STATE OF VERMONT
CONTRACT 'FOR SERVICES

I.

Page 1 of 46
Contract # 19863

Parties. This is a contract for personal services between the State of Vermont, Department of Corrections
(hereafter called "State"), and Corrections Corporation of America with a principal place of business in
Nashville, TN (hereafter called "Contractor"). The Contractor's form of business organization is a private
company that manages prisons, The Contractor's local address is N/A. It is the Contractor's responsibility to
contact the Vermont Department of Taxes to determine if, by law, the Contractor is required to have a
Vermont Department of Taxes Business Account Number.

2. Subject Matter. The subject matter of this contract is personal services generally on the subject of inmate
housing, Detailed services to be provided by the Contractor are described in Attachment A,

3, Maximum Amonnt. In consideration of the services to be performed by Contractor, the State agrees to pay
Contractor, in accordance with the payment provisions specitled in Attachment B, a sum not to exceed
$ 24,967,857,35,
4, Contract Term. The period of Contractor's performance shall begin on July 1,2011 and end on June 30,
2013,
5,

Prior Approvals. If approval by the Attorney General's Oftlce or the Secretary of Administration is
required, (under current law, bulletins, and interpretations), neither this contract nor any amendment to it is
binding until it has been approved by either or both such persons,

Approval by the Attorney General's Oftlce is required,
Approval by the Secretary of Administration!§. required,
6, Amendment. No changes, modifications, or amendments in the terms and conditions of this contract shall
be effective unless reduced to writing, numbered and signed by the duly authorized representative of the
S tate and Contractor.
7, Cancellation. This contract may be cancelled by either party by giving written notice in accordance with
Attachment G section 3 Termination,
8, Attachments. This contract consists of 46 pages including the following attachments, which are
incorporated herein:
Attachment A - Specitleations of Work to be Perfonned
Attachment B Payment Provisions
Attachment C - Customary State Contract provisions
Attachment D - Modifications of Insurance
Attaclnnent E - Business Associate Agreement
Attachment F - Customary Contract Provisions of the Agency of Human Services
Attachment G Inmate Housing Agreement
Exhibit A - Staftlng Guidelines for each Facility
Exhibit B - Suicide Management/Crisis Intervention

STATE OF VEI~\10NT
CONTRACT FOR SERVICES

The
I).
2).
3).
4).
5).
6).
7).
8)
9)

Page 2 of 46
Contract # 19863

order of precedence of documents shall be as follows:
This document
Attachment D
Attachment C
Attachment A
Attachment G
Attachment B
Attachment E
Attachment F
Other Attachments

WE THE UNDERSIGNED PARTIES AGREE TO BE BOUND BY THIS CONTRACT.

BY TIllE CONTRACTOR:
Da\-4w l

Signature:

.~

Name: Andrew Pallito

6.{:fJ ~y--(

'7

Signat&r~~.
Name: /Jl~" 111ej(~ I ~
I

•

Title: Commissioner
AgencylDept. :
Agency of Human Services
Department of Corrections

AHS Revised 07121108

\I i (£lIv-a·tcle"t}~t:'''f"<sk'rThl{eJ~jhe.h+
Phone: b 1::S/;26..3 --3,2, Cf 0

Title:

e-mail: tJ{Jdy{..SN:r" fV\~ \4J
Alternative Contact: (if any)

@: a~ .C..<J/h

STATE OF VERMONT
CONTRACT FOR SERVICES

ATTACHMENT A
SPECIFICATIONS OF WORK TO BE PERFORME])

Contractor will provide the following services for the State:

Contractor will provide services as outlined in Attachment G.

Page 3 of 46
Contract # 19863

STATE O:F VERMONT
CONTRACT FOR SERVICES

Page 4 of 46
Contract # 19863

ATTACHMENTB
CONTRACT FOR SERVICES
PAYMENT PROVISIONS
I. Contractor agrees to invoice the State for services on a monthly basis. The contractor agrees to render an
invoice to the State by fifteen (15) days following the last day of the month in which the service was
provided. The State will not be liable for payments for any service invoiced after the IS-day limit.
2. The State's payment terms for Contractor invoice(s) are 11et-30.
Payment shall be made within 30 days of a corrcct invoice.
See also Attachment G, section 22

3. In consideration of the services to be provided by Contractor, the State agrees to pay Contractor as follows:
Per Attachment G, section 22. The per bed cost per day is as follows:

Year One:
Year Two:
Year Three:
Year Four:

Lee
Adjustment
Center
$61.72
$63.57
$65.47
$67.43

Florence
Correctional
Center
$68.00
$70.04
$72.14
$74.30

And other reimbursement expenses per Attachment G, Section 6, Section 26 (m,o,q,x,y), and Section 31.

Additionally, it is hereby agreed and understood that this contract has no minimum amount. The
Contractors' services will be required on an "as needed" basis.
4. Contractor shall submit aJl invoices to:

Richard Byrne, Contract Manager
Vermont Department of Corrections
103 South Main Street
Waterbury, VT05671-IOOI

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 5 of 46
Contract # 19863

ATTACHMENT C
CUSTOMARY PROVISIONS FOR CONTRACTS AND GRANTS
1. Entire Agreement. This Agreement, whether in the form of a Contract, State Funded Grant, or Federally Funded Grant,
represents the entire agreement between the parties on the subject matter. All prior agreements, representations,
statements, negotiations, and understandings shall have no effect.
2. Applicable Law. This Agreement will be governed by the laws of the State of Vermont.
3. Definitions: For purposes of this Attachment, "Party" shall mean the Contractor, Grantee or Subrecipient, with whom the
State of Vermont is executing this Agreement and consistent with the form of the Agreement.
4. Appropriations: If appropriations are insufficient to support this Agreement, the State may eancel on a date agreed to by
the parties or upon the expiration or reduction of existing appropriation authority. In the case that this Agreement is
funded in whole or in pmi by federal or other non-State funds, and in the event those funds become unavailable or
reduced, the State may suspend or cancel this Agreement immediately, and the Statc shall have no obligation to fund this
Agreement from State revenues.
5. No Employee Benefits For Party: The Party understands that the State will not provide any individual retirement
benefits, group life insurance, group health and dental insurance, vacation or sick leave, workers compensation or other
benefits or services available to State employees, nor will the state withhold any state or federal taxes except as required
under applicable tax laws, which shall be determined in advance of execution of the Agrecment. The Party understands
that all tax returns required by the Internal Revenue Code and the State of Vermont, including but not limited to income,
withholding, sales and use, and rooms and meals, must be filed by the Party, and information as to Agrcement income will
be provided by the State of Vermont to the Internal Revenue Service and the Vennont Department of Taxes.
6. Independence, Liability: The Party will act in an independent capacity and not as officers or employees ofthe State.
The Party shall defend the State and its officers and employees against all claims or suits arising in whole or in part from
any act or om ission of the Party or of any agent of the Party. The State shall notify the Party in the event of any such
claim or suit, and the Paliy shall immediately retain counsel and otherwise provide a complete defense against the entire
claim or suit. The Party shall notify its insurance company and the State within 10 days of receiving any claim for
damages, notice of claims, pre-claims, or service of judgments or claims, for any act or omissions in the performance of
this Agreement.
After a final judgment or settlement the Pmiy may request recoupment of specific defense costs and may file suit in
Washington Superior Court requesting recoupment. The P31ty shall be entitled to recoup costs only upon a showing that
such costs were entirely unrelated to the defense of any claim arising from an act or omission of the Party.
The Party shall indemnify tile State and its officers and employees in the event that the State, its officers or employees
become legally obligatcd to pay any damages or losses arising from any act or omission of the Party.
7. Insurance: Before commencing work on this Agreement the Party must provide certificates of insurance to show that the
following 111 inimum coverage is in effect. It is the responsibility ofthe Party to maintain current certificates of insurance
on file with the state through the term ofthe Agreement. No wan"anty is made that the coverage and limits listed herein
are adequate to cover and protect the interests of the Party for the Party's operations. These are solely minimums that have
been established to protect the interests of the State.

Workers Compensation: With respect to all operations performed, the Party shall carry workers' compensation
insurance in accordance with the laws of the State of Vermont.
General Liabilitv and Property Damage: With respect to all operations performed under the Agreement, the Party
shall carry general liability insurance having all major divisions of coverage ineluding, but not limited to:
Premises - Operations
Products and Completed Operations

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 6 of 46
Contract # 19863

Personal Injury Liability
Contractual Liability
The policy shall be on an occurrence form and limits shall not be less than:
$1,000,000 Per Occurrence
$1,000,000 General Aggregate
$ I ,000,000 Products/Completed Operations Aggregate
$ 50,000 Fire/ Legal/Liability
Party shall name the State of Vermont and its officers and employees as additional insureds for liability arising out of this
Agreement.

Automotive Liabilitv: The Party shall carry automotive liability insurance covering all motor vehicles, including hired
and non-owned coverage, used in connection with the Agreement. Limits of coverage shall not be less than:
$1,000,000 combined single limit.
Party shall name the State of Vermont and its officers and employees as additional insureds for liability arising out of this
Agreement.

Professional Liability: Before commencing work on this Agreement and throughout the term of this Agreement, the
Party shall procure and maintain professional liability insurance for any and all services performed under this
Agreement, with minimwn coverage of$ 5,000,000.00 per occurrence, and $ 10,000,000.00 aggregate.
8. Reliance by the State on Representations: All payments by the State under this Agreement will be made in reliance
upon the accuraey of all prior representations by the Palty, including but not limited to bills, invoices, progress reports and
other proofs of work.
9. Requirement to Have a Single Audit: In the case that this Agreement is a Grant that is funded in whole or in part by
federal funds, and if this Subrecipient expends $500,000 or more in federal assistance during its fiscal year, the Subrecipient
is required to have a single audit conducted in accordance with the Single Audit Act, except when it elects to have a program
specific audit.
The Subrecipient may elect to have a program specific audit if it expends funds under only one federal program and the
federal program's laws, regulating or grant agreements do not require a financial statement audit of the Party.
A Subreeipient is exempt if the Party expends less than $500,000 in total federal assistance in one year.
The Subrecipient will complete the Certification of Audit Requirement annually within 45 days after its fiscal year end. If
a single audit is required, the sub-recipient will submit a copy of the audit report to the primary pass-through Party and
any other pass-through Party that requests it within 9 months. If a single audit is not required, thc Subrecipient will
submit the Schedule of Federal Expenditures within 45 days. These forms will be mailed to the Subrecipient by the
Department of Finance and Management near the end of its fiscal year. These forms are also available on the Finance &
Management Web page at: http://jJnance.vennont.gov/forms

10. Records Available for Audit: The Party will maintain all books, documents, payroll papers, accounting records and other
evidence peltaining to costs incurred under this agreement and make them available at reasonable times during the period
of the Agreement and for three years thereafter for inspection by any authorized representatives of the State or Federal
Government. If any litigation, claim, or audit is started before the expiration of the three year period, the records shall be
retained until all litigation, claims or audit findings involving the records have been resolved. The State, by any authorized
representative, shall have the right at all reasonable times to inspect or otherwise evaluate the work performed or being
performed under this Agreement.
11. Fair Employment Practices and Americans with Disabilities Act: Party agrees to comply with the requirement of Title
21 V.S.A. Chapter 5, Subchapter 6, relating to fair employment practices, to the full extent applicable. Party shall also

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 7 of 46
Contract # 19863

ensure, to the full extent required by the Americans with Disabilities Act of 1990, as amended, that qualified individuals
with disabilities receive equitable access to the services, programs, and activities provided by the Party under this
Agreement. Party further agrees to include this provision in all subeontracts.
12. Set Off: The State may set off any sums which the Party owes the State against any sums due the Party under this
Agreement; provided, however, that any set off of amounts due the State of Vermont as taxes shall be in accordance with
the procedures more specifically provided hereinaftcr.
13. Taxes Due to the State:
a.

Party understands and acknowledges rcsponsibility, if applicable, for compliance with State tax laws, including
income tax withholding for employees performing services within the State, payment of use tax on property used
within the State, corporate and/or personal income tax on income earned within thc State.

b.

Party certifies under the pains and penalties of pCljury that, as of the date the Agreement is signed, the Party is in
good standing with respect to, or in full compliance with, a plan to pay any and all taxes duc the State ofVermon1.

c.

Party understands that final payment under this Agreement may be withheld if the Commissioner of Taxes
determines that the Party is not in good standing with respcct to or in full compliance with a plan to pay any and
all taxes due to the State of Vermont.

Party also understands the State may set off taxes (and relatcd penalties, interest and fees) due to the State of Vermont,
but only ifthe Party has failed to make an appeal within the time allowed by law, or an appeal has been taken and
tinally determined and the Party has no further legal recourse to contest the amounts due.
14. Child Support: (Applicable if the Patty is a natural person, not a corporation or partnership.) Patiy states that, as ofthe
date the Agreement is signed, he/she:

a.
b.
c.

is not under any obligation to pay child support; or
is under such an obligation and is in good standing with respect to that obligation; or
has agreed to a payment plan with the Vermont Office of Child Support Services and is in full compliance with
that plan.

Party makes this statement with regard to support owed to any and all children residing in Vermont. In addition, if the
Party is a resident of Vermont, Party makes this statement with regard to support owed to any and all children residing
in any other state or territory of the United States.
15. Sub-Agreements: Party shall not assign, subcontract or subgrant the performance of his Agreement or any pOliion thercof
to any other Party without the prior written approval of the Statc. Party also agrees to include in subcontract or subgrant
agreements a tax certification in accordance with paragraph 13 above.

Notwithstanding the foregoing, the Statc agrees that the Party may assign this agreement, including all of the Party's rights
and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Patiy.
16. No Gifts or Gratuities: Party shall not give title or possession of any thing of substantial value (including propelty,
currency, travel and/or education programs) to any officer or employee of the State during the term of this Agreement.
17. Copies: All written repOlis prepared under this Agreement will be printed using both sides of the paper.
18. Certification Regarding Debarment: Party certifies under pains and penalties of peljury that, as of the date that this
Agreement is signed, neither Party nor Party·s principals (officers, directors, owners, or partners) are presently debarrcd,
suspended, proposed for debarment, declared ineligible or excluded from participation in fedcral programs or programs
supported in whole or in part by federal funds.

Attachment C -AHS Revised DIll III I

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 8 of 46
Contract # 19863

ATTACHMENT D
MODIFICATION OF CUSTOMARY PROVISIONS
OF
ATTACHMENT C OR ATTACHMENT F

1. The insurance requirements contained in Attachment C, Section 7 are hereby modified: Attachment C, Page 5,
Section 7 Worker's Compensation changed From: " ... Party shall carry workers' compensation insurance in
accordance with the laws of the State of Vermont. " To: " ...the Party shall carry workers' compensation insurance
in accordance with the laws of states where services are provided."

2.

Reqnirements of Sections in Attachment F are hereby modified: Attachment F, Page 15, Section 10, Add
Paragraph: "The Contractor's proprietary corporate information, including, but not limited to, its forms, systems,
software and processes developed in the regular course of Contractor's business and data, technical information
and materials that pertain to another customer/partner, another facility, or another inmate population shall remain
the property of the Contractor and is not the property of tlte State of Vermont. "

3. Reasons for Modifications: The language requires contractor to comply with workers' compensation laws in
the relevant states, if they have workers in Vermont, they must comply with Vermont Law.

4. Change to Attachment F requested by Contractor's legal staff and approved by AAG, Phillip Cykon.

Approval:

Assistant Attorney General:

Date:

State of Vennont - Attachment 0
Revised AHS - 12-08-09

Page 9 of 46
Contract # 19863

STATE OF VERMONT
CONTRACT FOR SERVICES
ATTACHMENT E
BUSINESS ASSOCIATE AGREEMENT

This Business Associate Agreement ("Agreement") is entered into by and between the State of Vermont Agency of
Human Services operating by and through its Department of Corrections ("Covered Entity") and Corrections
Corporation of America ("Business Associate") as of 711111 ("Effective Date"). This Agreement supplements and
is made a part of the Contract to which it is an attachment.
Covered Entity and Business Associate enter into this Agreement to comply with standards promulgated under the Health
Insurance Portability and Accountability Act of 1996 ("HIPAA") including the Standards for the Privacy of Individually
Identifiable Health Information at 45 CFR Parts 160 and 164 ("Privacy Rule") and the Security Standards at 45 CFR Parts 160
and 164 ("Security Rule"), as amended by subtitle 0 of the Health Information Technology for Economic and Clinical Health
Act.
The parties agree as follows:
1.

Definitions. All capitalized terms in this Agreement have the meanings identitied in this Agreement, 45 CFR Part 160,
or 45 CFR Part 164.
The term "Services" includes all work performed by the Business Associate for or on behalf of Covered Entity that
requires the use andlor disclosure of protected health information to perform a business associate function dcscribed in
45 CFR 160.103 under the definition of Business Associate.
The term "Individual" includes a person who qualifies as a personal representative
164.502(g).

III

accordance with 45 CrR

The term "Breach" means the acquisition, access, use or disclosure of protected health information (PHI) in a manner not
pcrmitted under the HIPAA Privacy Rule, 45 CFR part 164, subpart E, which compromises the security or privacy orthe
PHI. "Compromises the security or privacy of the PHI" means poses a significant risk of financial, reputational or othcr
harm to the individual.

2.

3.

Permitted and Required Uses/Disclosures of PHI.
2. I

Except as limited in this Agreement, Business Associate may use or disclose PHI to perform Services, as specificd
in the underlying contract with Covered Entity. Business Associate shall not use or disclose PHI in any manner
that would constitute a violation of the Privacy Rule if used or disclosed by Covered Entity in that manner.
Business Associate may not use or disclose PHI other than as permitted or required by this Agreement or as
Required by Law.

2.2

Busincss Associate may make PHI available to its employees who need access to perform Services provided that
Business Associate makes such employees aware of the use and disclosure restrictions in this Agreement and binds
them to comply with such restrictions. Business Associate may only disclose PHI for the purposes authorized by
this Agreement: (a) to its agents (including subcontractors) in accordance with Sections 8 and 16 or (b) as
otherwise permitted by Section 3.

Business Activities. Business Associate may use PHI received in its capacity as a "Business Associate" to Covered
Entity if necessary tor Business Associate's proper management and administration or to carry out its legal
responsibilities. Business Associate may disclose PHI received in its capacity as "Business Associate" to Covered Entity
for Business Associate's proper management and administration or to carry out its legal responsibilities if a disclosure is
Required by Law or if (a) Business Associate obtains reasonable written assurances via a written agreement from the
person to whom the information is to be disclosed that the PHI shall remain confidential and be used or further disclosed
only as Required by Law or tor the purpose for which it was disclosed to the person and (b)
the person notifies Business Associate, within three business days (who in turn will notify Covered Entity within three
business days after receiving notice of a Breach as specified in Section 5.1), in writing of any Breach of Unsecured PHl

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 10 of 46
Contract # 19863

of which it is aware. Uses and disclosures of PHI for the purposes identified in this Section must be of the minimum
amount of PHI necessary to accomplish such purposes.
4.

Safeguards. Business Associate shall implement and use appropriate safeguards to prevent the use or disclosure of PHI
other than as provided for by this Agreement. With respect to any PHI that is maintained in or transmitted by electronic
media, Business Associate shall comply with 45 CFR sections 164.308 (administrative safeguards), 164.310 (physical
safeguards), 164.312 (technical safeguards) and 164.316 (policies and procedures and documentation requirements).
Business Associate shall identify in writing upon request from Covered Entity all of the safeguards that it uses to prevent
impermissible uses or disclosures of PHI.

5.

