HomeMy WebLinkAboutDepartment of CorrectionsINTERAGENCY CONTRACT
PURPOSE
This Contract is entered into by Mason County (hereinafter Contractor) and the
Department of Corrections (hereinafter Department or DOC) for the purpose of maximizing the
efficient and cost effective use of existing resources and to provide adequate facilities and
programs for the confinement care, and treatment of Department offenders in accord with the
provisions of RCW 39.34 and RCW 72.68.040. The Department and the Contractor specifically
find this Contract is necessary and desirable in order to provide adequate confinement, housing
and care to the Department offenders transferred to and detained by the Contractor pursuant to
RCW 9.94A.631.
In consideration of the promises, payments, covenants and agreements contained in this
Contract, the parties agree as follows:
Article I
DEFINITIONS
Section 1.1 Contractor — means Mason County and its employees, licensed practitioners,
contractors, vendors and volunteers.
Section 1.2 Contractor inmate - means any resident of the Facility who is not a Department
offender.
Section 1.3 Department or DOC — means the Department of Corrections of the state of
Washington; any division section, office, unit or other entity of the Department, or any of the
officers or other officials lawfully representing the Department.
Section 1.4 Department offender - means any offender under the Department's jurisdiction.
Section 1.5 DOC Utilization Management Office — means the Department's medical contact
that receives, reviews, and approves Contractor's non -Formulary and extraordinary medical
care requests to provide necessary medical care to Department offenders. The Nurse Desk is
available telephonically 24 hours a day, 7 days a week at 360-725-8733 and during normal
business hours via email at NurseDesk@DOC1..wa.gov.
Section 1.6 Extraordinary medical care - means medically necessary medical, psychiatric or
dental care that is not commonly available through the Facility's health services and incurs
additional cost. this may include, but is not limited to, extraordinary medications such as
immunosuppressive drugs, and hepatitis C treatment and HIV medications.
Section 1.7 Facility - means the Contractor's non -Department operated correctional facility
used for the total confinement of Department offenders and Contractor inmates.
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Section 1.8 Formulary - means the Deparlmnent Pharmaceutical Management and Formulary
Manual. The Formulary can be viewed at
http://doc.wasgov/business/healthcareproviders/default.asp
Section 1.8.1 Formulary medication(s) - means the medication(s) medically necessary
according to the Offender Health Plan.
Section 1.8.2 Restricted Formulary medication(s) means the medication(s) is medically
necessary but the use is restricted to cases where there has been a documented failure of a
Formulary medication(s) or to certain populations or disease states.
Section 1.8.3 Non -Formulary medication(s) — means the medication(s) is not a part of the
Formulary. Non -Formulary medication(s) is not generally prescribed in the Department.
Section 1.9 In -Facility care - means medical, mental health and dental care provided as part
of the per diem to include all over-the-counter medication, which is any medication that does
not require a prescription, and routine medical supplies, routine medical/psychiatric/dental
care, regular health screenings, and emergent medical treatment provided on -site at the Facility
that is undistinguishable from services provided to Contractor inmates.
Section 1.10 Licensed practitioner - means any licensed health care practitioner performing
services within the person's authorized scope of practice followmg RCW Title 18.
Section 1.11 Medicaid — means Title XIX of the Social Security Act enacted by the social
security amendments of 1965 (42 U.S C. Sec. 1396; 79 Stat. 343), as amended.
Section 1.12 Medically necessary care - means medical care that meets one or more of the
following criteria for a given patient at a given time:
Section 1.12.1
Section 1.12.2
Section 1.12.3
Section 1.12.4
Section 1.12.5
Section 1.12.6
Section 1.12.7
Section 1.12.8
Is essential to life or preservation of limb, OR
Reduces intractable pain, OR
Prevents significant deterioration of activities of daily living OR
Is of proven value to significantly reduce the risk of one of the three outcomes
above (e.g. certain immunizations), OR
Immediate intervention is not medically necessary, but delay of care would
make future care or intervention for intractable pain or preservation of activities
of daily living, significantly more dangerous, complicated, or significantly less
likely to succeed, OR
Reduces severe psychiatric symptoms to a degree that permits engagement in
programming that advances correctional interests, OR
Is described as part of a Departmental policy or health care protocol or guideline
and delivered according to such policy, protocol, or guideline, OR
From a public health perspective, is necessary for the health and safety of a
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community of individuals and is medically appropriate, but may not be
medically necessary for the individual (for example, treatment for head lice);
Section 1.12.9 Not considered experimental or to be lacking in medically recognized
professional documentation of efficacy; and,
Section 1.12.10 Not administered solely for the convenience of the offender or the health care
provider.
