Pattern. It must be noted, however, that this c staffing pattern differs from the required staffing pattern outlined in RFP 32901-31202 Release 2.

i. Contractor compensation shall not increase if a vacant State position is reclassified as a Contractor position.

d. Services that would have been provided by a State employee in a vacant position become the responsibility of the Contractor.

e. i. The current rates of pay are detailed within RFP 32901-31202 Release 2 Attachment

Ten. ii. RFP 32901-31202 Release 2 Attachment Ten identifies whether the employee is enrolled

in the State employee benefits program. Due to HIPAA regulations, the State cannot release specific benefits coverage for each employee.

f.

i. Each of the State employees listed in Attachment Ten are one (1) full-time equivalent FTE.

ii. RFP 32901-31202 Release 2 Attachment Ten identifies which facility the employee is assigned to.

iii. The requirements for a Psychological Examiner 2 are as follows:

Possession of a master's degree in psychology, licensure as a Psychological Examiner and two (2) years of full-time responsible professional psychological examining experience. Possession of a doctorate in psychology may be substituted for the required experience.

RFP # 32901-31202 – Amendment # 12 of 21


f. Please provide specifics regarding these employees to include:

i. Number of FTEs

ii. Facility

iii. Type of position, title, and/or level of education

Other Requirements: Necessary Special Qualifications: Licensure as a psychological examiner with the State of Tennessee is required at the time of employment and must be maintained for the duration of employment. The educational requirements for a Correctional Program Director 1 are as follows: Graduation from an accredited college or university with a bachelor's degree and experience equivalent to substantial (five (5) or more years of) full-time varied increasingly responsible professional correctional experience including at least two (2) years of supervisory work; qualifying full-time professional experience in correctional work may be substituted for the required education, on a year-for-year basis, to a maximum of four (4) years; additional graduate coursework in a field pertinent to correctional work may be substituted for the required non-supervisory experience, on a year-for-year basis, to a maximum of two (2) years.

Appendix E -- Liquidated Damages Assessed to Date

Appendix E 60. a. Please provide historical data on a quarterly/annual basis regarding current Contractor Liquidated Damages costs and types of assessments.

b. Please provide (by year) the amounts of any staffing paybacks/credits the TDOC has assessed against the incumbent Contractor over the term of the current contract.

a. The State assesses Liquidated Damages monthly. The information is provided on a monthly basis below:

Month Liquidated

Damage Oct 2017 $ 16,750 Nov 2017 $ 13,000 Dec 2017 $ 18,650 Jan 2018 $ 20,750 Feb 2018 $ 17,500 Mar 2018 $ 17,300 Apr 2018 $ 18,725 May 2018 $ 32,600 Jun 2018 $ 24,950 Jul 2018 $ 16,425 Aug 2018 $ 34,150 Sep 2018 $ 45,325 Oct 2018 $ 83,875 Nov 2018 $ 44,875 Dec 2018 $ 27,125 Jan 2019 $ 39,550 Feb 2019 $ 26,275 Mar 2019 $ 40,975 Apr 2019 $ 57,950 May 2019 $ 57,450 Jun 2019 $ 53,650 Total $707,850

The majority of LDs assessed against the current contractor have been related to staffing.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment Five, Minimum Staffing Requirements., and Attachment Six, Levels of Mental Health Care and Examples of Service.

Attachments Five and Six

61. a. The MH caseloads per facility add up to 4,735. Please clarify the number of MH caseloads per facility that are receiving SUD Treatment Services.

b. Please clarify whether the total number of MH caseloads identified is an average over time or the actual number in 2018.

c. Please quantify the number of MH caseloads by mental health classification (i.e., Levels I through V) per facility.

a. As of Dec. 12, TDOC’s caseload (State managed facilities) was five thousand seven hundred and thirty-nine (5739). Some SUD is included in services provided to seriously mentally ill offenders, those in Supportive Living Units or those with co-occurring disorders. The agency provides different treatment services of different durations depending on offender need, and the numbers are constantly changing. The State is unable to provide a specific number by facility.

b. The total number of MH caseloads was an average over time. As of July 2019, the Behavioral Health population was five thousand five hundred and five (5,505). The July 2018 population was five thousand and seventy-four (5,074).

c. The caseload figures include the four (4) privately managed facilities, which are currently managed by CoreCivic and are beyond the scope of this procurement. The caseload numbers are not available by facility. 7957 MH pop total LC2 7439 LC3 325 LC4 154 LC5 39

Attachment Six, Levels of Mental Health Care and Examples of Service..

