HomeMy WebLinkAboutCONSENT Amend 1 re Healthcare delivery jail JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: David Fortino
DATE: January 21,2025
SUBJECT: Contract Amendment re: Subcontract for Professional Services; Jefferson
County; Healthcare Delivery, Inc.
STATEMENT OF ISSUE:
Amendment to Subcontract for Professional Services; Jefferson County; Healthcare Delivery, Inc. to modify
services to include updated standards of care for treatment of substance use disorders. Amends
compensation to reflect allowable annual increases per contract.
ANALYSIS:
The scope of services has been updated to included standards of care regarding substance use disorder
treatment in line with the Health Care Authorities requirements for the treatment of MOUD/MAUD.
Compensation has been updated to reflect current prices for 2025.
FISCAL IMPACT:
Total compensation not to exceed $357,974.00
RECOMMENDATION:
Approve Contract Amendment re: Subcontract for Professional Services; Jefferson County; Healthcare
Delivery, Inc.
REVIEWED BY:
"/"/E-5--
Mark McCaGfey, County Admin' for Date
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Healthcare Delivery Inc, Contract No: JCSO-123124
Contract For: PROFESSIONAL SERVICES CONTRACT for MOUD/MAUD m jails Term: 6 months
COUNTY DEPARTMENT: Jefferson County Shenfrs office
Contact Person: David Fortino
Contact Phone: 360-344-9743
Contact email: dfortino@cojefferwrima.us
AMOUNT: $357,974.00 PROCESS: Exempt from Bid Process
Revenue: NSA Cooperative Purchase
Expenditure: NIA Competitive Sealed Bid
Matching Funds Required: N/A Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
Fund # 001-180-000 RFP or RFQ
Munis Org/Obj oo1-18o-000 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
01
CERTIFIED: ■� N/A: 00,
Signature Plate
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: F N/A: .�•� si---- / 1i/a,/t.�
tgnature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 12/31/2024.
Contract amendment increasing the dollar amount.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 1/2/2025.
Standard amendment language included and orginal attached. Update
made to signature page.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
I
AMENDMENT#1 TO THE SUBCONTRACT FOR PROFESSIONAL SERVICES BETWEEN
JEFFERSON COUNTY AND HEALTHCARE DELIVERY, INC.
This Amendment is made and entered into by and between Jefferson County Washington ("County"),
and Believe in Recovery LLC ("Subcontractor") (collectively"the Parties").
WHEREAS,the Parties have entered into a certain professional services agreement("the
Agreement"), effective August 16, 2021;
WHEREAS,the Parties have agreed to extend the partnership with Services modification, and
Compensation adjustment;
WHERAS,the Parties now desire to amend said Agreement upon the terms and conditions
stated herein.
NOW,THEREFORE, the Parties, intending to be legally bound hereby, mutually agree as follows:
1. Services:
a. HDS shall perform the services set forth in this Contract and listed in detail on Exhibit A
attached hereto and by this reference incorporated herein (the "Services"),
Additionally, all work required by"Attachment 1: Statement of Work" Sections 2,except
where other contractors are responsible for the work, or sections overlap with work
being done by another contractor, in which case HDS shall coordinate with the other
contractor to ensure these requirements are met.
a true and correct copy of"Attachment 1: Statement of Work" is attached.
HDS shall not be required to perform any services which are not specifically identified in
this Contract.
2. Compensation:
a. The County will pay HDS for the performance of the Services based on the rates and
charges set forth on Exhibit B, a true and correct copy of"Exhibit B" is attached. Annual
total compensation not to exceed $357,974.00.
This Amendment is effective as of January 1, 2025.All other terms and conditions of the original
Agreement (as modified from time to time)shall remain in full force and effect unless otherwise
amended as provided in the Agreement.
SIGNATURE PAGE
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Healthcare Delivery Inc.Shannon Slack
Heidi Eisenhour, Chair Date
Contractor Representative(please print)
S/QC t Greg Brotherton, Commissioner Date
(Signoiur� Qrr��'Z tc�.-'
Heather Dudley-Nollette, Commissioner Date
Title
/Z ATTEST
Date
Carolyn Galloway Date
Clerk of the Board
;777
01/02/2025
Philip C. Hunsucker Date
Chief Civil Deputy Prosecutor
ATTACHMENT 1: STATEMENT OF WORK
1. Purpose
Support a comprehensive treatment program for incarcerated individuals with Opioid Use
Disorder (OUD) and Alcohol Use Disorder (AUD), beginning with screening upon entry and
ending with seamless transition to the care in the community, with use of Medications for
Opioid Use Disorder (MOUD) and Medications for Alcohol Use Disorder (MAUD) at its core.
This program contract supports RCW 71.24.599: Opioid use disorder—City and county
bails—Funding. (wa.gov).
Health Equity - This program also intends to address inequities in treatment and recovery
services by providing medically necessary treatment to incarcerated individuals. The
Contractor should understand cultural barriers and provide culturally appropriate services.
Additionally, this program intends to identify stigma and educate to ensure ongoing
collaboration and openness to change.
2. Work Expectations
The Contractor shall ensure funds are responsibly used towards the OUD and AUD
treatment programs in the jail and provide the community standard of care, including, at a
minimum, the following core components:
2.1. General Standards.
2.1.1. 2020 ASAM National Practice Guideline for the Treatment of Opioid Use
Disorder;
2.1.2 Guidelines for Managing Substance Withdrawal in Jails;
2.1.3. For American Indian/Alaska Native (AI/AN) program participants receiving
MOUD/MAUD Services, the Contractor's tribal liaison or designee, shall
coordinate with the program participant's Indian Health Care Provider (IHCP)
to ensure the IHCP can participate in treatment and discharge planning,
including continuity of care in the nearest IHCP clinically appropriate setting
for all AI/AN program participants.
2.2. Intake. The Contractor shall:
2.2.1. Continue MOUD and MAUD for individuals who are already taking these
medications upon entering the facility.
2.2.2. Continue the individual on the same medication at the same dose unless
ordered otherwise by the prescriber based on clinical need (documented in
the individual's medical record) with the exceptions listed below:
2.2.2.1. Injectable long-acting naltrexone may be converted to an
equivalent oral dose until just prior to release at which time the
injectable form shall be restarted.
Washington State 31 HCA Contract#K8167
Health Care Authority Attachment 1
2.2.2.2. Injectable long-acting buprenorphine may be converted to an
equivalent oral dose until just prior to release at which time the
injectable form shall be restarted.
2.2.2.3. Oral buprenorphine may be converted among the three
formulations (film, tablet with naloxone, tablet without naloxone).
2.2.2.4. If the individual is not pregnant, methadone may be transitioned to
buprenorphine if the jail is not a licensed Opioid Treatment
Program (OTP) and the nearest OTP is not within reasonable
driving distance from the jail or there is no OTP within reasonable
distance of the individual's release residence.
2.2.2.5. Though MOUD/MAUD may not be discontinued on a policy or
administrative basis because of the presence of other illicit or
controlled substances, administration of the community-based
MOUD or MAUD may be adjusted if clinically necessary due to
pharmacologic risks of drug-drug interaction.
2.2.3. Screen all newly admitted individuals for risk of acute withdrawal from opioids
and alcohol upon intake.
2.2.4. Screen for OUD and AUD without physical dependence (i.e. without a risk of
acute withdrawal) after intake, as long as the delay does not impair the ability
to begin treatment prior to release.
2.2.5. Offer initiation of MOUD treatment to individuals who are physically
dependent on opioids.
2.2.6. Educate individuals on treatment choices and the process for continuation of
access to MOUD/MAUD, during incarceration, and upon release.
2.2.7. Make available and offer treatment for OUD using some formulation of
methadone, buprenorphine, and naltrexone based on a mutually agreed-upon
plan between the prescriber and the individual, with the following exceptions
or caveats:
2.2.7.1. The jail may decline to offer methadone if the jail is not a licensed
OTP, and the nearest OTP is not within reasonable driving distance
from the jail or there is no OTP within reasonable distance of the
individual's release residence.
2.2.7.2. If there is no available buprenorphine provider in the community to
which the individual will release, the Jail must still offer
buprenorphine (tapered over several days) if opioid withdrawal is
clinically indicated.
2.2.7.3. If withdrawal is not clinically indicated and the only reason for
considering discontinuation of buprenorphine is the lack of an
available buprenorphine provider in the community to which the
individual will release, a decision whether or not— or when —to
Washington State 32 HCA Contract#K8167
Health Care Authority Attachment 1
discontinue buprenorphine prior to release should be made based
on a plan mutually agreed -upon between the individual and the
prescriber based on the length of time the individual is expected to
remain in the jail, the risks of opioid misuse or overdose during the
incarceration, and the individual's willingness to receive a dose of
an extended release injectable buprenorphine just prior to release
that will provide the individual a safe tapered withdrawal in the
community if no provider is available.
2.2.7.4. Provide naltrexone in oral formulation while the individual is
incarcerated. Offer injectable long-acting naltrexone or
buprenorphine as an option prior to release.
2.2.7.5. Offer oral buprenorphine without naloxone while the individual is
incarcerated but must discharge the individual on a formulation of
buprenorphine with naloxone unless there is a clinical reason not to
do so (e.g., the individual is discharged on injectable
buprenorphine, the individual is allergic to naloxone).
2.2.8. Contractor shall not facilitate forced opioid withdrawal (including withdrawal
using a tapering dose of buprenorphine or methadone) unless the individual
provides an informed refusal of treatment or the individual elects MOUD
treatment with naltrexone, in which case withdrawal is clinically required.
2.2.8.1. In such case, Contractor may use other medications (clonidine,
anti-emetics, anti-diarrheals, analgesics) in place of buprenorphine
or methadone if the individual so chooses or as adjuncts to these
medications, but they may not be the only withdrawal treatment
available.
2.2.8.2. Initiation of buprenorphine or methadone, whether for induction of
treatment or for withdrawal, may not be delayed for administrative
reasons, e.g., unavailability of a prescriber, beyond when they are
clinically indicated to be started.
2.2.9. Offer treatment for withdrawal with benzodiazepines to individuals entering
the facility who are physically dependent on alcohol, if clinically appropriate.
2.2.10. Provide immediate evaluation to individuals at risk for, or in, opioid or alcohol
withdrawal who refuse treatment by a medical or mental health prescriber or
a licensed mental health professional at the masters' level or higher, to
determine if they have decision-making capacity. If they do not, they must be
transported to a community hospital and may not return to the jail until they
are clinically safe to return to the jails AND have regained decision-making
capacity.
2.3. During Incarceration. The Contractor shall:
2.3.1. Offer initiation of MOUD/MAUD to individuals with OUD/AUD not already
identified and/or offered treatment at intake (e.g., individuals with OUD but
Washington State 33 HCA Contract#K8167
Health Care Authority Attachment 1
without physical dependence; individuals with AUD who underwent
withdrawal).
2.3.2. Educate individuals on treatment choices and the process for continuation of
access to MOUD/MAUD, during incarceration, and upon release.
2.3.3. Administer methadone and buprenorphine daily or more frequently.
2.3.4. Contractor will not use alternate-day ("Balloon") dosing of buprenorphine.
2.3.5. Offer counseling to individuals for their OUD and/or AUD disorder who are
expected to remain in jail for longer than one month.
2.3.6. Provide MOUD/MAUD not contingent on the individual's willingness to
participate in counseling.
2.4. Release. The Jail must accomplish the following prior to release:
2.4.1. Complete release planning and reentry coordination as soon as possible after
admission to ensure an effective plan is in place prior to release or in the
event of an unexpected release of an individual who needs continued
treatment and services.
2.4.2. Provide at least two (2) doses of naloxone (e.g., Narcan®) or nalmefene
(Opvee®) and training on how to administer the medications to all individuals
with OUD.
2.4.3. Schedule the first community appointment with a treatment facility for
continuation of MOUD or MAUD.
2.4.4. Provide - in hand, upon release, and at no cost to the individual - sufficient
doses of MOUD and/or MAUD to bridge individual until scheduled follow-up
appointment at community treatment facility (does not apply to individuals
treated with injectable MOUD). A thirty (30) day supply is recommended.
2.4.4.1. Inform individuals who are at risk of being released directly from
court, prior to going to court, that they may request to be
transported back to the jail by staff to receive these medications
prior to going home.
2.4.4.2. In situations where an appointment cannot be made, e.g., after-
hours bail-out, give the individual enough medication to last until
the next available appointment at the community treatment facility.
2.4.4.3. In situations where medications cannot be provided upon release,
e.g., unscheduled release at a time when medical staff are not
present in the jail:
2.4.4.3.1. Inform the individual that they may either return to the
jail in the morning to receive bridge medications; or
Washington State 34 HCA Contract#K8167
Health Care Authority Attachment 1
2.4.4.3.2. If no medical staff are present the following day, call in
a prescription for the same bridging medication to a
local pharmacy, at no cost to the individual.
2.4.5. Assist Medicaid-eligible individuals to sign-up with Medicaid or assist
individuals whose Medicaid coverage has been terminated to reestablish
coverage.
2.4.6. For any individual with Medicaid coverage, work cooperatively with the
individual's Managed Care Organizations (MCO) to facilitate re-entry,
including but not limited to allowing the MCO's agent timely access to the
facility and the individual.
2.5. Contract Management. The Contractor shall:
2.5.1. Ensure specific tools, such as job descriptions, policies and procedures, and
statements of work, are developed, and staff are adequately trained, to
ensure consistent and appropriate practice.
2.5.2. Attend monthly meetings with HCA Division of Behavior Health and Recovery
(DBHR) program administrator to discuss project contract requirements,
compliance, and problem-solving. Attend additional meetings as required or
deemed necessary by the HCA DBHR program administrator.
2.5.3. Contractor will cooperate with periodic site visits by the HCA DBHR program
administrator or designee and make all relevant records and personnel
available.
2.6. Activities.
2.6.1. Contractor shall expand their current MOUD program and will meet the
standard of care listed in Section 2, by doing the following:
2.6.1.1. Increase on-call provider time to ensure seamless service
delivery and timely care.
2.6.1.2. A case manager will coordinate intake processes,
transportation, and reentry planning, ensuring continuity of
care from jail to the community.
2.6.1.3. Offer long-acting injectable buprenorphine with increased RN
time to dose.
3. Reports.
3.1. Monthly Progress Reports. Reports shall include, but not limited to, the following:
3.1.1. How funding is being spent.
3.1.1.1. Prioritize funding towards efforts to sustain the MOUD/MAUD
program.
Washington State 35 HCA Contract#K8167
Health Care Authority Attachment 1
3.1.1.2. Budget updates.
3.1.2. Program details.
3.1.2.1. All components of the standard of care must be met.
3.1.2.2. Share barriers and successes.
3.1.2.3. Technical assistance.
3.1.2.4. Training participation.
3.1.2.5. Staff changes.
3.1.2.6. Additional information as needed.
3.1.3. Ongoing Staff Training
3.1.3.1. Name(s) and date(s) of conference(s) or training event(s) that
pertain to MOUD or MAUD in a jail setting or otherwise
deemed appropriate.
3.1.3.2. Program staff attendance for each conference or training
event.
3.2. Monthly Data Collection Spreadsheet.
3.2.1. The Contractor shall provide the data spreadsheet, filled out completely
with Section 3.2.3 below, using the template provided by HCA and
shared via the Managed File Transfer (MFT) portal.
3.2.2. The Contractor's participation requires performance monitoring activities,
including timely and accurate data reporting to the HCA DBHR. Further
evaluation, including on- and off-site data collection may be conducted
by HCA DBHR or a third party.
3.2.3. The Contractor shall submit a monthly report, template provided by HCA
DBHR, by the 10th day of the month with the following participant
information, (identified as having a current OUD), for the previous month:
3.2.3.1. Full name.
3.2.3.2. Date of birth.
3.2.3.3. Provider One #, SSN or another unique identifier.
3.2.3.4. Date of booking.
3.2.3.5. Date MOUD started: continued or induction?
3.2.3.6. Date of release if applicable.
Washington State 36 HCA Contract#K8167
Health Care Authority Attachment 1
3.2.3.7. Schedule first appointment upon release.
3.2.3.8. Which MOUD provided upon release.
3.2.4. Information will be collected via the MFT. It may be shared with The
Department of Social and Health Services Research Data and Analysis
(RDA) division for evaluation purposes.
4. Allowable expenses. The following is a list of allowable expenses. Contractor shall submit
items not on this list to HCA Contract Manager for approval before purchasing.
4.1. Program Staff.
4.1.1. Nursing.
4.1.2. Medical assistants.
4.1.3. Providers, prescribers.
4.1.4. Correctional staff.
4.1.5. Clerical or administrative staff for program reporting and administration.
4.1.6. Care navigators, reentry coordinators, peer support, substance use
disorder professionals, community health workers.
4.2. MOUD/Medications.
4.2.1. Medications for opioid use disorder (MOUD) FDA approved buprenorphine,
(this can include long-acting injectable buprenorphine), methadone and
naltrexone.
4.2.2. FDA approved medications for alcohol use disorder (MAUD).
4.2.3. Naloxone for jail and staff.
4.3. Program Supplies.
4.3.1. Technology:
4.3.1.1. Tablets.
4.3.1.2. Phones.
4.3.1.3. Security.
4.3.1.4. Internet/wi-fi enhancements to allow for telehealth.
4.3.1.5. Other supplies approved by HCA Contract Manager prior to
purchase.
4.3.2. Program Staff Office Needs:
Washington State 37 HCA Contract#K8167
Health Care Authority Attachment 1
4.3.2.1. Desk.
4.3.2.2. Chair,
4.3.2.3. Computer.
4.3.2.4. Phone.
4.4. Release and Reentry.
4.4.1. Transportation for program participants upon release to first appointment,
pick up prescription, safe place, etc.
4.4.2. Release kit items such as:
4.4.2.1. Naloxone.
4.4.2.2. Gift cards.
4.4.2.3. Clothing, shoes.
4.4.2.4. Personal hygiene items.
4.4.2.5. Phones.
5. Deliverables Table.
December 1, 2024— June 30, 2025
# Description Due Date Cost Reimbursement
Monthly max
1 Monthly Progress Report December 2024-May 2025: the
101h day of the month following
each month of service Monthly cost
June 2025: With final invoice reimbursement not to
2 Monthly Data Collection December 2024-May 2025: the exceed $11,628 per
Spreadsheet 101h day of the month following month
each month of service
June 2025: With final invoice
Subtotal $162,792
Indirect Cost (10%) $16,281
Total Maximum Cost Reimbursement $179,073
Washington State 38 HCA Contract#K8167
Health Care Authority Attachment 1
EXHIBIT A
Scope of Services:
HDS will provide inmate health care services for the Jefferson County Jail in accordance
with applicable standards of the American Medical Association ("AMA"), the State of
Washington, and the National Commission on Correctional Health Care. These include, but
are not limited to, the following:
1. Twenty-four (24)hour phone triage and consultation by an Advanced Registered
Nurse Practitioner or Medical Doctor for a monthly retainer as shown in the Compensation
Schedule with unlimited phone access. Response time will generally be within less than five
minutes of facility's call; however, due to technological problems with pagers and cell phones
on the road, it may be longer than five minutes and response time may be up to 20 minutes.
Any medical matter that requires urgent response will be promptly evaluated and managed by
phone.
2. Advanced Registered Nurse Practitioner with prescriptive privileges will attend
the Jail once each week and use telemedicine once each week,to conduct sick calls for inmates,
review all new inmate intake forms and inmate requests (kites), direct appropriate care and
"Special Needs Treatment Planning" for chronic health problems, conduct medical
history/physical exams as appropriate within NCCHC timeframes, and make referrals as
necessary to other providers. This service will be billed for a 10 hour per week minimum as
shown in the Compensation Schedule, Hours in excess of 10 hours per week will be billed
hourly as shown in the Compensation Schedule with a one hour minimum for scheduled
sessions.Unscheduled sessions will be billed a two hour minimum. Services shall also include:
(1) Weekly evaluation and ordering of necessary medical supplies and
pharmaceuticals,
(2) Utilization review of all billings.
(3) Training of Jail staff, as recommended by HDS, and authorized by Jail
administration.
(4) A monthly schedule of sick call coverage will be supplied to jail administration
by the 25th for the previous month. The schedule is subject to approval byjail administration.
3. At least one day per week, and more frequently as necessary, a Psychiatric
Advanced Registered Nurse Practitioner will review inmate medical records to direct necessary
Mental Health services, prescribe and review necessary psychiatric medications, and prepare
Mental Health discharge plans prior to release of inmates with mental health conditions. This
service will be billed for a 32 hour per month minimum as shown in the Compensation
Schedule. Hours in excess of 32 hours per month will be billed hourly as shown in the
Compensation Schedule, with a one hour minimum.
9
Jefferson County Jail
2025
EXHIBIT B (Continued)
Table B Staftin-.
Staff Position Staff Schedule Weekly Annul Total
Hours Hours cost
Nursing Staff $94.50 @ hr M, T, W, Th, Fri 40 2080 $196,560.00
ARNP $131.25 @ hr Two days a week 10 520 $68,250.00
Psych ARNP/ARNP $131.25 hr One day a week 8 416 $54,600.00
ARNP/RN Phone Covera e M,T KTH,Fri, Sat, Sun 168 8736 $12,600.00
Total Annual Cost $331,010.00
Table C Administrative Services
Adrnin krative Services Total Cost
Medical Director 516,380.00
Administrator $7,056.00
Clerical $3.528.00
u F� otal Annual gpst $26,964M
Invoice Line item Administrative Services monthly $2,247.00
RFP EXHIBIT B - TOTAL COST
Proposal
Administrative Cost $26,964.00
Annual Personnel Costs $331.010.00
1-1
otal Annual .Cost .� .�. 5357,974,00
Average monthly Invoice $29,831.17 (approximatel,N )
PROFESSIONAL SERVI CES CONTRA CT
HEALTHCARE DELIVERY,INC.
This Professional Services Contract (the "Contract") is entered into this _ day of July,
2021 by and between the County of Jefferson (the"County")and Healthcare Delivery, Inc.,
dba Healthcare Delivery Systems ("HDS").
RECITALS
A. The County desires to have certain health care services requiring specialized
skills and other supportive capabilities performed as set forth in this Contract.
B. HDS is qualified and possesses the skills and capabilities to perform the health
care services set forth in this Contract and desires to perform such services for the County.
CONTRACT
NOW, THEREFORE, the parties agree as follows:
1. SERVICES. HDS shall perform the services set forth in this Contract and listed
in detail on Exhibit A attached hereto and by this reference incorporated herein (the
"Services"), including the furnishing of all equipment necessary for the performance of the
Services. HDS shall not be required to perform any services which a re not specifically identified
in this Contract.
2. FACILITY; SUPPLIES. The County shall provide an appropriate medical
area in which HDS may perform the Services. The County shall provide all materials and
supplies necessary or desirable for HDS's performance of the Services, including,without
limitation,those items listed on Exhibit C attached hereto and by this reference incorporated
herein. The County shall provide inmate transport to and from the medical area and provide
security for all HDS staff when on site.
3. TERM. This Contract shall commence on the date hereof. HDS has assumes
responsibility for providing Jail inmate medical care under this Contract commencing on
August 1,2021. This Contract shall expire on July 31,2022. This Contract shall automatically
renew for successive periods of one(1)year each unless either party has given the other notice
of termination not less than ninety(90) days prior to the then current expiration date. In no
event shall there be more than four (4)renewals without the execution of new Contract.
4. COMPENSATION. The County will pay HDS for the performance of the
Services based on the rates and charges set forth on Exhibit B, for an annual total
compensation in the first year of this Contract not to exceed $245,680.00.The parties agree
to review the compensation,rates and charges payable to HDS on or before one hundred
twenty(120) days prior to each anniversary of this Contract. Increases shall not exceed
I
5% in any given year. If the parties are unable to agree on the compensation, rates,and
charges for the succeeding one ( 1) year term, then either party may terminate this Contract
effective upon its termination date as set forth in Section 3 ofthis Contract.
5. PAYMENT. HDS will submit an itemized invoice to the County on or after
the first day of each calendar month for Services performed during the immediately preceding
calendar month based on the rates and charges set forth on Exhibit A. The invoice shall list
the dates, hours, services, and charges. The County shall pay HDS within thirty(30) days
after receipt of a correct and conforming invoice. For purposes of Compensation and
i Payment, the term "due date" shall be the 301h day after the County receives a correct and
conforming invoice. With the exception noted herein, the County shall pay a late charge of
2% of any amounts not paid on or before the due date, and any amounts not paid when due
shall accrue interest at the rate of l% per month starting on the payment due date and
continuing until any overdue balance(s), including late charges, is/are received in full. As an
exception to the forgoing, HDS shall not be paid for services rendered under the Contract
unless and until they have been performed to the reasonable satisfaction of the County.
Moreover, in the event HDS has failed to perform any substantial obligation to be performed
by HDS under this Contract and such failure has not been cured within ten(10)days following
notice from the County,then the County may,in its sole discretion,upon written notice to HDS,
withhold any and all monies due and payable to HDS,without penalty until such failure to
perform is cured or otherwise adjudicated. "Substantial" for purposes ofthis Contract means
faithfully fulfilling the terns ofthe Contract with variances only for technical or minor
omissions or defects.
6. CONFIDENTIAL INFORMATION. Except as required as part of the
performance of the Services, either party may disclose, and neither party shall be required to
disclose,confidential information regarding the recipient of any of the Services for any purpose
except with the written consent ofthe recipient or the recipient's attorney or responsible parent
or guardian,or as otherwise permitted or required by law. This Contract is a Public Record
subject to the provisions ofthe Public Records Act, Ch. 42.56 RCW.
a. "Personal information" collected, used, or acquired in connection with
this Contract shall be used solely for the purposes ofthe Contract and shall
remain the property of the County. County staff authorized to see such
information will be designated in writing by the Jail Superintendent. HDS shall
have a non-exclusive license to review, generate, and use that information during
the term ofthis Contract.
b. For purposes ofthis Contract, the term "personal information" shall
mean information identifiable to any person, including, but not limited to,
information that relates to a person's name, health, finances, education, business,
use or receipt of governmental services or other activities, addresses, telephone
numbers, social security numbers, driver's license numbers, other identifying
numbers and any financial identifiers.
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c. For purposes of this Contract, the term "personal information" also
includes "Protected Health Information" as set forth in 45 CFR. § 160.103 as
currently adopted and as may hereafter be amended or revised and other
information that may be exempt from production to the public or other
unauthorized persons under either Ch.42.56 RCW, 42 USC §§1320 et seq., 42
CFR Part 2, Chapters 70.02, 70.24, 70.96A and 71.05 RCW or other state and
federal statutes and regulations governing confidentiality and/or disclosure.
d. HDS agrees to implement physical, electronic, and managerial
safeguards to prevent unauthorized access to "personal information". The County
reserves the right to monitor, audit, or investigate the use of personal information
collected, used, or acquired by HDS through this Contract.
e. HDS agrees not to release, divulge, publish, transfer, sell, or
otherwise make known "personal information" without the express written
consent of the subject person, the County, or as provided by law.
f. HDS agrees to indemnify and hold harmless the County for any court
costs,attorney's fees, or damages related to or arising from HDS's unauthorized
use or disclosure of`personal information".
g. To the extent required by law, HDS shall certify the return or destruction
of all"personal information" upon expiration ofthis Contract.
h. Any breach of this Section by HDS may result in termination of
this Contract in a manner consistent with Section 15 ofthis Contract.
i. The provisions of this Section shall be included in any contract or
agreement between the HDS and any and all of the HDS's subcontractors.
7. COMPLIANCE WITH LAW. HDS shall comply with all Federal, state and
local laws and regulations applicable to the performance of the Services, including those
governing licensing, registration, and certification.
8. AMENDMENT. Any amendment or modification to this Contract must be in
writing and signed by both parties to be effective.
9. NON-DISCRIMINATION. HDS shall not,on the basis of race,color,sex,sexual
orientation,religion,national origin, creed, marital status, age, Vietnam era or disabled veteran
status, or the presence of any sensory, mental, or physical disability,decry an individual any
Services required to be provided under this Contract.
10. INDEPENDENT CONTRACTOR. This Contract establishes an independent
contractor relationship between the parties and shall not be construed to create any relationship of
partnership or joint venture. None ofthe persons performing the Services shall be deemed to be an
3
employee or agent of the County for any purpose and no such person shall be entitled to any ofthe
benefits the County provides to its employees. Such persons are employees or agents of HDS and
HDS shall be responsible for directing and controlling such persons in the performance of the
Services and for compensating them,
11. LIMITATION OF LIABILITY; INDEMNIFICATION. HDS's liability on any
claim whatsoever for which HDS is responsible, including negligence and any damage or loss
arising out of or resulting from this Contract or the performance or breach hereof not covered,
reimbursed or paid for by the insurance maintained by or for the benefit of HDS under Section 12
of this Contract shall in no event exceed the total compensation paid to Consultant hereunder. Any
action for breach of this Contract must be commenced within two (2) years after the occurrence of
the event giving rise to such breach. In no event shall HDS be responsible for, or the County entitled
to recover, indirect, special, incidental or consequential damages. The County shall indemnify and
hold harmless HDS, and its employees and agents, from and against any claim, loss, liability or
damage(including attorneys' fees incurred in connection with the defense ofany action based on any
such alleged act or omission, which attorneys' fees shall be paid as incurred) arising out of or in
connection with any act performed, or omitted to be performed in connection with this Contract;
provided that such indemnification and hold harmless shall not cover(i) indemnification prohibited
by law,or (ii) any act or omission of HDS amounting to an intentional breach of this Contract,
fraud, gross negligence, or willful misconduct. Without limiting the foregoing, the County will
defend, indemnify, and hold HDS and its employees and agents harmless from and against any
claim, loss, liability, or damage resulting from the failure to provide medical care, treatment,
diagnostics, or pharmaceuticals to any person where HDS has advised the County of the medical
necessity therefor.
12. INSURANCE. Prior to commencing work,HDS shall obtain at its own cost and
expense the following insurance from companies licensed in the State of Washington with a Best's
rating of no less than A: VII. HDS shall provide to the County Risk Manager certificates of
insurance with original endorsements evidencing the insurance required by this clause prior to
the commencement of the Services. If any of the insurance requirements are not complied with
at the renewal date of the insurance policy, payments to HDS shall be withheld until all such
requirements have been met, or at the option of the County, the County may pay the renewal
premium and withhold such payments from the moneys due HDS.
All notices shall name HDS and identify the Contract by contract number or some
other form of identification necessary to inform the County of the particular contract
affected.
A. Workers Compensation.HDS shall procure and maintain for the life of the
Contract, Workers Compensation Insurance, in accordance with the laws of the State of
Washington. HDS specifically assumes potential liability for actions brought against the
County by HDS's employees, including all other persons engaged in the performance of any
work or service required of HDS under this Contract and, solely for the purpose of this
indemnification and defense, HDS specifically waives any immunity under the state industrial
insurance law, Title 51 R.C.W. HDS recognizes that this waiver was specifically entered into
pursuant to provisions of R.C.W. 4.24.115 and was the subject of mutual negotiation.
4
B. Commercial General Liability with a minimum limit per occurrence of
one million dollars ($1,000,000) and an aggregate of not less than two million dollars
($2,000,000) for bodily injury, death, and property damage. This insurance coverage shall
indicate on the certificate of insurance the following coverage:
Broad Form Property Damage with no employee exclusion;
Personal Injury Liability, including extended bodily injury;
Broad Form Contractual/Commercial Liability Premises - Operations
Liability (M&C);
Independent Contractors and Subcontractors; and
Automobile with a minimum limit per occurrence of$1,000,000 for
personal injury and property damage. This insurance shall indicate on
the certificate of insurance the following coverage:
Owned automobiles;
Hired automobiles; and,
Non-owned automobiles
C. HDS shall maintain in full force and effect professional liability/medical
malpractice insurance covering HDS and each of its employees and agents performing Services,
with coverage ol'not less than $1,000,000 in the aggregate.
Any deductibles shall be declared to and approved by the County prior to the approval of the
Contract by the County.
HDS shall include all subcontractors as insureds under its insurance policies or shall furnish
separate certificates and endorsements for each subcontractor. All insurance provisions for
subcontractors shall be subject to all of the requirements stated herein. Failure of HDS to
take out and/or maintain any required insurance shall not relieve HDS from any liability
under the Contract, or shall the insurance requirements be construed to conflict with or
otherwise limit the obligations concerning indemnification.
The County states it is a member of the Washington Counties Risk Pool (or"WCRP") and
through said membership has third-party liability coverage through the Memorandum of Li
ability Coverage ("MLC") provided to it by the W CRP in the amount of Twenty Million
Dollars ($20,000,000.00). For purposes of the MLC, HDS, its owner,any state-licensed
medical provider employed by or contracting with HDS and any employee, subcontractor
or representative of HDS shall be considered a"Protected Party" for the purposes of any
claim,lawsuit, or action arising from or proximately caused by the acts and/or omissions
of HDS during the course and scope of work perform ed by HDS in furtherance of this
Contract as more specifically described in the attached Scope of Services, Exhibit A to
this Contract. The third-party liability coverage provided by the M LC to the County shall
be primary to any professional liability/medical malpractice insurance HDS is required
to obtain and maintain pursuant to this Contract.
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13. JURSIDICTION. This Contract shall be governed by and construed in accordance
with the laws of the State of Washington. Any suit or proceeding in connection with this
Contract shall be brought and maintained only in Thurston County Superior Court.
14. ASSIGNMENT, DELEGATION, AND SUBCONTRACTING. HDS shall
perform the tenors of the Contract using only its bona fide employees or agents who have the
qualifications to perform under this Contract. The obligations and duties of HDS under this
Contract shall not be assigned, delegated, or subcontracted to any other person or firm without the
prior express written consent ofthe County. HDS warrants that it has not paid nor has it agreed to
pay any company, person, partnership, or firm, other than a bona fide employee working
exclusively for HDS, any fee, commission,percentage,brokerage fee, gift,or other consideration
contingent upon or resulting from the award ofmaking of this Contract.
15. TERMINATION. The County may terminate this Contract for convenience at any
time by giving ninety (90) days written notice to HDS. HDS may terminate this Contract for
convenience at any time by giving ninety(90)days written notice to the County. In either event,the
County shall pay HDS for all Services performed through the date of termination.
16. SEVERABILITY. If any part, knri, or provision of this Contract is held to be
illegal or unenforceable, the validity of the remaining provisions shall not be affected, and such
part, term, or provision shall be deemed modified to the extent necessary to make it legal and
enforceable, but if such modification is not possible, the rights and obligations of the parties shall be
construed and enforced as f this Contract did not contain the particular part tetra. or provision
held to be illegal or unenforceable. Notwithstanding the foregoing, if such modification or
elimination would materially and adversely alter the rights or obligations of a party, such party
may terminate this Contract by written notice to the other.
17. ENTIRE CONTRACT. This Contract is the complete expression of the parties'
agreement, and supersedes any prior or contemporaneous oral representations, understandings, or
agreements.
18. NO WAIVER. The failure of either party to insist on strict compliance with any of
the terms, covenants, or conditions of this Contract by the other party shall not be deemed a waiver
of that term, covenant, or condition, nor shall any waiver or relinquishment of any right or power
at any one time or times be deemed a waiver or relinquishment of that right or power for all or any
other times.
19. NOTICES. Any notice to be given hereunder by either party shall be in writing and
shall be deemed to be fully given on the date of service if served personally on the party to whom
notice is to be given, or on the third day after mailing if sent by certified or registered mail, return
receipt requested, at the address of the party as it appears beneath its signature below.
20. DEBARMENT. HDS certifies that is is not presently debarred, suspended or
proposed to for debarment, declared ineligible, or voluntarily excluded from participation in this
Contract by any Federal department or agency_
21. SUBSTANCE USE PROHIBITIONS. While performing services, the use of
illegal drugs, alcohol, or controlled substances on County property or premises is strictly
6
prohibited. HDS's employees shall not perform services while under the influence of drugs or
alcohol,and if discovered,may be reported to the appropriate law enforcement agency.
22. TOBACCO USE. The use of tobacco of any kind on property or premises of the
County shall comply with County policies.
23. COUNTERPARTS. This Contract may be executed in one or more counterparts,
each of which shall be deemed an original, and all of which counterparts together shall constitute
the same instrument which may be sufficiently evidenced by one counterpart. Execution of this
Contract at different times and places by the parties shall not affect the validity of this Contract,
so long as all the parties execute a counterpart of this Contract.
IN WITNESS WHEREOF, the parties have executed this Contract as of the date
and year first written above,
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SIGNATURE PAGE
COUNTY:
JEFFERSON COUNTY
BOA OF C' MMISSIONERS
Kat c n,Chair
Heid' .i � ur,Member _
Greg oth, to ember
ATTEST:
6Ga _ -
Carolyn C I lows v,Clerk of the oard
Date: ���(Q/� _..
A /Witinsucker
nly:
Phi 1p
Date: August 8,2021
Chief Civil Deputy Prosecutor
County Notice Address: Jefferson County Sheriff's Office
81 Elkins Road
Port Hadlock,WA 98339
HDS:
Healthcare Delivery,Inc.
� n Slack
Its: President
Notice Address: 9039 Silverspot Drive SE
Tumwater,WA 98501
8
EXHIBIT A
Scope of Services:
HDS will provide inmate health care services for the Jefferson County Jail in accordance
with applicable standards ofthe American Medical Association ("AMA"), the State of
Washington, and the National Commission on Correctional Health Care. These include, but
are not limited to, the following:
1. Twenty-four (24)hour phone triage and consultation by an Advanced Registered
Nurse Practitioner or Medical Doctor for a monthly retainer as shown in the Compensation
Schedule with unlimited phone access. Response time will generally be within less than five
minutes of facility's call; however, due to technological problems with pagers and cell phones
on the road, it may be longer than five minutes and response time may be up to 20 minutes.
Any medical matter that requires urgent response will be promptly evaluated and managed by
phone.
2. Advanced Registered Nurse Practitioner with prescriptive privileges will attend
the Jail once each week and use telemedicine once each week,to conduct sick calls for inmates,
review all new inmate intake forms and inmate requests (kites), direct appropriate care and
"Special Needs Treatment Planning" for chronic health problems, conduct medical
history/physical exams as appropriate within NCCHC timeframes, and make referrals as
necessary to other providers. This service will be billed for a 10 hour per week minimum as
shown in the Compensation Schedule. Hours in excess of 10 hours per week will be billed
hourly as shown in the Compensation Schedule with a one hour minimum for scheduled
sessions.Unscheduled sessions will be billed a two hour minimum. Services shall also include:
(1) Weekly evaluation and ordering of necessary medical supplies and
pharmaceuticals.
(2) Utilization review of all billings.
(3) Training of Jail staff, as recommended by HDS, and authorized by Jail
administration.
(4) A monthly schedule of sick call coverage will be supplied to jail administration
by the 25th forthe previous month. The schedule is subject to approval byjail administration.
3. At least one day per week, and more frequently as necessary, a Psychiatric
Advanced Registered Nurse Practitioner will review inmate medical records to direct necessary
Mental Health services, prescribe and review necessary psychiatric medications, and prepare
Mental Health discharge plans prior to release of inmates with mental health conditions. This
service will be billed for a 32 hour per month minimum as shown in the Compensation
Schedule. Hours in excess of 32 hours per month will be billed hourly as shown in the
Compensation Schedule, with a one hour minimum.
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4. A Medical Doctor will visit the Jail at least once each quarter. This service
will be billed monthly at the rate of one-twelfth of the annual amount shown on Table C of Exhibit
B.
5. HDS will provide an Administrative Registered Nurse who is a Certified
Correctional Health Professional, and will provide clerical support, as necessary to administer
this Contract and to provide documentation on the adequacy of care. These services will be
billed monthly at the rate of one-twelfth of the annual amounts shown on Table C of Exhibit B.
6. Initial set up and implementation of services are included at no additional
charge, and include:
(1) Policy and procedure review, update, or development per the National
Commission on Correctional Health Care Standards (NCCHC), or WASPC Standards at no
additional charge, prior to commencing medical services. This will include a standard intake
form and screening protocols in accordance with NCCHC standards to be used by Jail staff to
record proper information on medical conditions, mental condition, and use/dependence on
drugs and/or alcohol. This section will be reviewed and updated annually with each renewal of the
agreement.
(2) Necessary medical chart format review, update, or development at no additional
charge.
(3) Offender Health Plan review, update, or development.
(4) Orientation for staff at first scheduled sick call, to include company manual with
guidelines for contacting HDS, at no additional charge.
7. As requested, onsite Registered Nurse coverage can be provided, and will be
billed hourly as shown in the Compensation Schedule with one hour minimum for scheduled
sessions.Unscheduled sessions will be billed a two hour minimum.
8. Once per billing cycle, HDS will provide statistical information on services
rendered under this agreement in the format for an excel sheet provided by the county.
9. All inmate grievances/complaints pertaining to medical treatment/services
associated with this agreement will be answered in accordance with County policy by HDS.
Monthly statistics of all grievances filed(those with and without merit)will be maintained. HDS
will implement County recommendations in any disputed grievances.
10. As requested by the Jail administration, HDS can contract negotiation for
pharmaceutical services or contract negotiations with outside providers, and provide quality
management and administrative support as requested, billed hourly as shown in the
Compensation Schedule.
It. HDS will provide documentation of current and future renewals of state
licensure, licensure and malpractice insurance as per Contract for all practitioners.
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12. Practitioners will provide specialized medical equipment necessary to perform
sick call (i.e. stethoscopes, sphygmomanometers; otoscopes, ophthalmoscopes, percussion
hammers,etc.).
13. Medical records will be maintained according to "Section 6. Confidential
Information' ofthe Contract, and per policy to assure confidentiality,
14. HDS health providers will promote community health and prevention of
communicable disease within the Jefferson County Jail, by providing timely and appropriate
health care and education to inmates.
ll
EXHIBT B
AGREEMENT PRICE,AND STAFFING PLAN
Year One
Contact Information
...-
PropO5er5 Name. Healthcare Delivery n "C Shannon Slack
Systems Nat?le:
9039 Silverspot Drive SE
Address; Tltl Owner/President
_. Tumwater WA 98501
Phone
Number (360) 742-6882
Email:
s oun 360 mail.com
1. Personnel Rates:
Table A.
Staff Position/Certification Level/Title Rate per hour
Nursin IRe istered Nurse/Staff Nurse $70.00
Provider/MSN/Advanced Registered Nurse Practitioner $125.00
Provider/MSN/Ps ch Nurse Practitioner $125.00
Provider/PHD/Medical Doctor $150.00
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EXHIBIT B
(Continued)
Table B Staffing
Staff Position Staff Schedule Weekly Annual Total Annual
Hours Hours cost
Nursing Staff M.T,W,Th,Fri 25 1,300 $91,000.00
ARNP Two days a week 10 520 $65,000.00
Psych ARNPlARNP One day a week 8 416 $52,000.00
ARNPIRN Phone Coverage M,T,W,TH,Fri,Sat,Sun 168 8736 $12,000.00
Total Annual Cost
Table C Administrative Services
Administrative Services Total Co,,
Medical Director $15,600.00
Administrator $6,720.00
Clerical $3,360.00
Total Annual $25.fi Op
RFP EXHIBIT B—TOTAL COST
Proposal
Administrative Cost $25,680
Annual Personnel Costs $220,000.-',C
Total Annual Cost $245:680.00
EXHIBITC
Jefferson County Jail will provide the following as per Contract terms;
I. A private, secure area with appropriate furniture to perform medical examinations,
as well as all necessary medical supplies. All charts, medications and medical
supplies will be appropriately secured.
2. Inmate transport to and from the medical area, and security for practitioners while
onsite medical care is being delivered.
3. Inmate transport to prescribed outpatient visits for medical, dental, or diagnostic
needs.
4. All chart forms, stationery supplies, and copy services needed for onsite medical
care.
5. An accurate scale and thermometer capable of frequent use for onsite medical care.
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