Documenting and Reporting Breaches.
5.1

Business Associate shall report to Covered Entity any Breach of Unsecured PHI as soon as it (or any of its
employees or agents) become aware of any such Breach, and in no case later than three (3) business days after it (or
any of its employees or agents) becomes aware of the Breach, except when a law enforcement official determines
that a notification would impede a criminal investigation or cause damage to national security.

5.2 Business Associate shall provide Covered Entity with the names of the individuals whose Unsecured PHI has been,
or is reasonably believed to have been, the subject ofthe Breach and any other available information that is required
to be given to the affected individuals, as set forth in 45 CFR § I 64.404(c), and, if requested by Covered Entity,
information necessary for Covered Entity to investigate the impermissible use or disclosure. Busincss Associate
shall continue to provide to Covered Entity information concerning the Breach as it becomes available to it.
5.3

When Business Associate determines that an impermissible acquisition, use or disclosure of PHI by a member of its
workforce does not pose a significant risk of harm to the affected individuals, it shall document its assessment of
risk. Such assessment shall includc: I) the name of the person(s) making the assessment, 2) a brief summary of the
facts, and 3) a brief statement of the reasons supporting the determination oflow risk of harm. When requested by
Covered Entity, Business Associate shall make its risk assessments available to Covered Entity.

6.

Mitigation and Corrective Action. Busincss Associate shall mitigate, to the extent practicable, any harmful effect that is
known to it of an impermissible use or disclosure of PHI, even if the impermissible use or disclosurc does not constitute a
Breach. Business Associate shall draft and carry out a plan of corrective action to address any incident of impennissible
use or disclosure of PHI. If requested by Covered Entity, Business Associate shall make its mitigation and corrective
action plans available to Covered Entity.

7.

Providing Notice of Breaches.
7.1

If Covered Entity determines that an impermissible acquisition, access, use or disclosure of PHI for which one of
Business Associate's employees or agents was responsible constitutes a Breach as defined in 45 CPR § 164.402, and
if requested by Covered Entity, Business Associate shall providc notice to the individuals whose PH] was the
subject of the Breach. When requested to provide notice, Business Associate shall consult with Covered Entity
about the timeliness, content and method of notice, and shall receive Covered Entity's approval concerning thesc
elemcnts. The cost of notice and related remedies shall be borne by Business Associate.

7.2

The notice to affected individuals shall be provided as soon as reasonably possible and in no case later than 60
calendar days after Business Associate reported the Breach to Covered Entity.

7.3

The notice to affected individuals shall be written in plain language and shall include, to the extent possible, I) a
brief description of what happened, 2) a description ofthe types of Unsecured PHI that were involved in the Breach,
3) any steps individuals can take to protect themselves from potential harm resulting from the Breach, 4) a brief
description of what thc Business associate is doing to investigate the Breach, to mitigate harm to individuals and to
protect against further Breaches, and 5) contact procedures for individuals to ask questions or
obtain additional information, as set forth in 45 CFR § I 64.404( c).

STATE OF VERMONT
CONTRACT FOR SERVICES
7.4

Page 11 of 46
Contract # 19863
Business Associate shall notify individuals of Breaches as specified in 45 CFR § I 64.404(d) (methods of individual
notice). In addition, when a Breach involves more than 500 residents of Vermont, Business associate shall, if
requested by Covered Entity, notify prominent media outlets serving Vermont, following the requirements sct forth
in 45 CFR § 164.406.

8.

Agreements by Third Parties. Business Associate shall ensure that any agent (including a subcontractor) to whom it
provides PHI received from Covered Entity or created or received by Business Associate on behalf of Covered Entity
agrees in a written agreement to the same restrictions and conditions that apply through this Agreement to Business
Associate with respect to such PHI. For example, the written contract must include those restrictions and conditions set
forth in Section 14. Business Associate must enter into the written agreement bcfore any use or disclosure of PHI by
such agent. The writtcn agreement must identify Covered Entity as a direct and intended third party beneficiary with the
right to eniorce any breach of the agreemcnt concerning the use or disclosure of PI-II. Business Associate shall provide a
copy of the written agreement to Covered Entity upon request. Business Associate may not make any disclosure of PHI
to any agent without the prior written consent of Covered Entity.

9.

Access to PHI. Business Associate shall provide access to PHI in a Designated Record Set to Covered Entity or as
directed by Covered Entity to an Individual to meet the requirements under 45 CFR 164.524. Business Associate shall
provide such access in the time and manner reasonably designated by Covered Entity. Within three (3) business days,
Business Associate shall forward to Covered Entity for handling any request for access to PHI that Business Associate
directly receives from an Individual.

10. Amendment of PHI. Business Associate shall make any amendments to PHI in a Designated Record Set that Covered
Entity directs or agrees to pursuant to 45 CFR 164.526, whether at the request of Covered Entity or an Individual.
Business Associate shall make such amendments in the time and manner reasonably designated by Covered Entity.
Within three (3) business days, Business Associate shall forward to Covered Entity for handling any request for
amendment to PHI that Business Associate directly receives from an Individual.
11. Accounting of Disclosures. Business Associate shall document disclosures of PHI and all information related to such
disclosures as would be required for Covered Entity to respond to a request by an Individual for an accounting of
disclosures of PI-II in accordance with 45 CFR 164.528. Business Associate shall provide such information to Covered
Entity or as directed by Covered Entity to an Individual, to permit Covered Entity to respond to an accounting request.
Business Associate shall provide such information in the time and manller reasonably designated by Covered Entity.
Within three (3) business days, Business Associate shall forward to Covered Entity for handling any accounting request
that Business Associate directly receives from an Individual.
12. Books and Records. Subject to the attorney-client and other applicable legal privileges, Business Associate shall make
its internal practices, books, and records (including policies and procedures and PHI) relating to the use and disclosure of
PHI received from Covered Entity or created or received by Business Associate on behalf of Covered Entity available to
the Secretary in the time and manner designated by the Secretary. Business Associate shall make the same information
available to Covered Entity upon Covered Entity's request in the time and manner reasonably designated by Covered
Entity so that Covered Entity may determine whether Business Associate is in compliance with this Agreement.
13. Termination.
13.1

This Agreement commences on the Effective Date and shall remain in etfect until terminated by Covered Entity
or until all of the PHI provided by Covered Entity to Business Associate or created or received by Busincss
Associate on behalf of Covered Entity is destroyed or retumed to Covered Entity subject to Section 17.7.

13.2

If Business Associate breaches any material term of this Agreement, Covered Entity may either: (a) provide
an opportunity for Business Associate to cure the breach and Covered Entity may terminate this Contract without
liability or penalty if Business Associate does not cure the breach within the time specified by Covered Entity; or
(b) immcdiately terminate this Contract without liability or penalty if Covered Entity believes that cure is not
reasonably possible; or (c) if neither termination nor cure are feasible, Covered Entity shall report the breach to
the Secretary. Covered Entity has the right to seek to cure any breach by Business Associate and this right,
regardless of whcther Covered Entity cures such breach, does not lessen any right or remedy available to Covered

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 12 of 46
Contract # 19863
Entity at law, in equity, or under this Contract, nor does it lessen Business Associate's responsibility for such
breach or its duty to cure such breach.

14. Return/Destruction of PHI.
14.1

Business Associate in connection with the expiration or termination of this Contract shall return or destroy all PHI
received from Covered Entity or created or received by Business Associate on behalf of Covered Entity pursuant
to this Contract that Business Associate still maintains in any form or medium (including electronic) within thirty
(30) days after such expiration or termination. Business Associate shall not retain any copies of the PI-II.
Business Associate shall certify in writing for Covered Entity (J) when all PHI has been returned or destroyed and
(2) that Business Associate does not continue to maintain any PHI. Business Associate is to provide this
certification during this thirty (30) day period.

14.2

Business Associate shall provide to Covered Entity notification of any conditions that Business Associate believes
make the return or destruction of PHI infeasible. If Covered Entity agrees that return or destruction is infeasible,
Business Associate shall extend the protections of this Agreement to such PHI and limit further uses and
disclosures of such P]-[] to those purposes that make the return or destrnetion infeasible for so long as Business
Associate maintains such PHI.

15. Penalties and Training. Business Associate understands that: (a) there may be civil or criminal penalties for misuse or
misappropriation of PHI and (b) violations of this Agreement may result in notification by Covered Entity to law
enforcement officials and regulatory, accreditation, and licensure organizations. If requested by Covered Entity,
Business Associate shall pmiicipate in training regarding the use, confidentiality, and security of PHI.
16. Security RnIe Obligations. The following provisions of this Section apply to the extent that Business Associate creates,
receives, maintains or transmits Electronic PI-[] on behalf of Covered Entity.
16.1

Business Associate shall implement and use administrative, physical, and technical safeguards in compliance with
45 CFR sections 164.308, 164.310, and 164.312 with respect to the Electronic PI-lJ that it creates, receives,
maintains or transmits on behalf of Covered Entity. Business Associate shall identify in writing upon request
from Covered Entity all ofthe safeguards that it uses to protect such Electronic PHI.

16.2

Business Associate shall ensure that any agent (including a subcontractor) to whom it provides Electronic PHI
agrees in a written agreement to implement and use administrative, physical, and technical safeguards that
reasonably and appropriately protect the Confidentiality, Integrity and Availability of the Electronic PHI.
Business Associate must enter into this written agreement before any use or disclosure of Electronic PHI by such
agent. The written agreement must identify Covered Entity as a direct and intended third party beneficiary with
the right to enforce any breach of the agreement concerning the use or disclosure of Electronic PHI. Business
Associate shall provide a copy of the written agreement to Covered Entity upon request. Business Associate may
not make any disclosure of Electronic PHI to any agent without the prior written consent of Covered Entity.

16.3

Business Associate shall report in writing to Covered Entity any Security Incident pertaining to such Electronic
PHi (whether involving Business Associate or an agent, including a subcontractor). Business Associate shall
provide this written report as soon as it becomes aware of any such Security Incident, and in no case later than
three (3) business days after it becomes aware of the incident. Business Associate shall provide Covered Entity
with the information necessary for Covered Entity to investigate any such Security Incident.

16.4

Business Associate shall comply with any reasonable policies and procedures Covered Entity implements to
obtain compliance under the Security Rule.

17. Miscellaneous.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 13 of' 46
Contract # 19863

17.1

In the event of any conflict or inconsistency between the terms of this Agreement and the terms of the Contract,
the terms of this Agreement shall govern with respect to its subject matter. Otherwise the terms of the Contract
continue in effect.

17.2

Busincss Associate shall cooperate with Covered Entity to amend this Agreement from time to time as is
necessary for Covered Entity to comply with the Privacy Rule, the Security Rule, or any other standards
promulgated under HIPAA.

17.3

Any ambiguity in this Agreement shall be resolved to permit Covered Entity to comply with the Privacy Rule,
Security Rule, or any other standards promulgated under HIPAA.

17.4

In addition to applicable Vermont law, the parties shall rely on applicable federal law (e.g., H1PAA, the Privacy
Rule and Security Rule) in construing the meaning and effect of this Agreement.

17.5

As between Business Associate and Covered Entity, Covered Entity owns all PHI provided by Covered Entity to
Business Associate or created or received by Business Associate on behalf of Covered Entity.

17.6

Business Associate shall abide by the terms and conditions of this Agreement with respect to all PHI it receives
from Covered Entity or creates or receives on behalf of Covered Entity under this Contract even if some of that
information relates to specific services for which Business Associate may not be a "Business Associate" of
Covered Entity under the Privacy Rule.

17.7

The provisions of this Agreement that by their terms encompass continuing rights or responsibilities shall survive
the expiration or termination of this Agreement. For example: (a) the provisions of this Agreement shall continue
to apply if Covered Entity determines that it would be infeasible for Business Associate to return or destroy PHI
as provided in Section 14.2 and (b) the obligation of Business Associate to provide an accounting of disclosures
as set fOlih in Section II survives the expiration or termination of this Agreement with respect to accounting
requests, if any, made after such expiration or termination.

Attachment E- AHS Revised 01131111

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 14 of 46
Contract # 19863

ATTACHMENT F
AGENCY OF HUMAN SERVICES' CUSTOMARY CONTRACT PROVISIONS

1. Agency of Human Services - Field Services Directors will share oversight with the department (or field office) that is a
party to the contract for provider performance using outcomes, processes, terms and conditions agreed to under this
contract.
2. 2-1-1 Data Base: The Contractor providing a health or human services within Vermont, or near the border that is readily
accessible to residents of Vermont, will provide relevant descriptive information regarding its agency, programs and/or
contact and will adhere to the "Inclusion/Exclusion" policy of Vermont's United Way/Vermont 211. If included, the
Contractor will provide accurate and up to date information to their data base as needed. The "Inclusion/Exclusion" policy
can be found at w\yw.vermont2l1 .0Ul
3.

Medicaid Program Contractors:
jnspection ofRecords: Any contracts accessing payments for services through the Global Commitment to Health Waiver
and Vermont Medicaid program mllst fu!till state and federal legal requirements to enable the Agency of Human Services
(ABS), the United States Department of Health and Human Services (DHHS) and the Government Accounting Office
(GAO) to
Evaluate through inspection or other means the quality, appropriateness, and timeliness of services performed; and
Inspect and audit any financial records of such Contractor or subcontractor.
.Subcontracting for Medicaid Services: Having a subcontract does not terminate the Contractor, receiving funds under
Vermont's Medicaid program, from its responsibility to ensure that all activities under this agreement are carried out.
Subcontracts must specify the activities and reporting responsibilities of the Contractor or subcontractor and provide for
revoking delegation or imposing other sanctions if the Contractor or subcontractor's performance is inadequate. The
Contractor agrees to make available upon request to the Agency ofl-Iuman Services; the Department of Vermont Health
Acccss; the Department of Disabilities, Aging and Independent Living; and the Center for Medicare and Medicaid
Services (CMS) all contracts and subcontracts between the Contractor and service providers.
Medic]lj!LNotificali9n of Termination Requirements: Any Contractor accessing payments for services under the Global
Commitment to Health Waiver and Medicaid programs who telminates their practice will follow the Department of
Vermont Health Access, Managed Care Organization enrollee notification requirements.
Encounter Data: Any Contractor accessing payments for services through the Global Commitment to Health Waiver and
Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and
ensure that it can be linked to enrollee eligibility files maintained by the State.
Federal Medicaid System Securijy RequirementsJ::;ompliance: All contractors and subcontractors must provide a security
plan, risk assessment, and security controls review document within three months of the start date ofthis agreement (and
update it annually thereafter) to support audit compli[mce with 45CFR95.621 subpart F, ADP (Automated Data
Processing) System Security Requirements and Review Process.

4.

Non-discrimination Based on National Origin as evidenced by Limited English Proficiency. The Contractor agrees
to comply with the non-discrimination requirements of Title VI orthe Civil Rights Act of 1964,42 USC Section 2000d, et
seq., and with the federal guidelines promulgated pursuant to Executive Order 13166 of 2000, which require that
contractors and subcontractors receiving federal funds must assure that persons with limited English proficiency can
meaningfully access services. To the extent the Contractor provides assistance to individuals with limited English
proficiency through the use of oral or written translation or interpretive services in compliance with this requirement. such
individuals cannot be required to pay for such services.

5. Voter Registration. When designated by the Secretary of State, the Contractor agrees to become a voter registration
agency as defined by 17 V.S.A. §2103 (41), and to comply with the requirements of state and federal law pertaining to
such agencies.
6.

Drug Free Workplace Act. The Contractor will assure a drug-free workplace in accordance with 45 CFR Part 76.

7.

Privacy and Security Standards.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 15 of 46
Contract # 19863
Protected Health Information: The Contractor shall maintain the privacy and security of all individually identifiable health
information acquired by or provided to it as a part of the performance of this contract. The Contractor shall follow federal
and state law relating to privacy and security of individually identifiable health information as applicable, including the
Health Insurance Portability and Accountability Act (HIPAA) and its federal regulations,

Substance Abuse Treatment Information: The confidentiality of any alcohol and drug abuse treatment information
acquired by or provided to the Contractor or subcontractor shall be maintained in compliance with any applicable state or
fcderallaws or regulations and specifically set out in 42 CFR Part 2,
Other Confidential Consumer Information: The Contractor agrees to comply with the requirements of AHS Rule No, 08048 concerning access to information. The Contractor agrees to comply with any applicable Vermont State Statute,
including but not limited to 12 VSA § 1612 and any applicable Board of Health confidentiality regulations. The Contractor
shall ensure that all of its employees and subcontractors performing services under this agreement understand the sensitive
nature of the information that they may have access to and sign an affirmation of understanding regarding the
information's confidential and non-public nature.
Social Security nqmbers: The Contractor agrees to comply with all applicable Vermont State Statutes to assure protection
and security of personal information, including protection 11'om identity theft as outlined in Title 9, Vermont Statutes
Annotated, Ch. 62.
8.

Abuse Registry. The Contractor agrees not to employ any individual, use any volunteer, or otherwise provid
reimbursement to any individual in the performance of services connected with this agreement, who provides care, custod,
treatment, transpoliation, or supervision to children or vulnerable adults if there is a substantiation of abuse or neglect (
exploitation against that individual. The Contractor will check the Adult Abuse Registry in the Department of Disabilitie:
Aging and Independent Living. Unless the Contractor holds a valid child care license or registration from the Division (
Child Development, Department for Children and Families, the Contractor shall also check the Central Child Protectio
Registry. (See 33 V.S.A. §4919(a)(3) & 33 V.S.A. §6911(c)(3)).

9.

Reporting of Abuse, Neglect, or Exploitation. Consistent with provisions of33 V.S.A. §4913(a) and §6903, any agent
or employee of a Contractor who, in the performance of services connected with this agreement, has contact with clients
or is a caregiver and who has reasonable cause to believe that a child or vulnerable adult has been abused or neglected as
defined in Chapter 49 or abused, neglected, or exploited as defined in Chapter 69 of Title 33 V.S.A. shall make a report
involving children to the Commissioner of the Department for Children and Families within 24 hours or a report involving
vulnerable adults to the Division of Licensing and Protection at the Department of Disabilities, Aging, and Independent
Living within 48 hours. This requirement applies except in those instances where particular roles and functions are
exempt from reporting under state and federal law. Reports involving children shall contain the information required by
33 V.S.A. §4914. Reports involving vulnerable adults shall contain the information required by 33 V.S.A. §6904. The
Contractor will ensure that its agents or employees receive training on the repOIiing of abuse or neglect to children and
abuse, neglect or exploitation of vulnerable adults.

10. Intellectnal PropertylWork Product Ownership. All data, technical information, materials first gathered, originated,
developed, prepared, or obtained as a condition of this agreement and used in the performance of this agreement including, but not limited to all reports, surveys, plans, charts, literature, brochures, mailings, recordings (video or audio),
pictures, drawings, analyses, graphic representations, software computer programs and accompanying documentation and
printouts, notes and memoranda, written procedures and documents, which are prepared for or obtained specifically for
this agreement - or are a result of the services required under this grant - shall be considered "work for hire" and remain
the property of the State of Vermont, regardless of the state of completion - unless otherwise specified in this agreement.
Such items shall be delivered to the State of Vermont upon 30 days notice by the State. With respect to software computer
programs and / or source codes first developed for the State, all the work shall be considered "work for hire," i.e., the
State, not the Contractor or subcontractor, shall have full and complete ownership of all software computer programs,
documentation and/or source codes developed.
The Contractor shall not sell or copyright a work product or item produced under this agreement without explicit
permission from the State.
If the Contractor is operating a system or application on behalf of the State of Vermont, then the Contractor shall not
make information entered into the system or application available for uses by any other party than the State of Vermont,
without prior authorization by the State. Nothing herein shall entitle the State to pre-existing Contractor's materials.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 16 of 46
Contract # 19863
II. Security and Data Transfers. The State shall work with the Contractor to ensure compliance with all applicable State
and Agency of Human Services' policies and standards, especially those related to privacy and security. The State will
advise the Contractor of any new policies, procedures, or protocols developed during the term of this agreement as they
arc issued and will work with the Coutractor to implement any required.
The Contractor will ensure the physical and data security associated with computer equipment - including desktops,
notebooks, and other portable devices - lIsed in connection with this agreement. The Contractor will also assure that any
media or mechanism used to store or transfer data to or from the State includes industry standard security mechanisms
such as continually up-to-date malware protection and encryption. The Contractor will make every reasonable effort to
ensure media or data files transferred to the State are virus and spyware free. At the conclusion of this agreement and after
successful delivery of the data to the State, the Contractor shall securely delete data (including archival backups) from the
Contractor's equipment that contains individually identifiable records, in accordance with standards adopted by the
Agency of Human Services.