Attachment Six

62. a. Please provide the capacities, average populations, and locations of the TDOC segregation units.

b. Please confirm if there are designated locations for the out-of-cell programming for patients in restrictive housing.

i. If yes, are the designated locations currently equipped to facilitate such programming?

c. Please confirm the following numbers over the past two years, by year and facility:

i. Patients on psychotropic medication

ii. Suicide attempts and completions

iii. Suicide watches by facility

iv. Restrictive housing beds by facility

a. The capacities and locations of the segregation beds are listed below. As the numbers change daily, the State is unable to provide an average.

b. Yes. There are step-down programs at MCCX, WTSP, and TPW.

i. Yes. There are designated locations currently equipped to facilitate such programming.

c. i. Approximately seventy percent (70%) of the Behavioral Health Population is receiving psychotropic medications. The information is not available by facility.

c. ii. in Calendar Years 17, 18 and 19, there were twenty-two (22) completions.

c. iii. There were one thousand five hundred and forty-nine (1,549) suicide watches in FY 19. The requested information is not available by facility. Data from Jan. 2018 through Nov. 2019 indicate one thousand one hundred and fifty-nine (1,159) reports of suicide prevention, which averages a little over fifty (50) per month.

c. iv. Restrictive housing beds by facility:

Ninety-six (96) at WTSP

Eighty-eight (88) at SPND

One hundred and sixty-eight (168) at RMSI

Two hundred and forty (240) at MCCX.

Capacity Occupancy WTSP (males) 312 300 WTSP (females) 74 9 NWCX 144 133 DSNF 8 5 RMSI 288 253 TPFW 120 47 BCCX 257 191 MCCX 150 147 NECX 248 165 MLRC 30 0

RFP # 32901-31202 – Amendment # 12 of 21


Appendix C Current Behavioral Health Services Contract

Appendix C 63. Please provide a copy of the current Tennessee Department of Correction (“TDOC”) mental health services contract, including all exhibits, attachments, and amendments.

Please see the State’s response to Question 21.

RFP Section 2.1. Schedule of Events.

Page 6 64. Will the TDOC schedule site tours? No. The State will not include a facility tour in the procurement. .

Attachment Five - Minimum Staffing Requirements and Appendix C Current Behavioral Health Services Contract

Attachment Five and Appendix C

65. Is the staffing required under the current TDOC mental health contract identical to the Minimum Staffing Requirements listed in the current RFP? If not, please describe all differences.

No. The staffing pattern for the current contract is included as Appendix C and differs from the staffing pattern included in this procurement. Respondents are encouraged to compare the two documents if they feel the need, however the staffing pattern from the current contract is not germane to this solicitation.

Appendix A Vacant Current Contractor Positions and Appendix C Current Behavioral Health Services Contract

Appendices A and C

66. Is the staffing actually being provided at this time (taking into account any positions and/or hours being provided above or below what is required by the contract) identical to the Minimum Staffing Requirements listed in Attachment A of the current RFP? If not, please describe all differences

The staffing pattern required through the current contract is included in Appendix C. and vacancies have been noted in Appendix A. Appendix E, which details LDs assessed has been added as indicated in item 8 below.

Appendix C Current Behavioral Health Services Contract

Appendix C 67. Please provide the incumbent Contractor’s regional staffing plan.

The Staffing Pattern required by current contract is included in Appendix C. The staffing pattern germane to this solicitation is included as Attachment Five. The current Contractor’s staffing pattern is proprietary and is not germane to this solicitation.

Appendix A -- Vacant Current Contractor Positions

Appendix A 68. Please provide a listing of all current mental health vacancies, by position, by facility.

Please see Appendix A and the State’s response to Question 28.

Attachment Five Minimum Staffing Requirements

Attachment Five

69. What is the job title and educational level of the “BHA” position? Is this the Mental Health Administrator (MHA)?

The credentials listed in Attachment Five for the Behavioral Health Administrator (“BHA”) are a master’s degree in Behavioral Science with experience in Health Administration. The designation was revised from MHA to BHA in RFP32901-31202, Release 2.

Attachment 6.2. Technical Response & Evaluation Guide

Pages 18-26 70. Please provide RFP Attachment 6.2. Technical Response & Evaluation Guide.

Attachment 6.2. Technical Response & Evaluation Guide has been included in RFP 32901-31202, Release 2.

Attachment 6.6 Pro Forma Contract, Section A.2., #37 Clinical Director

Page 4 71. Is the “Clinical Director” the position of “PHD” indicated in Attachment Five, Minimum Staffing Requirements?

Yes. The Clinical Director is the position of PHD (psychologist) indicated in Attachment Five.

Attachment 6.6., Section A.2. #233 Sex Offenders.

Page 17 72. Is sex offender treatment included in the Scope of Work? If so, please describe the numbers of male and female inmates receiving treatment by facility.

Any Sex Offender treatment must adhere to the guidelines and policies of the Tennessee Sex Offender Treatment Board, which may be found at https://www.tn.gov/correction/tennessee-sex-offender-treatment-board/tsotb-documents---resources.html

and approved in writing by the State prior to implementation.

Please see the State’s Response to Question 43 for the number of Sex Offenders currently under treatment and the facility where treatment is currently located.

Attachment 6.6. Pro Forma Contract, Section A.7. Telepsychiatry.

Pages 22-23 73. Does the TDOC have guidelines for the use of telepsychiatry versus on-site provision of treatment?

Telepsychiatry services are to be provided in accordance with TDOC Policy # 113.33, found in Appendix B and as may be revised.

Attachment 6.6. Pro Forma Contract, Section A.1. Scope

Page 1 74. Are juvenile offenders included in the Scope of Work? If so, please provide information on numbers of juveniles by facility.