Section 1.13 Offender day —means any day a Department offender is in the custody of the
Contractor, including the first day the offender is enters the Facility to serve a Department
sanction of a term of confinement to be served in the Facility. An Offender day does not include
the day when the Department offender leaves the custody of the Contractor due to release to
the community, transfer to a Department institution, transfer to another Facility, or release to
the custody of the Department. An offender day ends at midnight.
Section 1.14 Offender Health Plan — means the Department's Offender Health Plan (OHP)
that describes the medically necessary medical, mental health, and dental services available to
Department offenders, as well as the services that are limited or not available. The OHP is not a
contract or a guarantee of services to Department offenders. 1'he OHP can be reviewed at
http://doc.wa.gov/family/Offenderlife/flocs/OffenderHealthPlan.pdf.
Section 1.15 Pre -authorization procedure — means the procedure by which the Contractor must
contact the Department's Nurse Desk at the Department's Utilization Management Office to
obtain the Department s authorization prior to providing to Department offenders the
extraordinary medically necessary care or care beyond what is normally provided to
Contractor's inmates, or prior to using restricted Formulary or non -Formulary medication(s) on
Department offenders.
Section 1.16 Per diem rate- means the amount per day per Department offender that the
Contractor will be reimbursed by the Department for all in -Facility care, including but not
limited to all medical, mental health, dental, food, clothing and housing which are the same or
similar that is provided to Contractor mmates.
Section 1.17 Secretary - means the Secretary of the Department and delegates authorized in
writing to act on the Secretary's behalf.
Article II
TERM OF THE CONTRACT/PAYMENT
Section 2.1 Term. this Contract supersedes all previous oral and written contracts and
agreements between the parties relating to the confinement, care, and treatment of Department
offenders. This Contract commences on January 1, 2016, and continues through December 31,
2018, unless terminated by either party pursuant to this Contract.
Section 2.2 Termination. 'Phis Contract may be terminated by either party, without cause,
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upon sixty (60) days written notice to the other party. Not later than 60 days after the receipt or
delivery of a termination notice, the Department agrees to take physical custody of Department
offenders confined at the Facility pursuant to this Contract.
However, if the Department offender is held pursuant to RCW 9.94A.631, the Contractor may
not require the Department to move the Department offender. Additionally, if this contract is
terminated and Department offenders remain detained pursuant to RCW 9.94A.631, then the
Department's per diem will revert to the OFM established rate.
The Contractor and the Department agree to waive the written notice requirement if either
party in its sole discretion, determines there is an immediate threat to public safety, health, or
welfare that requires contract termination In such cases, both parties agree to provide verbal
and written notice of the tettmmation as soon as possible.
Section 2.3 Termination Due to Non -Appropriation of Funds. The teams of this Contract
are contingent upon sufficient appropriations by the Washington State Legislature to the
Department to pay sums pursuant to this Contract If the Legislature does not allocate
sufficient appropriations, this Contract shall termminate immediately without penalty and
without the sixty (60) day notice period. The Department is responsible for the services
provided to Department offenders prior to teintination and removal of Department offenders,
as prescribed by law.
Section 2.4 Per Diem Billing. The per diem rate is $84.87 per Department offender. The
Contractor agrees to only bill the Department monthly for the actual bed days used by
Department offenders in the preceding month. The Contractor also agrees that it will not bill
the Department for any bed day that is the financial responsibility of any other jurisdiction, and
that it will submit monthly itemized bills to the Department in an electronic spreadsheet format
that mcludes the offender s name, DOC number, date of birth, and dates the offender was held
by the Contractor under the Department's authority If applicable, the Contractor agrees to
identify in the monthly bill, any beds that are being counted toward the day -for -day exchange
for any Contractor boarder being held by the Department in a Department institution.
