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RFS NO.: 329.00-011
CONTRACT
BETWEEN THE
STATE OF TENNESSEE, DEPARTMENT OF CORRECTION
AND
MHM SERVICES, INC.
THIS CONTRACT, by and between the State of Tennessee, Department of
Correction, hereinafter referred to as the "State" and MHM SERVICES, INC.
hereinafter referred to as the "Contractor", is for the provision of mental
health services as further defined in the "SCOPE OF SERVICES" below.
WHEREAS, the State provides mental health services to the inmate
population confined within twenty-one (21) Tennessee correctional facilities.
It is projected that there will be twenty-two (22) TDOC facilities operational
by June 1998. These facilities are located in the East, Middle, and West
Regions of Tennessee and are as follows:
EAST MIDDLE WEST
REGION 1 REGION 2 REGION 3
*Brushy Mountain State *Middle Tennessee *Cold Creek Correctional
Penitentiary Reception Center Facility
*Xxxxxx County Work Camp *Nashville Community Service *Lake County Regional
*Chattanooga Community Center Correctional Facility
Service Center *Riverbend Maximum Security *Xxxx Xxxxxxxx Reception Center
*Knoxville Community Service Institution *Northwest Correction Center
Center *Xxxxxx Center Industrial Prison *Xxxxx County Boot Camp
*Xxxxxx County Regional and Farm *West Tennessee High
Correctional Center *Tennessee Prison for Women Security Facility
*Northeast Correctional Center *Tennessee Correction Academy *Lauderdale County Facility
*Southeast Tennessee State *Tennessee Correctional Work (ANTICIPATED CONSTRUCTION
Regional Correctional Facility Center 1997)
REGION 4: XXXX X. XXXXXXX SPECIAL NEEDS FACILITY
THEREFORE, the State desires to contract with a vendor(s) who are
capable of providing quality mental health care in a cost effective manner.
The State wishes to reduce the number of contracts so as to improve the
continuity of service delivery throughout the correctional system. The State
intends to award an at-risk capitated rate contract for the services outlined
in the Scope of Services (Section A) below.
WITNESSETH, in consideration of the mutual promises herein contained,
the parties have agreed and do hereby enter into this Contract according to the
provisions set out herein:
A. SCOPE OF SERVICES:
1. GENERAL
A. All mental health services provided under
this contract shall be in conformance with
ALL TDOC policies as they may be amended from
time to time. (Only TDOC Mental Health
Policies are attached for the
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convenience of the proposer.) Other TDOC
Policies may be reviewed through a
coordinated effort with the Department's
Central Office.
1) Said policies are available for
review in the historical data and
statistics section of this document.
2) The TDOC shall be responsible for
notifying the Contractor in writing
of any policy changes that will
impact the Contractor.
3) At the institutional level, the
Contractor('s) clinicians shall
administratively respond to the TDOC
Warden or Warden's Designee.
Clinical matters are the sole
responsibility of the licensed
psychiatrist/psychologist. The
State's Director of Mental Health
shall assist in the statewide
coordination of services, monitoring
and continuous developmental aspects
of the terms outlined in this
contract.
B. The Contractor's service system shall provide
a uniform and consistent continuum of quality
mental health service delivery statewide.
The Contractor shall work in concert with
existing TDOC mental and medical
professionals, and other contract entities,
if applicable, in providing mental health
care.
C. The Contractor shall measure various
clinical/programmatic mental health outcomes.
At a minimum, the State shall require the
Contractor to evaluate response to prescribed
psychiatric medications, improvement in
mental health status, patient
functioning/sense of well-being, etc. The
State in a cooperative effort shall assist in
the development of additional outcome
measures. The Contractor shall abide by the
following milestone schedule for the
development, standardization, and reporting
requirements of the outcome measures.
Within 90 days from Contract Execution: The
Contractor shall propose in writing to the
Director of Mental Health Services draft
standardized outcome measures to be utilized
regionally/state wide.
Within 120 days from Contract Execution: The
Contractor shall have revised and developed,
in consultation with the Director of Mental
Health Services, functional outcome
measurement instruments that can be used
regionally/state wide. The instruments will
be applied and data gathered in such a manner
as to allow the collection of both
time-series and cross-sectional data. The
instruments may vary based upon the treatment
objectives and geographical location,(i.e.
XxXxxxx Special Needs Facility) but the
instrument must be universal enough to report
meaningful information to both the Director
of Mental Health Services and the Director of
Contracts Administration.
Failure to meet these milestones will be
considered an incident of noncompliance for
each week they are not performed. The
mechanism outlined in E.15. "Special Terms
and Conditions" may be applied in the event
the milestones are not met (See Attachment
A).