Attachment 6.6. Pro Forma Contract, Section A.26.j. Psychiatric Services. Women’s Transition’s Center in Chattanooga

Page 32 75. a. Are psychiatrists/APNs currently assigned to provide services on-site, via telepsychiatry or a combination?

b. Are psychiatrists/APNs assigned to provide services from one or more of the facilities? If so, which facilities?

c. What are the current (past years’ time) number of hours provided for services at the Center?

a. Current Contractor staff assigned to TPW go to the Chattanooga Reentry Center. Telepsychiatry services are also available at the Chattanooga Reentry Center.

b. Yes. Psychiatrists/APNs are assigned to provide services from TPW. c. Approximately one (1) half day per month.

https://www.tn.gov/correction/tennessee-sex-offender-treatment-board/tsotb-documents---resources.html


RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.6. Pro Forma Contract, Section A.32.d Substance Use Disorder Treatment. Certified Peer Specialist.

Page 37 76. a. How many Certified Peer Recovery Specialists are currently used in each facility?

b. Does the Contractor bear any cost in providing for these inmate (peer) positions?

a. Currently fifty-three (53) Inmates have been trained as Certified Peer Recovery Specialists. b. TDOC envisions having between five (5) and ten (10) Certified Peer Recovery Specialists in each

facility. The Contractor will bear the inmate wage costs for the Certified Peer Recovery Specialists.

Attachment 6.2 Technical Response & Evaluation Guide, Section B.17

Pages 23-24 77. With regard to the “three completed” customer references required by the RFP: we retain the overwhelming majority of our clients from contract to subsequent contract, leaving us with no applicable “completed” contracts (as they are all still current). Will the TDOC please accept one or more of the following alternatives, so bidders are not penalized for retaining (as opposed to completing) contracts?

a. Accept three (3) additional current clients in lieu of the three (3) completed projects

b. Accept current clients in a second or third contract iteration (i.e., with a past “completed” contract) as a completed project

c. Accept a current, but soon to expire, contract as a completed project

A reference for a customer whose contract was not renewed or re-awarded could serve as a completed project. A completed contract with a customer who subsequently awarded a new contract would also be acceptable for a reference. The standard RFP requirements for references will stand as issued, including completed and current projects.

Attachments Seven Population Projections, Eight TDOC Statewide Map, and Nine Behavioral Health Pharmacy Utilization Reports and Formulary

Attachment Seven, Eight and Nine

78. We are unable to locate these in the RFP documents. Can the DOC please provide the following items?

a. Current and historic population levels for each of the DOC facilities

b. A statewide map showing the locations of DOC facilities

c. Behavioral health pharmacy reports and the current formulary

Please see State’s Response to Question 30 regarding Attachments Seven through Nine.

a. Population averages for Fiscal Years 2005/2006 through 2019/2020 are included in the Tennessee Bed Space and Operating Capacities Report for November 2019, which has been added as Appendix G.

b. A statewide map showing the facility locations has been provided in Attachment Eight c. The current Formulary has been provided in Attachment Nine.

Attachment 6.6. Pro Forma Contract, Section A.24.b.

Page 29 79. With regard to the RFP-required NCIC background checks, who is financially responsible for paying for this service: the TDOC or the Contractor?

The cost for each required NCIC background check is the responsibility of the Contractor.

Attachment 6.6. Pro Forma Contract, Section A.24.a.

Page 29 80. With regard to drug testing for potential employees, does the TDOC have any requirements on the testing methodology, e.g., saliva, urinalysis, etc.?

Please refer to Attachment 6.6. Pro Forma Contract Section A.24.a. which specifies that drug testing must be performed in accordance with TDOC Policy # 302.12., which is included in Appendix B.

Attachment 6.6., Pro Forma Contract, Section A.35.

Page 46 81. Will the TDOC allow “grandfathered” credentialing for incumbent professional staff already employed or contracted by the current Contractor?

Yes, if the incumbent’s Contractor staff are properly qualified and credentialed are hired by the Contractor awarded through this RFP, they will be ‘grandfathered’.


Appendix E 82. Please provide (by year) the amounts of any staffing paybacks/credits the TDOC has assessed against the incumbent Contractor over the term of the current contract.


83. Are any of the TDOC facilities currently subject to any court orders or legal directives? If “yes,” please provide copies of the order/directive


84. With regard to lawsuits pertaining to TDOC inmate mental health care, frivolous or otherwise:

a. How many have been filed against the TDOC and/or the incumbent mental health care provider in the last three years?

b. How many have been settled in that timeframe?

There have been no lawsuits filed.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment Six Levels of Mental Health Services and Examples of Services

Attachment Six

85. RFP page 108 lists the types of services to be provided which includes Segregation Evaluations. Please provide the capacities, average populations, and locations of the TDOC segregation units.

Please see State’s Response to Question 62.

86. Please confirm that overtime and agency hours will count toward the hours required by the contract.

Overtime is not an acceptable method of meeting Contractor staffing requirements.

State agency staff time is not an acceptable method of meeting Contractor staffing requirements.

87. Please confirm that paid-time-off hours will count toward the hours required by the contract.

The Contractor must ensure that all contract staffing requirements are met, regardless of whether staff are on paid-time-off hours. Paid-time-off-hours do not count toward the hours required by the contract.