12. Computing and Communicatiou: The Contractor shall select, in consultation with the Agency of I·luman Services'
Infonnation Technology unit, one of the approved methods for secure access to the State's systems and data, if required.
Approved methods are based on the type of work performed by the Contractor as part of this agreement. Options include,
but arc not limited to:
I.

Contractor's provision of ecrtified computing equipment, peripherals and mobile devices, on a separate Contractor's
network with separate internet access. The Agency of Human Services' accounts mayor may not be provided.

2.

State supplied and managed equipment and accounts to acccss state applications and data, including State issued
active directory accounts and application specific accounts, which follow the National Institutes of Standards and
Technology (NIST) security and the Health Insurance Portability & Accountability Act (HIPAA) standards.

The State will not supply e-mail accowlts to the Contractor.
13. Lobbying. No federal funds under this agreement may be used to influence or attempt to influence an officer or employee
of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the awarding of any federal contract, continuation, renewal, amendments other than federal appropriated
funds.
J 4.

Non-discrimination. The Contractor will prohibit discrimination on the basis of age under the Age Discrimination Act of
1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on the basis of sex under Title IX of
the Education Amendments of 1972, or on the basis of race, color or national origin under Title VI of the Civil Rights Act
of 1964. No person shall on the grounds of sex (including, in the case of a woman, on the grounds that thc woman is
pregnant) or on the grounds of religion, be excluded from participation in, be denied the benefits of, or be subjected to
discrimination, to include sexual harassment, under any program or activity supported by state and/or fedcralllll1ds.
The Contractor will also not refuse, withhold from or deny to any person the benefit of services, facilities, goods,
privileges, advantages, or benefits of public accommodation on the basis of disability, race, creed, color, national origin,
marital status, sex, sexual orientation or gender identity under Title 9 V.S.A. Chapter 139.

15. Euvironmental Tobacco Smoke. Public Law 103-227, also known as the Pro-children Act of 1994 (Act), requires that
smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, child care, carly childhood development services, education or library
services to children under the age of 18, if the services are funded by federal programs either directly or through state or
local governments, by federal grant, contract, loan or loan guarantee. The law also applies to children's services that are
provided in indoor facilities that are constructed, operated, or maintained with such Federal funds.
'rhe law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug
or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities
where Women, Infants, & Children (WIC) coupons are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000
for each violation and/orthe imposition of an administrative compliance order on the responsible entity.
Contractors are prohibited from promoting the use of tobacco products for all clients. Facilities supported by state and
federal funds are prohibited from making tobacco products available to minors.

Attachment F - Revised AHS J 21J Oil 0

Page 17 of 46
Contract # 19863

STATE OF VERMONT
CONTRACT FOR SERVICES

ATTACHMENT "G"
INMATE HOUSING AGREEMENT
THIS AGREEMENT is made and entered into by and between the VERMONT OEPARTMENT OF
CORRECTIONS, hereinafter referred to as the "VTOOC" or "State" and CORRECTIONS
CORPORATION OF AMERICA, hereinafter referred to as "Contractor."
WHEREAS, the Contractor has prison beds available and is willing to contract for the confinement
of VTOOC inmates; and
WHEREAS, VTOOC is empowered and authorized to enter into contracts and agreements with
other legal entities; and
WHEREAS, the Contractor has legal authority to enter into an agreement with VTOOC;
NOW THEREFORE, for and in consideration of the mutual covenants, conditions, and promises
contained herein, the parties hereto agree as follows:
1.

OESCRIPTION OF SERVICES
(a)

Facilities

Except as otherwise provide herein, the following Contractor Facilities will be utilized in the
housing of the VTOOC inmates: Lee Adjustment Center and the Florence Correctional Center. It is
the intent of the parties that the VTOOC inmates shall be consolidated into Lee Adjustment Center
to the extent allowed given the custody and specific housing needs of the population. Vermont
inmates will be housed together in all facilities and, to the extent allowed by facility design and
facility inmate populations, kept separate from other populations. Provided however, due to the
configuration of the Lee Adjustment Center, VTOOC inmates housed at the Lee Adjustment
Center may be housed with other inmates of the same classification.
It is the intent that the Florence Correctional Center will be used for the higher custody
inmates that may not be at the Lee Adjustment Center. Contractor has determined that there is a
40 bed unit available at Florence Correctional Center in order to house the inmates in a general
population setting, giv'lng the Vermont general population inmates the opportunity to participate in
GEO or vocational training classes, unless behaviors require the use of a segregation setting.
Provided however, the Contractor shall only be obligated to make the 40 man pod available for so
long as VTOOC uses at least 95% of the beds in the pod. Inmates transferred from the 40 bed
unit to a segregation setting shall count towards the 95%. In the event that the VTOOC population
falls below 95% of the 40 man pod, the Contractor shall work with VTOOC to identify an alternate
housing location that suits the population need at that time.
Lee Adjustment Center and the Florence Correctional Center are accredited by the
American Correctional Association (ACA) and shall maintain such accreditation throughout the
term of this Agreement. Lee Adjustment Center is accredited by the National Commission on
Correctional Health Care (NCCHC) and shall maintain such accreditation throughout the term of
this Agreement.
The Florence Correctional Center shall obtain and/or be actively working
towards NCCHC accreditation within one year of signing this Agreement and shall maintain
accreditation throughout the term of this Agreement once it is obtained.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 18 of 46
Contract # 19863

VTOOC shall retain priority for the use of beds at the Lee Adjustment Center and shall not
be involuntarily relocated so long as VTOOC uses at least 380 beds (95% of the 400) on a
continual basis. At any time the parties may mutually agree to utilize other facilities at the same
per diem rate or to house additional inmates. Prior to any other facility being used for the housing
of VTOOC inmates, an on site visit by VTOOC officials must occur.
The Contractor shall provide the inmates with care and treatment, furnishing subsistence
and all necessary routine medical care; providing for their physical needs; making programs of
training and treatment consistent with the inmates' needs available; retaining the inmates in safe,
supervised custody; maintaining proper discipline and control; making certain that sentences and
orders of the committing court in the State of Vermont are faithfully executed; providing the same
access to the law library and rehabilitation programs as any other inmate housed by the Facility to
the extent appropriate for their custody level and in conSUltation with VTOOC; and otherwise
complying with applicable laws.
(b)

General Outies

The Contractor shall maintain staffing levels at the Facility in accordance with ACA
standards and in sufficient numbers and rank to maintain the safety of the public, staff and
offenders and to adequately carry out the provisions of this Agreement. The Contractor shall
provide VTOOC with staffing guidelines for each facility where VTOOC inmates are housed prior
to execution of this Agreement. Said staffing guidelines are attached hereto as Exhibit A. In the
event of any change to the staffing guidelines for the staff assigned to the particular VTOOC
housing units during the term of the Agreement, such revised guidelines shall be discussed with
the VTOOC Contract Manager and upon agreement shall be provided to VTOOC. Subject to the
provisions of this Agreement, the Contractor shall provide VTOOC inmates care and treatment,
including the furnishing of acute, chronic and emergency medical care consistent with the
requirements of ACA standards, NCCHC standards, and constitutionally appropriate guidelines,
provide for their physical and mental health needs, make available work, education, training and
treatment programs, retain them in safe, supervised custody, maintain proper discipline and
control, make certain that any applicable court orders are complied with, provide reasonable
access to the courts, and otherwise comply with all applicable law. The Contractor will provide
reports to the VTOOC Contract Manager on the adjustment of VTOOC inmates consistent with
VTOOC reviews. Contractor shall provide management of VTOOC inmates including
classification, disciplinary activity, programming and other inmate activity.
The Contractor shall provide for inmate rights in accordance with ACA Fourth Edition
Standards. The Contractor shall provide to each inmate upon arrival an Inmate Handbook
(orientation guide) that includes, but is not limited to, the following information on: rules and
procedures, penalties and offenses, disciplinary procedures, access to courts, law library and
attorneys, mail, visiting, telephone, grievances, PREA information, indigent criteria and
procedures, medical care, religious programs available, educational programs available, work
assignments, and pay scale. A verbal orientation shall also be provided upon arrival. This Inmate
Handbook should be updated annually.
2.

OURATION

STATE OF VERMONT
Page 19 of 46
CONTRACT FOR SERVICES
Contract # 19863
This Agreement shall be in full force and effect from July 1, 2011 until June 30, 2013, unless terminated
by notice from either party in accordance with Section 3 of this Agreement The Agreement may be
renewable for one additional two-year period upon mutual agreement of the parties.
3.

TERMINATION

This agreement may be unilaterally terminated, with or without cause, by thirty (30) days written
notice by VTDOC or one hundred eighty (180) days notice by Contractor, mailed to the other party by
registered U.S. mail, return receipt requested. Any notice so mailed and any notice served by personal
delivery shall be deemed delivered and effective upon receipt or upon attempted delivery. This method of
notification will be used in all instances, except for emergency situations when immediate notification is
required pursuant to the appropriate sections of this Agreement
4.

RIGHT OF INSPECTION

VTDOC shall have the right to inspect, unhindered, at all times any Facility housing VTDOC
inmates as needed to monitor Contractor's operational compliance with the Agreement VTDOC shall
have the right to inspect or otherwise evaluate the work performed or being performed under this
contract Access to documents shall be limited to those records required for such evaluation purposes
and VTDOC's defense of claims and/or lawsuits.
5.

INMATE INFORMATION

Separate information packets shall be provided electronically by VTDOC for each inmate to be
transferred to the Contractor no later than the date of the inmate's arrival at the Contractor's Facility. Said
packets shall consist of at least the following: information and necessary documents relating to the case
history including disciplinary and classification records and any Security Threat Group (STG) related
documents; physical and clinical records; identification of persons known to pose a security threat to the
inmate; judicial and administrative rulings and orders relating or pertinent to the inmate and the
sentences pursuant to which confinement is to be had or to continue; identification data, photographs,
and fingerprints.
6.

TRANSPORTATION OF INMATES

Except as otherwise indicated, transportation of an offender for purposes of litigation arising as a
result of the Contractor's acts and/or omissions in the performance of this contract shall be at
Contractor's expense.
At no expense to VTDOC, Contractor shall provide one (1) thirty-man round trip transport every
three weeks between Vermont and the Lee Adjustment Center for the purpose of transporting inmates.
Contractor shall provide one (1) thirty-man round trip transport quarterly between Vermont and the
Florence Correctional Center for the purpose of transporting inmates. Provided however, in the event
that more frequent transports between Vermont and Florence are necessary, VTDOC and Contractor
may mutually agree to add additional transports between, but in no event shall these transports occur on
a greater than monthly basis.
Additional transportation needed for the return of the offender to the physical custody of VTDOC
shall be at VTDOC's expense.
Additional transportation needed for the movement of the inmates between CCA Facilities shall be
at Contractor's expense.
7.

TRANSFER OF INMATE FUNDS/PERSONAL PROPERTY

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 20 of 46
Contract # 19863

(a) Transfers from Vermont to a CCA Facility
Personal funds due transferred inmates shall be provided by VTDOC at the time of transfer to be
credited to the account of the transferred inmate by the Contractor.
The Contractor shall work with VTDOC on the collection of debt that may be owed by Vermont
Inmates in the Contractor's custody. VTDOC shall provide Contractor on a monthly basis a list of
the current inmate debt accounts. Monies collected from inmate accounts via Contractor shall be
submitted to VTDOC Central Business Office on a monthly basis.
VTDOC inmates shall be allowed to possess personal property as outlined in the Contractor's
policies for each Facility at which VTDOC inmates are housed. Contractor shall provide the
VTDOC allowable property lists prior to the implementation of this agreement
Subject to the Contractor's limitations on the amount of personal property that may be transferred
to the facility with each inmate, the Contractor will be responsible for the cost of transferring
inmate personal property to the facility.
VTDOC will package and inventory the personal property of each inmate prior to transferring the
inmate to the Facility. VTDOC shall screen the inmates' property for dangerous contraband such
as weapons, non-prescribed drugs, tobacco, or cell phones. The Contractor shall not be
responsible for inmate property damaged in transit, if said damage is related to improper
packaging.
(b) Transfers from a CCA Facility to Vermont
Upon return of the inmate to VTDOC, the Contractor shall provide the funds in the amount due the
inmate at the time of return. On the day of the return the funds shall be sent to the Lock Box along
with a list of the inmates being transferred, their dates of birth and the amount owed to each. For
every day after the transfer day that the funds are not transferred to the VTDOC, the Contractor
may be penalized $100.00.
VTDOC shall provide Contractor with allowable personal property lists for Vermont Facilities. Only
that property on the lists will be accepted.
Contractor will be responsible for the cost of
transferring inmate personal property to Vermont Contractor shall be liable for property damaged
due to improper packaging by Contractor upon inmate's transfer out of the Facility.
Contractor shall screen all inmates' property for dangerous contraband such as weapons, nonprescribed drugs, tobacco, or cell phones. For every violation the contractor may be penalized
$100.00.
(c) Commissary and Telephone Profits
The Contractor shall retain all commissary and telephone profits.
8.

POLICY AND PROCEDURES

STATE OF VERMONT
Page 21 of 46
CONTRACT FOR SERVICES
Contract # 19863
Contractor shall provide VTDOC with a complete set of Policy and Procedures that govern the
operations of the Facilities housing Vermont Inmates. Contractor shall provide VTDOC allowable
property lists for each living unit as well as for each inmate status that are governed by their policy or
procedures. Any time there is a change in the Policy or Procedures, the Contractor shall discuss the
change with VTDOC thirty (30) days prior to the change being implemented. When failing to notify /
consult with VTDOC prior to implementation the Contractor may be penalized $100.00.

9.

CLOTHING, LINEN AND LAUNDRY

The Contractor will be responsible for laundry, repair, and replacement of inmate clothing during
the VTDOC inmates incarceration at the Facility to ensure clean clothes and bedding on a weekly basis.
Upon admission, a minimum of three (3) sets of clean Facility uniforms and three (3) sets of
undergarments and socks, clean bedding (to include sheets, blanket(s), pillow and pillow case and
mattress), climate appropriate outer wear Gackets, etc.) and deck shoes or other appropriate footwear
shall be provided VTDOC inmates, if needed. In addition, inmates shall receive footwear appropriate to
their work assignment. Tennis shoes shall be made available for purchase in the commissary. Contractor
shall provide laundry services to the inmate at no charge to the inmate in accordance with established
Contractor policies.
10.

INMATE WORK TRAINING AND EDUCATION
(a)
VTDOC inmates may be employed by the Contractor for work to be performed for the
benefit of the Facility such as: maintenance, clerical, janitorial, kitchen and laundry. The parties
agree that the wage rate for these jobs shall be the wages in place at the Facility as dictated by
standards goveming the Facility, including but not limited to applicable statutes, but in no event
shall be lower than the wages paid for the same work to inmates at the Facility from other
jurisdictions. It is understood and agreed that this provision does not create an
employer/employee relationship subject to the Federal Fair Labor Standards Act; and that such
work is performed as part of the custodial arrangement. The Contractor shall include in its
monthly reports to the Contract Manager information regarding the job, pay rate and number of
hours worked for each VTDOC inmate.
(b)
Inmates from VTDOC will be afforded the opportunity to participate in programs of
occupational training or work on the same basis as any other inmate housed by the Contractor
and as appropriate to the inmate's custody level. Vocational programming at the Lee Adjustment
Center will include, but is not limited to, Standardized Craft Training and Non-construction
Industries Training. Compensation in connection with any such participation (whether as payment,
incentive, or for any other therapeutic or rehabilitative reasons) shall be paid by the Contractor to
inmates of VTDOC as set forth in 10. (a) above. Any such inmates of VTDOC shall be subject to
the regular work discipline imposed upon other inmate participants in the particular program.
However, nothing contained herein shall be construed to permit or require any inmate of VTDOC
to participate in any training, industrial, or other work program contrary to the laws of the State of
Vermont. Inmates from VTDOC shall not be eligible for furloughs, participation in the work release
program, or be employed in work programs outside the secured perimeter of the Facility.

11.

RECREATION

STA TE OF VERMONT
Page 22 of 46
CONTRACT FOR SERVICES
Contract # 19863
The Contractor shall provide VTOOC inmates with equipment and supplies for indoor or outdoor
recreation and leisure time activities equal to that provided to other jurisdictions but not less than one and
one-half (1 %) hours each day, seven days each week except in circumstances that do not permit the
Contractor to provide such, including, but not limited to, inmates who are in segregation, during
lockdowns and during inclement weather. Contractor shall maintain logs to reflect the times that
recreation is offered and the numbers of inmates utilizing the recreation being offered.

12.

RELIGION
Contractor shall provide facilities for religious programs in accordance with ACA standards.

13.

MEALS.

The Contractor shall provide VTDOC inmates with a nutritionally balanced, varied diet of adequate
portions of food pursuant to standards established by the American Corrections Association. All menus
will be approved by a registered dietician or nutritionist and all meals will be prepared in compliance with
the approved menus. The Contractor shall provide special meals which meet medical or religious
requirements of applicable VTDOC inmates. Special medical meals must meet the nutritional
requirements as prescribed by a medical doctor.
14.

VISITS

The Contractor shall provide VTDOC inmates with the opportunity to participate in visiting
privileges from family members and friends for the purpose of maintaining family and social relationships,
and to facilitate the inmate's re-entry to the community.
Visiting privileges shall be based on the same schedule and procedures afforded to other inmates
housed by the Contractor and as appropriate to the inmate's custody level except that:
(a) Any person banned from visiting an inmate in Vermont shall also be
banned from visiting at the Contractor's facility. VDOC shall furnish current documentation
of persons who are banned from visiting VTDOC inmates who are housed at the Contractor's
facility.
(b) Contractor shall establish procedures to provide for contact visits
between a Vermont inmate and any minor child for which he has custody or parental control.
(c) Contractor will maintain the equipment at the Contractor's facility that would allow for visits
using secure IP Compatible video equipment connected to a high speed internet line that
will allow an inmate's family to have video contact with the inmate. This needs to be done at
no additional cost to the inmate or the family. VTOOC shall be responsible for the cost of the
equipment and system in Vermont.
15.