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D. The Contractor shall adhere to the specific
performance measures outlined in Attachment
A. The State shall reserve the right to
expand upon the performance measures denoted
in Attachment A. The State's Director of
Mental Health Services may solicit the
expertise of the Contractor in the
development of any new performance
measure(s). The State shall commence the
assessment of damages as it relates to
performance measures 60 days from the date of
contract execution.
The Contractor shall report to the Director
of Mental Health Services and the Director of
Contracts Administration the results of any
approved and functional performance/outcome
measures. The information will be provided
in both electronic and paper formats. The
utilized for service delivery comparisons
such as, but not limited to, effectiveness of
service delivery. During the developmental
stage, a distinction will be made as to
whether the performance measure is
determining the outcome of a specific program
intervention or the performance expectation
of the contractor.
E. Upon approved written consent, conduct or
participate in the development of research
studies in conjunction with state and/or any
other professional entity deemed appropriate
by the TDOC.
F. The contract providers will actively
participate, when applicable, with the
State's Quality Assurance/Improvement program
as it relates to mental health service
delivery.
G. When applicable, the appropriately licensed
clinician will provide clinical supervision
to psychological internship or practicum
students.
H. The TDOC shall, when applicable, provide
specialized training for sexual offender
treatment programs. The contractor shall
follow the program philosophy and design
standards as presented by the TDOC.
I. The Contractor shall provide technical
assistance to the TDOC Director of Mental
Health Services in developing a standard
anger management/violent offender treatment
program that is to be implemented at selected
TDOC sites. Implementation date and
treatment sites to be determined.
J. The Contractor shall designate an individual
with the overall responsibility for this
contract. This person shall be available to
consult and coordinate service delivery with
the State's Director of Mental Health and/or
other designated state officials.
K. When required, the Contractor shall enter
specific service delivery information into
the Tennessee Offender Management Information
System (TOMIS). Training and access to
equipment shall be provided by the TDOC.
L. The Contractor shall insure adequate backup
coverage to address the clinical service
needs of any TDOC facility.
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2. PSYCHIATRIC SERVICES
A. Psychiatric services shall be provided by
licensed physicians who are board eligible or
board certified in psychiatry. Standards of
practice shall be according to those of the
community and in compliance with state and
federal laws.
B. Evaluate and diagnose in accordance with the
current DSM criteria those inmates referred
by the Mental Health Treatment Team or other
health care staff.
C. Complete psychiatric evaluations/assessments
as necessary and provide an individual
treatment plan specific for those patients
requiring psychiatric intervention to include
medication.
D. Patients shall have a documented physical
assessment prior to the prescribing of a
psychotropic medication.
E. Provide that all medications shall be
reviewed, and orders renewed if necessary, at
least every thirty days as specified by
policy.
F. Patients receiving psychiatric medications
shall receive a direct assessment from a
psychiatrist prior to ninety (90) days
elapsing.
G. Prescribe only those medications approved in
the TDOC's formulary, unless otherwise
approved as TDOC procedure dictates.
H. Provide consultation to mental health service
staff and administrative staff and
participate in the treatment team reviews
when clinically necessary.
I. Provide accessibility for twenty-four (24)
hours per day, seven (7) days per week per
calendar year emergency consultation with the
mental health and health care staff. Such
availability may be by telephone unless
circumstances necessitate on-site delivery.
J. Provide a direct assessment to a patient
within 72 hours from the time a telephone
order was given for cases involving
restrictive therapeutic dispositions.
K. Provide clinical
recommendations/consultations and
coordination of patient referrals to other
specialized TDOC programs, or designated
contract hospitals. The contractor(s) must
secure appropriate privileges at the
designated hospital to provide services if
required. Said services may be provided in a
written format and/or visual presentation,
role play, teleconferencing medium, etc.
L. Provide an appropriate level of psychiatric
monitoring of patients requiring psychotropic
medication intervention.
M. When applicable, provide or assist in the
provision of a mental health education
program to other institutional staff that
shall include, but not be limited to, the
following:
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(1) Early detection of potential mental
health problems, i.e., signs and
symptoms of mental illness,
retardation, and chemical
dependency.
(2) Crisis intervention/suicide
precaution programs.
(3) Said services may be provided in a
written format, audio/visual
presentation, role play,
teleconferencing medium, etc.
3. PSYCHOLOGICAL SERVICES
A. The delivery of doctoral level psychological
services shall be provided by psychologists
with health service provider designation who
are licensed by the State of Tennessee or who
have legal reciprocity to practice in the
state of Tennessee. Standards of practice
shall be according to those of the community
and with State and Federal laws.