88. Please provide an inventory (by facility) of office equipment (e.g., PCs, printers, fax machines, copiers) currently in use at the TDOC facilities and identify which equipment will be available for use by the selected provider.

MCCX State Owned Equipment – Eight (8) State Computers and Telehealth Equipment Contractor Owned – One (1) computer and three (3) Printers. MLCC State Owned Equipment – Six (6) State Computers, three (3) Printers, and Telehealth Equipment Contractor Owned – One (1) Computer. DSNF State Owned Equipment – Twelve (12) State Computers Contractor Owned – Five (5) Computers these are not for telehealth BCCX Contractor Owned – Five (5) Computers WTSP State Owned Equipment – Seven (7) State Computers, Telehealth Systems two (2), Two (2) Printers, Three (3) Dictation Systems Contractor Owned – Two (2) Computers NECX State Owned Equipment – Seven (7) State Computers, One (1) Printer Telehealth Equipment Contractor Owned – One (1) Computer NWCX State Owned Equipment - One (1) Telehealth System and Two (2) State Owned computers Contractor Owned – Two (2) Computers RMSI State Owned Equipment – Five (5) State Computers Three (3) Printers, and Telehealth Equipment Contractor Owned – One (1) Computer TCIX State Owned Equipment – One (1) State Computer, One (1) Printer, and Telehealth Equipment Contractor Owned – Two (2) Computers (one doesn't work correctly)

All equipment detailed above as being owned by the State will be available for Contractor use.

89. Please provide an inventory (by facility) of telehealth/telepsychiatry equipment currently in use at the TDOC facilities and identify which equipment will be available for use by the selected provider.

Please see the State’s response to Question 88.

90. How does mental health staff at the TDOC facilities currently access the Internet: through a facility network or through connectivity provided by the incumbent Contractor? Who is financially responsible for such Internet access?

The State maintains a network with internet connection for State computers and State video conference equipment residing on the network. If the Contractor uses equipment on this network, it is provisioned by the State. Any circuit obtained by the Contractor is done so at the Contractor’s responsibility.

RFP # 32901-31202 – Amendment # 12 of 21


91. Please confirm mental health staff members have no responsibility for the medication administration/Pill Pass process.

The Inmate Health Services Contractor staff is responsible for medication administration.

92. Please identify and provide contact information for the current TDOC pharmacy Contractor.

Clinical Solutions is the current pharmacy Contractor. Pertinent contact information will be provided following contract award.

93. On average, what percentage of TDOC inmates are prescribed psychotropic drugs each month?

On average, seventy (70%) percent of the Behavioral Health population receives psychotropic medications.

Attachment 6.6. Pro Forma Contract, Section E.2,

Page 57 94. Section E.2, Page 42, Performance Bond states, “The Performance Bond shall be in an amount equal to one hundred percent (100%) of the Maximum Liability”. However, Section 1.10, Performance Bond, Page 4, requests a bond in the amount of $1,000,000. Please clarify and confirm the Performance Bond amount required.

RFP Section 1.10 has been revised to match Pro Forma Contract Section E.2. as detailed in RFP 32901-31202 as detailed in Item 3 below. The Performance Bond shall be equal to one hundred percent (100%) of the awarded contract maximum liability.

Attachment Four, Key Performance Indicators Manual

95. Would the State consider a grace period for incoming Contractors during contract transition, such as no penalties for the first 90 days?

The first ninety (90) days of the contract are intended to provide a successful transition between the current and new contracts. The State anticipated no penalties during the transition period.

Attachment Four, Key Performance Indicators Manual

96. Please provide the current vacancies or a staffing report. What penalties have been assessed for staffing under the current contract?

Please see State’s Response to Question 68 and Appendix E.

Appendix E 97. Please provide the performance measure withhold amounts charged to the current Contractor for each of the last three years.

Please See State’s response to Question 26 and Appendix E.

Attachment Nine 98. Please provide the amount the current Contractor has expended on psychotropic medications for each of the last three years.


99. Please provide a staffing matrix with the current hourly rates and/or salaries by position.

All Respondents are responsible for determining necessary staffing components in accordance with the Staffing Pattern. It is also the Respondent’s responsibility to determine salaries consistent with the market to prepare their proposal. The State will not provide information proprietary to the current Contractor.

Attachment Five 100. Please provide the current staffing pattern of positions providing sex offender treatment services.

1.5 FTE located at DSNF.

101. Will the awarded behavioral health Contractor be responsible for any of the lab costs or will with medical Contractor assume all of these costs?

The Inmate Health Services Contractor is responsible for lab costs.

Attachment 6.3., Cost Proposal & Scoring Guide

Pages 27-28 102. Is the State willing to accept alternative price proposals on the payment structure to a fixed fee model?

The State has revised Attachment 6.3. Cost Proposal & Scoring Guide as a part of RFP 32901-31202 Release 2. The State will not accept alternative pricing proposals. Please revisit RFP Section 3.1.2.1. which reads as follows:

3.1.2.1. A Respondent must only record the proposed cost exactly as required by the RFP Attachment 6.3., Cost Proposal & Scoring Guide and must NOT record any other rates, amounts, or information.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment 6.3., Cost Proposal & Scoring Guide

Pages 27-28 103. If the State does not find a fixed fee model acceptable, would the State accept a floor and a ceiling on the PIPD rates?