RESTRICTIVE HOUSING

(a)

Discipline
i) Inmates from VTDOC shall be subject to the policies and procedures as well as the
rules and regulations of the Contractor. The Contractor shall have physical control and
the power to exercise disciplinary authority over all inmates from VTDOC provided: (1)

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 23 of 46
Contract # 19863

the disciplinary action is reasonable and proportionate in relation to the violation; (2) the
action taken is impartial and nondiscriminatory; (3) the action is neither arbitrary nor
retaliatory; (4) the discipline is not physically abusive; and (5) accurate, detailed reports
of formal disciplinary actions against VTDOC inmates are provided to the Contract
Manager within seventy-two (72) hours of the date the action is finalized or the
punishment is administered; for every day after the 72-hour notification related to a
serious conduct infraction is not made, the Contractor may be penalized $100.00.
ii) Inmates who have violated the Contractor's rules and regulations will be subject to the
same disciplinary rules and regulations as any other inmate housed by the Facility.
However, nothing contained herein shall be construed to authorize or permit the
imposition of a type of discipline prohibited by the laws applicable to the State of
Vermont. This shall include a prohibition against the placement of any Vermont inmate
on disciplinary segregation for more than thirty (30) consecutive days.
(b)

Protective Custody
i) Inmates from VTDOC who need separation from the general population at their request
or requiring protection from other inmates for reasons of health or safety shall be placed
in protective custody. The Contractor shall have physical control and the power to
exercise protective custody authority over all inmates from VTDOC provided: (1) there is
a written request from an inmate for protection or the Contractor can demonstrate a risk
to the inmate; (2) an investigation is performed in order to validate this status; (3)
periodic reviews occur to assess the continued need for protection; (4) decisions to
support protective custody are documented; and (5) accurate, detailed reports and
formal written decisions involving VTDOC inmates are provided to the Contract
Manager within seventy-two (72) hours of the date the action is finalized; for every day
after the 72-hour notification related to a protective custody inmate is not made, the
Contractor may be penalized $100.00. Protective custody is not a punitive measure
and is used only when no reasonable, safe alternative is available.
ii) VTDOC inmates on Protective Custody will be housed in the least restrictive
environment possible. Provided however, unless the number of inmates on Protective
Custody is sufficient to occupy at lease 95% of a housing unit, such inmates may be
housed in segregation until such times as a sufficient number of Protective Custody
inmates exists to fill 95% of a housing unit.

(c)

Administrative Segregation
i) Inmates from VTDOC who need separation from the general population when the
continued presence of the inmate in the general population would pose a serious threat
to life, property, self, staff, or other inmates or to the security or orderly running of the
institution shall be placed in administrative segregation. The Contractor shall have
physical control and the power to exercise administrative segregation authority over all
inmates from VTDOC provided: (1) the Contractor can demonstrate that the inmate
poses a threat; (2) an investigation is performed in order to validate this status; (3)
decisions to support segregation are documented; (4 periodic reviews occur to assess
the continued need for segregation; and (5) accurate, detailed reports and formal written
decisions involving VTDOC inmates are provided to the Contract Manager within
seventy-two (72) hours of the date the action is finalized; for every day after the 72-hour

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 24 of 46
Contract # 19863

notification related to an inmate on Administrative Segregation status is not made, the
Contractor may be penalized $100.00.
ii) If an inmate appeals their placement on Administrative Segregation to the Warden or
higher authority, a copy will be sent to the VTDOC Contract Manager for any relative
input.
(d)

In the areas of Restrictive Housing, such as Disciplinary Segregation, Administrative
Segregation, and Protective Custody Contractor shall adhere to the following VTDOC
Policy and Directives at the Lee Adjustment Center:
(i)
(ii)
(iii)
(iv)
(v)

410 - Due Process
410.01 - Facility Rules and Inmate Discipline
410.03 - Placement on Administrative Segregation
410.05 - Protective Custody
410.06 - Restrictive Housing Status, Conditions of Confinement

Waiver - 410.06 part 7c - (Daily visits are required by a health care professional not a
qualified mental health professional) (Follow attachment 2 of the Directive)
16.

GRIEVANCES

Inmates from VTDOC will be afforded access to reasonable, impartial and non-discriminatory
grievance and misconduct procedures in compliance with the applicable ACA standards, including a final
level of appeal to VTDOC. Inmate grievances will be answered within fifteen (15) days of receipt;
provided the Contractor may extend this deadline by up to 15 additional days if staff or inmates required
to investigate the grievance are not available or in the event there are other extenuating circumstances.
(a)
VTDOC is responsible to respond to grievances and appeals on matters occurring during
the inmate's incarceration prior to and up to the actual transfer of the inmate to the Facility
including such issues as: reasons for the transfer; transfer of personal property until custody is
relinquished to the Facility; uses of force to require transfer; trust fund; oversight of contract
compliance.
(b)
The Contractor is responsible to respond to grievances and appeals on matters occurring
during the inmate's incarceration in the Facility except sentence administration issues and
classification to lower or higher security status. A copy of all formal & informal grievances will be
provided to the VTDOC within 24 hours of being answered and failure to do so may result in a
$100.00 penalty for every 24 hour period they are not provided.
(c)
If an inmate appeals a grievance to the Warden or higher authority, a copy will be sent to
the VTDOC Contract Manager for any relative input in the resolution. Failing to include the
Contract Manager on appeals may result in a $100.00 penalty for each occurrence.
(d)
Inmate grievances are reviewed to identify potential areas of concern and to determine if
problematic patterns exist. Inmate grievances will be documented in a log to assist in monitoring
compliance with policy and procedure related to inmate grievances and to summarize those areas
which are frequently the topic of inmate dissatisfaction. A narrative review of grievances along
with the Contractor's reasoning for them must be included in the monthly report.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 25 of 46
Contract # 19863

(e)
Unless otherwise extended according to Contractor policy, all inmate grievances will be
responded to within fifteen days of receipt and included in the monthly reporting. For every day
after the deadline an inmate grievance goes unanswered, the Contractor may be penalized
$100.00.

17.

NOTIFICATION OF INMATE INCIDENTS, EMERGENCIES, ESCAPES AND DISCIPLINE

The CONTRACTOR will notify the VTDOC, according to the contact list provided by VTDOC, as
soon as reasonably possible, but no later than two hours after the start of the incident, by telephone or email for any incident listed below which involves a VTDOC inmate:
(a)
(b)
(c)

Inmate escape;
Use of deadly force;
Use of force in which there is an injury to a VTDOC inmate
requiring medical treatment;
(d)
Use of force in which mechanical restraining devices are used for other than temporary
control;
(e) Alleged or known assault, including sexual assault, by an employee, inmate, or civilian;
(f)
Disturbance involving three or more inmates which is not brought under control within 15
minutes;
(g)
Death of an inmate;
(h) Property destruction rendering a living unit or support service area unusable;
(i)
Hostage situation;
U)
Use of chemical agents including hand-held OC units;
(k) Suicide attempt;
(I)
Transport to a hospital;
(m) PREA incidents.
For every hour after the 2-hour notification is not reported to the VTDOC, the Contractor may be
penalized $100.00. Provided however, in no event shall the penalty exceed $1,000.00.
The initial phone contact will be followed up by an electronic copy of the facility's 5-1A report with
in 72 hours of the incident
For every hour after the 72 hour that the 5-1A report is not received the Contractor may be
penalized $100.00. Provided however, in no event shall the penalty exceed $1,000.00.

18.

HEARINGS

CONTRACTOR shall provide adequate on-site facilities for any court ordered hearings, status
conference, deposition or other legal proceedings, and parole hearings ordered and conducted by the
state or federal courts in which a VTDOC inmate may be made available by telephone or secure video
conferencing. Such facilities shall include a private room, a writing table, and a chair for each participant
and teleconferencing equipment
19.

CUSTODY CLASSIFICATION

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 26 of 46
Contract # 19863

Inmates placed pursuant to this agreement shall be of a custody classification that is consistent
with the policies and procedures of the Contractor and the rules and regulations of the state of
incarceration.
Inmates placed pursuant to this agreement shall not be reduced in custody classification unless
agreed to in advance and in writing by VTDOC. However, the Contractor reserves the right to increase
the custody classification of inmates in a manner consistent with its policies and procedures and shall
notify VTDOC within seventy-two (72) hours of such action.
20.

RETAKING OF INMATES
(a)
The Contractor will surrender any VTDOC inmate to the proper officials of VTDOC upon
demand made to the Contractor and presentation of official written authority to receive said
inmate.
(b)
In the event that VTDOC sends an inmate to the facilities who, in the opinion of the
Contractor, is unsuitable for housing at the facility due to classification, medical, mental health or
other reasons, after consultation with VTDOC and the Facility Warden VTDOC shall retake such
inmate on the next available transport.

21.

PHOTOGRAPHING AND PUBLICITY

Institutional or other officials of the Contractor shall not be authorized to release publicity
concerning inmates from Vermont. Contractor shall not release personal histories or photographs of such
inmates or information concerning their arrivals or departures or permit reporters or photographers to
interview or photograph such inmates without the express written permission of VTDOC and of the
inmate. The Contractor may photograph inmates from Vermont as means of identification for official use
only; however, photographs of an inmate may be disseminated to appropriate law enforcement officials
and to the press in the event of any escape from an institution by such inmate.
All requests for media interviews with VTDOC inmates must be approved in advance by the
VTDOC Contract Manager.
22.

COST AND REIMBURSEMENT

Except as otherwise provided herein, the entire cost to VTDOC for housing inmates transferred by
VTDOC under the terms of this Agreement shall be fixed at the $61.72 per inmate per day for Lee
Adjustment Center and $68.00 for Florence Correctional Center for the first year of this contract. On July
1 of 2012 and every subsequent July 1 in which this Agreement or any renewal term is in effect, the then
current rates shall increase by three percent (3.0%). The rates for the four year term shall be as follows:

Year One:
Year Two:
Year Three:
Year Four:

Lee
Adjustment
Center

Florence
Correctional
Center

$61.72
$63.57
$6547
$6743

$68.00
$70.04
$72.14
$74.30

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 27 of 46
Contract # 19863

VTDOC shall be billed monthly by the Contractor. VTDOC shall pay the Contractor for the day the
Contractor takes custody of an inmate and every subsequent day the inmate remains in the custody of
the Contractor, except the Contractor shall not be paid for the day the inmate ceases to be in the custody
of the Contractor. Contractor shall present VTDOC with an invoice no later than 15 days after the close
of the month. Payment shall be made within thirty (30) days of a correct invoice. Man day invoices will
be submitted separately from any other invoices. VTDOC and the CONTRACTOR shall use all
reasonable efforts to ensure that an invoice is reviewed and, if necessary, corrected in a timely fashion.
Contractor is subject to performance penalties within this contract. During the duration of this
contract, VTDOC shall provide the Contractor with a warning notice on the first occurrence of a breach
under a particular contract section for which a performance penalty would otherwise be applicable unless
the VTDOC deems the breach as egregious. On the second and any subsequent occurrence of a
breach VTDOC may assess the specified penalty. When a penalty is levied, the Contractor has 15 days
to appeal the penalty. In turn, VTDOC has 15 days after the appeal has been received to make a final
determination. If the penalty remains, the Contractor has 15 days to make payment to the VTDOC. In
the event that a pattem is established whereby Contractor has successfully appealed multiple instances
of penalties, VTDOC and Contractor shall reconsider the penalty provisions hereunder to ensure that
systemic problems with transmission or other exigent circumstances are not causing undue workload for
either Contractor or VTDOC with respect to the penalty provisions.

23.

CONTACT PERSON/CONTRACT MONITOR

In order to effectively administer this agreement, each party shall appoint a contact person for the
respective state. The contact information for the VTDOC will be Contract Manager, 103 South Main
Street, Waterbury, VT 05671-1001 (Tel: 802-241-1936 Fax: 802-241-1933). The contact person for the
Contractor will be Ben Shuster, Senior Director, Partnership Relations, 10 Burton Hills Boulevard,
Nashville, TN 37215 (Tel: 615-263-6612 Fax: 615-263-3100). Replacement of the individuals named
herein may be accomplished by written notice to the other party. All notices, reports, billings, and
correspondence to the respective parties to this agreement shall be sent by certified mail to the
addresses listed above.
Contractor will provide VTDOC contract monitors office space that has a lock that is not masterkeyed, a desk, chair, telephone/fax/computer lines (for internet access only). Contractor will not be
responsible for fax or non-business-related telephone costs. VTDOC contract monitors shall have
unhindered access at all times to Vermont inmates and staff and to all areas of the Facility and to nonfinancial documents and records relating to Contractor's obligations under the Contract. Access will
include employee qualifications, training requirements, disciplinary records relative to serious incidents
and security breaches and reports concerning Facility repairs and maintenance. Access shall be in strict
compliance with privacy rights and shall be kept confidential. VTDOC contract monitors may attend
regularly scheduled operational meetings between Facility administration and staff pertaining to
Contractor's obligations under the Contract. VTDOC contract monitors shall not be allowed to attend
meetings with Contractor's legal counsel, corporate officials or meetings involving employee disciplinary
matters. VTDOC contract monitors shall not have access to records pertaining to inmates from other
jurisdictions.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 28 of 46
Contract # 19863

VTDOC shall receive an annual credit of Fifty Thousand Dollars ($50,000.00) to offset its expense
for the on-site contract monitors. This credit shall be deducted on each monthly invoice in the amount of
Four thousand One Hundred and Sixty Six dollars and sixty seven cents ($4,166.67). Beginning on July
1, 2012 and continuing each year that this Agreement or any renewal term is in effect, the annual credit
for the on-site contract monitor shall increase by three percent (3%) over the prior year's credit and the
amount deducted on the monthly invoice will be adjusted accordingly.
24.

ESCAPES

The Contractor shall notify VTDOC within two (2) hours upon the verification of an escape of an
inmate transferred pursuant to this agreement and shall take all action necessary to affect the
apprehension of the escaped inmate. In the case of an escape to a jurisdiction other than the state in
which the inmate was housed, the responsibility for extradition or rendition proceedings shall be that of
the VTDOC, but nothing contained herein shall be construed to prevent or affect the activities of officers
and agencies of any jurisdiction directed toward the apprehension and return of an escapee. Any
reasonable and actual costs up to $50,000.00 incurred by VTDOC in connection with any escape and or
rendition and extradition process shall be chargeable to and borne by Contractor.
25.

INTERDICTION PROGRAM
(a) Urinalysis
All inmates transferred pursuant to this agreement shall be required to participate in routine
urinalysis testing for cause and random samplings. Each month 5% of the population shall be
tested via random samplings. All drug test results for unauthorized drugs shall be reported to the
Contract Manager in the monthly report. Testing costs will be included in the rate set forth in
Section 22.
Each month that 5% of the population is not tested the Contractor may be penalized
$300.00.
(b) Shakedowns
Each month 10% of the population shall be searched. This is to include the inmate, the
inmate's room or sleeping quarters, and the inmate's personal property. All shakedown results
shall be reported to the Contract Manager in the monthly report.
Each month that 10% of the population is not searched the Contractor may be penalized
$300.00.
In addition to the inmates and the inmate areas, Contractor shall also shakedown the
common areas of the facility on a routine basis so that each quarter all of the common areas in the
Facility will have been searched.
Each quarter (Jul - Sept, Oct - Dec, Jan - Mar, Apr - Jun) that all of the common areas
have not been searched the Contractor may be penalized $500.00.
(c) Contraband

Contractor shall maintain a log of all dangerous contraband (e.g. illegal drugs, weapons, cell
phones, escape paraphernalia, etc). Entries in the log at a minimum shall contain what it was, where it

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 29 of 46
Contract # 19863

was found, who found it, and when it was found (date and time). The log should also include how the
contraband was disposed of. Provided however, Contractor shall not be required to log nuisance
contraband such as excess property or items, although prohibited, that do not constitute a danger to the
good order and security of the facility.
26.

MEDICAL

It is the intent of the State that inmates receive care comparable to that available to inmates in
Vermont. The Contractor's written policies and procedures will describe health services, medical
services, and dental services to be provided. At a minimum, these must meet ACA standards, federal,
state and local laws and regulations, as well as the following State policies and procedures. In
accordance with subsection (w) of this section 26, Contractor shall follow NCCHC standards.
(a)

Reception Screening

Contractor shall conduct a receiving screening on all newly admitted State inmates within
twenty-four (24) hours of the inmate's arrival at the Contractor's facility. This screening shall be
conducted by a qualified medical professional and shall include review of State medical
information and the following:
(1) Inquiry into current and past illnesses, health problems and conditions;
(2) Any past history of serious infectious or communicable illness, and any treatment
or symptoms (e.g., chronic cough, hemoptysis, lethargy, weakness, weight loss, loss
of appetite, fever, night sweats) suggestive of such illness;
(3) Mental illness, including suicide risk;
(4) Dental problems;
(5) Allergies;
(6) Medications taken and special health (including dietary) requirements;
(7) use of alcohol and other drugs, and any history of associated withdrawal
symptoms
(8) Other health problems designated by the responsible physician or medical
professional performing the screening; and
(9) Observation of the following:
behavior, which includes state of consciousness, mental status (including
•
suicidal ideation), appearance, conduct, tremors and sweating;
•
body deformities and ease of movement;
•
persistent cough or lethargy; and
•
Condition of skin, including trauma markings, bruises, lesions, jaundice,
rashes, infestations, and needle marks or other indications of drug abuse.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 30 of 46
Contract # 19863

For every hour beyond the first 24 hours an inmate is not screened, the Contractor may be
penalized $100.00. Provided however, in no event shall the penalty exceed $1,000.00.

(b)

Access to Services

At the time of initial intake, each inmate will be provided with a health care services
orientation and information on how to access health care services while in the facility. The
orientation will include:
(1) The purpose of intake history and physical evaluation, provision of emergency
services, pharmaceutical services and policies, and infirmary and in-patient services;
(2) Specific sick call times and procedures;
(3) Procedures for obtaining physical and mental health care services;
(4) Health care services staffing, and the behavior expected of inmates while in the
health care services area; and
(5) Grievance procedures.
(c)

Physical Examinations

Physical examinations shall be conducted annually or as clinically indicated. The
Contractor shall conduct physical examinations in accordance with requirements of the National
Commission on Correctional Health Care (NCCHC) standards, including gathering of lab data.