B. Evaluate and diagnose in accordance with the
current DSM criteria those inmates referred
by the Mental Health Treatment Team or other
health care staff.
C. Complete psychological
evaluations/assessments as necessary and
provide an individual treatment plan specific
for those patients requiring psychological
intervention(s).
D. When clinically/programmatically deemed
appropriate, provide individual and/or group
therapy/consultation.
E. Participate in the treatment team reviews
when necessary.
F. Be responsible for twenty-four (24) hours per
day, seven (7) days per week per calendar
year emergency consultation with the health
care or other mental health staff. Such
availability may be by telephone unless
circumstances necessitate on-site delivery.
G. Provide clinical recommendations and
coordination of referrals of patients to
XxXxxxx Special Needs Facility or other
specialized TDOC treatment units.
H. Provide clinical supervision and/or
consultation to institutional psychological
examiner(s), mental health program
specialist(s), alcohol and drug counselors,
and health care staff.
I. The Contractor shall provide or assist in the
provision of mental health education programs
to other institutional staff that shall
include but not be limited to the following:
(1) Early detection of potential mental
health problems, i.e., signs and
symptoms of mental illness,
retardation, and chemical
dependency.
(2) Crisis intervention/suicide
precaution programs.
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(3) Provide consultation supervisory
services to mental health staff
involved in special programs. Said
services may be provided in a
written format and/or visual
presentation, role play,
teleconferencing medium, etc.
J. Complete the initial thirty (30) and ninety
(90) day mental health assessments on
specially segregated inmates as policy
dictates. Review findings documented by
other licensed professionals.
K. Provide psychological evaluations upon the
request of the Board of Paroles.
L. Provide psychological evaluations to all
newly hired correctional officer/probation
officers with the Tennessee Department of
Corrections. Said evaluations shall be,
1) Centrally provided at the Tennessee
Correctional Academy located in
Tullahoma, Tennessee. The TDOC may,
in the future decentralize the
evaluation process.
2) The test battery shall minimally
consist of the MMPI II, but may
include the IPI and a stress
management inventory. Equivalent
assessment measures/inventories may
be utilized as clinically deemed
appropriate.
3) The Contractor may utilize
psychological examiners who are
licensed in the State of Tennessee
to assist in providing psychological
evaluations to all newly hired
correctional officers/probation
officers employed with the Tennessee
Department of Correction. Standards
of practice shall be in accordance
to those of the community and with
state and federal laws.
B. PAYMENT TERMS AND CONDITIONS:
1. The Contractor shall be compensated based upon the
capitated rates as follows:
Capitated Annual Rate
July 1997 - December 1997 $129.94
January 1998 - December 1998 $133.19
January 1999 - December 1999 $136.52
January 2000 - December 2000* $139.93
January 2001 - December 2001* $143.43
* Option Years
Each month, the State will provide information to the
Contractor regarding inmate population. The
Contractor will use TDOC's information to prepare its
monthly invoice to the State.
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2. The Capitated Rate in Paragraph 1 of this Section,
shall constitute the entire compensation due the
Contractor for the Service and all of the Contractor's
obligations hereunder regardless of the difficulty,
materials or equipment required. The Capitated Rate
include, but are not limited to, all applicable
taxes, fees, overheads, profit and all other direct
and indirect costs incurred or to be incurred, by the
Contractor. The cost of medications issued from
Central Pharmacy will be deducted from the Capitated
Rate Payment.
3. The Capitated Rates in Paragraph 1 of this Section
are firm for the duration of the Contract and are not
subject to escalation for any reason, unless amended.
In the event of changes in the anticipated scope of
services, governmental regulations or other
circumstances, the State or the Contractor may submit
a written request for amendment. If, within thirty
(30) days thereafter the parties are unable in good
faith to negotiate satisfactory modifications, the
party submitting the request may terminate this
Contract by giving sixty (60) days notice.
4. The Contractor shall submit all invoices, in a form
acceptable to the State with all of the necessary
supporting documentation, prior to any reimbursement
of allowable costs.
5. The Payment of an invoice by the State shall not
prejudice the State's right to object to or question
any invoice or matter in relation thereto. Such
payment by the State shall neither be construed as
acceptance of any part of the work or service
provided nor as an approval of any of the costs
invoiced therein. Contractor's invoice shall be
subject to reduction for amounts included in any
invoice or payment theretofore made which are
determined by the State, on the basis of audits
conducted in accordance with the terms of this
contract, not to constitute allowable costs. Any
payment shall be reduced for over-payments, or
increased for under-payments on subsequent invoices.