Section 2.4.1 The Contractor agrees to run all sanctions imposed by the Department
consecutively to all other sanctions and/or sentences imposed by any other jurisdiction, unless a
court order requires them to run concurrently.
Section 2.4.2 The Department's financial responsibilities under this Contract terminate when
the Department takes custody of the Department offender, when the Department's sanction has
been served, or when the Department's hold or detainer is no longer valid, whichever is earlier.
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Article III
RESPONSIBILITIES
Section 3.1 Target Population. Department offenders transferred to the Contractor will be
primarily, but not exclusively those who are in violation of community supervision
requirements or who are awaiting a hearing on alleged violations, parenting sentencing
alternative violators, and work release violators.
Section 3.2 Offender Housing, Confinement and Sanction time. The Contractor agrees to
take into custody, confine and supervise Department offenders in the Facility pursuant to this
Contract Department offenders may be integrated with the Contractor's inmate population, as
allowed by law, regulation, and ordinance. Placement of Department offenders in the Facility
following this Contract may occur at any time after the beginning of the terllt of this Contract,
pursuant to this contract.
However, in the absence of a contract, if a community corrections officer arrests or causes the
arrest of an offender pursuant to RCW 9.94A.631., the offender shall be taken into custody,
confined and detained and shall not be released from custody except upon approval pursuant
to a written order by authorized Department staff.
Section 3.2.1 Each party agrees that Department offenders shall serve any Department imposed
sanction time consecutive to all other sentences and to non-DOC confinement, pursuant to RCW
9.94A.171(3), RCW 9.94A.589(2)(a) and RCW 9 94A.505(6), unless a Court of competent
jurisdiction orders otherwise In the event this occurs, the Contractor agrees to provide the
Department with a copy of the Court's order.
Section 3.2.2 Each party agrees to notify the other in writing any time the Department's
jurisdiction has been tolled, or should be tolled by non-DOC confinement pursuant to RCW
9.94A.171(3), RCW 9.94A 589(2)(a) or RCW 9 94A.505(6).
Section 3.2.3 The Contractor agrees that the Department shall not be financially responsible for
any Deparintent offender during the period the Department offender is serving consecutive
non-DOC confinement.
Section 3.3 Transportation of Department Offenders
Section 3.3.1 I'he Department agrees to provide or arrange for transportation of
Department offenders to and from the Facility except when the transportation is
determined by Facility staff to be necessary to secure an emergency medical evaluation or
treatment, or when transportation is required to support the orderly operation of the
Facility, in which case the Contractor shall provide the transportation.
Section 3.3.2 The Contractor agrees to provide transportation, if the Contractor has
transportation, to and from designated sites on its regularly scheduled trips and to assist,
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when possible, in the transportation of Deparhnent offenders to and from other facilities in
surrounding counties, including placing Department offenders on the Contractor's
transportation during regularly scheduled trips.
Section 3.3.3 1'he Department agrees to reimburse the Contractor for all reasonable
costs incurred by the Contractor for its transports of Department offenders in response to a
request by the Department, unless the Department offender is transported by the
Contractor during the Contractor's regularly scheduled trip. See Attachment A.
Section 3.3.4 the Department shall be responsible for the transportation of Department
offenders to and from Department institutions. The Department agrees to provide the
Contractor a minimum of 24 hours written notice prior to transporting a Department
offender from the Facility. Nothing in this section precludes the Contractor from waiving
the 24 hour written notice requirement.
Section 3.4 Return of Department Offenders to the Department.
Section 3.4.1 Return of Department offenders to Department. The Department may
demand that a Department offender be returned to Department custody at any time. the
return will be at the Department's expense unless the Department offender is transported
by the Contractor during a Contractor's regularly scheduled trip to the scheduled
destination.
