Department of Corrections and Rehabilitation (CDCR)/ California Prison Health Care Services (CPHCS) OCULAR PROSTHESIS SERVICES

Transcription

1 1. INTRODUCTION/SERVICES OCULAR PROSTHESIS SERVICES A. This is a master agreement in which the contractor shall provide all labor, staff, personnel, materials, supplies, transportation, license/permits/certification and equipment necessary to provide Ocular Prosthesis Services to inmates/patients referred for such services. Services shall include, but are not limited to the evaluation, fitting, fabrication, painting and delivery of the ophthalmic prostheses (artificial eyes) to inmates/patients referred from the institution. Services shall be provided as directed by the institution s Health Care Manager/Chief Medical Officer (HCM/CMO) or assigned designee. For purposes of this contract; the designee shall be a civil service employee. Refer to Exhibit H, List of participating Institutions, for a list of CDCR institutions and addresses. B. Contractor agrees that all expenses associated with travel to and from the institution, lodging, and all training expenses, such as Continuing Medical Education for referred personnel, shall be at the expense of the Contractor and will not be reimbursed by CPHCS. Any and all services performed outside the scope of this agreement will be at the sole risk and expense of the Contractor. C. Contractor or personnel referred by the Contractor must be able to perform the tasks associated with providing the above medical service(s) and assume full responsibility for services performed. Contractor agrees that all referred personnel will be required to render health services to any inmate/patient as needed. Referred personnel will perform services in accordance with state laws and regulations and shall at all times comply with universal safety precautions and maintain CDCR security measures and a safe work environment D. Contractor acknowledges that CPHCS is not obligated to provide or pay for inmate/patient health care services or treatment beyond those which are essential to prevent death, or permanent and/or severe disability. If health care service or treatment is nonessential or could safely be deferred until the inmate/patient is released from custody, when he/she is able to arrange for services for himself/herself, CPHCS shall defer services. Prior authorization must be obtained and documented in the inmate/patient s health record for those excluded health care services or treatments listed in CPHCS s Medical Standards of Care. E. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor and will not be reimbursed by CPHCS. F. The Contractor assumes full responsibility for the provisions of these services

2 2. LICENSES/PERMITS/CERTIFICATION REQUIREMENTS A. The Contractor and/or referred staff providing services to inmates/patients, must be authorized to practice Ocularist Services in the State of California in accordance with the California Code of Regulations (CCR), Title 22, Division 3, Subdivision 1, Chapter 3, Article 3, Section, and must be Certified by the National Examining Board of Ocularists (NEBO). B. A copy of the Contractor s certification and all other required licenses and permits must be submitted to the institution(s), prior to commencement of services and remain valid throughout the term of the contract. There must be no current or prospective limitations on said licenses, permits or certifications. C. The Contractor shall, at the Contractor s own expense, provide and maintain the organizational and administrative capabilities to carry out the duties and responsibilities which include, but is not limited to, professional staff, allied and supportive personnel necessary to provide all of the appropriate Ocular Prosthetic Services as defined by applicable statutes and regulations pertaining to Ocular Prosthetic Services. D. Contractor shall comply with all federal, State, and local requirements including the CCR Title 22, Division 5, Chapter 12, Article 3, Section E. For continuation of privileges with the institution(s), the Contractor shall be responsible for the timely renewal of his/her State issued identification card, and any other licenses and/or certifications required to perform Ocularist services and fabrication of ophthalmic prostheses (artificial eyes). The Contractor must maintain such licenses/certifications at Contractor s expense. The preceding shall also be a condition of CPHCS s obligation to pay for services provided under this contract. 3. CONTRACTORS RESPONSIBILITIES A. Contractor shall provide Ocular Prosthesis Services on an as-needed basis to inmates/patients at the institution and/or in the community as authorized and directed by the HCM/CMO or designee. Contractor shall evaluate inmate/patients and provide ophthalmic prosthetic devices, if necessary. Each ophthalmic prosthetic device provided by the Contractor shall be new and fitted to the inmate/patient. Contractor shall be responsible for all adjustments, fittings and follow-up care of the ocular prosthetic device to ensure devices are properly fitted well within the eye socket without falling out or rotating. No compensation shall be made to the Contractor for additional modifications and/or adjustments of the ocular prosthetic device. The HCM/CMO has sole discretion as to acceptability of work provided by the Contractor and/or contracted staff. B. Contractor shall deliver (upon request of the institution) or have available the ocular prosthetic devices to the inmate/patient at the institution within fifteen (15) - 2 -