6. The State reserves the right to deduct from amounts
which are or shall become due and payable to the
Contractor under this or any contract between the
parties any amounts which are or shall become due and
payable to the State by the Contractor.
7. In no event shall the maximum liability to the State
under this contract exceed SEVEN MILLION FOUR HUNDRED
SEVENTY-THREE THOUSAND THREE HUNDRED FOUR DOLLARS
($7,473,304.00).
8. The Contractor shall complete and sign an
"Authorization Agreement for Automatic Deposits (ACH
Credits) Form". This form shall be provided to the
Contractor by the State. Once this form has been
completed and submitted to the State by the
Contractor, all payments to the Contractor, under
this or any other contract the Contractor has with
the State, shall be made through the State's
Automated Clearing House wire transfer system. The
Contractor shall not commence work or invoice the
State for services until he has completed this form
and submitted it to the State. The debit entries to
correct errors authorized by the "Authorization
Agreement for Automatic Deposits Form" shall be
limited to those errors detected prior to the
effective date of the credit entry. The remittance
advice shall note that a correcting entry was made.
All corrections shall be made within two banking days
of the effective date of the original transaction.
All other errors detected at a later date shall take
the form of a
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refund, or in some instances, a credit memo if
additional payments are to be made
C. TERM:
This Contract shall be effective for a period of 36 months,
commencing on July 1, 1997 and ending on June 30, 2000. The
State shall have no obligation for services rendered by the
Contractor which are not performed within the specified
period. The State shall have the option to renew the contract
for two additional one (1) year periods.
D. STANDARD TERMS AND CONDITIONS:
1. The State is not bound by this Contract until it is
executed by the appropriate parties and is approved
by the appropriate State officials as indicated on
the signature page of this Contract.
2. This Contract may be modified only by a written
amendment which has been executed and approved by the
appropriate state officials as indicated on the
signature page of this Contract.
3. The State may terminate this Contract by giving the
Contractor at least sixty (60) calendar days written
notice before the effective termination date. The
Contractor shall be entitled to receive equitable
compensation for satisfactory authorized services
completed as of termination date. Said termination
shall not be deemed a breach of contract.
4. If the Contractor fails to properly perform its
obligations under this Contract or violates any terms
of this Contract, the State shall have the right to
immediately terminate the Contract and withhold
payments in excess of fair compensation for completed
services. The Contractor shall not be relieved of
liability to the State for damages sustained by the
virtue of any breach of this Contract by the
Contractor.
5. The Contractor shall not assign this Contract or
enter into a subcontract for any of the services
performed under this Contract without obtaining the
prior written approval of the State. If such
subcontracts are approved by the State, they shall
contain, at a minimum, Paragraphs D.6 and D.8 of this
Contract.
6. The Contractor warrants that no part of the total
Contract amount shall be paid directly or indirectly
to any employee or official of the State of Tennessee
as wages, compensation, or gifts in exchange for
acting as officer, agent, employee, subcontractor, or
consultant to the Contractor in connection with any
work contemplated or performed relative to this
Contract.
7. The Contractor shall maintain documentation for all
charges against the State under this Contract. The
books, records, and documents of the Contractor,
insofar as they relate to work performed or money
received under this Contract, shall be maintained for
a period of three (3) full years from the date of the
final payment, and shall be subject to audit, at any
reasonable time and upon reasonable notice, by the
State agency or the Comptroller of the Treasury, or
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their duly appointed representatives. The Financial
Statements shall be prepared in accordance with
generally accepted accounting principles.
8. No person on the ground of handicap or disability,
age, race, color, religion, sex, national origin, or
any other classification protected by Federal and/or
Tennessee State constitutional and/or statutory law
shall be excluded from participation in, or be denied
benefits of, or be otherwise subjected to
discrimination in the performance under this
Contract, or in the employment practices of the
Contractor. The Contractor shall, upon request show
proof of such non-discrimination, and shall post in
conspicuous places, available to all employees,
applicants, visitors and offenders notices of
non-discrimination.
9. The Contractor, being an independent Contractor,
agrees to carry adequate public liability and other
appropriate forms of insurance. The Contractor shall
show proof of such insurance coverage.
10. The Contractor agrees to pay all taxes incurred in
the performance of this Contract.
11. The State shall have no liability except as
specifically provided in the Contract.
12. The Contractor shall comply with all applicable
Federal and State laws and regulations in the
performance of this Contract.
13. This Contract shall be governed by laws of the State
of Tennessee.