(d)

Sick Call

Contractor will provide a sick call system which provides inmates with unimpeded access to
health care services. Health care staff will collect, triage and respond to all inmate requests daily.
The frequency of sick call will be consistent with NCCHC standards. If the inmate's custody status
precludes attendance at sick call, appropriate measures will be taken to provide access to health
care services.
(e)

Emergency Services

Contractor is required to provide an immediate response to inmates with emergency health
care needs. Contractor will have twenty-four (24) hour physician coverage or telephone on-call
coverage and specific written policies and procedures to address emergency response and the
emergency transfer of inmates. Contractor shall ensure that an inmate's medical chart accurately
and completely documents all services provided by Contractor and community health care
providers in emergency situations.
(f)

Inpatient Services

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 31 of 46
Contract # 19863

Contractor shall staff and utilize observation beds available at Contractor's facilities for
admissions which do not require hospitalization. Inmates requiring respiratory isolation will be
housed in a designated negative air pressure room. If an inmate requiring respiratory isolation is
housed at a Facility without the requisite equipment, Contractor shall transfer the inmate to a
properly equipped facility. The Contractor shall comply with state and federal laws and NCCHC
standards with respect to the management and operation of observation beds.
Medical observation is a transient housing location for those inmates with stable
illnesses/injuries not requiring hospitalization. Examples of appropriate inmates include, but are
not limited to seizure activity, infectious diseases, allergic reactions, suicide precautions, post
hospitalization convalescent care, etc. Inmates are monitored by security staff and attended to by
nursing staff as ordered by the physician. The physician/psychiatrist orders observation status,
monitors all care, and is responsible to determine release from medical observation.
(g)

Hospitalization

Contractor shall identify the need, schedule, coordinate and pay for any inpatient
hospitalization and related services for any inmate, consistent with terms of Paragraph (y).
Contractor shall ensure that an inmate's medical chart accurately and completely documents
services provided by community health care providers and that such documentation is included in
the medical transfer record when the inmate returns to VTDOC. The Contractor shall notify the
VTDOC Director of Health Services of every Vermont inmate placed in a hospital. Such
notification may be by electronic or other means and shall not exceed twenty-four (24) hours
beyond placement.
Under no circumstances shall Contractor limit or delay access to inpatient hospitalization,
including inpatient psychiatric hospitalization for inmates needing this level of care to the extent
possible given resources available in the community where the facility is housed. In the event that
an inmate is in need of psychiatric hospitalization that exceeds the short term hospitalization
available in the local jurisdiction, the inmate shall be returned to Vermont. If the State believes that
the Contractor is not transporting inmates needing inpatient hospitalization in timely fashion, the
State's Chief Medical Officer shall audit the case in consultation with the Contractor's Chief
Medical Officer. After the audit, if the parties' Chief Medical Officers mutually determine that the
Contractor was found to not be timely in the service delivery the Contractor may be penalized
between $100 and $1,000.00 per case, at the discretion of the VTDOC based on the severity of
the case. Failure to reach satisfactory resolution of such a case may be grounds for termination of
the contract by the State.
(h)

Specialty Outpatient Services

When available, the Contractor shall arrange for qualified medical specialists to visit the
facilities so that inmates may be maintained within the security of the Contractor facility. If
necessary, an outside referral will be made for services that cannot be provided at the facility. To
the degree possible; diagnostic testing will be performed on-site. A referral process will be initiated
to provide specialists with all pertinent information needed to facilitate timely diagnosis and
treatment. The medical specialist will receive diagnostic testing results, substantive patient history
and clinical findings, in the form of a written referral.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 32 of 46
Contract # 19863

Contractor shall be responsible for scheduling, authorizing and coordinating all specialty
services. All inmates returning from outside hospital stays will be seen immediately upon return by
a medical professional, and a progress note regarding the review will be documented in the
inmate's health care record. Contractor shall ensure that an inmate's medical chart accurately and
completely documents services provided by the community health care provider and that such
documentation is included in the medical transfer record when the inmate returns to VTDOC.
Under no circumstances shall Contractor limit or delay access to specialty services for
inmates identified as needing this care. The Contractor shall make every effort, within four weeks
of the date on which a referral is made, to schedule the appointment for specialty care. If the
State believes that the Contractor is not providing specialty services in a timely fashion, giving due
consideration to the availability of the required specialty services in the local jurisdiction, the
State's Chief Medical officer shall audit the case in consultation with the Contractor's Chief
Medical officer. After the audit, if the parties' Chief Medical Officers mutually determine that the
Contractor was not timely in the service delivery the Contractor may be penalized $100 per day for
each day that the date of the appointment extended past four weeks from the date of referral.
Provided however, the Contractor shall not be penalized in the event that the Contractor can show
that reasonable efforts were made to schedule the appointment with the required specialty
provider and that the delay in scheduling the appointment was the cause of the specialty provider.
(i)

Laboratory Services

Contractor shall provide lab diagnostiC testing. Laboratory testing will include routine,
special chemistry and toxicology analysis. The laboratory will meet all applicable state and federal
requirements for specimen handling, testing and reporting. All services provided shall meet
standards set forth by the American College of Pathology.
U)

Radiology Services

A radiology technician will be available to provide radiology services. Inmates will be
referred off-site for procedures beyond the scope of services provided on-site. A Board-Certified
radiologist will read the studies in a timely manner. The radiology report will be documented, and
maintained in the inmate's health care record. The Contractor's Medical Director will review, initial
and date all radiology reports. A verbal or electronic notification of all positive findings will be
furnished to the VTDOC Medical Director or his/her designee within three working days; if verbal
notification is given, this notification is to be followed up by a written notice of findings within 10
working days.
(k)

Diet Therapy

Special diets will be available to inmates when medically indicated and ordered. Contractor
will document the need and dietary services required. The inmate's orientation to the therapeutic
diet will be documented in the health care record. In accordance with NCCHC standards,
Contractor shall coordinate reviews of all diets at least every six months with a registered dietitian.
(I)

EKG Services

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 33 of 46
Contract # 19863

Contractor shall provide EKG services and necessary EKG equipment. The EKG contract
will provide for immediate reading and reporting of results of EKG, Nursing staff will receive inservice training related to EKG services,
(m)

Medical Prosthetics

With the prior approval by the Vermont Health Services Director Contractor shall provide
prosthetic devices to inmates as medically indicated, Prosthetics will be selected according to
community standards, but also must conform to security requirements of the State, The costs
associated with providing prosthetics shall be bome by the State,
(n)

Optical Services

Contractor shall identify the need, schedule, coordinate and pay for the dispensing,
evaluation, and fitting services of an optometrist. Inmates requesting health care services for
visual problems will be evaluated using the Snellen eye chart by nursing staff, If a visual
deficiency beyond 20/70 is identified, the inmate will be referred to Contractor's optical service
provider,
Contractor shall provide one (1) set of eyeglasses to inmates if prescribed and deemed
necessary by the optometrist, consistent with Paragraph (y) of this Section, Inmates requiring
treatment and services beyond the scope of services offered on-site will be transported to
specialists in the community, Inmates shall be eligible to receive follow-up eye exams every two
years,
(0)

Pharmaceuticals

Contractor shall provide a total pharmaceutical system, including medications prescribed by
mental health care providers, which is sufficient to meet the needs of the State inmates,
Contractor shall be responsible for the costs of drugs administered under the contract, consistent
with the limitations described in Paragraph (y) of this Section, Policies, procedures and practices
addressing pharmaceuticals will be in compliance with all applicable state and federal regulations,
The pharmaceutical system will have the following components:
(1)
Medication ordered by a qualified provider (physician, psychiatrist, nursepractitioner, dentist) will be appropriately documented in the MAR and health record,
(2)
A pharmaceutical inventory will be established to facilitate the initiation of
pharmaceutical therapy upon the physician's order. An inventory control system will be
implemented to ensure the availability of necessary and commonly prescribed
medications, and to protect against the loss of pharmaceuticals, All pharmaceuticals
will be prepared, maintained and stored under secure conditions,
(3) An adequate and proper supply of antidotes and emergency medications will be
available,
(4) Contractor will maintain a formulary listing the available medications, and this
formulary shall be available to the State,

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 34 of 46
Contract # 19863

(5)
While it is recognized that formulary prescribing is the norm, cases may arise in
which non-formulary medications are determined to be the most effective treatment.
When this occurs, the non-formulary medication request will be processed per the
Contractor's policy. In the event that VTDOC requires the use of a non-formulary
medication, the VTDOC will reimburse the Contractor for costs above and beyond the
formulary cost. The Contractor will provide the VTDOC Clinical Director of Health
Services with a formulary list and a monthly report of all non-formulary requests and
their disposition. Information will include inmate name, medication requested, and
disposition.
(p)

Medication Administration

The Contractor shall maintain a medication administration system which meets the needs
of State inmates. Medication will be administered to inmates by nurses or other authorized
personnel three times daily or as ordered. The administration of each medication will be
documented on a medication administration record. Documentation on the medication
administration record will clearly indicate those instances when an inmate refuses a medication or
is not available to receive a medication. Medication administration times will be adjusted to meet
the needs of inmates who participate in work details or classes. If an inmate refuses a specific
medication three times, the inmate will be counseled and requested to sign a refusal form.
(q)

Dental Services

Contractor shall provide on-site dental services which include preventive and restorative
care. The initial dental appraisal and instruction in oral hygiene will be conducted at the time of the
initial health appraisal by a qualified healthcare professional and within fourteen (14) days of
admission. The Contractor's provision of a dental screening for all referred inmates shall be
conducted by a licensed dentist. Nurses who provide oral hygiene instruction will receive inservice training.
Inmates may request dental services in accordance with the Contractor's protocols and
procedures. Inmates will be seen as soon as practicable, based on acuity of need. Inmates who
require treatment beyond the capabilities of the Contractor's licensed dentist will be referred to a
dental specialist. With the prior approval by the Vermont Health Services Director, dental
prostheses will be provided as determined by a licensed dentist in accordance with the Federal
Bureau of Prisons' (FBOP) policy on dental prosthesis. The costs associated with providing such
dental prostheses shall be borne by the State.
(r)

Hepatitis Treatment

It is recognized by the Parties that the prevalence of hepatitis in prison populations is
higher than the general public. The Contractor will provide appropriate treatment, consistent with
NCCHC and/or CDC guidelines, according to protocols developed by the Contractor and
approved by the VTDOC Health Services Director.
(s)

Mental Health Services

The Contractor shall provide all services related to the mental health needs of State
inmates, including assessment, diagnosis, treatment, pharmacology and psychopharmacology.

STATE OF VERMONT
Page 35 of 46
CONTRACT FOR SERVICES
Contract # 19863
Inmates being transferred to the Contractor will be screened by the State for mental health needs,
restrictions and necessary accommodations prior to transfer. Information pertaining to mental
health treatment will be conveyed in written form and, if necessary, verbal communication to
insure continuity of care. The Contractor will provide written documentation of mental health
treatment activities, including refusal of care and will include such documentation in the medical
transfer record when the inmate returns to VTDOC.

Vermont Department of Corrections agrees to review the mental health needs and stability
of all inmates proposed for placement with CCA facilities. CCA may request the prompt return to
Vermont of any inmate whose mental health cannot be readily maintained while out of state.
(t)

Suicide Prevention and Crisis Intervention

The Contractor shall provide routine screening and evaluation of inmates to assess and
prevent suicidal ideation or behavior. When an inmate is suspected of being at risk of harm to
himself, the Contractor shall take all necessary measures and interventions to insure the inmate's
safety. Compliance with standards of professional practice shall be followed.
When an inmate experiences psychiatric emergencies or crisis, the Contractor will take all
necessary measures to respond to the inmate's needs and assure safety of the inmate and staff.
This shall include short-term psychiatric hospitalization of a temporary nature to the extent
possible given the resources available in the community where the facility is housed. In the event
that an inmate is in need of psychiatric hospitalization that exceeds the short term hospitalization
available in the local jurisdiction, the inmate shall be returned to Vermont.
Contractor shall document all relevant information and interactions with suicidal inmates
and include relevant information in the inmate's medical chart. Communication with the State
shall be initiated if an inmate engages in serious suicidal conduct or shows symptoms of serious
psychological deterioration. Contractor shall provide suicide prevention and crisis intervention
services in accordance with its policies and procedures attached hereto as Exhibit B. Said
policies and procedures are subject to change by Contractor in accordance with best practices,
ACA, NCCHC and the changing health needs of the inmates.
Health Care Records

(u)

The Contractor shall maintain a problem-oriented health care record, and will include
medical, dental, chemical dependency, and mental health care information. Contractor will provide
full and unrestricted access to and copies of the appropriate health care record to the State within
the scope of legal and regulatory requirements and in accordance with the State's policies,
procedures and directives. The standardized health care record shall contain the following
information:
•
•
•
•
•
•
•

Problem list;
Completed intake screening form;
Health appraisal form;
Clinical (SOAP) notes;
Physician orders;
Inmate requests for health care services, including illnesses and injuries;
All diagnostic findings, treatments and dispositions;

STATE OF VERMONT
CONTRACT FOR SERVICES

•
•
•
•
•
•
•
•
•
•
•
•
•

Page 36 of 46
Contract # 19863

Prescribed medications and their administration;
Laboratory, radiology and other diagnostic studies;
Consent and refusal forms;
Release of information forms;
Place, date and time of health care encounters;
The health care provider's name and title;
Hospital reports and discharge summaries;
Intra-system and inter-system transfer summaries;
Specialized treatment plans;
Consultation forms;
Health Care Services reports;
Inmate medical grievance forms;
Documentation of all medical, dental and mental health care services provided, whether
from inside or outside the facility.

A health care record will be initiated during the inmate's first health care encounter and shall
contain complete and accurate records of health care services provided during the individual's
incarceration at Contractor's facilities. The State will provide health information at the time of
transfer, and the Contractor shall provide relevant records to the State upon an inmate's return to
the State's custody. Contractor shall return records in tabulated or otherwise organized folders
which are then placed in individual manila envelopes or other suitable sealed package. The health
care provider's signature and title will be recorded for each encounter. All outside health care
services, such as laboratory results, or physician consultation reports, will be filed as part of the
permanent health care record. Health care records shall be maintained securely and in a
confidential manner at all times, and in compliance with all applicable laws and regulations,
including, but not limited to, the Health Insurance Portability and Accountability Act of 1996
("HIPAA") (including regulations promulgated pursuant to HIPAA, such as the Standards for the
Privacy of Individually Identifiable Health Information and the Security Standards, at.45 CFR Parts
160 and 164: hereafter, the Privacy and Security Rules) and the Confidentiality of Alcohol and
Drug Abuse Patient Records, at 42 CFR Part 2.
(v)

Quality Assurance and Improvement Program

The Contractor shall implement a Quality Improvement Program ("QIP"), as set forth by
NCCHC standards. The program will be designed to assure that quality is provided in the most
appropriate and cost-efficient manner" for the VTDOC. The program shall allow development of
site-specific plans reflective of the facility's health care services systems.
The program shall consist of the following elements:
(1) Risk Management -Contractor shall establish a logical and thorough system of
policies and procedures to minimize exposure to liability. Risk management activities
focus on the identification of clinical events which have or may have the potential of
placing the inmate, health care provider, or the facility at risk. Identified risk areas are
investigated and analyzed to develop policies and procedures that reduce risk and
maintain a safe clinical setting. The QIP shall include a safety component to provide a
safe environment for inmates, employees and visitors.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 37 of 46
Contract # 19863

(2) Infection Control -Contractor's infection control policies and procedures shall
focus on the prevention, identification and control of diseases acquired in the facility
setting or brought in from the outside community. The infection control program will
address hand washing, housekeeping, decontamination, disinfection and sterilization
of equipment and supplies, medical isolation, infectious and parasitic laundry,
infectious waste, pest control and parasite infected environments.
(3) Utilization of Services -Contractor shall collect and monitor statistical data to detect
potential problems. Volume data reporting forms will be used to report data and to
track the utilization of health care services on a year-to-date basis. All deviations will
be reviewed for problem identification. Contractor will monitor the utilization of all
health care services provided off-site, as compared to national data on incarcerated
populations, and will be readily available for telephone consultations. Contractor shall
provide the State with a monthly report identifying utilization patterns; those inmates
transferred offsite to the hospital emergency department; and a status report on all
inmates in local hospitals and infirmaries. Contractor's volume data reporting forms
will also be used to prepare a narrative report on the types and numbers of services
provided.
(4) Inmate Grievances -Grievances are reviewed to identify potential areas of concern
and to determine if problematic patterns exist. Inmate grievances will be documented
in a log to assist in monitoring compliance with policy and procedure related to inmate
grievances and to summarize those areas which are frequently the topic of inmate
dissatisfaction. All inmate grievances will be responded to within fifteen days of receipt
and included in monthly reporting.
The State and Contractor shall identify personnel who will communicate about the QIP
program. The Contractor shall provide monthly reports to the State detailing levels of service
provided and systems issues encountered. The content and form of these reports shall be
determined by the Parties.
(w)

NCCHC Standards and ACA Accreditation

Lee Adjustment Center has obtained NCCHC accreditation and it shall be maintained
throughout the term of this Agreement. Florence Correctional Center shall obtain and/or be
actively working towards NCCHC accreditation within one year of the signing of this Agreement
and shall maintain accreditation throughout the term of this Agreement.
Both, Lee Adjustment Center and Florence Correctional Center are ACA accredited and
shall maintain such accreditation throughout the term of this Agreement.

(x)

Inmate Death

In the event of the death of an inmate, the Contractor shall immediately notify the Contract
Manager. Arrangements shall be made for a fingerprint (right thumb or right index) to be taken.
The coroner of the local jurisdiction shall be requested to perform an autopsy for any death of a
Vermont inmate. The Contract Manager shall furnish instructions and information regarding the
disposition of the body. All expenses relative to the autopsy, any necessary preparation of the
body and shipment or express charges, pursuant to the Contract Manager's instructions, shall be

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 38 of 46
Contract # 19863

reimbursed by VTOOC. The parties may arrange to have the Contractor take care of the burial
and all matters related or incidental thereto and all such expense shall be paid by VTOOC. The
provisions of this paragraph shall govern only the relations between the parties and shall not affect
the liability of any relative or other person for the disposition of the deceased or for any expenses
connected therewith.
(y)

Contractor Limitations

The Contractor shall be responsible for the cost of providing all outpatient medical, dental
and medication services, including specialty clinics and all medically related transportation, both
routine and emergency. The Contractor shall be responsible for inpatient hospital and surgery
charges for the first Twenty Thousand Dollars ($20,000.00) in costs per inmate, per incident.
Thereafter, VTOOC shall be liable for all inpatient hospital and surgery charges. The Contractor
shall be responsible for all outpatient surgery, including oral surgery. As the VTDOC will pay
inpatient hospital and surgery charges after the first $20,000.00, the Contractor shall cause the
medical provider's invoice(s) to detail the cost to be paid by the VTOOC and the Contractor
separately. In the event the medical provider is unwilling to separate these costs, the VTOOC and
Contractor shall allocate the costs between them in accordance with the terms set forth herein.
All medical bills will be submitted for re-pricing by the Contractor.
Both parties
acknowledge the industry standard of six months for providers to submit a clean claim for
services. The Contractor shall make all reasonable efforts to ensure that invoices are submitted
to VTOOC as soon as reasonably practical after such re-priced invoices are received by the
Contractor but no later than 210 days after the date of the service. The Contractor and the
VTOOC will develop an agreeable billing format which would be used for all medical bills which
would comply with HIPPA standards.
The Contractor shall be required to obtain written VTOOC approval of all scheduled
inpatient hospitalization and surgery as soon as Contractor can reasonably be expected to
anticipate the length of stay and/or the cost of treatment. In the event of emergency
hospitalization, the Contractor shall notify the VTOOC within 24 hours thereafter. VTOOC's
contact person for such approvals and notifications shall be VTOOC's Director of Health Services.
The Contractor shall inform the medical care facility that certification for continued hospital
stay is required by the VTOOC and must be initiated by the medical care facility if the cost of the
inmate's anticipated stay will exceed $20,000.00.
Notwithstanding any provision contained herein to the contrary, any inmate's medical
expenses resulting from the negligence or willful wrongdoing of the Contractor, its officers, agents
or employees, shall be fully paid for by the Contractor.
Except as otherwise indicated herein, the Contractor shall furnish eyeglasses and shall be
responsible for the purchase of special limited-use equipment. Except as otherwise indicated
herein, prosthetics and durable medical equipment shall be furnished by the Contractor. Ourable
medical equipment, a standard medical term, shall include, but not be limited to, such items as

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 39 of 46
Contract # 19863

crutches, orthopedic braces, nebulizers, etc, Cost of medical equipment which exceeds $2,500,00
shall be the responsibility of VTDOC.
The Contractor shall continue to provide security for an inmate assigned to the facility at an
off site medical facility after the first 72 hours, if requested to do so by the VTDOC, In that event,
the VTDOC shall reimburse the Contractor in the amount of time and a half at the starting wage of
a Correctional Officer in the facility providing such service, Prior to submitting an invoice for
reimbursement for security provided a VTDOC inmate at an off site medical facility, Contractor
shall ensure that the invoice is submitted only for the provision of such service and not for any
additional hours that the Correctional Officer may have worked that are not for the provision of
such service,

Provided that the VTDOC is aware or has been notified prior to the hospitalization of the
inmate, the Contractor shall not be responsible for inpatient hospitalization costs, including any
surgery and specialty services, associated with the treatment of persons with known Acquired
Immune-Deficiency Syndrome (AIDS), as defined by the Center for Disease Control, organ
transplants, renal dialysis, cancer treatment and Hep, C treatment The Contractor shall be
responsible for inpatient and outpatient hospitalization costs for HIV infected patients, as noted
above when not associated with treatment of their HIV disease, The Contractor shall not be
responsible for the cost of providing AZT, or other medications therapeutically indicated for the
treatment of inmates with AIDS or HIV infection, Such treatment will be at the VTDOC's discretion
and expense and requires pre-authorization, The VTDOC will screen all transfers to exclude
inmates currently being treated for active AIDS, cancer, renal dialysis and Hep C, Any inmate
who is first diagnosed with any of these conditions while at the Contractor's Facility will be
evaluated by VTDOC and the Contractor's Health Services Administrator for the Facility for a
mutual determination of whether the acuity of the condition is appropriate for housing at the
Contractor's Facility, If, upon mutual decision of the parties, the inmate remains at the Facility,
VTDOC will reimburse the Contractor for all costs associated with treating the condition.

