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Brevard County Sheriff’s Office

Client Location and Contact:

|Brevard County Jail Complex |Client contact: Sheriff J.R. “Jack” Parker |

|860 Camp Road |(321) 264-5201 |

|Titusville, Florida 32790-4095 |Contract date: July 1, 2005 |

| |1,700 inmates |

Scope of Services:

Along with our comprehensive medical services program, we operate a recently opened 300-bed medical housing unit. We employ over 38 full-time professionals and support staff including permanent employees and contract staff.

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|“Armor assigns priority to improving our medical services here. |

|Their personal touch and the commitment of the Medical Director |

|assure me that there is a high standard for the quality of care. |

|Communications are superior.” |

|Commander Susan Jeter |

|Brevard County Sheriff’s Office |

Milestones:

Working closely with the Sheriff’s Office staff, our medical services program now features new leadership who has assumed complete accountability for their performance. During the contract transition, major changes in the physical plant and inmate housing increased the scope and complexity of the program for our staff at the facilities.

← Leadership Development and Program Management – We improved staff stability and morale by appointing new experienced leadership for our medical services program.

← Medical Providers – In addition to appointing a highly experienced correctional physician as medical director, we have added a mid-level provider (physician assistant) to increase medical coverage through additional hours and flexible scheduling.

← Program Expansion – Throughout the expansion, realignment, and construction of new inmate housing, we developed flexible staffing plans and installed procedures and equipment (including a golf cart) to accommodate the decentralized facilities.

← Accreditation – Our program at Brevard County has been fully accredited by FMJ, and we have begun planning with the Sheriff’s Office to secure NCCHC accreditation.

← Medical Housing Unit – We recently organized and opened a special medical housing unit that has over 300 medical and behavioral health beds with improved facilities, equipment, and space.

← Telemedicine – To increase available on-site services, we are currently implementing a telemedicine program that focuses on wound care.

← Dental Services – We are reorganizing dental services, improving equipment, and expanding the availability of dental services on site.

Broward County Sheriff’s Office

Client Location and Contact:

|Dept of Correction & Community Control |Client contact: Lt. Colonel Rick Frey |

|555 S.E. 1st Avenue |(954) 831-5924 |

|Fort Lauderdale, Florida 33301 |Contract date: December 1, 2004 |

| |5,400 inmates |

Scope of Services:

We provide our comprehensive health care services program to inmates in five separate jails and four satellite booking facilities. We manage on-site specialty clinics for HIV, women’s health, orthopedics, and optometry, as well as a 109-bed infirmary. We provide a specialized mental health program along with the Sheriffs Office’s staff featuring a wide array of behavioral services including individual therapy, psychopharmacology, and suicide prevention programs. We employ a staff of 275 full-time employees including permanent employees and contract staff.

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|“Armor has provided open discussions and follow-up that is action |

|oriented and in the best interest of health care for inmates who have |

|medical issues. Over the last several years, we were able to |

|strengthen and create new public health programs in collaboration with|

|Armor and the Broward Sheriff’s Office.” |

|David L. Roach, Administrator |

|Broward County Health Department |

Milestones:

At Broward County Jails, a large urban jail system with diverse facilities and programs, we serve a rapidly growing urban community. With a jail system larger than many state systems, Broward Sheriff’s Office must continuously address challenges created by this growth and the system’s complexity. We have excelled at Broward because we dedicate expert senior management to the contract and have built a strong partnership with our client to meet their needs.

← Accreditation – Since the contract began, we have maintained FMJ, FCAC, ACA, and NCCHC accreditation, which confirms that our medical, mental health, and dental services comply with these rigorous standards.

← Accelerated Start Up – We successfully started program in less than 30 days.

← Recruitment and Staffing – Initially Broward County Jails did not have the required number of full-time employees. We have since filled all of the positions, increased staffing levels, and reduced the number of vacancies (currently less than four percent).

← Health Department Programming – With the support of the Sheriff’s Office, we have accelerated integrating the jails’ program with the county health department, including HIV/STD testing. Inmates are now offered the Hepatitis A and B vaccine series at the time of their health appraisal. The health department follows up with the inmates upon their release.