E. SPECIAL TERMS AND CONDITIONS:
1. Should any of these special terms and conditions
conflict with any other terms and conditions of this
Contract, these special terms and conditions shall
control.
2. Where a term in the Contract differs from the RFP
and/or the proposal, the Contract shall rule. Where
a term in the RFP differs from the proposal, the RFP
shall rule.
3. The Contractor shall maintain confidentiality of all
records in acceptance with state and federal law; and
TDOC policy.
4. This Contract and any extension of the terms of this
Contract are subject to appropriation and
availability of State and/or Federal funds. In the
event that the funds are not appropriated or are
otherwise unavailable, the State reserves the right
to terminate this Contract upon written notice to the
Contractor. Upon receipt of the written notice, the
Contractor shall cease all work associated with the
Contract. Should such an event occur, the Contractor
shall be entitled to compensation for all authorized
services satisfactorily completed as of the
termination date.
5. Upon expiration or early termination of this
Contract, the Contractor agrees to cooperate with any
treatment successor to effect an orderly and
therapeutically efficient transition for those
patients actively receiving care.
6. The Contractor agrees to indemnify and hold harmless
the State as well as its officers, agents and
employees from all claims, losses or suits accruing
or
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resulting to any person, firm, corporation or other
entity which may be injured or damaged as a result of
acts or omissions of the Contractor relating to this
Contract. The State shall give the Contractor
written notice of each such claim or suit and full
right and opportunity to conduct the Contractor's own
defense.
7. The sovereign immunity of the State shall not apply
to the Contractor nor any subcontractor, agent,
employee, or insurer of the Contractor. Neither
Contractor nor any subcontractor, agent, employee, or
insurer of the Contractor may plead the defense of
sovereign immunity in any action arising out of the
performance or failure to perform any responsibility
or duty under this Contract.
8. The Contractor shall be responsible for the correct
use, maintenance and protection of all equipment
furnished by the State under this Contract. Upon
termination of this Contract, all equipment furnished
shall be returned to the State in good order and
condition as when received, reasonable use and wear
thereof excepted. Should the equipment be destroyed,
lost or stolen, the Contractor shall be responsible
to the State for the residual value of the equipment
at the time of loss.
9. The Contractor shall document mental health services
provided utilizing an approved TDOC format. The
Contractor in concert with TDOC institutional staff
shall enter service codes into the Tennessee Offender
Management Information System (TOMIS). This
automated process shall serve as a data collection
mechanism for each contract provider.
10. The Contractor shall submit to the institutional
Warden or Warden's designee a hard copy of their TDOC
Services Provided Encounter Log as supporting
documentation.
11. If requested by the State, the Contractor must agree
to random background checks which shall include
fingerprinting by the State's internal affairs
department. If requested by the State, the
Contractor must submit copies of drivers licenses
and/or social security cards to be on file with the
State. If background checks are requested, such
checks shall be at the expense of the Contractor.
Results of such checks shall be provided to the
State.
12. The Contractor shall at all times honor the security
of the TDOC Tennessee Offender Management Information
System (TOMIS) information and shall not misuse,
abuse, alter, or attempt to alter the information
contained within TOMIS, except as pertains to the use
and data entry requirements necessary to fulfill the
Contractors obligations under the terms of this
Contract.
13. The Contractor shall be duly licensed to conduct
business within the State of Tennessee.
14. The Contractor shall establish a performance bond in
the amount of $100,000.00 for regional contracts or
$400,000.00 for a statewide contract. Said
performance bond shall be in the form of a bond
issued by an insurance company or other reputable
bonding agent that is acceptable to the State. The
following shall be the contractual terms controlling
this performance bond.
a. Said performance bond shall be in force for
the duration of the Contract.
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b. Should the State terminate this Contract
under Section D.3., the Contractor shall
continue to fully provide the services
required under this Contract during the sixty
(60) day termination period as provided by
Section D.6. of this Contract in its
entirety.
c. Should the Contractor fail to provide these
services during the sixty (60) day
termination period, then the State shall be
entitled to recover actual damages against
the performance bond.
15. The State's Director of Mental Health and Director of
Contracts Administration shall review mental health
performance/outcome measures to determine compliance,
effectiveness and quality of service delivery. If
services designated to the Contractor are deemed
non-compliant, the State's Directors shall submit to
the Contractor a written warning citing the specific
non-compliant issue(s). If upon reinspection the
non-compliant item(s) remain deficient, a stipulated
liquidated damages value shall be assessed per
non-compliant item(s) for the reporting period
identified (See Attachment A). The contractor's
payment shall be reduced by the amount of accumulated
liquidated damages within thirty (30) days from the
point of receiving the second written notice.
16. Prior to the end of the first contract year, the
Contractor shall submit for TDOC approval a mental
health service delivery recommendation plan. The
plan shall be prepared with the assistance of the
State's Director of Mental Health. The plan should
include a method for determining the types and levels
of service needs; a method for determining resource
needs; alternative service technology; etc. Upon
approval of the plan, the state then reserves the
right to renegotiate the Contract provisions with the
existing Contractor.
17. The parties agree that due to the complicated nature
of the Contractor's obligations under this Contract,
it would be difficult to specifically designate a
monetary amount for a breach by Contractor designated
in Attachment A as said amounts are likely to be
uncertain and not easily proven. Contractor hereby
represents and convenants that it has carefully
reviewed the liquidated damages contained in
Attachment A and agree that said amounts are the
liquidated damages resulting from agreement between
the parties, represent a reasonable relationship
between the amount and what might reasonably be
expected in the event of breach, and are a reasonable
estimate of the damages that would occur from a
breach.
18. It is hereby agreed between the parties that the
liquidated damages represent solely the damages and
injuries sustained by the State in losing the benefit
of the bargain with Contractor and do not include any
injury or damage sustained by a third party and
Contractor agrees that the liquidated damage amount
is in addition to any amounts the Contractor may owe
the State pursuant to the indemnity provision
contained in Section E(6) or otherwise.
19. The State may continue to withhold the liquidated
damages or a portion thereof until the Contractor
cures the breach or the State terminates the
Contract.
20. The State is not obligated to assess liquidated
damages before availing itself of any other remedy.
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21. The State agrees to provide Contractor thirty (30)
days notice to cure in the event Contractor fails to
properly perform its obligations under this Contract
or violates any terms of this Contract.
22. The State may choose to discontinue liquidated
damages and avail itself of any other remedy
available under this Contractor or at law or equity;
provided, however, Contractor shall receive a credit
for said liquidated damages previously withheld.
23. The Contractor shall not publish any outcomes based
on data obtained from the operation of this Contract
without prior written consent of the TDOC.
24. The Contractor shall be responsible for the costs of
all medications prescribed by the Contractor's
providers and said costs shall be a part of the
capitated rate. The TDOC will forward to the
Contractor a monthly statement itemizing the drugs
prescribed by the Contractor's providers and
detailing the direct deductions made from the
Contractor's payments. The Contractor's providers
shall utilize the TDOC formulary for the purpose of
prescribing medications. The TDOC central pharmacy
shall be responsible for packaging and distribution
of psychopharmacological prescriptions. Provided
that, with the consent of TDOC, Contractor, at its
own cost, may utilize other reasonable alternatives
for purchasing, packaging and distribution of
psychopharmacological prescriptions, provided that
the TDOC pharmacy first shall be given the
opportunity to match any alternative proposal for the
purchase, packaging and distribution of
psychopharmacological prescriptions which Contractor
is considering.
25. TDOC may delegate or authorize other parties in
writing to perform any of the services or functions
specified in this contract as being the
responsibility of TDOC. TDOC may, upon written
notice to the contractor, delegate or authorize the
services of functions to be performed by another
party.
26. The State may require the Contractor to modify
staffing provisions if, upon review, the provisions
of services are deemed unacceptable in meeting the
clinical or program needs at any given TDOC facility.
27. The Contract shall be governed by the laws of the
State of Tennessee. Any legal proceedings against
the State regarding this Contract shall be brought in
the State of Tennessee administrative or judicial
forum. Request shall be in Davidson County,
Tennessee.
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MHM SERVICES, INC.
BY:
/s/ XXXX XXXXXXX
------------------------------------------------ ---------------------
XXXX XXXXXXX, PRESIDENT DATE
FED I.D. NO. 521223048
---------------------------------
STATE OF TENNESSEE
DEPARTMENT OF CORRECTION
BY:
/s/ XXXXX XXXXXXXX 7/2/97
---------------------------------------- ---------------------
XXXXX XXXXXXXX, COMMISSIONER DATE
APPROVED:
TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION
BY:
/s/ XXXX X. XXXXXXXX JUL 11 1997
---------------------------------------- ---------------------
XXXX X. XXXXXXXX, COMMISSIONER DATE
APPROVED:
COMPTROLLER OF THE TREASURY
BY:
/s/ XXXXXXX X. XXXXXXXXX 7-15-97
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XXXXXXX X. XXXXXXXXX, COMPTROLLER DATE
13
14
PERFORMANCE MEASURES
ATTACHMENT A
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DEFICIENCY DEFINITION LIQUIDATED
DAMAGES
I A performance standard which, if not met, is $200 will be assessed
likely to be physically or psychologically for each Type I
distressing to the patient. There will be a deficiency found at
disruption in the quality of care and policy the time of reporting.
adherence.
II A performance standard which, if not met, has $75.00 will be assessed
the potential to adversely impact the care of a for each Type II
given patient and/or adversely impact deficiency found at
administrative/clinical practice. the time of reporting.
III A performance standard which, if not met, $50.00 will be assessed
prevents the state from monitoring the for each Type III
contractor's performance and/or may deficiency found at
adversely impact continuity of care. the time of reporting.
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NOTE: A written warning will be submitted to the contractor denoting a
particular deficiency prior to assessing any damages. A second deficiency
in the same area will warrant assessment of damages.
15
PROVIDER PERFORMANCE MEASURES
SERVICE DESIRED PERFORMANCE REPORTING
AREA OUTCOME MEASURE STANDARD REQUIREMENT
Administrative Treatment providers Providers acknowledge A1 100% of the service Able to initiate the
A1 have satisfactory understanding of their providers are capable performance
working responsibilities of recognizing and measurements
relationship with related to performance implementing required process.
facility staff and measures. services.
are familiar with
TDOC policy and
procedures.
Administrative Provider and TDOC A2 75% of surveyed Reported by type of
A2 staff satisfaction TDOC sites rated their provider utilizing a
reporting rate experience with satisfaction scaled
contract personnel to score, i.e., Likert
be fair to good. 90% Scale.
rated it as good or
excellent.
Administrative Providers report type A3 100% of service When applicable,
A3 of service(s) providers accurately services reported
provided. fill out service logs daily by provider
and enter data. utilizing TOMIS.
(TDOC staff may
provide assistance.)
Administrative Clinical/administra- Telephone non-response A4 80% of providers Response time for
A4 tive staff obtain or significant delay. respond to for non-emergency
access to provider. non-emergency inquiries.
inquiries within 24
hours.
A4.1 95% of Response time for
psychiatrists respond emergency inquiries
to emergency inquiries in minutes.
within 15 minutes.
SERVICE REPORTING DEFICIENCY
AREA FREQUENCY TYPE
Administrative 60 days III
A1 After contract
initiation.
Administrative Annually III
A2
Administrative Weekly III
A3 (state
generated
report)
Administrative Quarterly III
A4
Quarterly I
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PROVIDER PERFORMANCE MEASURES
SERVICE DESIRED PERFORMANCE REPORTING
AREA OUTCOME MEASURE STANDARD REQUIREMENT
Clinical Emergency psychiatric On-site review of C1 100% of the Number of documented
C1 cases reviewed within emergency intervention(s) psychiatrists providing days to respond. (Phone
reasonable period of that requires phone emergency phone dated and signed by
time following phone consult. consultation will see psychiatrist.
consultation and patient(s) within a 72
ordering of hour period from the
intervention. time of the original
phone order.
Clinical Patients are seen for Average length of time C2.1 100% of specialty Number of patients and
C2 routine and specialty patient waits to be seen referrals to psychiatry number of days that
psychological/ from the time of referral shall be seen within 14 elapsed beyond 14 days
psychiatric consults/ to face-to-face contact day time period. before patient was
treatment in a timely with psychiatrist or seen.
manner. psychologist.
C2.2 100% of routine Number of patients and
referrals to number of days that
psychologist shall be elapsed beyond 14 days
seen within a 30 days before patient was seen
time period.
Clinical Patients prescribed Frequency of face-to-face C3 98% of the patients A sample of patients
C3 psychotropic contact with psychiatrist prescribed psychotropic who have been
medications will meet for patients prescribed medication will have prescribed psychotropic
face-to-face with a psychotropic medications. met directly with a medications by
psychiatrist as psychiatrist every 3 frequency of
indicated by the months. face-to-face contact
treatment plan but with psychiatrist
not less frequently during previous 3
than once every 3 months.
months.
Clinical Treatment plans that Percentage of patients C4. 98% of all patients A sample of diagnosed
C4 address the clinical with a diagnosis who have warranting a treatment patients with treatment
care of a patient a treatment plan to plan will have been plans shall be
meet the approval of address their mental reviewed, signed and reviewed.
the psychiatrist needs. dated by the
and/or psychologist. psychiatrist and/or
psychologist. An
appropriate diagnosis
will have been assigned
to each patient.
SERVICE REPORTING DEFICIENCY
AREA FREQUENCY TYPE
Clinical Quarterly for XxXxxxx I
C1 Special Needs
Facility). Every four
months for other TDOC
facilities.