The Facility shall have first aid equipment, which meets American Correctional Association
standards, available at all times for medical emergencies, Staff trained in emergency first aid
procedures, including cardio-pulmonary resuscitation shall be present on each shift, State
licensing and certification requirements shall apply to health care personnel working in the Facility
to the same extent as they apply to equivalent personnel in the community, The Facility shall
make provisions for medical examination of any employee or resident suspected of a
communicable disease,
The Facility shall have written policies and procedures regarding the possession and use of
controlled substances, prescribed medications and over-the-counter drugs, The policies and
procedures shall stipulate that prescribed medications are administered according to the
directions of the prescribing physician, There shall be written policies and procedures which
specify that the records of all medications distributed by Facility staff shall be maintained and
audited monthly, and include the date, time and name of the resident receiving medication, and
the name of staff distributing it Health history records shall accompany the resident to the facility
and shall be kept current Staff shall be made aware of resident's special medical problems,

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 40 of 46
Contract # 19863

At this time, there is no medical co-pay program for VTOOC inmates. If, at some point in
the future, an inmate medical co-pay is instituted, the Contractor shall be allowed to institute the
same. Contractor shall retain any co-pays that are collected.
27.

REMOVAL FROM INSTITUTION

The Contract Manager shall be informed within twenty-four (24) hours of all cases where an
inmate is removed from the Contractor's institution for emergency medical treatment, scheduled doctor's
appointment, or any other reason. All reasonable care shall be exercised for the safekeeping and care of
the inmate.
28.

ACCESS TO COURTS, LEGAL RESEARCH & SUPPLIES.

Legal services, access to a law library, and access to counsel will be provided in accordance with
ACA Fourth Edition standard and VTOOC Oirective 385.01 Inmate Access to Courts. The Contractor will
provide a commensurate service as provided by the VTOOC in its facilities.
The Contractor will ensure all VTOOC inmates court access is in compliance and consistent with
the US Constitution and US Supreme Court. The Contractor will provide access to federal and housing
state's legal materials and texts at the Facility to include legal research materials required to meet ACA
Fourth Edition and constitutional standards. Contractor shall provide VTOOC with a list of federal and
Kentucky State legal materials and texts at the Facility prior to the implementation of this agreement.
Vermont-specific legal material and texts shall be furnished by VTOOC. Contractor will provide a
secure and monitored location to house Vermont-specific legal material.
The Contractor will provide typewriters, including ribbons, and typing paper; notary services;
photocopying services, including photocopy paper; legal size envelopes; in sufficient quantity to meet
constitutional standards. Inmates may be billed for above items and services consistent with VTOOC
Oirective 385.01. Indigent VTOOC inmates' legitimate legal fillings will not be delayed due to inability to
pay. The Contractor is entitled to recoup photocopy fees when the inmate has sufficient funds in his
account.
VTOOC shall be responsible for designating and providing the first set of texts and all
supplements and updates of the Vermont-specific legal reference materials to Contractor facilities
housing 60 or more VT inmates. If the initial set of materials is lost or destroyed, Contractor shall provide
replacements or replacement costs.
The Contractor shall provide a monthly inventory of VTOOC law library legal texts and materials to
VTOOC Oirector of Legal Education 103 South Main Street, Waterbury, VT 05671-1001 (Tel: 802-2411164 Fax: 802-241-2565). This inventory will specify books missing or damaged.
Contractor
understands that they must submit the inventory no later than the 5th of each month unless the 5th of the
month is a Saturday or Sunday in which case the inventory must be submitted on the next workday.
Failure to timely submit the inventory may result in the Contractor being penalized $100.00 per day.

29.

VERMONT LEGAL MATERIALS and LAW LIBRARY ACCESS

STATE O.F VERMONT
CONTRACT FOR SERVICES

Page 41 of 46
Contract # 19863

Contractor will provide adequate on-site facilities to accommodate VTDOC legal materials,
computers or kiosks, and VT inmates. Such facilities will include chairs, writing tables, file cabinets,
bookcases, and typewriters. Contractor will institute (2) two paid work assignments for a Vermont Law
Librarian for each facility housing 60 or more Vermont inmates.
Contractor will provide VTDOC inmates with access to all legal materials referenced in Paragraph
28. Legal reference materials and library access will be available during hours that facilitate reasonable
access during nonworking, visiting, or program hours including weekends and evenings, provided that
such access will be available at least Twelve (12) hours each week and, provided further that the
minimum hours of library access will be increased if such is required by court-imposed deadlines or
order. The Contractor will provide VTDOC inmates in segregation and protective custody access to the
law library collection established pursuant to this section. If direct access cannot be provided to VTDOC
inmates in segregation or protective custody, a process shall be established allowing VTDOC inmates in
segregation or protective custody to request reasonable numbers of materials from a law library and noncontact access to the inmate law librarian.
30.

ATTORNEY CALLS

Contractor shall provide adequate on-site facilities for all attorney calls to insure confidentiality and
privacy on a non-monitored telephone line.
31.

MAIL.

Inmates will be provided with mail service. Inmates shall be provided the opportunity to use up to
seven (7) first class postage stamps per week. Contractor shall develop a system to track the usage by
inmate by week and submit documentation with a monthly invoice for reimbursement.
Indigent inmates shall be provided with supplies for correspondence. No request for mailing of
verified legal pleading will be denied under this provision regardless of postage limit or financial status of
the inmate. The Contractor is entitled to recoup postage fees when the inmate has sufficient funds in his
account.
Inmates from VTDOC may not correspond through the mail with any individual on the VTDOC's
negative contact list as established in 28 V.S.A. 11 § 802 (c) (d). The Contractor will receive this list from
the Contract Manager. A new list will be provided to the Contractor either upon the Contractor's request
or when changes are made to the list by the VTDOC
32.

RECORDS AND REPORTS FROM CONTRACTOR
The Contractor shall provide the following information and reports:
a) Any time an inmate is placed in segregation, for any reason, a written report
documenting the reason will be sent electronically to the Contract Manager within
twenty-four (24) hours; for every hour after the 24-hour notification is not made, the
Contractor may be penalized $100.00, Provide however, in no event shall the
penalty exceed $1,000.00;
b) Every Monday a report will be sent electronically to the Contract Manager by 1100
hours (EST) that shows the number of inmates in segregation by name, their

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 42 of 46
Contract # 19863

admission date into segregation, the reason for their placement, and when they were
released from segregation; for every day after the report is not received, the
Contractor may be penalized $100.00;
c) Monthly Reports to include:
a. Food Service Report - Menu for the upcoming month, number of times the
menu was changed last month, number of special diets prepared, other;
b. Disciplinary reports - a report that reflects the inmate names, rule infractions,
level of infractions, outcomes of each charge, date of infraction, and dates of
completion;
c. Grievance reports - a report that reflects the inmate names, the category of
the complaint, the resolution, and dates throughout the process; including
formal and informal grievances;
d. Urinalysis Report - name, date, random/cause, results, (positive for);
e. Extraordinary Occurrence Reports - dates, names, categories;
f. Shake downs and searches - random and cause;
g. Contraband Log of items found, who had them and where they were found;
h. Visitation - numbers of inmates receiving visits and the number of visitors,
hours visiting; including contact and noncontact visits;
i. Religious Services - hours, participants, faith;
j. Recreation - indoor, outdoor, activities, participants;
k. Education - hours, participants, classes;
I. Work - hours, participants, jobs;
m. New / current lawsuits by Vermont inmates served on the facility;
n. STG information;
o. Prison Rape Elimination Act (PREA) statistics;
p. Health Services Statistical Report;
q. Other Programs as agreed to by Contractor;
r. Updates on staffing, personnel issues / discipline or
terminations
The Contractor, except for the notification requirements noted in Section 17 above shall provide
reports of all serious conduct infractions within seventy-two (72) hours to VTDOC. Access to all record
information collected on inmates from VTDOC related to inmate programming, medical, mental health,
etc. will be made available to designated personnel of VTDOC.
The Contractor shall provide a monthly report to VTDOC on all VTDOC inmates housed in
Contractor facilities. This report will specify each inmate's program attendance and participation,
educational participation, and/or employment. Contractor understands that they must submit the report
no later than the 7th of each month unless the ih is a Saturday or Sunday in which case the Report must
be submitted on the next work day. For every day after the ih that the report is not received, the
Contractor may be penalized $100.00.
33.

GOVERNING LAW

Except where expressly otherwise provided, the laws and administrative rules and regulations
applicable to the state where the Contractor's correctional facilities are located shall govern in any matter

STATE OF VERMONT
Page 43 of 46
CONTRACT FOR SERVICES
Contract # 19863
relating to an inmate confined pursuant to this agreement. Vermont law shall govern in matters related to
the interpretation and enforcement of this Agreement.
34.

INDEPENDENT CONTRACTOR STATUS

The Contractor shall perform its duties hereunder as a Contractor and not as an employee.
Neither the Contractor nor any agent or employee of the Contractor shall be or shall be deemed an agent
or employee of the State of Vermont.
Contractor shall pay when due all required employment taxes and income tax withholding
including all federal and state income tax and local health tax on any monies paid pursuant to this
agreement. Contractor acknowledges that the Contractor and its employees are not entitled to
unemployment insurance benefits unless the Contractor or a third party provides such coverage and that
the State does not pay for or otherwise provide such coverage. Contractor shall have no authorization,
express or implied, to bind the State of Vermont to any agreements, liability or understanding except as
expressly set forth herein.

35.

NOTICES

Any notice provided for in this agreement shall be in writing and served by personal delivery or by
certified mail, return receipt requested, postage prepaid, at the addresses listed in Section 23 unless
written notice of a change is received from the other party. Any notice so mailed and any notice served
by personal delivery shall be deemed delivered and effective upon receipt or upon attempted delivery.
This method of notification will be used in all instances, except for emergency situations when immediate
notification is required pursuant to the appropriate sections of this agreement.
36.

ASSIGNMENT

No right or interest pursuant to this agreement shall be assigned or delegated by the Contractor
without the prior written permission of the VTDOC. However, the Contractor is authorized to subcontract
with any entity for the performance of the Contractor's obligations hereunder provided each such
subcontractor agrees to be bound by all applicable provisions of this Contract. The Contractor
acknowledges it will not by the act of subcontracting be absolved or released from any obligations under
this Contract and will remain responsible for all performance under this Contract. Contractor shall not
assign its rights and responsibilities under this Agreement without the prior written approval of VTDOC.
37.

NO THIRD-PARTY BENEFICIARY ENFORCEMENT

It is expressly understood and agreed that enforcement of the terms and conditions of his
Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the VTDOC
and the Contractor, and nothing contained in this Agreement shall give or allow any claim or right of
action whatsoever by any other person on this Agreement. It is the express intention of the VTDOC and
the Contractor that any entity, other than the VTDOC or the Contractor receiving services or benefits
under this Agreement, shall be deemed an incidental beneficiary only.
This agreement is not intended to create any right, liberty interest or entitlement in favor of any
inmate. The agreement is intended only to set forth the contractual rights and responsibilities of the
contract parties. Inmates shall have only those entitlements created by Federal or State constitutions,
statutes, regulations or case law.

STATE OF VERMONT
CONTRACT FOR SERVICES
38.

Page 44 of 46
Contract # 19863

MODIFICATION AND WAIVER

This Agreement contains the entire Agreement and understanding between the parties and
supersedes any other agreements conceming the subject matter of this transaction, whether oral or
written. No modification, amendment, notation, renewal or other alteration of or to this agreement shall
be deemed valid or of any force or effect whatsoever, unless mutually agreed upon in writing by the
parties. No breach of any term, provision or clause of this agreement shall be deemed, waived or
excused, unless such waiver or consent shall be in writing and signed by the party claimed to have
waived or consented. Any consent by any party to, or waiver of, a breach by the other, whether express
or implied, shall not constitute consent to, waiver of, or excuse of any other different or subsequent
breach.
39.

HEADINGS

Headings herein are for convenience of reference only and shall not be considered any
interpretation of this agreement.
40.

TIME OF THE ESSENCE

Time is of the essence in the performance of all of the parties' obligations and duties under this
Agreement.
41.

SEVERABILITY

If any term or condition of this Agreement shall be held to be invalid, illegal or unenforceable, this
agreement shall be construed and enforced without such provision to the extent this Agreement is then
capable of execution within the original intent of the parties.
42.

RISK OF PHYSICAL DAMAGE TO FACILITY

The risks and costs of physical damage to the Contractor's facility incurred as a direct result of the
placement of the VTDOC's inmates in the Contractor's facility shall be considered usual costs incidental
to the operation of the facility and part of the costs reimbursed by the fixed rate per inmate day as
provided by Section 22.
43.

COMPLIANCE WITH APPLICABLE LAWS

The Contractor shall, at all times during the performance of its obligations of this Agreement
strictly adhere to all applicable federal laws and regulations, including protection of the confidentiality of
all applicant/recipient records, papers, documents, tapes or any other materials that have been or may
hereafter be established which relate to this Agreement. The Contractor acknowledges that the following
laws are included: Title VII of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1972,
the Education Amendments of 1972, the Age Discrimination Act of 1975, the Americans With Disabilities
Act, including Title 11, Subtitle A, 24 U.S.C. Sec. 12101, et seq. and all rules and regulations applicable
to these laws prohibiting discrimination because of race, religion, color, national origin, creed, sex, age
and handicap in federally assisted health and human services programs. This assurance is given in
consideration of and for the purpose of obtaining any and all federal grants, or other federal financial
assistance.

STATE OF VERMONT
CONTRACT FOR SERVICES

Page 4S of 46
Contract # 19863

The Contractor assures the VTDOC that at all times during the performance of this Agreement
that no qualified individual with a disability shall, by reason of such disability, be excluded from
participation in, or denied to benefits of service, programs, or activities performed by the Contractor, or
be subjected to any discrimination by the Contractor upon which assurance the VTDOC relies.
Contractor shall provide any information and assistance necessary for VTDOC to fulfill any federal
VOl/TIS grant requirements for funds for the financing of this agreement.

44.

CONFIDENTIALITY OF RECORDS

Contractor acknowledges that it has components that are covered entities within the meaning of
HIPAA, including the HIPAA Privacy and Security Rules, and that the component which provides
services under this Attachment G is such a covered entity. Contractor represents to the VTDOC that the
component providing services under this Attachment G will honor and abide by its obligations as a
covered entity under the Privacy and Security Rules.
VTDOC acknowledges that it may act as a covered entity under HIPAA, including the HIPAA
Privacy and Security Rules. Accordingly, VTDOC requires that Contractor honor and abide by the
Business Associate terms attached hereto and incorporated into this Agreement as Attachment E, and
Contractor represents to VTDOC that it shall do so.
Furthermore, unless otherwise provided, and without in any way limiting the meaning or effect of any of
the terms of Attachment E:
(a)
In the event the Contractor shall obtain access to any records or files of the VTDOC in
connection with this Agreement, or in connection with the performance of its obligations under this
or any other Agreement, the Contractor shall keep such records and information confidential and
shall comply with all laws and regulations concerning the confidentiality of such records to the
same extent as such laws and regulations apply to the VTDOC.
(b)
Contractor shall specifically keep confidential all records and files of VTDOC inmates;
Contractor shall obtain prior written approval from VTDOC before releasing or disclosing the
contents of any such records or files, except where it is impracticable for Contractor to obtain such
prior written approval (e.g., in the context of referrals for specialty outpatient services or an
emergency circumstance); provided, however, that Contractor may only release or disclose the
contents of any such records or files in accordance with the requirements of this Agreement,
including Attachment E, and must notify VTDOC of any such release or disclosure made without
the prior written approval of the VTDOC, promptly after such release or disclosure occurs.
Contractor further acknowledges that this requirement is in addition to and not in lieu of any other
laws respecting confidentiality of inmate files and records. The VTDOC acknowledges that officials
from other state Department of Corrections may be entitled to access VTDOC inmate records
from time to time; however, the Contractor will not permit such access without the prior written
approval of VTDOC. The VTDOC acknowledges that it will not invoke this subsection (b) to
preclude Contractor from releasing or disclosing any such records or files to the extent that
Contractor is compelled by applicable law to make such a release or disclosure.

Page 46 of 46

STATE OF VERMONT
CONTRACT FOR SERVICES

Contract # 19863

(c)
Contractor agrees to notify and advise in writing, all employees and agents (including
subcontractors, consultants, and licensees) of the said requirements of confidentiality and of
possible penalties and fines imposed for violation thereof, and secure from each an
acknowledgment of such advisement and agreement to be bound by the terms of this agreement
as an employee or agent (including a subcontractor, consultant, or licensee) as the case may be.
(d)
Any breach of confidentiality by the Contractor or third party agents (including
subcontractors, consultants, or licensees) of the Contractor shall constitute good cause for the
VTDOC to cancel this Agreement, without liability; and within thirty (30) days after such
cancellation, and at the direction of VTDOC, Contractor shall return or destroy all information
received from VTDOC, or created or received by Contractor on behalf of VTDOC. Contractor shall
not retain any copies of such information except as needed to address claims and/or lawsuits, and
shall certify for VTDOC, in writing, when all such information has been returned or destroyed, and
that Contractor does not continue to maintain any such information, with such certification to be
provided during such thirty (30) day period.

(e)
Any VTDOC waiver of an alleged breach of confidentiality by the Contractor or third party
agents of the Contractor is not to imply a waiver of any subsequent breach.
The parties understand and agree that subsections (a) through (e) apply to information that is
considered protected health information ("PHI") within the meaning of HIPM, including the HIPM Privacy
and Security Rules, as well as information that is not considered PHI. As required by Section 15.2 of
Attachment E, in'the event of any conflict or inconsistency between the terms of Attachment E and the
terms of subsections (a) through (e) of this Section 35, the terms of Attachment E shall govern;
provided, however, that there is no such conflict or inconsistency to the extent that subsections (a)
through (e) create any obligation or responsibility for Contractor that is not identified in Attachment E. In
addition, there is no such conflict or inconsistency as it concerns the use or disclosure or other handling
by Contractor of information that is not PHI, and subsections (a) through (e) unquestionably apply to all
such uses, disclosures and other handling, without the necessity for comparing such subsections to the
terms of Attachment E.
IN WITNESS WHEREOF, the parties have caused their representatives to execute this Agreement as of
the date first written above.