Section 3.4.2 Contractor's Return of Deparhnent offenders. The Contractor may
request to return a Department offender to the Department s custody at any time for
documented behavioral or medical/mental health problems that the Contractor is unable to
manage. the Department agrees to accept custody as soon as possible, but not later than
seven days after receiving the Contractor's request If the Contractor requests the
Department offender's return, and the Department cannot meet the Contractor's
timeframe, then the Contractor may transport the offender to the nearest Department
designated location.
Section 3.4.3 Court's Return of Department Offenders. If a Court of competent
jurisdiction orders a Department offender to be returned to the Department, then the
Department agrees that it will accept custody as soon as possible, but no later than seven
days after receiving notice. The Department shall be responsible for the Department
offender's transportation to the nearest suitable Department designated location, unless the
offender can be transported by the Contractor during the Contractor s regularly -scheduled
trip.
Section 3.5 Return of Department Offender to the Community. Prior to releasing a
Department offender to the community, the Contractor agrees to complete a national "Wants
and Warrants" check as mdicted below, and to notify the Department and any interested
jurisdiction of the Department offender's pending release. The notification shall occur at least
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seven business days prior to a Department offender's release to the community due to the
Department offender's completion of a sanction or sentence In extenuating circumstances, the
notification may occur less than seven business days prior to release, but in no event may it
occur later than 24 hours prior to release. The Department offender may be released to the
community when the Department's sanction has been served, or when the Department s hold
or detainer is no longer valid. See Attachment A.
Section 3.6 Jurisdiction. Deparinient offenders placed in the Contractor's custody are under
the Department s jurisdiction. However, upon the Department offender's placement at the
Facility, the Department authorizes the Contractor to assume custody. The Department agrees
to provide the Contractor with documentation of the Contractor's authority to detain the
offender.
Section 3.7 Public Records. Both parties agree to comply with Washington State's Public
Records Act, RCW 42.56.040 through 42.56.570 (act). The act requires each party to make
available for inspection and copying nonexempt "public records." A "public record" includes
any 'writing containing information relating to the conduct of government or the performance
of any governmental or proprietary function prepared, owned, used, or retained" by the party
in accord with RCW 42.56.070(1).
Section 3.8 Medical Care. It is the intent of the parties that Department offenders in the
Contractor's custody receive safe appropriate and cost-effective medical care consistent with
the Department's Offender Health Plan and Attachment B.
Section 3.8.1 Contractor Responsibilities.
3.8.1.1 The Contractor agrees to provide Department offenders in the Facility
care equivalent to the care provided to Contractor inmates. The
Contractor agrees to provide Department offenders 24-hour access to
emergency medical care. The Contractor agrees to provide the most
cost-effective medically appropriate method of transportation and
security for all Department offenders taken out of the Facility, to in -
county emergent and non -emergent medical appointments. 1'he
Contractor may require Department offenders to pay co -pay fees for
medications.
3.8.1.2 The Contractor agrees to follow the Department's pre -authorization
procedure through the Department's Utilization Management Office for
all extraordmary medically necessary care provided to Department
offenders and for all health care provided to Department offenders
beyond what is normally provided to Contractor's mmates, and for the
use of restricted Formulary and non -Formulary medication(s) for
Department offenders. The use of Formulary medications requires no
pre -authorization for use, provided the criteria listed in the Formulary
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are met.
3.8.1.3 ONLY the Department's Nurse Desk can authorize the transfer of a
Department offender from the Facility for medical reasons.
3.8.1.4 In an emergency, when pre -authorization is not feasible, the Contractor
agrees to notify the Department, as soon as possible, but not later than
four hours after transporting a Department offender to the nearest
emergency room or other medical facility and before any hospital
admission. The Contractor agrees to be financially responsible for all
health care provided to Department offenders that is not pre -authorized
unless it is both emergent and medically necessary.