The State has revised Attachment 6.3. the Cost Proposal & Scoring Guide as a part of RFP 32901-31202 Release 2. The State will not accept alternative pricing proposals. Please revisit RFP Section 3.1.2.1. which reads as follows:

3.1.2.1. A Respondent must only record the proposed cost exactly as required by the RFP Attachment 6.3., Cost Proposal & Scoring Guide and must NOT record any other rates, amounts, or information.

Appendix D Appendix D 104. Please provide the memorandum of understanding or other scope of service agreements for the Secondary Chance Re-Entry Grant.

The Second Chance Grant contract is included as Appendix D.

Appendix D Appendix D 105. Please clarify if the Second Chance Re-Entry Grant is currently being used by the State.

The Second Change Re-entry Grant is currently being used by the State.

Attachment 6.6. Pro Forma Contract, Section A.20, Contract Monitoring

Page 26 106. Is the satisfaction survey is intended for inmates, administrators, facility staff, or all of the above? If facility staff members are intended to participate, would this include healthcare staff?

The satisfaction survey is meant for TDOC Central Office and facility staff including the Wardens.

Attachment Five Minimum Staffing Requirements and Attachment 6.6. Pro Forma Contract Section A.3

Page 20 107. Attachment Five displays 11 facilities in the staffing matrix. RFP Page 1 references 10 state managed facilities. Please clarify and list the facilities this contract would cover.

Services are to be provided at all eleven (11) State-managed facilities.

Attachment 6.6., Pro Forma Contract, Section A.32.j.5.b

Page 42 108. The RFP references Forensic Social Workers (FSWs).

a) Are there identified forensic social workers in the community?

b) How many psychologists would need to be educational psychologists in order to complete Special Education Evaluations for use in developing IEPs?

c) How many Special Education Evaluations occur annually?

d) Are Special Education Evaluations completed on individuals between the ages of 18-21? Or are juveniles housed within TDOC facilities that require these evaluations?

e) What accrediting agency designates psychologists as Health Service Providers?

a. All Forensic Social Workers are in the community. The FSWs receive case management information from the facilities.

b. Members of the IEP team are detailed in Appendix B TDOC Policy #117-07 Section VI.B., and include a general education teacher, principal or designee and a psychological examiner/psychologist if necessary. If a psychologist is necessary, the psychologist must possess a Health Service Provider designation.

c. Ten (10) Special Education Evaluations occur per year d. Special Education Evaluations are conducted on juveniles up to age twenty-one (21). e. The Tennessee Board of Psychology is the accrediting body which designates psychologists as

Health Service Providers.

Attachment 6.6 Pro Forma Contract, Section A.7

Pages 22-23 109. Which TDOC facilities currently utilize telemental health?

All TDOC managed facilities use Telehealth Services for the delivery of Behavioral Health Services.


Pages 22-23 110. What providers, hospitals, or clinics provide services to the TDOC using telemental health services?

It is the Respondent’s responsibility to develop such a proposed network. Any such proposed network must be approved in writing by the State.


Pages 22-23 111. Will nurse practitioners be permitted to provide telemental health services?

Yes. Nurse Practitioners can provide Telehealth Services for the delivery of Behavioral Health Services.


Pages 22-23 112. What is the average number of telemental health encounters per month?

On average, four hundred and fifty (450) Telehealth encounters for Behavioral Health Services take place each month.


Pages 22-23 113. Does the TDCO currently employ designated Telehealth Facilitators (onsite staff who facilitate the telehealth appointments)?

a) If yes, how many and where are they located?

The State does not currently employ Telehealth Facilitators. All Facilitators are Contractor staff.

RFP # 32901-31202 – Amendment # 12 of 21



Pages 22-23 114. Are there identified Telehealth Coordinators (regional staff who coordinate telehealth schedules, assist with telehealth troubleshooting, training, etc.)?

a) If yes, how many and where are they located?

All Telehealth Coordinators are Contractor staff. The assigned locations for Contractor staff will depend on where the Contractor’s providers are located.


Pages 22-23 115. What type of network connectivity is currently in place for telemental health?

There is limited fiber strand count available between buildings. There is no available state-owned fiber exiting facility compounds.


Pages 22-23 116. Does the telehealth and telemental equipment utilize the TDOC’s network or is the network maintained by behavioral healthcare contractor?

The network is maintained by the Behavioral Health Contractor.


Pages 22-23 117. Who is responsible for the establishment and maintenance of network lines that operate current telehealth equipment?

a) Will network management remain the same with contract award?

TDOC will maintain the fiberoptics and will remain responsible for making the fiberoptics available as detailed in the State’s response to Question 115. Network management will be the responsibility of the Contractor.


Pages 22-23 118. What equipment is utilized for telehealth at each facility? This includes the platform to operate (ex. Zoom, Polycom RealPresence, etc.).

Please see the State’s response to parts b and c of Question 44 and Question 88.