VERMONT DEPARTMENT OF CORRECTIONS

c;;t2-'

BY:

DATE:

AND%WPALUTO
COMMISSIONER OF CORRECTIONS

COR~ECTIONS

CORPORATION OF AMERICA

I

BY:

LN~a~ta~s~h~a~K~M~et~a~lf~~~~------Vice President, Partnership

evelopment

DATE:

~6~~,;L~4+-~+4){__

"ClK11IIC1I1A111K1 11I1TlII1I

RORENCE CORRECTIONAL CENnR

florence. ArIzona
1900
Beds ".860 Federal/40 m
•
S,TAfF bEP!-Q'(iIl1l~fl4t
MANAGEMENT/SUPPORT
SECURITY/OPERATIONS
UNIT MANAGEMENT
MAINTENANCE
SERVICES
PROGRAMS
EDUCATION
HEALTH SERVICES

at ~tIlFt·~ pq~mofl4

.

MANAG"'I)II"'~TISUPPORT
Warden
Assistant Warden

Training Manager
Manager, Operations Finance

Accountant
Accounting Clerk I
Manager, HUman Resources

HR Generalist
Personnel Investigator

Personnel Assistant (Personnel Assistant I)
Manager, Quality Assurance
Safety Manager
Coordinator, QA / Safety
Investigator
Grievance Coordinator

Administrative Clerk

25.50
124.00
173.50
9.00
4.00
4.00
2.00
33.85

.

375.85

••

1ST

Mailroom Clerk
Administrative Supervisor
Secretary
Administrative Clerk, HR
Administ~ative Clerk ~ Business

.

.

iOTAI;.

Mailroom Supervisor

.....

.'

SIiIfT
1
2
1
1
1
2
1
1
1
1
1
1
1
1
1
1
2
1
1
1
1
2

2ND
SHifT
0
0
0
0
0
0
0
0
0
0
0
0
0
0

a
a
0
0
0

a
a
a

3RD

DAYS

RELIEF

TOTAL

SHifT
0
0
0
0
0
0
0
0
0
0
0
0
0

COVERED
5
5
5
5
5
5
5
5
5
5

FACTOR
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1,00
1.00
1.00
1,00
1.00
1.00
1,00
1,00
1.00
1.00
0.50
1.00

S,AfF
1.00
2.00
1.00
1.00
1.00
2.00
1.00
1.00
1,00
1.00
1,00
1,00
1.00
1,00
1.00
1,00
2,00
1.00
1.00
1,00
0,50
2.00
25.~Q:

a
a
0
0
0
0
0

a
a

5
5
5
5

5
5
5
5
5
5
5
5

TOTAl1$,

SECU~ITY/OPI=~~TION&
Chief of Security
Assistant Chief of Security
Shift Supervisor
Assistant Shift Supervisor
Assistant Shift Supervisor, STG
SCO ' Housing Zone
SCO, STG
SCO, K,9
Assistant Shift Supervisor, DHO
• Investigations Olncer
SCQ, Armory/Key Control
* Visitation Officer

SCO, Transportation
* Transportation Officer

. SHI,FT
1
1
1
1
1
0
1
1
1
1
1
3
2
5
Pagelof4

2ND

3RD

DAYS

RELIEF'

tOTAL

SHIfT
0

SHifT
0

a

a

1
1
0
0
0
0

1
1
0
2
0
0

COVEReD
5
5
7
7

a
a
a
a
a

a
a
a
a
a
a

fACTOR
1,00
1.00
1.70
1,70
1,00
1,70
1,00
1,00
1.00
1.00
1,00
1,70
1,00
1.00

STAFF
1.00
1,00
6.00
5.00
1,00
3,00
1,00
1,00
1,00
1,00
1.00
5,00
2,00
10.00

5

5
7
5

5
5
5
5
7
5
5

RORENCE CORREmONAl CENTER

IffCIIITRAC1S1AH111GPAmnll

Horelee. ArIzona
1900
n.860 F8dora1/40 VTJ
• .. Beds
. ......
.
seCU~rfY/OPFI14T'Ol1!!s'.· .••.·
•
•
•
•

Front Entrance (Lobby) Officer
Central Control Officer
Perimeter Security (Mobile)
Vehicle Sallyport Officer

* Recreation Officer

•
•
•
•
'*
•
•
•
•
•

Utility/Search & Escort Officer
Work Detail Officer
Tool Control Officer
Kitchen Officer
Education Officer

Medical Officer
SCO - Intake/Release
Intake/Release Officer
Property Officer
Hobby Craft Officer
Court Security Officer - Tucson

* Court Security Officer - Yuma
* Correctional Officer, Part~Time
Administrative Clerk - Yuma

Administrative Clerk - Inmate Phone Monitoring
Administrative Clerk

1ST

2ND

3RC

. DAYS

ReLIEF

TotAL

SfilFT

$H!fT

SHiFT

CO\(EflEP

FAprqF!

STAFF

1
3
2
1
5
2
1
1
1
1
1
1
2
1
1
3
1
4
1
1
1

1
3
2
0
3
3
0
0
1
0
1
1
2
0
1
0
0
0
0
0
0

0
2
1
0
0
2
0
0
0
0
1
1
2
0
0
0
0
0
0
0
0

7
7
7
5
7
7
5
5
7
5
7
5
5
5
5
5
5
5
5
5
5

1.70
1.70
1.70
1.00
1.70
1.70
1.00
1.00
1.70
1.00
1.70
1.00
1.00
1.00
1.00
1.00
1.00
0.50
1.00
1.00
1.00

2ND

3RC

bAYS

RELIEF

tOTAL

SHIFT

SHIFT

SHIFT

cOyEfl!'O

FACTOR

STAFF

1
1
1
2
3

0
0
0
0
0

0
0
0
0
0

5
5
5
5
5

1.00
1.00
0.50
1.00
1.00

1.00
1.00
0.50
2.00
3.00

1
2
1
2
2

0
0
1
2
2

0
0
0
2
2

5
5
5
7
7

1.00
1.00
1.00
1.70
1.70

1.00
2.00
2.00
10.00
10.00

1
2
1
2
2
1

0
0
1
2
2
1

0
0
0
2
2
1

5
5
5
7
7
7

1.00
100
1.00
1.70
1.70
1.70

1.00
2.00
2.00
10.00
10.00
5.00

1
2
1
2
2

0
0
1
2
2

0
0
0
2
2

5
5
5
7
7

1.00
1.00
1.00
1.70
1.70

1.00
2.00
2.00
10.00
10.00

TOTAL

1ST

UNIT IIIIANAG,EI\IIEtH

•
*

•
*
•

•
*

.....

Chief of Unit Management
Classification Supervisor
Records Supervisor
Records Clerk
Administrative Clerk
Unit 0 - 320-Sed Cellblock
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer
Unit F - nO-Sed Cellblock (Female GP I Segregation)
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer
Housing Officer - Segregation
Unit G - 320-Bed Cellblock
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer

Page 2 of4

.

3.00
14.00
9.00
1.00
14.00
12.00
1.00
1.00
3.00
1.00
5.00
3.00
6.00
1.00
2.00
3.00
1.00
2.00
1.00
1.00
100
1~4.!l~'

IIICIIf/llACI',AFIIII'PAmRII

flORENCE CORRECTIONAL CENTER

Florence. Arizona
1•gOO Bods n•860 Fodoral/40 m

. ··lst

UNIT MAN~Gt=ME!lIT

•
•

•
*

•
*

•

TOTAL·

.
•

DAVS

REliEF

totAL

SHIFT

Sf-\!FT

CP\(~RED

FACTOR

STAff

1
2
1
1
2

0
0
1
1
2

0
0
0
1
1

5
5
5

1.00
1.00
1.00
1.70
1.70

1.00
2.00
2.00
5.00
9.00

1
2
1
2
2

0
0
1
2
2

0
0
0
2
2

5
5
5
7
7

1.00
1.00
1.00
1.70
1.70

1.00
2.00
2.00
1000
1000

1
2
1
2
2

0
0
1
2
2

0
0
0
2
2

5
5
5
7
7

1.00
1.00
1.00
1.70
1.70

1.00
2.00
2.00
10.00
1000

1
0

0
1

3

3

0
0
2

5
7
7

1.00
1.70
1.70

1.00
2.00
14.00

••

......

.

..

..

•••
.

MAINTENANCE
Maintenance Supervisor
Assistant Maintenance Supervisor
Maintenance Worker
Administrative Clerk

..

3RO

SHIFT .

Unit H - 300-Bed Cellblock
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer
Unit J - 320-Bed Cellblock
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer
Unit L - 320-Bed Cellblock
Unit Manager
Case Manager
Correctional Counselor
Pod Control Officer
Housing Officer
Segregation - 104-Bed Cellblock
Assistant Shift Supervisor
SCO
Housing Officer

2ND

........

7
7

. ..

1St

2NiJ

SH.lFT

SHIFT

3RD
SHIFT

COVEReD

REU~F
FACTOR

TOtAL
STAFF

1
0
4
1

0
1
2
0

0
0
0
0

5
5
5
5

1.00
1.00
1.00
1.00

1.00
1.00
6.00
1.00

DAYS

TOTA!-

~.()O

..

SERViCES

...
:
Manager, Warehouse/Commissary
Warehouse/Commissary Worker
* Food Service Manager
• Assistant Food Service Manager
* Food Service Supervisor
..

.

..

1ST

2ND

3RD

DAYS

REliEF

TOTAL

SHIFT

SHIFT

SHIFT

COVEflEp

FACTOR

STAFf

1

0
0
0
1
1

0
0
0
0
0

5

1.00
1.00
1.00
1.00
140

3
1
0
2
.

TOTAL
PROGMM~
Chaplain
Recreation Supervisor
Administrative Clerk
• Contract Attorney

ifO.'r!!Ill'

t'1i3.5/l:

5
5

5
7

.

1ST

2ND

3~D

DAYS

SHIFT

SlilFT

Stl iFT

j::OVEflEP.

2
1
1

0
0
0

0
5
0
5
0
5
CONTRACT I PRN

~ELIE~
FJ;CTOf/. .

1.00
1.00
1.00

1.00
3.00
Contract
Contract
Contract
4.0.0
TOTAL
STAFF

2.00
1.00
1.00

4\lllfi

..

Pagc30f4

"CINTIIACTSTAlllIIIIPAnIlllI

RORENCE CORRECnONAl CENTER

Florence, arizona

1900
Beds (1860
Federal 140 vn
•
•
EDUCATION

2ND

3RD

SH.!Fr

SlilfT

SHIFT

1

1

1St

.

Library Aide
" Librarian

DAYS

RELIEF

TotAL

cpYERl'P

FAprpR

SHFF

1.00

2.00

5
0
CONTRACT / PRN

2,:Qmi

TOTAl-

HEALTH SERViCeS

•
*

•
•

6~HOURSHIFTS
Health Services Administrator
Physician (CMA)
ARNP/PA (CM A)
Dentist (CDA)
Dental Assistant
Dental Assistant, Part-Time
Clinical Supervisor (RN)
RN - CQI
LPN
Certified Medical Assistant
Psychologist! LCSW
Mental Health Coordinator
X-Ray Technician
Medical Records Clerk
Psychiatrist
Dentist
Optometrist
ARNP/PA

..

'. SHin

1
2
1
1
1
1
1
1
1
1
1
1
1
2

HEALTH SERVICES
12-HO !JR SHIFT~

.

RN
LPN

.

TQTIl;J,; .

2ND

1ST
'

.

SHin·

3RD ..
S\,\!FT

DAYS
. CP\!EREP

RELIEF

TOTAL

F~CTbR

STAfF

0
0
5
1.00
0
0
5
1.00
5
1.00
0
0
5
0
0
1.00
5
1.00
0
0
0
0
5
0.25
5
0
0
1.00
5
1.00
0
0
0
0
5
1.00
1
0
5
1.00
5
0
0
1.00
5
0
0
1.00
5
1.00
0
0
0
0
5
1.00
CONTRACT / 16 HOURS PER WEEK
CONTRACT / PRN
CONTRACT / PRN
CONTRACT / PRN

1ST

2ND

DAYS

RELIEF

SHIFT

SHIFT

COVERt;:D

FACTO~

3
2

1
2

7
7

2.20
2.20

'

.

1.00
2.00
1.00
1.00
1.00
0.25
1.00
1.00
1.00
2.00
1.00
1.00
1.00
2.00

TOTAL
.

STAFF

8.80
8.80

33.85

Post pas/lions Included In the CorrectIOnal Officer job clasSification,
FLORENCE1900-USMS-ICE-VT-06/03/11
** Positions hired on a contractual or fee basis for selVices rendered.
*** Positions are not budgeted - only to be used when savings are accrued from turnover and vacancies.

Page4of4

1II111J11111A1l1STAlllIIG NmJllI

LEE ADJUSTMENT CENna
BeatIVVIlle.lenlllCQ
550 Beds m Inmales)

Page 1 of3

VlCIIII1/IAC1S1J1H1NIJ PAmIIN

LEE UJUSTMENT CENnR

BeaUWIlle, lelllleo
550 Beds M Inmates]

Page 2 of3

IITCOIl1RACTlTAHlNGPAmIIN

lEE ADJUSTMENT CENTER

BealtVVllle. leltueb
550 Beds M'llmales]
HEA.LTH SERVICES

•
•
•
•

Health Services Administrator
Dentist (CDA), Part-Time
Dental Assistant, Part-Time
RN
LPN
LPN
Medical Records Clerk
ARNP/PA
Physician
Psychiatrist
Psycholoqist

1ST

2ND

3RD

DAYS

RELIEF

TOTAL

SHIFT

SHIFT

SHIFT

COV.ERED

FACTOR

STAFF

1
1
1
1
0
1
1

0
0
0
1
1
0
0
CONTRACT I
CONTRACT I
CONTRACT I
CONTRACT I

24
8
6
24

0
0
0
1
1
0
0
HOURS
HOURS
HOURS
HOURS

5
5
5

7
7
5
5
PER WEEK
PER WEEK
PER WEEK
PER WEEK

1.00

1.00

OAO
OAO

OAO
OAO

1.68
1.68
1.20
1.00

5.04
3.36
1.20
1.00

12.40

TQT,6;L

EDUCA.TlON
Instructor Supervisor
Academic Instructor
Vocational Instructor
Library Aide
Administrative Clerk
TOTAL

..

1ST

2ND

3RD

DAYS

RELIEF

TOTAL

SHIFT

SHIFT

SHIFT

COVERED

FACTOR

STAFF

1
1
2
1
1

0
0
0
0
0

0
0
0
0
0

5
5
5

..

Post POSItions Included In the CorrectIonal Officer job clasSificatIon .
U
"ioU

Positions hired on

a contractual or fee basis for selVices rendered.

Salary and benefits of commissary staff reimbursed commissary profits.

Page 3 of 3

5
5

1.00
1.00
1.00
1.00
1.00

100
1.00
2.00
1.00
1.00

6.00
LAC550-VTRFP-12HOUR-06/02l11

.

cc~

CORRECTIONS CORPORATION OF AMERICA

POLICY

Suicide Management

TITl.E ..

I

.•..

..

13

CHAPTER

I PIlLJf:v
NUMBER

13-84

I

Page 1 of 6

~FFECTJ\lEP!H!TE .

SUPERSEP\:S PATE

AUGUST 23. 2009

OCTOBER 22. 2007

....
SIGNA TURE ON FILE AT FACILITY SUPPORT CENTER

LEE ADJUSTMENT CENTER

Bill Andrade, MD
Chief Medical Officer

fAC!PTY
NAME

SIGNA TURE ON FILE AT FACILITY SUPPORT CENTER

i'AC!LITY I'ffl'CTI\IE OI,\TE

FACIL!TYSUPERSEOES OI,\TI'

FEBRUARY 1. 2010

JUNE 1. 2008

Richard P. Seiter
Executive Vice PresidenVC/liet Corroctions Officer
SIGNA TURE ON FILE AT FACILITY SUPPORT CENTER

G.A. puryear, IV
Executive Vice President/General Counsel

.

13-84.1 POLICY:
CCA Health Services Department will provide for suicide management through assessment, patient
safety interventions, and treatment

13-84.2 AUTHORITY:
CCA Company Policy

13-84.3 DEFINITIONS:
Licensed Independent Practitioners (LIP) - For the purpose of this policy only, Physicians, Physician's
Assistant, Advanced Registered Nurse Practitioner and Psychiatrist Each LIP shall perform duties
according to the state scope of practice guidelines.
Protective Factors - Patient characteristics or factors associated with avoidance of self-harm behavior.
Qualified Health Care Professional (QHCP) - Includes physicians, physician assistants, nurse
practitioners, nurses, dentists, mental health professionals, and others who by virtue of their education,
credentials, and experience are permitted by law within the scope of their professional practice acts to
evaluate and care for patients.
Qualified Mental Health Professionals (QMHP) Includes psychiatrists, psychologists, psychiatric social
workers, psychiatric nurses and others whom by virtue of their education, credentials and experience
are permitted by law to evaluate and care for the mental health needs of patients.
Risk Factors - Historical factors or other patient characteristics associated with self-harm behavior.
Self-Injurious Behavior - Actions that result in self-harm.
Suicidal - Pre-occupation with thoughts of self-harm or actively engaging in behavior that is likely to
cause serious bodily harm, with the intended and explicit purpose of ending one's life.
Suicidal Gestures - Statements, threats and behavior that suggests thoughts, intent or plan to harm
oneself
Suicide Precautions with Constant Observation -Twenty-four (24) hour direct one-an-one observation
of inmates/residents who are actively suicidal as evidenced by engaging in behavior that is likely to
cause death. This type of observation will be used for inmates/residents who are initially placed under
suicide watch and then per written order of an LIP as defined in this policy.
Suicide Precautions without Constant Observation
Twenty-four (24) hour observation (per written
order of an LIP as defined in this policy) of inmates/residents who are engaged in suicidal ideation,
verbal threats, self-harm, or who exhibit self-injurious or destructive behavior, or demonstrating other
concerning behaviors. This type of observation requires staff to be present, within sight or sound

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

AUGUST 23, 2009

Page 20f6

13-84

distance, and to perform direct visual observation on a varied schedule of one (1) minute to fifteen (15)
minutes but not to exceed fifteen (15) minutes.
13-84.4 PROCEDURES:

PROCEDURES INDEX
SECTION

A
B
C
D
E
F
G
A

SUBJECT
Initial Identification/ScreeninCi
On-Goino Identification/Screenina
Safe Housina/Supervision
Suicide Attempt
Downqradinq and Discontinuation
Transfer
Follow-Up

INITIAL IDENTIFICATION/SCREENING
1.

An initial mental health screening will be performed by health trained or QHCP upon the
inmate/resident's arrival to the facility.
a.

B.

Patient inmates/residents will be screened utilizing the 13-50A Initial Health
Screening form. Screening will include inquiry regarding:
i.

Past suicidal ideation and/or attempts;

ii.

Current ideation, threat, plan:

iii.

Prior mental health treatmentlhospitalization;

iv.

Recent significant loss Gob, relationship, death of family member/close
friend, etc.);

v.

History of suicidal behavior by family member/close friend; and

vi.

Suicide risk during prior confinement.

b.

The 13-50A Initial Health Screening form is a screening inventory and IS NOT
the only guide for referral to mental health services.

c.

The patient inmate/resident's prior medical, mental health, and suicide risk
during prior confinement will be verified through either manual or management
information system review.

2.

During the full health appraisal, the LIP will evaluate any signs, symptoms, or
information received by the patient inmate/resident that may require referral to mental
health staff for additional assistance.

3.

A comprehensive mental health evaluation will be completed in accordance with CCA
Policy 13-61 Mental Health Services.

ON-GOING IDENTIFICATION/SCREENING
Due to the strong association between patient inmate/resident suicide and special management
housing assignment (e.g. disciplinary, administrative, or protective custody segregation), any
patient inmate/resident aSSigned to a special management unit will receive a pre-segregation
health evaluation (See CCA Policy 13-42, Segregation Access to Health Care) for early
detection of potential suicide risk.