3.8.1.5 Following the OHP and consistent with RCW 70.48.130(2), the
Department does not consider experimental or elective procedures to be
medically necessary. The Department will not reimburse for elective or
experimental medical procedures. The Department will not be
responsible for the payment of or for medical care required as a result of
any tort committed by the Contractor, or its employees, or by its agents,
contractors, vendors, or volunteers in the course of their providing
services to Department offenders, or for care which could have
foreseeably been prevented.
3.8.1.6 1he Contractor agrees to be financially responsible for all unauthorized,
non -emergent and non -medically necessary health care provided to
Department offenders.
3.8.1.7 The Contractor agrees to be financially responsible for any medical costs
mcurred due to the negligent action or inaction of Contractor's
employees.
3.8.1.8 Extraordinary Medical care costs may be billed to the Department only if
pre -authorized by the Department.
Section 3.8.2 Department Responsibilities.
3.8.2.1 The Deparinient agrees to be financially responsible for pre -authorized
extraordinary medical care provided by the Contractor to Department
offenders that is consistent with this Contract, the OHP and the
Formulary.
3.8.2.2 If the Depariitient offender is under the exclusive jurisdiction of the
Department, then the Department may authorize medically necessary
care. However, if it is later determined that another jurisdiction(s) or
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entity is financially responsible; then the Department may decline to pay
for part or all of the costs associated with the medically necessary care.
3.8.2.3 The Department agrees to reimburse the Contractor for emergency
medical costs incurred by a Department offender under the conditions of
this Contract. Emergency medical care costs may include a facility fee,
physician services, labs and x-rays. The Department is not obligated to
reimburse the Contractor for medical care or treatment provided to a
Department offender without the Department's pre -authorization in a
nonemergency, or without the notice required by paragraph 3.8.1.4 in
emergency situations.
3.8.2.4 The Department may, at its option, request that the Contractor return a
Department offender to the Department's custody for medical reasons.
The Department's medical financial responsibilities under this Contract
teiminate when the Department takes custody of the offender, when the
Department s sanction has been served, or when the Department s hold
or detainer is no longer valid, whichever is earlier.
3.8.2.5 1he Department at its sole discretion may provide Department offenders
prescription medications, or reimburse the Contractor for prescription
medications that the Contractor provides, as long as the Contractor -
provided prescription medications are consistent with the Offender
Health Plan and the Formulary. Restricted Formulary and non -
Formulary medications must be pre -authorized by the Department's
Utilization Management Office See Attachment B.
Section 3.8.3 Safe Transfer of Care.
3.8 3.1 HIPAA - Both parties agree to follow the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). HIPPA protects the
privacy of individually identifiable protected health information. It
allows the exchange of this information between the Department and the
Contractor for the purpose of billing and payment. This allows the
Contractor to provide the Department with information documenting
the Contractor's treatment activities so that the Contractor can receive
reimbursement under this Contract for costs of health care provided to
Department offenders. See CFR 45 § 164.506. HIPPA also clarifies the
standard for use and disclosure for correctional institutions and other
law enforcement custodial situations in CFR 45 §164.512.
3.8.3.2 The Contractor agrees to consult with a registered nurse at the receiving
facility and/or the Department's Utilization Management Office prior to
transferring a Department offender for medical reasons. "Transferring,"
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as used in this section, includes moving the Department offender into
the Contractor's medical unit within the Facility.
3.8.3.3 the Contractor also agrees to consult telephonically with the medical
staff at any facility receiving the Department offender and agrees to
transport, with the Department offender, any applicable medical
records, current care instructions, and all appropriately labeled
medications. the medical record shall at a minimum mclude the
Department offender's name, DOC number, date of birth, any known
allergies, current medication hst, and description of current medical
problem(s), the Facility medical care previously provided, and the
Facthty medical staff contact information.
3.8.3.4 The Department agrees to transport, with the Department offender, any
applicable medical records, current care instructions, and all
appropriately labeled medications. the medical record shall at a
minimum include the Department offender s name, DOC number, date
of birth, any known allergies, current medication list and description of
current medical problem(s), the Facility medical care previously
provided, and the Department's institutional medical staff contact
mformation.
