HEALTH CARE SERVICES CONTRACT

 HEALTH CARE SERVICES CONTRACT

                 This agreement is made this 3rd day of June, 1996, by
            and between Prison Health Services, Inc. (``PHS'') and the
            State of Delaware, Department of Correction (``State'').

                                      RECITALS
                 WHEREAS, the State desires to purchase the health care
            services offered by PHS, to serve the needs of the State and
            the inmate population in Delaware; and

                 WHEREAS, the State has asked prospective vendors to
            submit proposals for contract No. 96-333-MS; and

                 WHEREAS, PHS intends to provide the aforementioned
            health care services to the State and its proposal was
            accepted by the State.

                 NOW THEREFORE, in consideration for the mutual promises
            contained herein, the parties enter into this agreement and
            its related documents to govern their relationship.  The
            Terms and Conditions of this agreement are contained within
            the State's Health Care Services Contract Request for
            Proposal (with all addenda thereto) and the proposal
            response submitted by PHS; however, the State requests and
            PHS agrees to modification of the Request for Proposal and
            the response thereto pursuant to Section III A.3. of the
            Request for Proposal as follows:

            1.   Management Information System
                 -----------------------------
                 PHS will provide a basic computer based information
                 system capable of reporting aggregate data and
                 providing E-mail linkage to the Department.

                 The Department agrees to allow the installation of the
                 secure telephone lines and other connections required
                 to operate the system.  PHS guarantees the system will
                 be installed and operational by October 1, 1996.

            2.   Medical Escorts
                 ---------------
                 PHS agrees that the Department will not be required to
                 provide security escorts for PHS' personnel within the
                 department's facilities when those personnel are
                 performing routine job functions.  The Department
                 agrees, however, to provide security escorts for PHS
                 personnel only to the extent that such escorts would
                 normally be provided for any other civilian personnel.

            3.   Secure Inpatient Hospital Facilities
                 ------------------------------------
                 
                 PHS agrees to diligently pursue, with hospitals located
                 within the State of Delaware, the establishment of a
                 secure unit within one or more of those hospitals.  The
                 size of the secure unit(s) will be determined by need
                 as determined by the Department, PHS and the
                 hospital(s).  The secure unit(s) will be established,
                 in cooperation with the Department, as expeditiously as
                 possible.

            4.   Staffing of Baylor Women's Correctional Institution
                 ---------------------------------------------------
                 PHS agrees that the medical unit at the Baylor's
                 Women's Correctional Institution (BWCI) can be staffed
                 24 hours per day, 7 days per week by medical personnel
                 without requiring similar 24 hour staffing by a
                 correctional officer.  The Department agrees that
                 patient rooms in the BWCI infirmary will have locking
                 doors and that keys to those rooms will be provided to
                 PHS personnel.  The Department agrees that security
                 personnel will be provided to within a reasonable
                 period of time following a request from PHS personnel
                 when there is a need to provide medical services to a
                 maximum security inmate, or other inmate who poses a
                 security risk to the medical unit staff or the
                 facility, who is housed in the infirmary.  The
                 Department may, at its discretion, provide such limited
                 security services in the infirmary via either
                 correctional officers assigned ``rover'' duties or
                 permanent position assignments within the infirmary.

            5.   Mental Health Staffing
                 ----------------------
                 PHS will provide mental health staff on a regionalized
                 basis to meet the requirements of the Department's
                 Request for Proposal.  Staffing is projected in Full
                 Time Equivalents (FTE's) at 3.2 FTE Mental Health
                 Counselors (MHC's), 2.2 FTE Psychologists (Psychol),
                 and 1.0 FTE Psychiatrist (Psych).  The Department
                 agrees that PHS may have mental health evaluations
                 performed by nursing personnel.

            6.   Dental Services
                 ---------------
                 PHS agrees to use only Delaware licensed dentists to
                 provide the dental services described in its proposal.
                 PHS intends to hire dentists as employees of PHS.
                 Staff will be obtained first by recruiting those
                 dentists already providing services within the
                 facilities.  The parties agree, however, that retention
                 of existing staff is at the option of PHS.  Additional
                 staff, if needed, will be recruited locally through
                 advertising and professional referrals.  PHS will also
                 work with the Board of Dental Examiners to identify
                 dentists seeking employment.  Should PHS determine a
                 need to subcontract dental services in the future, it
                 will provide the Department advance notice of its
                 intent and will further provide copies of any such
                 subcontract agreements to the Department in advance of
                 the effective date of the subcontract.