Pages 22-23 119. Will the equipment and/or internet connectivity remain if contract awarded?

Equipment owned by the State will remain onsite as referenced in the State’s response to Question 23. The State anticipates equipment owned by the current Contractor being removed if the contract is awarded to a different Contractor.

Internet connectivity will be the responsibility of the Contractor.

Attachment 6.6. Pro Forma Contract, Section A.6.B, Additional Requirements

Page 22 120. The RFP discusses the need to provide specialized training and develop mental health programming for the treatment of special populations including sex offenders.

a) What programs are currently provided to sex offenders in TDOC?

b) Please provide any statistics available reflecting the number of sex offenders participating in treatment programming, by facility

a. The curriculum currently used is Treating Sex Offenders: An Evidence Based Manual by Jill D. Stinson. Sex Offender Treatment must be in accordance with the guidelines and policies of the Tennessee Sex Offender Treatment Board, which may be found at https://www.tn.gov/correction/tennessee-sex-offender-treatment-board/tsotb-documents---resources.html

b. Please see State’s response to Question 43.

Attachment 6.6. Pro Forma Contract, Section A.6.B, Additional Requirements

Page 21 121. In reference to “specialized training” and “mental health programming for the treatment of specialized populations to include women, juveniles, sex offenders, and trauma victims,” the RFP requires that the Contractor “…shall follow the program philosophy and design standards required by the state.” Please provide the program philosophy and design standards for the referenced programs.

The program philosophy and design standards have been provided within RFP #32901-31202 Release 2 Appendix F: Specialized Training and Mental Health Programming.



RFP # 32901-31202 – Amendment # 12 of 21


RFP Pro Forma Contract Section A.32, Substance Use Disorder Treatment

Pages 36-44 122. The RFP frequently references the need for the Contractor to “develop and implement” (subsections b, c, d, e) as well as “design and implement” (subsections g, I, k) treatment programming, thus giving the impression the services do not currently exist.

a) Please clarify if it is the expectation of TDOC that the successful Contractor will implement a new program that differs materially from the one currently in place?

b) If so, are there any particular changes to the current program the TDOC would like to see, and is there a timeframe within which the TDOC expects these programs to be designed, developed, and implemented?

a. If a Respondent has something to offer that is not available through current programming, the Respondent may submit the proposed offering inclusive of the changes to the State for written approval. A high-level description of the current programming has been provided in Appendix F: Specialized Training and Mental Health Programming.

b. SLUs can be improved or enhanced. In terms of a timeframe, such improvements or changes, once approved in writing by the State would take place during the first six (6) months of the contract upon award, in collaboration with the State’s Director of Behavioral Health.

RFP Pro Forma Contract Section A.33.D, Reporting Requirements

Page 45 123. The RFP states, “Contractor shall be required to participate and link to the State’s EHR system.” Please clarify the timeline and expectation of this requirement?

Please see the State’s response to Question #15.

RFP Pro Forma Contract Section A.24.B, Staffing Requirements, Background Investigations

Page 29 124. Definitions No. 26 & No. 27 indicate that “The Contractor shall not hire ex-felons or relatives of felons currently incarcerated in Tennessee”, yet in the definition of Certified Peer Recovery Specialist Trainer (CPRST; Definition #27) the RFP indicates that the CPRSTs “shall be Certified Peer Recovery Specialists themselves…” Definition #26, Certified Peer Recovery Specialist (CPRS), indicates that a CPRS is “an inmate with two (2) years of sobriety…” Please clarify how Contractors are to hire CPRSTs while at the same time meeting the requirement that ex-felons not be hired.

Contractors may not hire ex-felons to fill the Certified Peer Recovery Specialist Trainers positions. Contractors may hire individuals who are not felons but have been Certified Peer Recovery Specialists prior to becoming Certified Peer Recovery Specialist Trainers.

It is TDOC’s intent however, for Inmates to be trained and certified and to serve as Certified Peer Recovery Specialists while incarcerated. Inmate Certified Peer Recovery Specialists would not be eligible for hire once released from the facility as Contractors may not hire ex-felons to fill these positions.

Attachment 5, Minimum Staffing Requirements

Attachment Five

125. In the header of the staffing requirements, there is a column titled “BHA” but the definitions refer to a “MHA.” Please clarify.

The header notations within Attachment Five have been revised as reflected in RFP 32901-31202, Release 2.

RFP Section 2, Page 6, RFP Timeline

Page 6 126. The RFP’s schedule of events provides for a total of seven calendar days between the State issuing answers to questions and the due date for the final proposal. This timeframe is also reflected in RFP Amendment 1. In contrast, the State has afforded itself 45 calendar days to respond to bidders’ questions. Would the State please reconsider this schedule and provide a minimum of 14 calendar days between issuing answers to questions and the proposal due date? This would help ensure that the State is receiving responsible proposals that have been fully informed by the answers. If bidders are not provided adequate time to digest and integrate the State’s answers, the time invested by the State to respond to bidders’ questions may not yield the benefits intended.

The RFP Schedule of Events has been revised to provide Respondent’s with thirty (30) calendar days between issuing the State’s response and the Response Deadline as is reflected in RFP 32901-31202 Release 2.

RFP Section 1.7. Pre-Response Conference

Page 3 127. Please confirm in writing the statement provided orally at the pre-bid conference indicating that the State’s intention is to commence the new contract on January 1, 2020.

The State’s current contract is set to expire on June 30, 2020. As such, the target start date for the new contract is July 1, 2020. Adequate time will be needed to transition Services and execute the awarded Respondent’s Implementation Plan. To avoid a disruption in Service, a minimum of three (3) months is recommended to prepare for a July 1, 2020 start date. In addition, please note that only the State’s official, written responses and communications with Respondents are binding with regard to this RFP. Oral communications between a State official and one or more Respondents are unofficial and non-binding (see RFP Communications, Section 1.4.3., pg. 2 for reference).

RFP # 32901-31202 – Amendment # 12 of 21


Attachments Three, Performance Measures and Four, Key Performance Measures Manual

Attachments Three and Four

128. These attachments provide the State’s performance measures and liquidated damages schedule. To ensure that all bidders have equal understanding of where service delivery challenges may exist, please provide, by facility and by performance indicator, the amounts of liquidated damages levied during the most recent 12-month period.

The Liquidated Damages assessed to date have been provided within RFP #32901-31202 Release 2 Appendix E as referenced in item 8 below.

Attachment Three, Performance Measures

Attachment Three

129. In the final paragraph at page 59 of the Pro Forma Contract, indicates that audits will begin effective October 1, 2019, that the results of audits for the period July through September 2019 will be informational only, and that adjustments to compensation will be effective with audits performed beginning January 1, 2020. If the new contract is to start on January 1, 2020, please update the timeframes described in the final paragraph of Attachment Three. Is the intent to provide the new Contractor with a three-month timeframe before compensation adjustments are imposed?

The timeframes have been adjusted to reflect a July 1, 2020 start date. If the procurement schedule dictates further changes to the desired contract start date, the dates will be revised prior to contract signature.

The State’s intent is to provide the awarded Contractor with a three (3) month timeframe for implementation before compensation adjustments are imposed.

RFP Attachment Five Attachment Five

130. This attachment includes mental health caseload data, which is helpful. Please supplement this data by specifying what percentage of the mental health caseloads at each facility is receiving psychotropic medications. For example, 455 inmates are on the mental health caseload at NECX. How many of these inmates are receiving psychotropic medications?

Seventy percent (70%) of the Behavioral Health population is receiving psychotropic medications. The State does not track the number of Inmates at each facility receiving psychotropic medications.


131. Please supplement the mental health caseload data provided in RFP Attachment Five by providing, for each facility, the number of patients designated as suffering from a Serious Mental Illness (SMI) and the number of patients designated as suffering from a Serious and Persistent Mental Illness (SPMI).

Inmates designated as suffering from a Serious Mental Illness receive Level of Care 3. Inmates designated as suffering from a Serious and Persistent Mental Illness receive Level of Care 4. Levels of Care 3 and 4 are housed in Supportive Living Units.

Five (5) male facilities house SLU.

One (1) female facility houses a SLU

SLU populations begin at sixty (60) each and range upward.

All inmates at DSNF are LC4s.


132. Do the positions listed in Attachment Five represent the incumbent behavioral health contractor’s current staffing, or does Attachment Five include additional positions that are not currently part of the incumbent’s current staffing but desired by the TDOC?

Attachment Five details the FTEs that must be filled by the Contractor via the contract resulting from this RFP. Attachment Five does not reflect the current Contractor staffing.


133. If Attachment Five includes additional positions above and beyond the current behavioral health contract staffing, please identify these positions and indicate which positions, if any, are currently state employees.

None of the positions in Attachment Five are filled by State employees. Contractors are free to compare Attachment Five to the staffing pattern provided as part of the current contract. It must be noted, that the current staffing pattern is not germane to this procurement.

RFP Attachments Seven, Eight, Nine, and Ten

Attachments Seven, Eight, Nine and Ten

134. Please provide RFP Attachments Seven, Eight, Nine, and Ten, which are listed or referred to in the RFP/Pro Forma Contract but have not yet been produced.

Please see the State’s Response to Questions 29 and 30.

RFP # 32901-31202 – Amendment # 12 of 21


RFP Attachment 6.2., Section C.7. Page 26 135. At page 26 of the RFP, Item C.7 refers to Pro Forma Contract Section A.4 in the context of the Second Chance Re-Entry Grant and integrated substance use disorder-mental health services at BCCX. Item A.4 does not address these elements and instead addresses General Requirements. Should the reference in Item C.7 be to Pro Forma Contract Section A.5?

The correct section reference is Attachment 6.6. Pro Forma Contract Section A.5., as is now detailed in RFP 32901-31202, Release 2.

Pro Forma Contract, items 195 and 196, Page 13

Page 13 136. This defines Serious Mental Illness and Serious and Persistent Mental Illness in terms of “serious functional impairment” and “tremendous disability.” How are these thresholds of impairment and disability currently measured? Has the State operationalized these definitions to ensure consistent interpretation?

TDOC Policy #113.87, as provided in Appendix B, clearly specifies the Levels of Care 3 and 4 used by the State.

Information is collected through Behavioral Health assessments conducted by various Behavioral Health professionals. Cases are then reviewed in multi-disciplinary treatment teams to determine the most appropriate level of care.

Pro Forma Contract, item 202, Page 14

Page 14 137. This appears to define the “SOAP” format as referring to “Simple Object Access Protocol.” Please confirm that, rather than the definition provided by item 202, the “SOAP” format has the usual meaning for mental health documentation and refers to “Subjective, Objective, Assessment, and Plan” elements of a progress note.

The corrected definition is now reflected in RFP 32901-31202, Release 2.

Attachment 6.6. Pro Forma Contract, Section A.8.a,

Page 23 138. This makes reference to section A.23.j with regard to staffing weekend and evening shifts. Pro Forma Contract, Item A.23.j addresses the Certified Peer Recovery Specialist Trainer, not behavioral health staff coverage. Please clarify the correct contract section to which Item A.8.a is intended to refer. Is this A.24.i?

The corrected section reference is now reflected in RFP 32901-31202, Release 2.

Attachment 6.6. Pro Forma Contract, Section A.13

Page 24 139. This addresses the need to supervise interns and practicum students. Please identify the number of interns and practicum students, the facilities(s) at which they currently receive training, and the host universities, colleges, and technical schools involved.

TDOC or the current behavioral health Contractor has established affiliation agreements with Union University, Vanderbilt University, the University of Tennessee, Belmont University, Lipscomb University, Middle Tennessee State University, Trevecca Nazarene University, Tennessee State University and Bethel University.

The students from the above named institutions may serve as interns in prison facilities or at Day Reporting Centers.

The number of students currently serving as interns is not available.

Attachment 6.6. Pro Forma Contract, Section A.24.e,

Page 29 140. This requires the Contractor to ensure employees comply with TDOC requirements for uniforms and indicates the Contractor is responsible for purchasing uniforms. Please confirm that behavioral health staff are not required to wear uniforms.

Behavioral Health Services Contractor staff are not required to wear uniforms; however, Contractor staff are required to be professionally dressed according to their position and wear a State-issued photo identification card at all times which readily identifies employees as Contractor staff.

Attachment 6.6. Pro Forma Contract, Section A.24.f.1,

Page 30 141. This makes reference to Section A.21 with regard to clerical staff, while Section A.21 of the Pro Forma Contract addresses Re-entry and Mental Health Transition Services. Please clarify to which element of the Pro Forma Contract Item A.24.f.1 should refer.

The section reference has been changed to A.23.i. within RFP 32901-31202 Release 2

Attachment 6.6. Pro Forma Contract, Section A.29.a,

Page 35 142. This section outlines the requirements for focused evaluations at the NWCS Special Education Program. Please provide data sufficient to determine the volume of these evaluations on a monthly or annual basis.

Typically, there are no more than ten (10) such evaluations per year.

RFP # 32901-31202 – Amendment # 12 of 21


Attachment Five Attachment Five

143. This section indicates that the Contract is subject to the appropriation and availability of State or federal funds. Does the Department anticipate being funded for all of the positions listed in Attachment Five?

The State does anticipate being funded for all positions detailed in Attachment Five. It is possible, however, that anticipated State funding could change, hence the inclusion of the standard contract language provision.

RFP Section 3.1. Response Form Pages 7-8 144. The RFP states, “A technical response must not include any pricing or cost information. If any pricing or cost information amounts of any type (even pricing relating to other projects) is included in any part of the technical response, the state may deem the response to be non-responsive and reject it.” Please clarify if this refers to sharing information about the cost savings we have provided to other clients in working with them. This information will showcase our ability to the State.

Dollar amounts detailing specific cost savings provided to other clients would be considered pricing or cost information if included in the technical proposal and could lead to a proposal being found non-responsive and disqualified. It would be sufficient to say that the Contractor provided a customer with significant cost savings.

3. Delete RFP # 32901-31202, in its entirety, and replace it with RFP # 32901-31202, Release # 2, attached to this amendment. Revisions of the original RFP document are emphasized within the new release. Any sentence or paragraph containing revised or new text is highlighted. 4. The document ‘Current Vacant Contractor Positions” has been added as Appendix A. 5. The document ‘Applicable TDOC Policy’ has been added as Appendix B. 6. The document ‘Current Behavioral Health Contract’ has been added as Appendix C. 7. The document ‘Second Chance Grant Contract’ has been added as Appendix D. 8. The document ‘Liquidated Damages Assessed to Date’ has been added as Appendix E. 9. The document ‘Specialized Training and Mental Health Programming’ has been added as Appendix F. 10. The document “Tennessee Bed Space and Operational Capacity Report November 2019’ is added as Appendix G. 11. The document ‘Annual Reports’ has been added as Attachment Eleven.

11. RFP Amendment Effective Date. The revisions set forth herein shall be effective upon release. All other terms and conditions of this RFP not expressly amended herein shall remain in full force and effect.

STATE OF TENNESSEE DEPARTMENT OF CORRECTION REQUEST … · 2/25/2020 · in RFP 32901-31202,...

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