Clinical Quarterly for II
C2 reception centers.
Every four months for
other TDOC
facilities.
Quarterly for II
reception centers.
Every four months for
other TDOC
facilities.
Clinical Annually II
C3
Clinical Annually II
C4
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Clinical Documentation that all In-house mental health C5. 100% of documented Memorandum noting
C5 in-house mental health policies reflect TDOC mental health in-house approval of each
policies have been policy requirements and policies shall meet the in-house mental health
approved by the accepted clinical approval of the policy.
psychologist and/or practices of the psychologist and/or
psychiatrist. community. psychiatrist through
memorandum.
Clinical Annually II
C5
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PATIENT/PROGRAM OUTCOME PERFORMANCE
SERVICE DESIRED PERFORMANCE REPORTING
AREA OUTCOME MEASURE STANDARD REQUIREMENT
Administrative Implement specific Contractor will The contractor will The state will be in
A1 patient/program develop with the submit to the state's a position to
outcome measures assistance and Director of Mental implement outcome at
statewide/regionally approval of the Health several it's discretion.
state specific patient outcome
patient/program measures.
outcome measures.
SERVICE REPORTING DEFICIENCY
AREA FREQUENCY TYPE
Administrative 120 days after III
A1 contract initiation
NOTE: Additional patient/program outcome performance measures shall be
developed at a later date. Not all outcome measures will be subject to
liquidated damages.
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CONTRACT SUMMARY SHEET
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[ ] NEW CONTRACT [ ] FA [ ] GR [ ] DP [ ] RV CONTRACT NUMBER RFS NUMBER
[X] AMENDMENT #1 [ ] ID [ ] Z [ ] DG [ ] NC --------------------------------------------------
[ ] GU [ ] GG [ ] DL FA-98-12426-01 329.00-011
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[ ] OTHER CONTRACTING PARTY (VENDOR): [ ] GRANTEE: VENDOR I.D. NUMBER
MHM SERVICES, INC. [ ]V [X]C 521223048
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STATE AGENCY: CORRECTION DIVISION: ADMINISTRATION/MENTAL HEALTH SVCS
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PROGRAM CONTACT: XXXXX XXXXXX FISCAL CONTACT: XXXX XXX
FLOOR(SUITE)/BLDG: 4TH FLR XXXXXX XXXXXXX BLDG. FLOOR(SUITE)/BLDG: 3RD FLR XXXXXX XXXXXXX BLDG.
TELEPHONE: 000-0000 TELEPHONE: 000-0000
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ALLOTMENT COST MAJOR & MINOR GRANT IS ON GRANT SUBGRANT CFDA
CODE CENTER OBJECT CODE FUND STARS CODE CODE NUMBER
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329.01 43 083 [ ] YES
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BEGINNING DATE: 7/1/97 TERMINATION DATE: 6/30/00
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ESTIMATED EXPENDITURES BY FISCAL YEAR BY FUNDING SOURCE:
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TOTAL CONTRACT AMOUNT
FY STATE FEDERAL INTERDEPARTMENTAL OTHER INCLUDING ALL AMENDMENTS
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98 $2,303,856.00 $2,303,856.00
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99 $2,506,155.00 $2,506,155.00
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00 $2,663,293.00 $2,663,293.00
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TOTAL $7,473,304.00 $7,473,304.00
===========================================================================================================================
CONTRACT SCOPE/SERVICE DESCRIPTION:
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PROVISION OF MENTAL HEALTH SERVICES FOR THE INMATE POPULATION CONFINED WITHIN THE TN DEPT. OF CORRECTION
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CHECK ONE FOR EACH CATEGORY:
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[ ] FISCAL YEAR FUNDING IS STRICTLY LIMITED.
[ ] FUNDS MAY ROLL FORWARD TO SUBSEQUENT FISCAL YEARS WITHIN THE CONTRACT TERM.
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[X] VENDOR IS ALREADY SET UP IN STARS ON ACH.
[ ] VENDOR ACH FORM IS ATTACHED.
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[X] CURRENT FORM W-9 INFORMATION IS ON FILE IN ACCOUNTS.
[ ] A FORM W-9 IS ATTACHED.
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APPROVED BY FISCAL OFFICER: COMPLETE FOR AMENDMENTS ONLY:
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ORIGINAL CONTRACT THIS AMENDMENT
AND PRIOR AMENDMENTS
/s/ XXXX X. XXX 11-3-97 ---------------------------------------------------------------
---------------------------------------------------- TERMINATION
SIGNATURE DATE DATE:
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OCA USE ONLY FY/FUNDING:
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TOTAL:
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