            7.   Effect of Population Increase on Contract Cost
                 ----------------------------------------------
                 Tables A - F are deleted and replaced by the following
                 formula
                 Fixed annual cost       $4,867,720+
                 Variable Cost of        $65.50 per inmate per month
                                          with co-pay and
                                         $66.50 per inmate per month 
                                          without co-pay

                 Thus, if one assumes an average daily population of
                 5,000 inmates, the annual variable cost with co-pay
                 would be $3,930,000, and the total annual cost would be
                 $8,797,720.  The per inmate variable cost is not
                 intended to cover the increased staffing cost resulting
                 from the expansion of the inmate population into new
                 housing units, excluding the Boot Camp, Prison
                 Industries Dorm and Pre-Trial Building at Sussex
                 Correctional Institution as described in the Request
                 For Proposal.  The 600 cell facility at Delaware
                 Correctional Center will require staffing increases.
                 When it is determined that additional staffing above
                 the staffing plan identified in PHS' proposal is
                 needed, the Department will negotiate in good faith
                 with PHS as to the dollar amount to be added to the
                 contract to cover increased staffing costs.

            8.   Contract Implementation Not Dependent on Receipt of
                 ---------------------------------------------------
                 Data
                 ----
                 The Department agrees to provide as much of the medical
                 information and data requested in PHS' proposal as is
                 reasonable available prior to the effective date of the
                 contract.  The Department agrees to provide PHS with
                 access to inmate medical files and facility medical
                 units following the formal award of contract in order
                 to allow PHS to gather critical medical information
                 needed to facilitate a smooth contract transition.  PHS
                 agrees that implementation of contracted services in
                 not dependent upon the receipt of such data.

            9.   Second Option Costs
                 -------------------
                 The Department and PHS agree that the costs associated
                 with a second medical opinion, when that opinion is
                 requested by an inmate, are the responsibility of the
                 inmate and not the Department or PHS.  Such costs
                 include, but are not limited to, physician fees,
                 charges for any tests or studies, hospital charges,
                 transportation costs and salaries for escort officers.
                 The inmate will be required, prior to obtaining a
                 second opinion, to sign a release of financial
                 responsibility form that releases the Department and
                 PHS from the responsibility for such costs.  The inmate
                 will also be required to make or secure advance payment
                 for all such costs.

            10.  Disaster Plan
                 -------------
                 PHS will develop, for each of the Department's
                 facilities where PHS provides services, comprehensive
                 disaster plans in compliance with the Department's
                 Request For Proposal requirements and in keeping with
                 NCCHC Standards.  Each individual disaster plan will
                 define the emergency medical procedures to be followed
                 in the event of man-made or natural disaster, either
                 internal or external to the facility.  The plans will
                 be developed in coordination with the facilities'
                 security plan and will be incorporated into the
                 facilities' overall emergency plan.
                 In addition to detailing the actual emergency medical
                 procedures to be followed by health care staff, the
                 disaster plans will address staffing, transportation,
                 supply, equipment and communication needs in emergency
                 situations.  Orientation of new health care staff will
                 include a review of the responsibilities of each staff
                 member with respect to the disaster plan.  Detailed,
                 written procedures will be maintained in the medical
                 unit for responding to disasters.
                 Disaster plans will be exercised annually.  Such drills
                 will provide familiarization training to staff members
                 to ensure that appropriate action will be taken in the
                 event of an actual disaster.

            11.  Subcontractors
                 --------------
                 PHS agrees to provide the Department with copies of all
                 contracts for services PHS subcontracts in advance of
                 those services being provided.  The Department
                 acknowledges that all such subcontracts are proprietary
                 in nature and agrees, subject to any applicable
                 Delaware Law, to treat them as confidential and not
                 subject to release to anyone outside of the Department
                 without PHS' written approval.

            12.  Acceptance of Performance Guarantees
                 ------------------------------------
                 PHS acknowledges and, without exception, accepts all
                 performance guarantees identified in the Department's
                 Request For Proposal.  The Department agrees to provide
                 PHS with written notice of any deficiency.  If the
                 deficiency is corrected within 15 calendar days of such
                 notice, no penalties will be imposed.

            13.  Medicaid Rates
                 --------------
                 PHS agrees to identify an savings it obtains should the
                 Department secure the ability to utilize Medicaid
                 reimbursement schedules for services provided to
                 inmates.  PHS further agrees to share any such savings
                 it may realize with the Department with 75% of the
                 savings realized to be credited to the Department.
                 PHS, in the normal course of dealing with hospitals and
                 other providers, negotiates discounts from charges as
                 well as other payment schedules and rates.  To
                 calculate the savings if providers accept Medicaid
                 rates, PHS will subtract the Medicaid rates from the
                 negotiated PHS rates in place at that time.  That
                 difference is the ``Medicaid Savings''.  Adjustments
                 will be made with the Department on a quarterly basis
                 based on a ``Medicaid Savings Report'' which PHS will
                 provide 60 days after the close of each quarter.

            14.  Laboratory Services
                 -------------------
                 The Department agrees that laboratory tests for
                 sexually transmitted diseases including, but not
                 limited to, RPR/VDRL's and smears for chlamydia and
                 gonorrhea, as well as sputum cultures for communicable
                 diseases and throat cultures for Strep will be
                 performed by the state health department at no expense
                 to PHS.

            15.  OTC Medications
                 ---------------
                 The Department agrees, subject to security
                 considerations, to have over-the-counter-medications
                 (OTC's) that are identified by PHS placed on the inmate
                 commissary list.  PHS agrees to limit such OTC's to no
                 more than thirty.

            16.  Chronic Care Unit
                 -----------------
                 PHS agrees to staff the Chronic Care Unit at the Sussex
                 Correctional Institution (SCI) with two full time
                 Mental Health Counselors (MHC's) and one additional
                 full time staff person.  These positions, which will
                 not be back filled during periods of paid leave, are
                 intended to replace the Mental Health Counselor and
                 Recreational Therapist positions specified as ``As
                 Required in Appendix I & J'' in Proposed Staffing Plan
                 for SCI on page 168 of PHS' proposal.  Payment for this
                 staff is included in the Annual Fixed Rate.

                 
            17.  Transition Unit
                 ---------------
                 PHS acknowledges that the ``Transition Unit'' referred
                 to in Section II,D, on page 125, of its proposal is
                 located at the Multi-Purpose Criminal Justice Facility
                 and not, as stated in the proposal, at the Sussex
                 Correctional Institution.

            18.  Backfill
                 --------
                 PHS agrees to maintain minimum staffing levels and
                 agrees to maintain reasonable back-fill.  PHS agrees to
                 back-fill at least solo coverage to meet work
                 performance.

            19.  Position Reclassifications
                 --------------------------
                 With the approval of the Department, which may not be
                 unreasonably denied, the job classifications of up to 4
                 positions may be changed by PHS to a lower
                 classification.

            20.  Flexibility
                 -----------
                 PHS agrees to work in a flexible manner with the
                 Department to seek mutually beneficial mechanisms to
                 reduce the cost of inmate health care services
                 throughout the term of the contract.

            21.  NCCHC STANDARDS:
                 ---------------
                 PHS guarantees that it will comply with all NCCHC
                 Standards necessary to maintain accreditation.

            22.  Termination for Convenience
                 ---------------------------
                 In addition to the State's rights to termination as
                 outlined in the Request For Proposal, PHS may terminate
                 the Agreement upon 180 days written notice to the
                 Department.  Such written notice shall be served by
                 certified mail.

            IN WITNESS WHEREOF, the parties hereto have signed this
            agreement:

            STATE OF DELAWARE                  PRISON HEALTH SERVICES,
            DEPARTMENT OF CORRECTION           INC.

            BY:______________________          BY: ________________________
            TITLE:___________________          TITLE:______________________
            DATE:___________________           DATE:_______________________ 

Basic Info X:

Name: HEALTH CARE SERVICES CONTRACT
Type: Services Contract
Date: Aug. 14, 1996
Company: AMERICA SERVICE GROUP INC /DE
State: Delaware

Other info:

Date:

  • 3rd day of June , 1996
  • October 1 , 1996

Organization:

  • Prison Health Services , Inc.
  • Department of Correction
  • State 's Health Care Services Contract Request
  • State of Delaware
  • Full Time Equivalents FTE
  • FTE Mental Health Counselors MHC
  • Board of Dental Examiners
  • Delaware Correctional Center
  • Multi-Purpose Criminal Justice Facility
  • Sussex Correctional Institution

Location:

  • Delaware

Money:

  • $ 4,867,720+
  • $ 65.50
  • $ 66.50
  • $ 3,930,000
  • $ 8,797,720

Percent:

  • 75 %