3 working days after initial consultation. Contractor shall train the inmate/patient and CPHCS staff on the proper handling and care of the ocular prosthetic device. C. Contractor shall make appropriate recommendations on the patients seen and follow referring physician s orders. Contractor shall ensure that evaluations and documentation meet all requirements and standards set by the agency and the CCR Title 22, Health Care Services, Section and 51519, esq., for Ocular Prosthetic Services. D. Unless otherwise indicated and approved by the HCM/CMO or designee, Contractor shall provide all necessary and appropriate Ocular Prosthetic Services to inmate/patients within the confines of the institution grounds. Contractor shall allow CPHCS or its duly authorized representative to inspect, monitor performance, and evaluate the quality, appropriateness and timeliness of ocular prosthetic services provided under this contract. This shall include review of Contractor s inmate/patient records and audits of any or all fiscal books, reports, and records pertaining to the contract. Contractor shall provide said records or any copy thereof, during normal working hours, within reasonable time of CPHCS s written notice and request. E. Contractor shall only refer institution inmate patients for consulting, diagnosis and/or treatment, including surgery, to physicians or health care facilities under contract with the institution, and only after approval by the HCM/CMO or designee, unless exempted in cases of medical/surgical emergencies when these contract providers may not be immediately available. F. Contractor shall ensure consultation and progress reports are completed as required in the patient chart and/or outpatient report. Contractor shall include codes for all prescriptions orders. G. Contractor shall provide the institution HCM/CMO with a quarterly report on the balance of present contract. H. Contractor shall maintain continuity of all work performed from start to finish. I. Contractor shall make every effort to provide the same fully certified Ocularist on an ongoing basis for the term of the contract. 4. GUARANTEE A. The Contractor shall guarantee the ocular prosthetic device and services performed for a minimum of one (1) year from date of final fitting (approval must be obtained by the HCM/CMO or designee). If it is determined that failure has occurred due to a defective ocular prosthetic device or workmanship, Contractor shall correct the failure at no additional expense to the State. Correction shall occur during normal State business hours upon request for service by the HCM/CMO or designee

4 5. REPAIRS/MAINTENANCE A. Contractor shall repair/maintain new and existing ocular prosthetic devices upon request of the HCM/CMO. Reimbursement will be made only to the ocular prosthetic device not under the guaranteed section and shall be paid by the State in accordance with the CCR Title 22, Health Care Services, Sections and 51519, esq. 6. CDCR RESPONSIBILITIES A. CPHCS shall issue all policies and procedures pertaining to inmate/patient treatment. B. CPHCS shall maintain the authority to determine the manner in which the inmate/patient is supervised after the course of treatment has been implemented. C. CPHCS reserves the right to establish written criteria for the provision of Ocular Prosthetic Services under this contract. 7. REQUEST FOR SERVICES A. At the time of scheduling, CPHCS shall provide the Contractor with an estimate of the period of time the institution anticipates the need for Ocular Prosthesis services. This will be a good faith estimate based on the circumstances known to CPHCS at the time of the request. It is not a guarantee of business and is subject to change depending on CDCR s fluctuations in the inmate population. B. Contractor agrees to provide on-site services as arranged with the HCM/CMO or designee on an as-needed basis, in accordance with each institution s policies and procedures. Normal hours of clinic operation are Monday through Friday between the hours of 7:00 a.m. and 5:00 p.m. Clinics may be 2, 4, 6, or 8 hours each, typically ranging from one to two clinics per week. C. Contractor acknowledges that the institution may request services at any time, including weekends and holidays, if needed for emergency services. D. Contractor shall have available a contact person with twenty-four (24) hour telephone availability. Telephone answering devices (e.g., message machines) are not acceptable. The initial contact will be by telephone, however, CPHCS shall follow-up with a facsimile. E. CPHCS may cancel or change requested assignments without incurring any liability. Contractor shall notify CPHCS at least twenty-four (24) hours in advance of scheduled services if unable to provide services for reasons other than illness, or immediately provide replacement staff to avoid disruption of service