← Acute Hospital Care – We are currently looking into establishing a secure inpatient medical unit with North Broward Hospital District.

← Utilization – We successfully reduced and maintained fewer emergency department visits.

← Infection Control – Our MRSA surveillance and control program at Broward was featured at the national meetings held by ACA and NCCHC.

← Educational Affiliations – We host fourth-year medical students from NOVA Southeastern University (NSU) College of Osteopathic Medicine for an elective rotation in correctional health care. Physicians credentialed as NSU associate clinical professors serve as preceptors. Additionally, we offer student internships through our affiliation with Florida Atlantic University for the Masters in Mental Health program.

Escambia County Sheriff’s Office

Client Location and Contact:

|Escambia County Sheriff’s Office |Client contact: Commander Fred Alford |

|1700 W. Leonard Street |(850) 436-9822 |

|Pensacola, Florida 32501 |Contract date: October 1, 2006 |

| |1,900 inmates |

Scope of Services:

Along with our comprehensive medical services program, we operate a 50-bed infirmary and employ more than 45 full-time employees including permanent employees and contract staff.

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|“Armor has mobilized an expert transition team of experienced |

|professionals and installed management systems that assure quality |

|care. As a result, the transition was seamless and was accomplished |

|with no disruption of service.” |

|Former Sheriff Ron McNesby |

|Escambia County, Florida |

Milestones:

In the first year of our contract, we achieved full NCCHC accreditation while working intensely to implement new training and compliance programs.

← Accreditation – With the jails on probation as a result of an NCCHC survey completed before our contract, we made NCCHC compliance a high priority. We stationed a team of senior clinical specialists and program managers at the jails to prepare for the pending survey and were subsequently awarded full accreditation. We have also maintained FMJ accreditation.

← Contract Transition – We completed the contract transition seamlessly and well within the client’s timetable. Our transition team was comprised of senior clinical staff and operations specialists including corporate headquarters staff.

← Electronic Medical Record – We are working with MedAppz, Inc. to install a comprehensive electronic medical records system. The design and specifications will soon be complete. Installation is scheduled before January 1, 2009.

← Mental Health – We worked with the Sheriff’s Office to activate a specialized discharge-planning network that incorporates the local community mental health agency into pre-release treatment programming, referral, and on-going treatment following release. We ensure continuity of care for inmates with chronic mental illness by coupling weekly meetings on site with continuous case management by community mental health providers.

← Staffing – In this highly competitive nursing marketplace, we actively and continuously recruited local nurses to sharply reduce the number of agency nurses at the jails.

← Utilization Management – We are maintaining off-site hospital and specialty costs well below budgeted levels and within our aggregate cap on off-site costs. We have also employed a hospital-based case manager to monitor hospital care.

← On-site Clinics and Chronic Care – We have expanded the number and frequency of on-site specialty services and have more than doubled enrollment in inmate chronic care programs.

Glades County Sheriff’s Office

Client Location and Contact:

|1995 E St. |Client contact: Sheriff Stuart Whiddon |

|Route 78 NW |(863) 946-1600 |

|Moore Haven, Florida 33471 |Contract date: July 1, 2007 |

| |570 inmates |

Scope of Services:

We provide our comprehensive medical services program to inmates housed at the new Glades County Jail in Moore Haven. We employ more than 18 professionals including permanent employees and contract staff.

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|"At Glades, we are impressed by the way security staff and health |

|service providers work together. It sets a standard for other jails |

|where our inmates are housed. We are pleased to see such teamwork." |

|Immigration and Customs Enforcement |

|Surveyor |

Milestones:

We supported the Glades County Sheriff’s Office (GCSO) during the final stages of planning the expanded jail and helped to implement administrative systems and health care services with GCSO staff before the opening. After several months with our health services administrator on site, the new jail opened and, within the first three months, expanded to serve even more inmates that expected. We are proud to be providing the first ever medical services in GCSO’s brand new jail.

← Staffing – Beginning from the first day, we fully staffed the program, and staff has been stable with no turnovers. We have also been able to attract an experienced nursing staff.

← Accreditation – The jail’s first FMJ survey is planned for October 2008.