C.

SAFE HOUSING/SUPERVISION

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

AUGUST 23, 2009

Page 3 016
1.

13-84

When observation, history, or interview suggests that a patient inmate/resident is
potentially suicidal or following a suicide attempt, the following steps will be taken.
a.

Initially patient inmates/residents will be placed in a cell under suicide
precautions with constant observation (i.e. twenty-four [24J hour direct one-onone observation) pending further direction from an LIP.
i.

ii.

b.

The cell should be as suicide resistant as is reasonably possible (free
of all obvious protrusions and provide full visibility to staff).
•

Ordinarily, suicide precaution will occur in the Health Services
Department in a suicide resistant cell.

•

When ordered by an LIP, suicide precaution may alternately
occur in an approved suicide resistant cell in segregation or
another area of the facility.

•

In cases where suicide precautions occur in a cell other than
an approved suicide safe cell, the Managing O'"ector, Facility
Operations and Regional Director, Health Services will be
notified.

Until assessed by a QMHP, only the following items will be permitted in
the cell:
•

Undergarments (unless an LIP determines these present a risk
of self-harm),

•

Suicide smock and/or blanket (when clothing is removed from a
suicidal patient inmate/resident the inmate/resident will be
issued a safety garment or other protective clothing that is
suicide resistant and prevents humiliation and degradation),

•

Safety mattress (tear resistant).

iii.

All other personal belongings, objects, and clothing that could be used
in a suicidal manner are to be initially removed.

iv.

Finger foods only will be permitted, eating utensils and plastic wrap are
prohibited.

v.

The patient inmate/resident's behavior will be observed and
documented by staff on the 13-63A Monitoring Form from initial
placement until release from suicide precaution status.

The appropriate LIP will be notified and an order will be written in the chart with
a SOAP note detailing reasons for placement.
i.

An LIP, who has order-writing privileges, may authorize suicide
precautions with or without constant observation.
•

Patient inmates/residents under suicide precautions with
constant observation will have twenty-four (24) hour direct oneon-one observation.

•

Patient inmates/residents under suicide precautions without
constant observation will have twenty-four (24) hour
observation with staff present, within sight or sound distance.
Observation will include direct visual observation on a varied
schedule of one (1) minute to fifteen (15) minutes, but not to
exceed fifteen (15) minutes.

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

Page 4 of6

AUGUST 23, 2009

ii.

13-84

Restraints
Restraint/Equipment use must be in accordance with CCA Policy 13-69
Personal Restraint. OHCP are to use the least restrictive management
orders that are consistent with clinical conditions.
•

c.

D.

The patient inmate/resident will be evaluated by a OMHP as soon as
reasonably possible but within forty-eight (48) hours (seventy-two [72] hours for
holidays and weekends) of placement. The evaluation will be documented on
the 13-84A Self-Harm/Suicide Risk Assessment. At that time, the OMHP will
develop a plan of care for the patient inmate/resident that will include at least a
daily assessment by the OMHP or OHCP. The plan of care will focus on
patient safety, reduction of self-harm risk factors, and enhancement of
protective factors associated wHh avoidance of self-harm behavior.
The
OMHP assessment may also determine which personal belongings, if any, may
be returned to the patient inmate/resident.

SUICIDE ATTEMPT
1.

E.

Use of soft restraints and protective helmets may be authorized
by the LIP or by OHCP with verbal approval from the LIP.
Written orders must be obtained within twenty-four (24) hours.

Any employee who discovers a patient inmate/resident engaging in self-harm shall
immediately:
a.

Request assistance and notify health services staff.

b.

Survey the scene to assess the severity of the emergency. This assessment
includes determining that the area is safe to enter.

c.

If the suicide attempt involves hanging by the neck, alert other staff to retrieve
the cut down tool and make every effort to relieve the pressure off the victim's
neck.

d.

Begin standard first aid and/or CPR as necessary.

e.

Preserve the area as a crime scene, until otherwise determined by the
Warden/Administrator or Administrative Duty Officer.

2.

Employees shall never presume that the victim is dead, but rather initiate and continue
appropriate life-saving measures until relieved by arriving medical personnel.

3.

AlthOugh not all suicide attempts require emergency medical intervention, all suicide
attempts shall result in immediate intervention and assessment by the Health Services
Department.

DOWNGRADING/DISCONTINUATION
1.

Patient inmates/residents under suicide precaution with or without constant
observation may not be downgraded or discharged from suicide precautions until a
OMHP:
a.

Reviews the patient inmate/resident's medical record;

b.

Confers with correctional personnel regarding the patient inmate/resident's
behavior;

c.

Assesses the patient inmate/resident using 13-84A (if downgrading or
discontinuation occurs prior to the assessment required in C.1.c. above, it will
be completed at this time);

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

Page 5 of 6

2.

F.

AUGUST 23, 2009

d.

Writes a progress note; and

e.

Develops and/or updates a written plan of care.

13-84

The QMHP is required to collaborate with the appropriate LIP (i.e., psychiatrist in
facilities having this staff or contract position) to confer on the patient inmate/resident's
status. In the event that the state scope of practice does not permit orders by a QMHP,
the LIP will provide written or verbal approval of the order based on the QMHP
consultation and recommendation.

TRANSFER
In the event a patient inmate/resident on suicide precaution is being transferred from the
custody of CCA, the patient inmate/resident's suicide precaution status will be documented on
the 13-86A Transfer/Release Screening form to ensure continuity of care.

G.

FOLLOW-UP
1.

In order to ensure continuity of care for suicidal patient inmates/residents, all patient
inmates/residents discharged from suicide precautions shall remain on the mental
health case load and receive regularly scheduled follow-up assessments by mental
health staff until the patient inmate/resident is transferred or released from the facility.
a.

b.

2.

Unless the patient inmate/resident's individual treatment plan directs otherwise,
the reassessment schedule shall be as follows:
i.

Daily for the first five (5) days',

ii.

Then once a week for two (2) weeks; and

iii.

Then once every month until the patient inmate/resident is released
from treatment by the QMHP.

In the absence of a QMHP, follow-up assessments may be performed by an
LIP. For daily contacts, a QHCP may conduct follow-up assessments in
consultation with a QMHP or LIP via telephone (e.g. weekends and holidays).

Mortality and Morbidity Review Process
a.

All completed suicides and suicide attempts requiring outside medical treatment
shall be examined through a mortality and morbidity review process in
accordance with CCA Policy 13-52 Quality Management Program.

b.

The review shall be multidisciplinary and include correctional, medical, and
mental health personnel.

c.

The review process shall include a critical inquiry of the following:
i.

Circumstances surrounding the incident;

ii.

Facility procedures relevant to the incident;

iii.

All relevant training received by involved staff;

iv.

Pertinent medical and mental health services/reports involving the
victim;

v.

Possible precipitating factors leading to the suicide or serious attempt;
and

vi.

Recommendations, if any, for changes in policy, training, physical
plant, medical or mental health services, and operational procedures.

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

AUGUST 23, 2009

Page 6 of 6
3.

13-84

Critical Incident Debriefing
Health Services staff will participate in critical incident debriefings as described in CCA
Policy 5-1 Incident Reporting. The Chaplain, mental health staff, or appropriate
designee will provide debriefing to staff and inmates/residents who are affected by
critical incidents at the facility.

13-84.5 REVIEW:
The Chief Medical Officer or qualified designee will review this policy on an annual basis.
13-84.6 APPLICABILITY:
All CCA Facilities (Provided contractual requirements do not mandate otherwise)
13-84.7 APPENDICES:
None
13-84.8 ATTACHMENTS:
13-84A

Self-Harm/Suicide Risk Assessment

13-50A

Initial Health Screening

13-63A

Monitoring Form

13-86A

Transfer/Release Screening

13-84.9 REFERENCES:
CCA Policy 5-1
CCA Policy 9-19
CCA Policy 13-42
CCA Policy 13-50
CCA Policy 13-52
CCA Policy 13-61
CCA Policy 13-63
CCA Policy 13-69
CCA Policy 13-86
ACA

4-4373M/4-ALDF-4C-32M
4-4416/4-ALDF-4C-33

NCCHC P-G-05E/J-G-05E
JCAHO EC.1.10
EC.1.20
PC.5.60

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

CC!.
SIGNA TURE ON fiLE AT FACILITY SUPPORT CENTER
Bill Andrade, MD
Chief Medical Officer
SIGNA TURE ON FILE AT FACILITY SUPPORT CENTEB

Richard P. Seiter
Executive Vil;(! President/Chief Corrections Officer

I Steve Groom

SIGNA TURE ON FILE AT FACILITY SUPPORT CENTER

Executive VicePresidentlGeneliilCounsel

1-1IPOLICY/POST ORDER CHANGE NOTICE (PCN)
Policy/PO
Number:
TITLE:

1

1

13 -84
1

Policy/PO Effective
Date:

Page 1 of2
08/23/09

SUICIDE MANAGEMENT

PCN ASSIGNED NUMBER

PCN EFFECTIVE DATE

13-84(01)

DECEMBER 8, 2010

FACILITY

I LEE ADUSTMENT CENTER

FACILITY EFFECTIVEDA TE

FACILITY SUPERSEDES la, applicable)

MAY 1, 2011

NONE

PCN's will be located on the top of the affected policy/post order in chronological order (for hard copy policy/post
order manuals) and will be available in electronic policy/post order manuals. PCN's shall be removed and
archived with the affected policy/post order once the policy/post order has been superseded.

DADO

D DELETE
[SJ CHANGE TO/FROM
13-84.4 A.1.
CHANGE FROM:
An initial mental health screening will be performed by health trained or OHCP upon the inmate/resident's arrival
to the facility.
CHANGE TO:
An initial mental health screening will be performed by health trained staff or OHCP upon the inmate/resident's
arrival to the facility.
13-84.4 A.l.a.
CHANGE FROM:
a.

Patient inmates/residents will be screened utilizing the 13-50A Initial Health Screening form. Screening
will include inquiry regarding:
i.

Past suicidal ideation and/or attempts;

ii.

Current ideation, threat, plan;

iii.

Prior mental health ireatmenVhospitalization;

iv.

Recent significant loss Uob, relationship, death of family member/close friend, etc.);

v.

History of suicidal behavior by family member/close friend; and

vi.

Suicide risk during prior confinement.

10112109
Proprietary Information - Not For Distribution - Copyrighted

Property of eCA

Page 2 of 2

DECEMBER 8, 2010

13-84(01 )

CHANGE TO:

a.

Patient inmates/residents will be screened utilizing the 13-50A Initial Health Screening form. Screening
will include inquiry regarding:
i.

Current medications and mental health treatment;

ii.

Past suicidal ideation and/or attempts;

iii.

Current ideation, threat, plan;

iv.

Prior mental health treatmenUhospitalization;

v.

Recent significant loss Gob, relationship, death of family member/close friend, etc.);

vi.

History of suicidal behavior by family member/close friend; and

vii.

Suicide risk during prior confinement.

10/12/09

Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

13-84A

L

Self-Harm I Suicide Assessment

Inmate/Resident Name: _ _--::-:-..,,-:-::-:-:-_ _ _ _ _ Inmate/Resident Number: _ _ _ 008: __
Age: _ _ Gender: IJ Male ~"j Female Marital Status: :-] Single n Married/CL
SECTION 1: RISK FACTORS (Historic and Recent\
L.:' Yes :-J No

Yes I:! No

r':

Yes

,No

Yes· , No
"Yes ,No

r

:-1 Yes --I No
I r--) Yes ;: No
L.~_Yes :--j No

Divorced/Separated

(when?)_ _ __

Psychiatric hospitalization, outpatient treatment,
or medication:

o Yes [J No

Suicidal ideation, attempt(s):

Diagnosis associated with suicidal behavior (e.g.,

1_, Yes U No
eYes -1 No
;-: Yes '-; No

Sudden calm

Axis! - mood, bipolar, psychotic disorders):

~-'_-'No

t:;

Inter ersonal violence
Impulsive behavior
Victimization due to criminal violence
Family history of suicide attempts or
Axis I diagnosis requiring hospitalization
Drug! alcohol abuse or dependence
Sex offense{s) involving children
Anxiety, ~gitation, fearful ._~._

Yes f:' No
i:! Yes UNo
'-_:Yes
No
Yes '-j No
1

• Yes --, No

n Yes

UNo

l

followi~g ideation or attem~__,~

Upset over failed suicide attemBt
Release from psychiatric inpatient status _
Poor compliance with treatment / medication
Abnormal response to incarceration
Prison conflict J fear for safet~
Relationship Joss J relationship problems

__

Lack of social sU0"'2.rt(or perception)
Events causing humiliation, shame, despair

..-

U Yes -I No
Significant medical illness I chronic pain
-, Yes:::! No
Recent disciplinary action.
·i Yes iJ No
Recent
bad news
,-,-~,

",-

SECTION 2: DIRECT INQUIRY
Ili-Yes ::~I N~ Suicide ideation or thoughts of dying are presented (describe):----'

hs

No

Self harm plan and intent is present (describe):

_SECl:Ig~;..f'~OTECTIVE FACTORS ,J,Current)
~~ . i No

Yes
No
,JYes ,:tNo
--:'-Yes f; No
1

, Yes eNo
i._: Yes
No

Supportive spouse
Children at home
Job assiqnment
Exercises reqularlv
Group activities
Future orientation

eJ Yes uNo

Supportive familv I friends

u Yes [No
: I Yes !~: No
-.1 Yes; No
Yes ) No
:.' Yes ii No

Reliqious J spiritual J cultural support
Willina to discu~s I addr~ss problems
PsYchotropic medication
Medication compliant, therapeutic alliance

J
---I

I,

i
---1

Absence of symptoms of psychosis

SECTION 4: Narrative (SOAP format) I Interventions to Address Safety and Treatment Needs
(S) Reason for assessment, patient report not noted above: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

(0)

History, known factors, observations not noted above: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

(A) Assessment: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(P) Plan (describe only interventions or plans not indicated below): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Interventions Selected to Address Safety and Treatment Needs:
Placement
o Suicide Precaution with constant observation
o Suicide Precaution without constant observation
o Mental Health Observation
o Return to housing unit
Referral for I Delivery of Care: (Note any actions taken at time of patient contact)
o Psychiatry clinic (for initiation or adjustment of medication) _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
o Mental health outpatient treatment (cognitive,behavioral or other intervention) _ _ _ _ _ _ __
o Not applicable
Plan for follow-up: Date: _ _ _ _ Clinician: _ _ _ _ _ _ _ _ _ __
Mental Health Professional Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,Date: _ _ _ _ _ _~
8/23/09
Proprietary Information - Not For Distribution - Copyrighted

Property of Corrections Corporation of America

,~®

ACORD

CERTIFICATE OF LIABILITY INSURANCE Page

~

DATE (MMJOD/YYYV)

I

1 of 2

04/04/2011

THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NQT AFFIRMATIVELY OR NEGATlVEL Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
PELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

r-

IMPORTANT: If the certificate holder is an ADDITIONALINSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subiectto
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such end~)fsement(s).

PRODUCER

CONTACT
NAME:
PHONE

willis of Tennessee, Inc.
26 Century Blvd.
P. O. Box 305191
Nashville, TN 37230-5191

E-MAil

-888-467-2378

NO):

certificates@WilJis.com

~f1ESS:

I NSURER(S)AFFORI?~ NG COVERAG E

... INSURER A:
INSURERB:

..

INSURED

I,eNC
FAX

877-945-7378

NC NO EXT:

Corrections Corporation of America
10 Burton Hills Blvd.
Nashville, TN 37215

INSUREAC:

Catlin

Specia~ty

National

uni~n

NAICff

Insurance

Comp~ny

Fire Insurance

115989-001

Co~pany

19445-002

Chartis _Specialty Insuranc,: Company

26883-005

Hampshire Insurance Company

23841-001

INSURERD: New
!NSURERE:
!NSURERF;

' M""'"

'15766674

Nt!

THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE
NAMED ABOVE FOR THE .pOLICY PERIOD
INDICATEq. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

;'~i\i'
!

A

~

TYPEOF'
r.F'NI"R

LIABILITY

I

X

y

POL
XGC2015700412

LIMITS

I
14/1/2011

4/1/2012

GENERALlIABJUTY

ICLAIMS-MADE[i] OCCUR

•

-B

oeNCO"

-;:;,;;, '
~POLICY
~

C

"IT ,pp,

B
D

A

PER

'AGG

-

HIRED AUTOS

~

UMBRELLA LIAS

14309455

i4 / 1

,!?n1 1

4/1/2012

I

i

,ULED

i

OCCUR

IX

8125184

4/1/20n

4/1/2012

AOS 061967463

:~~~~~~~

4/1/2012

CA 061967464
FL 061967465

4/1/2011

TX 061967466
PLM20:

4/1/20n
4/1/2011

:~~~~~~~

IIRReNce

CLAIMS MADE

I

25,00C

"

WORKERS COMPENSATION
AND EMPLOYERS'lIAB!lITY
YIN
ANY PROPR1ETORJPARTNERlEXECUTJVE
OFFICERJMEMBER EXCLUDED?
fMandatory in NH)
f yes, describe under
DESCRIPTION OF OPERATIONS below

0 INIA

Healthcare
Professional Liability
Claims Made Form

Iv",.

4/1/2012

4/1/2012

L 000,000

Is
Is

5,000,000

5.000.,000
5,000,000
2,000,000

I'

BODILY

M

",,000,000

1$
1$
1$
1$
1$

BODIL

ANY AUTO
ALL'OWNED
AUTOS

OED
B

,e<

rI l I\'~5TFxl LOC

EXCESS LIAS

D

~~

Is

X I,v;;~~~
E.L EACH,
I
,FA FMP' nYFe
E.L

1$
1$
1$
\$
1$
1$

25,000,000
25,000,000

IUdit

EL

. POLICY LIMIT

1$
1$
1$

1,000,000
1,000,000
1,000,000

$5,000,000 Each Loss
$5~OOO,OOO Aggregate

,m"" 'p,ee j , 'cq""cd)

See Attached

CERTIFICATE HOLDER

CANCELLATION
SHOULD ANY OF THE ABOVE DESCRlBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL 8E DELIVERED IN
ACCORDANCE W!TH THE POLlCY PROVISIONS.

State of Vermont
Attn: Dept. of Corrections
1229 Portland Street, Suite 101
St. Johnsbury, VT 05819

AUTs9(]~JL

CoIl: 3316772 Tpl:1245562 Cert:~ 6674
ACORD 25 (2010/05)

© 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID: n2.0~0,,-5_ _ __
LOC#: ._ _ _ __

ADDITIONAL REMARKS SCHEDULE
y

Page - 2 of 2-

NAMED INSURED

Willis
of Tennessee, Inc.
-.

-

POLICY NUMBER

See First Page

--

CARRIER

Corrections Corporation of America
10 Burton Hills Blvd.
Nashville, TN 37215

-i"CCOOE
EFFECTIVE DATE:

See First Page
ADDITIONAL REMARKS

See First Page

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
FORM NUMBER: 2 5

Workers Compensation - New Jersey
Carrier:
New Hampshire Insurance Company
Policy Number:
Policy Period:

061967467
04/01/2011 -

04/01/2012
Limits:
$17000,000 EL Each Accident
$1,000,000 EL Disease - Each Emplo¥ee
$1,000,000 EL Disease - Policy Lim1t

It is agreed that State of Vermont is included as an Additional Insured as respects to General
Liability.

ACORD 101 (2008/01)

CoIl: 3316772 Tpl: 1245562 Cert: 15766674
©2008ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD