Common use of INTRODUCTION/SERVICES Clause in Contracts

INTRODUCTION/SERVICES. A. This is a Statewide Agreement in which the Contractor shall provide Prosthetic and Orthotic services, on an as-needed basis, to patients/youth referred for such medical services from CDCR/CCHCS. Contractor shall provide all labor, materials, staff, transportation, licenses, permits and every other item of expense necessary, unless otherwise stated. Services shall be provided on-site upon request and under the direction of the institution Chief Executive Officer or Chief Medical Executive (CEO/CME) or designee, or the Division of Juvenile Justice Facility (facility) Chief Medical Officer (CMO) or designee. For purposes of this Agreement, CDCR/CCHCS designee must be a civil service employee. The institution CEO/CME or designee, and facility CMO or designee retains professional and administrative responsibility for services rendered. B. Contractor and/or Provider must be able to perform the tasks associated with providing services as noted in the heading under the scope of their license. Contractor agrees that all Providers referred by Contractor will be required to render health services as defined and required by law on an as-needed basis. Contractor and/or Provider will perform services in accordance with federal and state laws and regulations and CDCR/CCHCS policies and procedures and shall at all times comply with standard safety precautions and maintain CDCR security measures and a safe work environment. C. Contractor and/or Provider agree that, unless otherwise stated, all expenses associated with travel to and from the institution/facility, lodging, and all training expenses shall be borne by the Contractor or Provider, and will not be reimbursed separately by CDCR/CCHCS. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor. D. Contractor and/or Provider acknowledge that CDCR/CCHCS is not obligated to provide or pay for patient/youth health care services or treatment beyond those which are essential to prevent death, or permanent and/or severe disability. If health care service or treatment is nonessential or could safely be deferred until the patient/youth is released from custody, when he/she is able to arrange for services for him/her, CDCR/CCHCS shall defer services. Prior authorization must be obtained and documented in the patient’s/youth’s health record for those excluded health care services or treatments listed in the CDCR/CCHCS Medical Standards of Care and National Standards for the service provided under this Agreement. E. CDCR/CCHCS Medical Standards of Care shall be used as a reference when prior authorization is granted. CDCR/CCHCS Medical Standards of Care means InterQual® Care Planning Criteria, published by McKesson Health Solutions, LLC, except to the extent they conflict with the Inmate Medical Services Policies and Procedures (IMSP&P), except to the extent the InterQual® criteria or the IMSP&Ps conflict with Articles 8 and 9, Subchapter 4, Chapter 1, Division 3, of Title 15 of the California Code of Regulations (CCR). The IMSP&Ps are available at ▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇.▇▇▇/imspp.aspx. Requests for InterQual® criteria should be directed to ▇▇@▇▇▇▇.▇▇.▇▇▇. In the event CDCR/CCHCS adopts another objective standard for Utilization Management (UM) review to screen patient/youth health care regarding prior authorization, inpatient admissions, and other types of UM review, institution/facility shall notify the Contractor and/or Provider of the new standard no less than thirty (30) calendar days before the new standard is implemented.

INTRODUCTION/SERVICES. A. This is a Statewide Agreement in which for the Contractor shall provide Prosthetic purpose of obtaining and Orthotic services, on an as-needed basis, to patients/youth referred for such medical services from CDCR/CCHCS. Contractor shall provide all labor, materials, staff, transportation, licenses, permits and every other item of expense necessary, unless otherwise stated. Services shall be provided providing on-site upon request Oral and under Maxillofacial Surgeon (OMFS) Services for referred patients/youths for whom California Department of Corrections and Rehabilitation (CDCR)/California Correctional Health Care Services (CCHCS) has the direction of responsibility to provide such services. OMFS services include, but are not limited to, the institution Chief Executive Officer Procedures listed or Chief Medical Executive (CEOdescribed in Exhibit B-1, Bid Rate Sheet, and/or B-2, CDCR/CME) or designee, or the Division of Juvenile Justice Facility (facility) Chief Medical Officer (CMO) or designee. CCHCS Standardized Fees to this Agreement. B. For purposes of this Agreement, “Contractor” is the party hereby contracting with CDCR/CCHCS designee must and who is presumed to be qualified to have an active role under this Agreement as a civil service employeeProvider of OMFS services. The institution CEO/CME or designeeAdditionally, Contractor is also presumed to have a relationship with other OMFS Providers, for availability purposes in order to provide OMFS services as needed to meet the purpose of this Agreement. “Provider(s)” shall refer to any OMFS Provider who undertakes and facility CMO or designee retains professional and administrative responsibility for provides OMFS services rendered. B. Contractor pursuant to this Agreement, as arranged through and/or Provider must be able to perform the tasks associated with providing services Contractor as noted Contractor’s employee, agent, sub- contractor or via any other type of relationship with Contractor. “Provider(s)” includes Contractor with respect to any instance or capacity in the heading under the scope of their licensewhich Contractor is or may be acting as an OMFS Provider. Contractor agrees that he/she and all Providers referred by Contractor Provider(s) are or will be required to render health services as defined familiar with this Agreement and required will abide by law on an as-needed basis. Contractor and/or Provider will perform services in accordance with federal its terms and state laws and regulations and conditions. C. The responsibility of CDCR/CCHCS policies to provide OMFS services is limited to those services which are reasonable and procedures and shall at all times comply with standard safety precautions and maintain CDCR security measures and a safe work environment. C. Contractor and/or Provider agree thatnecessary to protect life, unless otherwise statedprevent significant illness or disability, all expenses associated with travel to and from the institution/facility, lodgingor alleviate severe pain, and all training expenses shall be borne are supported by the Contractor or Provider, and will not be reimbursed separately by CDCR/CCHCSoutcome data as being effective care. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor. D. Contractor and/or Provider acknowledge that CDCR/CCHCS is not obligated to provide or pay for patient/youth health care services or treatment beyond those which are essential to prevent death, or permanent and/or severe disability. If health care For any service or treatment that is nonessential or could safely be deferred until the patient/youth is released from custody, when he/she said services shall be so deferred. Any OMFS service considered under this Agreement is able otherwise subject to arrange for services for him/herthe prior authorization requirement and all other requirements, processes and limitations expressed herein, such as the request and scheduling process, and/or other limitations and requirements as imposed by law. When prior authorization is required, it must be obtained as specified in this Agreement’s Exhibit A-1, Service Specifications. For any service that is provided without the necessary and documented authorization, or which is otherwise not authorized or allowed in accordance with this Agreement, CDCR/CCHCS shall defer services. Prior authorization have no obligation to pay for the service. D. Each Provider must be obtained qualified, willing and documented able to provide OMFS services and perform any associated tasks in accordance with his/her professional licensure, which shall be maintained in good standing with the appropriate government agency. Additional required qualifications for each Provider are listed in Exhibit A-1, Service Specifications. E. Each Provider bears the responsibility for providing each OMFS service and performing any associated task in a manner consistent with the commonly accepted “Standard of Care” for the subject service. The applicable Dental Standard of Care is considered to be care provided in a manner consistent with how a careful, reasonable and prudent Provider would provide care in the patient’s/youth’s health record for those excluded health care services same or treatments listed in the similar clinical presentation. CDCR/CCHCS Medical Standards does not assume, agree to or otherwise accept a duty to defend or indemnify a Provider against any civil or criminal action arising out of Care and National Standards for the service provided under or in association with this Agreement. E. F. In addition to meeting the applicable Standard of Care, each Provider bears the responsibility for providing each OMFS service and performing any associated task in accordance with federal and state laws and regulations, as well as CDCR/CCHCS Medical Standards policies and procedures, including all pertaining to CDCR safety and security. Consistent with the above stated responsibilities, Providers are otherwise subject to the oversight and direction of Care CDCR/CCHCS officials as necessary, including CDCR institutions or the Division of Juvenile Justice facility (DJJ facility) Supervising Dentist (SD) or designee. For purposes of this Agreement, such CDCR/CCHCS designee must be a civil service employee. G. For the on-site OMFS services in question, CDCR/CCHCS shall make available the standard OMFS instruments, handpieces, related supplies and materials as necessary for Provider(s)’ use. The Dental staff at the institutions/facilities consists of, but is not limited to, Dental Assistants and Supervising Dental Assistants who are available as surgical assistants. H. Except as otherwise stated in this Agreement, Contractor shall provide and be responsible for all labor, transportation, license(s), permits and every other item of expense necessary or incurred in providing OMFS services. Any expense anticipated or incurred by Contractor or its Providers, whether associated with travel to and from a CDCR institution and/or DJJ facility, including for lodging, food, or any other expense, or for any expense associated with work- related training, shall be used the sole obligation of the Contractor or its Provider incurring the expense, or, as a reference when prior authorization is grantedbetween Contractor and Provider, as may have been agreed by and between them. CDCR/CCHCS Medical Standards of Care means InterQual® Care Planning Criteria, published has no obligation to pay or reimburse any such expense incurred by McKesson Health Solutions, LLC, except to the extent they conflict with the Inmate Medical Services Policies and Procedures (IMSP&P), except to the extent the InterQual® criteria or the IMSP&Ps conflict with Articles 8 and 9, Subchapter 4, Chapter 1, Division 3, of Title 15 of the California Code of Regulations (CCR). The IMSP&Ps are available at ▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇.▇▇▇/imspp.aspx. Requests for InterQual® criteria should be directed to ▇▇@▇▇▇▇.▇▇.▇▇▇. In the event CDCR/CCHCS adopts another objective standard for Utilization Management (UM) review to screen patient/youth health care regarding prior authorization, inpatient admissions, and other types of UM review, institution/facility shall notify the Contractor and/or Provider of the new standard no less than thirty (30) calendar days before the new standard is implementedits Providers.