5 F. Contractor shall ensure that all ordered ocular prosthetic services shall be scheduled consistent with the institution needs. Once scheduled, service shall be delivered at the time scheduled, unless unavoidable circumstances occur. 8. HOURS OF OPERATION A. Contractor agrees to provide services Monday through Friday, between the hours of 8:00 a.m to 3:30 p.m. In accordance with each institution s policies and procedures or as mutually agreed upon between HCM/CMO or his/her designee and the Contractor. Institution may request services at any time, including weekends and holidays, if needed. Contractor shall provide services within twenty-four (24) hours notification by CPHCS. 9. CANCELLATION A. Contractor shall give twenty-four (24) hours notice to the HCM/CMO or designee prior to cancellation of scheduled clinics, if for reasons other than illness. If Contractor cancels a scheduled clinic, no payment will be made for that clinic. B. CPHCS may cancel or change requested provider assignments by telephone, without incurring any liability, up to twenty-four (24) hours before a Contractor s scheduled reporting time. If CPHCS cancels or changes a requested assignment for any reason, less than twenty-four (24) hours before a scheduled reporting time, CPHCS shall pay a cancellation fee of one hundred dollars ($100) per hour for one-half of the Contractor s scheduled clinic hours for that day. C. Services cancellation due to Emergency Security Situation: In the event the institution cannot run the clinic due to an emergency security situation, such as a lockdown, the institution shall attempt to contact the Contractor a minimum of two (2) hours prior to the reporting time of the scheduled clinic. If contact is not attained, the Contractor will be reimbursed for one hundred dollars ($100.00). D. Contractor shall notify CPHCS at least twenty-four (24) hours in advance of scheduled services if unable to provide services for reasons other than illness, or immediately provide replacement staff to avoid disruption of service. 10. FAILURE TO PERFORM A. CPHCS shall routinely evaluate the work performance of the Contractor and/or Contractor s subcontractor or referred personnel assigned to CPHCS to determine if CPHCS standards and departmental/institutional policies and procedures are being maintained. Any Contractor, and/or Contractor s subcontractor or referred personnel who fails to perform or who are physically or mentally incapable of performing the required duties as required by this contract shall not be permitted to perform service. The HCM/CMO or designee shall state in writing the reasons the personnel did not meet the required qualifications. CPHCS shall not pay Contractor, Contractor s subcontractor, or referred - 5 -

6 personnel for any work, which are deemed unacceptable in accordance with the required duties contemplated by this contract. B. The State reserves the right to award multiple contracts for back-up purposes. When services are needed, the lowest primary contractor shall be contacted first. WHEN and ONLY IF, the lowest contractor is unable to provide the requested services, the second lowest Contractor shall be contacted. This process will be repeated based on the number of contracts awarded and will take place each time the institution/facility contacts the Contractor to provide services. C. Contractors with multiple agreements for the same service(s) at the same institution(s) shall be obligated to provide service(s) at the rate(s) specified in the contractor s primary agreement (i.e., the agreement first bid) until all obligations under that agreement (e.g., number of hours) are satisfied before the rate(s) in any subsequent agreement(s) can be used. The only exception to this provision occurs when the rate(s) in a subsequent agreement is lower than those of the primary agreement; the state then has the sole right to determine which rate(s) will be applied. D. Failure to provide services on three (3) or more documented occasions during this Agreement term may result in termination of the Agreement; or may result in the institution not having to contact your company prior to going to the other contractors for the duration this Agreement. The HCM/CMO or designee has sole discretion in this selection 11. PERSONNEL A. Institution shall approve in advance all required personnel assigned to the contract. If any employee of the Contractor is unable to perform due to illness, resignation, or factors beyond the Contractor s control, the Contractor shall immediately submit qualifications of proposed substitute personnel to institution for approval. Failure to do so may be cause for termination of this contract. B. Assigned Personnel referred through this agreement must be proficient in the English language; be able to speak fluently, understand oral and written communications, and write effectively in the English language. Any personnel referred who fails to meet the minimum qualifications shall not be permitted to perform service. The HCM/CMO or his/her designee shall state in writing the reason(s) the referred personnel does not meet minimum qualifications. CPHCS shall not pay the Contractor for any hours worked by the referred personnel. C. The Institution Contract Liaison shall be notified of any additions or corrections to the Contractor s list of prospective employees at least five (5) working days before the employee s start date