← Telemedicine – We began several on-site services including telemedicine for wound care.

← Emergency Response – Within our first year, we had to mobilize an emergency plan to absorb inmates evacuated from other Department of Corrections’ facilities due to regional fires. Our process worked as planned, without any problems.

← Revenue Recovery – Inter-Governmental Billing – We have worked closely with jail administrators to track utilization. At Glades, a new jail with contracts to house inmates in the custody of multiple governmental agencies, we help them to recover revenue by supplying documentation that supports inter-governmental billing. Revenue recovery is important to many of our clients but, because of the size of this jail and their level of contracting, recovering this revenue is critical to their financial feasibility.

← Pharmacy – We implemented a local pharmacy agreement designed especially for this isolated, rural location to ensure reliable delivery and emergency responsiveness. This new arrangement has been essential for us to attain the operating standards we must maintain to support the Sheriff’s Office’s initiatives to contract housing to other agencies.

← Teamwork with Security – We developed effective partnerships between our providers and the jail’s security staff by emphasizing that we support the jail’s public safety mission. As a result, we have an excellent collaboration between correctional officers and jail administration.

Hillsborough County Sheriff’s Office

Client Location and Contact:

|Falkenburg Road Jail Medical Unit |Client contact: Major Curtis Flowers |

|520 N. Falkenburg Rd. |(813) 247-8318 |

|Tampa, FL 33619 |Contract date: October 1, 2005 |

| |4,100 inmates |

Scope of Services:

We provide our comprehensive medical services program at two large facilities, each with over 2,000 inmates. The program features on-site clinics for women’s health and orthopedics. We operate two 50-bed infirmaries for male and female inmates and employ more than 200 FTEs including permanent employees and contract staff.

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|“We have a really good relationship at the jails with Armor. They |

|make my job easier because they put together a packet that really |

|works. Our inmates agree that with Armor’s help, they get the |

|assistance they need when released.” |

|Sarah Setser |

|Hillsborough County |

|Department of Health & Social Services |

Milestones:

We recognize the Sheriff has made it a high priority to provide excellent medical services throughout this metropolitan correctional system. We have focused on open and continuous communication to establish and preserve a partnership dedicated to enhancing all aspects of the program.

← NCCHC Program of the Year 2007 (Discharge Planning) – This national award was presented by Accreditation Surveyors. We worked together with the Sheriff’s Office and local providers to install a program of pre-release medical discharge planning that addresses the chronic and continuing care needs inmates have upon release. Incorporating follow-up procedures and outcomes analysis, the program reduces jail recidivism and improves compliance with treatment plans.

← Inmate Grievance System – We have significantly reduced the number of grievances and shortened the time needed to resolve and report grievances by appointing a grievance coordinator and installing a centralized procedure for receiving and processing complaints.

← Accreditation – The medical services program has maintained its FMJ, ACA, and NCCHC accreditation even while we implemented substantial organizational changes to improve performance.

← Medical Teams Assigned to Pods – We have implemented pod-specific medical programming to help coordinate custody and health care for each housing unit.

← On-site Clinics – We have expanded on-site specialty services by organizing multiple clinics, such as orthopedic and obstetrics clinics, at the jails.

← Community Partners – We continue to support the Sheriff’s Office in integrating jail and community programs by working closely with Hillsborough County Department of Human Services and community mental health centers to provide joint programs at the jails.

← Educational Affiliations – We partner with the University of South Florida to support their forensic medicine program by hosting a psychiatric fellowship program at the jail. We are developing an agreement that will include a faculty appointment for Armor’s Medical Director and allow the University’s residents and students to participate in the program.

Martin County Sheriff’s Office

Client Location and Contact:

|Martin County Sheriff’s Office |Client contact: Sheriff Robert Crowder |

|800 Monterey Rd |(772) 220-7000 |

|Stuart, Florida 34994 |Contract date: November 1, 2005 |

| |600 inmates |

Scope of Services:

Along with our comprehensive medical services program, we operate a medical housing unit and employ more than 18 professionals and support staff including permanent employees and contractors.

|“The priority attention that Armor has given to our compliance with |

|national accreditation standards and to stabilizing our staff has |

|resulted in a stronger sense of professionalism. As a physician at the|

|jail prior to the Armor contract, I have seen a greater commitment to |

|correctional health care here in Martin County.” |

|Don Scheurer, MD |

|Armor Medical Director |

Milestones:

With the jail’s rapidly growing inmate population and need for expanded and improved services, we have provided our client with comprehensive corporate resources. We have worked closely with the Sheriff’s Office to increase productivity and coverage as the jail’s inmate population rose by 20 percent. As a result, we have remained within the initial contract terms without increases to date.

← Accreditation – Within one month of starting the contract, we successfully completed an FMJ accreditation survey. We also completed NCCHC accreditation with commendation during the summary conference and, during the first year of operation, supported the Sheriff’s Office in an audit by the FCAC.

← Permanent Staffing – We are generally fully staffed and have no vacancies. We have sharply reduced the jail’s use of agency staffing and do not employ temporary staff in a location that was previously staffed mainly by agencies.

← Organization of Mental Health Services – We seamlessly maintained mental health services after the subcontracted provider abruptly terminated its services. This change, along with consolidating the psychotropic medication supplier, has stabilized the mental health program and improved overall service. We have increased productivity and psychiatric provider hours without increasing costs.

← Community Coordination – With our support, the health department is now on site testing inmates for HIV and RPR.

← Disaster Plans – Our staff participated in disaster planning with the Sheriff’s Office and successfully completed the jail’s first-ever unannounced mock disaster drill. The drill included filming and post-drill analysis, which was also used to prepare for NCCHC accreditation.

Palm Beach County Sheriff’s Office

Client Location and Contact:

|Palm Beach County Sheriff’s Office |Client contact: Sheriff Ric Bradshaw |

|3228 Gun Club Road |(561) 688-3021 |

|West Palm Beach, Florida 33406-3001 |Contract date: May 1, 2006 |

| |2,900 inmates |

Scope of Services:

We provide our comprehensive medical services program at three facilities and operate on-site specialty clinics for orthopedics and chronic care, two infirmaries, and two medical housing units. We employ over 115 professionals with both permanent employees and contract staff.

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|“I became an Armor staff member from our previous contractor. Since |

|then, Armor's supportive management group has made me feel like I am |

|part of the family. They encourage all employees to spread their wings|

|and fly. I plan on "soaring" with Armor Correctional Health Services |

|for a long, long time.” |

|Vicky Brackin |

|Armor HSA |

Milestones:

Armor has partnered successfully with the Sheriff’s Office to implement new programs, increase accessibility to on-site care, and expedite critical treatment timeframes. We are implementing innovative approaches to staff development to enhance retention of our health providers. Innovative approaches to inmate health education have improved inmate satisfaction with healthcare services.

← Accreditation – Within 30 days of starting up the program, we mobilized staff to pass the FMJ survey. We also supported the Sheriff’s Office in an audit by the FCAC within weeks of beginning the program. In May 2008 we successfully completed the NCCHC survey with a recommendation for full accreditation. Our ACA survey is scheduled for September 2009.

← Intake and Medical Screening – By condensing the intake screening process and training technicians in immediate screening procedures, we met the Sheriff’s Office goal of expediting inmate histories and physicals. We performed this work while installing a new history and physical system with new forms, adjusted staffing, and revised reporting.

← Mental Health – For this program, where we coordinate care with a separately contracted mental health provider, we organized new mental health staffing under a comprehensive provider to significantly improve the program’s responsiveness and fully integrate mental health care.

← Discharge Planning – Working with the Sheriff’s Office and community-based providers, we linked dedicated staff and providers to support follow-up upon release for Palm Beach County. We also appointed a full-time discharge planner to work with community organizations to provide follow-up with inmates upon release.

← Reception Unit – We have assigned a special team to support the inmate reception process. Medical services are based in the new unit.

← Annual Skills Fair – To focus our staff on specialized skills related to their work, we sponsored a special event featuring staff development and educational opportunities (e.g., equipment, pharmacy, etc).

Sarasota County Sheriff’s Office

Client Location and Contact:

|Sarasota County Jail |Client contact: Major Kurt Hoffman |

|2020 Main Street |(941) 861-4059 |

|Sarasota, Florida 34327 |Contract date: October 1, 2007 |

| |1,100 inmates |

Scope of Services:

We provide our comprehensive medical services program to inmates housed at the Sarasota County Jail, where our on-site specialties include optometry and orthopedics. We employ over 30 professionals with both permanent employees and contract staff.

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|“We have worked with Armor Correctional Services for some time. They |

|respond to all requests in a timely manner. When we bring items or |

|cost questions to their management’s attention, they respond quickly. |

|Their level of services are equal to or better than the previous |

|vendor. On-site services have helped keep our overtime cost down. We |

|are well served and very pleased.” |

|Frank Carroll |

|Sarasota Contract Monitor |

Milestones:

In this very competitive marketplace, we achieved a very smooth start-up without any service interruptions.

← Accreditation – We are in the process of completing the requirements for the NCCHC survey in August. We plan to maintain FMJ and FCAC accreditation.

← Staffing – In this highly competitive nursing marketplace, we actively and continuously recruited local nurses to sharply reduce the number of agency nurses at the jail. Overall, have achieved full staffing.

← Utilization Management – We have reduced emergency department visits, hospital admissions, and ambulance transports, and trends indicate a 50 percent reduction in hospital days. We have negotiated favorable terms with the community hospital and strengthened the jail’s partnership with the hospital to contain costs.

← Educational Affiliations – We are currently developing a partnership with a college of osteopathic medicine to host students who will work with the college’s medical faculty at the jail. 

← Contract Monitor – We have supported the Sheriff’s initiatives to increase accountability by working with their first full-time, on-site contract monitor.

← Florida Police and Fire Games – We participated as a corporate sponsor of these statewide athletic competitions hosted by the Sarasota Sheriff’s Office in June 2008. We were pleased to play a small part in helping our client as they assume a leadership role among other Florida criminal justice and public safety agencies.

St. Johns County Sheriff’s Office

Client Location and Contact:

|St. Johns County Sheriff’s Office |Client contact: Mark E. Simpson |

|4015 Lewis Speedway |(904) 810-3682 |

|St. Augustine, Florida 32084 |Contract date: November 15, 2007 |

| |550 inmates |

Scope of Services:

We provide our comprehensive medical services to inmates housed at the St. Johns County Jail. In July 2008, we were moved into the new infirmary that will function as the medical clinic and office area while the jail is remodeled. After the remodeling, we will operate a new medical unit and 10 bed infirmary. We employ over 17 providers and professionals, many of whom were retained as we assumed management.

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|"Changing health care contractors was a good decision. Armor focused |

|on a smooth transition in order to maintain continuity and employment |

|of key staff. The company did a great job. Armor also acted |

|immediately to address our concerns. Today the program is steadily |

|improving thanks to our relationship with Armor." |

|Mark Simpson MBA, CPFO |

|St. Johns County Sheriff's Office |

Milestones:

As the Sheriff’s Office upgrades the medical unit, we are implementing guidelines and agreements to lower off-site utilization, including improved working relationships with area hospitals.

← Accreditation – As part of our compliance plan, we expect to maintain FCAC, FMJ, and NCCHC accreditation.

← Contract Transition – At the Sheriff's request, we accepted the challenge to improve customer service and access to inmate health care at St. John’s when we assumed this contract for inmate health services from another provider. We executed a seamless contract transition while increasing corporate support for the local staff and containing off-site medical costs.

← Staff Retention – Through our staff recruitment and retention strategy, we retained all key staff by announcing the contract change in a timely and effective manner, thoroughly orienting existing staff, and assigning key corporate staff on site prior to and during the contract conversion process.

← Utilization Management – To implement our approach to utilization management, we have established direct relationships with the University of Florida Health Science Center, Shands Jacksonville, which the jail uses to provide specialty outpatient, emergency, and inpatient care, when needed.

← Medical Providers – While staying within the established inmate health care budget, we increased medical provider coverage by adding a nurse practitioner and scheduling on-site medical services for specific cases.

← Pharmacy – We continued the Sheriff's Office’s preferred pharmacy contract to ensure continuous client satisfaction with pharmacy services.

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