Tennessee State Government



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STATE OF TENNESSEE

DEPARTMENT OF CORRECTION

REQUEST FOR INFORMATION

FOR

ELECTRONIC HEALTH RECORD SYSTEMS

RFI # 32901-31253

[JANUARY 20, 2021]

1. STATEMENT OF PURPOSE:

The State of Tennessee, Department of Correction issues this Request for Information (“RFI”) for the purpose of purchasing an Electronic Health Records (EHR) system for correctional settings. We appreciate your input and participation in this process.

2. BACKGROUND:

TDOC oversees just under 100,000 offenders. Of this number, 78,511 are under probation, parole or community corrections, approximately 20,000 are incarcerated in a combination of 11 State-managed facilities, four privately managed facilities and more than 20 county jails.

Health Services performs extensive medical and dental screenings on all offenders immediately upon arrival at intake facilities. Tennessee's correctional health care system is a multidisciplinary approach that offers access to a health care delivery system providing offenders with access to such services as medical and dental sick call, emergency care, chronic care clinics, medication management, diagnostic tests and procedures, infirmaries, inpatient hospitalization, substance use treatment and specialty services working closely with Behavioral Health Services to ensure unified delivery of integrated health care.

The TDOC strives to improve the health status of its inmate population while providing for them a safe housing and working environment. Communicable illnesses such as Tuberculosis (TB), Methicillin-Resistant Staphylococcus Aureus (MRSA), and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) continue to be a major focus for Health Services. In addition, the department has begun to implement a major effort to standardize treatment plans and guidelines for the management of chronic illnesses such as diabetes, hypertension, hepatitis c, and asthma.

Through the contract for medical services, Health Services utilizes managed care practices to assure the efficient management of our medical and dental operations and expenditures. The utilization management system is used to pre-approve all requests for specialty consultations. In addition, the Office of Clinical Services is committed to providing a level of care within the department's infirmaries that allow us to treat offenders at the institutional level, when clinically appropriate, instead of relying on more costly outpatient care. Behavioral Health Services sets the policy standards for the delivery of behavioral health and substance use treatment services and evaluates the care provided throughout the TDOC system. The goals are to (1) reduce the debilitating effects of serious mental illness and maximize each offender's ability to participate in programs while maintaining a safe prison environment for offenders and staff, and (2) help prepare offenders with mental illness and/or substance use treatment needs to successfully transition from incarceration back to the community. A continuum of services is provided including psychological assessment, case management, medication management, crisis intervention, individual/group therapy, substance use treatment services and sex offender treatment program.

At initial intake into TDOC, behavioral health staff assess all offenders for their level of mental health functioning. The designated level of care allows for an efficient allocation of behavioral health resources while ensuring that offenders are placed in a facility that is capable of providing for their behavioral health needs. An offender's level of care designation is periodically reviewed to ensure the assigned level accurately reflects his or her current mental health functioning and level of treatment needs.

Offenders, whose ability to cope with the ordinary demands of life within a correctional environment is significantly impaired due to mental illness, are housed in designated Supportive Living Units (SLUs). The SLU provides a structured environment separate from the offender general population and are designed to assist seriously mentally ill offenders in functioning psychosocially and vocationally at the highest possible level within the correctional setting. These units offer a therapeutic milieu with a spectrum of programming designed to support and treat the mentally ill offender based on his/her individual treatment plan.

Behavioral Health Services utilizes standardized protocols and guidelines for community transition of offenders with mental illness. The focus is treatment team effectiveness, case management, and transition/reentry of offenders with special mental health needs. Forensic social workers are additionally utilized to help identify treatment resources in the community and provide for successful reentry. Behavioral Health Services supports the use of behavioral and cognitive-behavioral interventions as an alternative to the exclusive reliance on psychotropic medication in addressing offenders' mental health issues.

The mission of the Substance Use Disorder program is to break the cycle of substance use, criminal behavior, and incarceration in order to provide a safe and drug-free living and working environment both within state correctional facilities as well as in the local communities to which offenders return.

The Tennessee Department of Correction (TDOC) Substance Use Disorder programs are based on the idea that the participant is ultimately responsible for his/her recovery. Participants work closely with treatment staff to develop individual treatment goals and strategies. Each program develops and maintains a philosophy of treatment and therapeutic goals for their respective programs that is approved by the Director of Behavior Health Services.

A variety of treatment options are available to offenders based upon their assessed level of treatment needs.

For offenders with severe substance use disorders, intensive nine-to-twelve (9-12) month residential programs are available in which participants progress through multiple treatment phases. Based on the modified therapeutic community model, this highly structured community setting is used to provide a peer based support system for program participants. Program responsibilities are distributed through a structure board and participants are taught to take responsibility for their actions. In addition to substance use treatment, participants receive General Equivalency Diploma (GED) education, motivational group therapy, cognitive behavioral therapy, rational decision making, criminal thinking, parental skill development, anger management, victim's impact, job readiness/vocational training (where available), facility-based community service work and aftercare (where available).

For offenders with moderate substance use disorders, less intensive group therapy services are available. Group therapy is a four-to-six (4-6) month intensive outpatient program in which participants are required to complete, at minimum, 150 hours of structured evidence-based treatment services. Substance use problems are closely tied to social relationships; therefore, the focus is using group therapy as a tool for both prevention and for treatment.

The Parole Technical Violator Diversion Program (PTVDP) is additionally available for offenders who are reincarcerated due to a technical violation of their condition of parole. Currently located at Turney Center Industrial Complex Annex, this seventy-five (75)-bed program runs in conjunction with the modified therapeutic community program at the facility. The program lasts an average six (6) months and addresses the same topics covered in our standard therapeutic communities. Emphasis is placed on identifying offenders' reentry needs in order to make a successful crime and drug-free integration back into society.

To ensure the highest quality of care at the least expense to Tennessee taxpayers, Clinical Services is committed to Statewide Continuous Quality Improvement, a comprehensive program of evaluation and research. The mission of the Statewide Continuous Quality Improvement Committee (SCQI) is to:

Promote wellness among offenders in the custody of the Tennessee Department of Correction in a consistent manner throughout the state.

Identify opportunities for improvement that impact inmate health care, then evaluate and recommend corrective actions for operational and/or clinical management.

Demonstrate improvement in the quality of care through measured outcomes.

Identify areas of potential liability. Recommend corrective action to prevent occurrence of events that lead to increased liability.

The SCQI committee is divided into three (3) subcommittees: Morbidity & Mortality, Pharmacy & Therapeutics, and Peer Review. Teams of experienced clinicians and administrators meet on a regular basis to review, evaluate and make recommendations for improvement for all services.

One of the State-managed facilities, the Lois M. Deberry Special Needs Facility, provides services for offenders with multiple and complex medical problems, including acute and convalescent health care, intensive mental health intervention, three skilled nursing units to provide care for offenders recovering from surgery or serious illness, housing for offenders whose treatment regimen that is not manageable at other TDOC facilities, inmates with long-term medical needs, and a community hospital to provide inpatient and outpatient for the offender population in a designated secure area. An assisted living unit is located at this facility for TDOC offenders who are aged or infirm and unable to care for themselves within a traditional prison population. Health Care, Behavioral Health Care and Pharmacy Services are provided under contract, with the three (3) contractors working together under the supervision of the Department’s Chief Medical Officer, Director of Behavioral Health, and Director of Pharmacy. Contractor staff would be among the potential users of an Electronic Health Records System.

Medical Records are currently maintained as paper files in keeping with TDOC policy # 113.04 which is incorporated into this solicitation as Attachment One. In the event that an offender is transferred to a different prison facility or transported to an external hospital for care, copies of paper files are maintained at the sending institution and a separate set accompany the inmate in transit.

TDOC currently uses a legacy Offender Management Information System. The EHR system must be able to interface with the OMS, as well as other systems including but not limited to the pharmacy system, the STRONG-R validated risk-needs assessment system, telehealth systems and the State’s contracted drug testing vendor system.

The State anticipates approximately 1,500 plus system users to include but not be limited to Agency Executive Leadership, Community Supervision staff, Clinical Services staff including Medical and Behavioral Health, Health Services Administrators, Food Services staff, Agency Contract Monitoring and Audit staff, staff from other State agencies with oversight authority and contractor staff as detailed above.

The State is interested in a correction-specific Electronic Health Record system, a system designed and created specifically for use in prison facilities.

3. COMMUNICATIONS:

1. Please submit your response to this RFI via e-mail to:

Priscilla Wainwright, Director of Contracts Administration Tennessee Department of Correction

320 Sixth Avenue North Nashville TN 37243

priscilla.wainwright@

2. Please feel free to contact the Department of Correction via e-mail with any questions regarding this RFI. The main point of contact will be:

Priscilla Wainwright, Director of Contracts Administration Tennessee Department of Correction

320 Sixth Avenue North Nashville TN 37243

priscilla.wainwright@

3. Please reference RFI # 32901-31253 with all communications to this RFI.

4. RFI SCHEDULE OF EVENTS:

| | | |

|EVENT |TIME |DATE |

| |(Central Time Zone) |(all dates are State business |

| | |days) |

| |RFI Issued | |January 20, 2021 |

| |RFI Response Deadline | |February 3, 2021 |

5. GENERAL INFORMATION:

1. Please note that responding to this RFI is not a prerequisite for responding to any future solicitations related to this project and a response to this RFI will not create any contract rights. Responses to this RFI will become property of the State.

2. The information gathered during this RFI is part of an ongoing procurement.  In order to prevent an unfair advantage among potential respondents, the RFI responses will not be available until after the completion of evaluation of any responses, proposals, or bids resulting from a Request for Qualifications, Request for Proposals, Invitation to Bid or other procurement method.  In the event that the state chooses not to go further in the procurement process and responses are never evaluated, the responses to the procurement including the responses to the RFI, will be considered confidential by the State. 

3. The State will not pay for any costs associated with responding to this RFI.

6. INFORMATIONAL FORMS:

The State is requesting the following information from all interested parties. Please fill out the following forms:

|RFI #32901-31253 |

|TECHNICAL INFORMATIONAL FORM |

|RESPONDENT LEGAL ENTITY NAME:       |

|RESPONDENT CONTACT PERSON: |

|Name, Title:       |

|Address:       |

|Phone Number:       |

|Email:       |

|BRIEF DESCRIPTION OF EXPERIENCE PROVIDING SIMILAR SCOPE OF SERVICES/PRODUCTS |

|      |

|FILL IN WITH REQUESTED INFORMATION AS NEEDED |

| |

|How long has your EHR system been in commercial use? |

| |

|Is your EHR system accessible on desktop, laptop, android/ios tablet; android/ios smartphone? |

|What are minimum hardware requirements for devices to access the system? |

|Are any specific web browser(s) required to access the system? |

|Does the system require any specific internet connectivity requirements? |

| |

|Can the EHR system be accessed behind prison facility walls if no internet connectivity is available? |

| |

|Is technical assistance available twenty-four (24) hours a day, seven (7) days per week? |

| |

| |

|Is your EHR system scalable in terms of number of users? |

| |

|Is your EHR system scalable in terms of number of inmate records? |

| |

|Is access role-based? |

| |

|Does your EHR support documentation of intake medical screenings, vital signs, blood sugar checks, and other health checks? |

| |

|Does your EHR provide a mechanism for user-defined, ad hoc reporting and analytical reporting? |

| |

|Does your EHR provide the ability to attach other digitized documents (e.g. captured by a fax server) to an inmate/patient’s record and/or |

|uploads electronically? |

| |

|Does your EHR support resource scheduling (e.g. equipment, rooms and clinicians) and patient scheduling into those resources? |

| |

|Does your EHR capture patient data electronically from medical devices (e.g., glucometers, Positive Airway Pressure Machines (aPAP/cPAP), |

|sleep studies, Electrocardiogram (EKG/ECG), x-rays, etc.)? |

| |

|Does your EHR support documenting on handheld or tablet devices (wireless and/or corded)? |

| |

|Does your EHR support telemedicine (e.g., remote consultations, psychology and tele-psych)? |

| |

|Does your EHR support infection control monitoring, tracking and reporting? |

| |

|Does your EHR possess the ability to create and/or generate electronic forms and reports as required by the customer? |

| |

|Are your EHR system reports end-user customizable? |

|Are data elements exportable? |

| |

|Does your EHR system have the ability to route, sign and markup documents should be available, i.e. e-signature. |

| |

|Does your EHR system have the capability to enable/disable specific components to adapt to the needs of each facility and/or medical |

|specialty? |

| |

|What kind of training is provided for agency/contract partner staff? |

| |

|Are billable units based on number of administrative users? Per day/week/month? |

|If customization is needed, what are billable units for such? |

| |

|Which municipal, county, State correctional agencies are currently using the product? |

| |

|How long have they been using system? |

|What was implementation timeline? |

|Was timeline met? If not, what were circumstances, how long beyond timeline did implementation take place? |

|Was any customization required? |

|Did agency digitalize existing medical records or was that part of implementation process? |

| |

|Was this their first system? |

|For most customers, who are typical user types? |

|Agency Executive Leadership/Clinical staff, |

|contract partners, |

|agency monitoring/audit; other State oversight/monitoring staff |

| |

|What is the largest correctional agency currently using your system? |

| |

|How many inmate records is your system capable of archiving? |

| |

|Are records unified – health, dental, behavioral health combined – or are they separated by discipline? |

| |

|What medical/Federal IS regulations does your EHR system comply with? |

| |

|What certifications does your EHR system possess? |

| |

|Does your system simply archive records or does it have interfaces with medical/diagnostic references such as Diagnostic and Statistical |

|Manual of Mental Disorders (DSM)? |

| |

|How does your firm address EHR system upgrades and/or system sunsets or phase-outs? |

| |

|Does your EHR system have modules? What other related modules may be of interest to TDOC? |

|COST INFORMATIONAL FORM |

|Describe what pricing units you typically utilize for similar services or goods (e.g., per hour, each, etc.:       |

|Describe the typical price range for similar services or goods       |

|FILL IN WITH REQUESTED INFORMATION AS NEEDED |

|ADDITIONAL CONSIDERATIONS |

|Please provide input on alternative approaches or additional things to consider that might benefit the State:       |

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