7 D. Contractor shall obtain at least two (2) reference checks on each staff member and maintain records of verification. Such records shall include the following: 1. Name of person contacted and date 2. Name of previous facility/areas/units worked 3. Length of employment, and 4. Rehire status 12. CDCR ORIENTATION/TRAINING A. Prior to any work assignment, Contractor shall ensure that personnel attend the appropriate orientation/training provided by CPHCS. This orientation/training provided by CPHCS personnel will ensure that all Contractor personnel assigned to CPHCS are familiar with the operations of the Institution/facility, its medical facilities, California Code of Regulations, Title 15, CDCR Director s Rules and Regulations, and any bylaws that may apply. Orientation/training may include, but is not limited to the following: 1. Required documents to be carried (i.e., license(s), CDCR identification badge, registry identification, if applicable); 2. Inmate security policies and procedures; (No cell phones, pagers, or recording devices) 3. Reporting for beginning/ending of shift assignment; 4. Rules governing overtime; 5. Uniform or dress code; 6. Reporting of personal illness; 7. Reporting of industrial illness or injury; 8. Background investigations, fingerprinting and Digest of Laws Relating to Association with Prison Inmate Requirements; 9. Authorization to be on CDCR premises limited to scheduled work hours or orientation; 10. Rules governing gate clearance requirements; 11. Administrative and related service provided policies/procedures; 12. Infection control; 13. California Occupational Safety and Health Administration (CAL OSHA) regulations relating to Bloodborne Pathogens; 14. CDCR Tuberculosis (TB) Exposure Control Plan; 15. Patient/Personal Safety relating to fire, electrical hazards, disaster preparedness, hazardous material, equipment safety and management, Safe Drinking Water and Toxic Enforcement Act of 1986, Employee Right to Know, Advanced Directive and Patients Rights; 16. Sexual Harassment; and 17. Use of Force. B. Contractor shall maintain all employee records, including all records of required health examinations, employment records such as W-2 Forms, etc., for a minimum of three (3) years following the termination of employment of any Contractor staff assigned to CPHCS

8 C. To maintain continuity of services and insure safety for all workers should a prolonged need for services develop, Contractor shall make available to CPHCS only those certified Ocularist who have completed the CPHCS Orientation/Training. 13. INSPECTIONS A. Inspections shall be carried out by the HCM/CMO or his/her designee at various times during the contract term to check on the quality of work and determine acceptability of work performed before contract payment will be approved. 14. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION CONTACT INFORMATION Should questions or problems arise during the term of this agreement, the contractor should contact the following offices: Billing/Payment Issues: Refer to Exhibit I, List of Regional Accounting Offices and addresses. /Performance Issues: See List of Participating Institutions Exhibit H The Institution Contract Representative can be contacted Monday through Friday, 8:30 a.m. to 4:00 p.m. (each institution may vary in times), except weekends and holidays. The institution s contract liaison or his/her designee shall prearrange all needed services to assure continuity of care and to minimize the disruption of CDCR s workload. General Contract Issues: California Prison Health Care Services - Contracts Phone Number: (916) FAX Number: (916)