Section 3.8.4 Medical Care Utilization Review. The Contractor agrees to allow the
Department and its agents to conduct concurrent and retrospective utilization audits and
reviews of any and all medical services provided to Department offenders. The Contractor
agrees that any and all of its medical service contracts will include authorization for the
Department's concurrent and retrospective utilization audits and reviews of any and all
medical services provided to Department offenders.
Section 3.8.5 Medical Billing. Contractor costs incurred for a Department offender's
medical care not included in the per deim will be reimbursed by the Department consistent
with this Contract and Attachment B.
The Contractor agrees to electronically send itemized monthly bills to the Department at:
DOCHOMedicalRAB@DOC I .WA.GOV.
1'he itemized reimbursement claims must contain the Department offender s name and
DOC number and attached supporting documentation of the service provided that
includes the date(s) of service, the name of the practitioner who ordered the service, details
of the service/item(s) provided, the prescriptions(s) provided, the facility(s) that provided
the service(s), and a copy of any health care claims paid to off -site providers.
The Contractor agrees to submit itemized billing statements electronically to the
Department for reimbursement and data collection purposes. If billings received do not
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contain the detailed information or supporting documents required, they will be returned
to the Contractor and not processed.
1'he Contractor agrees to submit itemized bills for medical services no later than six months
after the date of service If medical or pharmaceutical bills are received 365 days or more
after the date of service, the Department may decline to reimburse the Contractor for
those bills.
Section 3.9 Notification of Release Date. The Department agrees to calculate a Department
offender's release date and to notify the Contractor, in writing, of the Department offender's
release date from a Department imposed sanction. The Contractor will not release a
Department offender unless the Department's sanction has been served, or when the
Department's hold or detainer is no longer valid.
Section 3.10 Contract Coordinator. Each party agrees to identify a coordinator who is
responsible for administering the Contract on behalf of that party. Should the coordinator be
absent for an extended period of time, the coordinator shall arrange for, and notify the other
party in writing of, the alternate contact person during the coordinator's absence. The DOC
Contract Coordinator's contact information is provided in Attachment A.
Section 3.11 Facility Space for Violation Hearings and Reviews. The Contractor agrees to
provide Department staff and officers suitable facilities for conducting Department offender
hearings and reviews Monday through Friday during normal business hours and at other times
upon written notice.
the Contractor will provide a room with sufficient confidential space to safely and efficiently
conduct Department offender hearings and reviews. Sufficient space means that the room
provided will allow all participants to hear the proceedings and must be of a size sufficient to
accommodate at least three sitting people and must be equipped with overhead fighting, at least
one electrical power/outlet, a desk, three chairs, and a working telephone with a line able to call
local and long distance telephone numbers outside the Facility.
Where possible the Contractor agrees to provide a means for contacting the Contractor during
the hearing If a ' panic button" or other method is not available, the Contractor agrees to ensure
Department offenders remain restrained during Department hearings and reviews.
Section 3.12 Inspections. the Contractor agrees to allow the Department and its agents to
inspect and audit the Facility(s) with or without advance notice. 1'he inspection/audit may
include, but is not limited to: reviewing holding and detaining facilities, expense reports, and
Department offender medical records and interviewing Department offenders.
Section 3.13 Offender Programs. Department offenders will have the same access to
programs provided to Contractor inmates housed in the Facility. Should the Department elect
to provide additional programs for Department offenders at the Department's expense, the
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Contractor agrees to provide workspace to conduct those programs, provided that such space is
available and not being used by the Contractor.
Section 3.14 Orientation. Upon a Department offender's arrival at the Facility, the Contractor
agrees to fingerprint conduct an NCIC check and provide an orientation for the Department
offender in the same mariner as for a Contractor inmate This orientation must include the
Facility's: 1) requirements for work; 2) Facility rules and disciplinary procedures; 3) medical
care availability; and 4) visitation rules.
1'he Deparhr►ent will advise Department offenders of the requirement to follow the rules of the
Facility
Section 3.15 Clothing.
Section 3.15.1 Clothing and bedding for Department offenders will be provided and
maintained in accordance with the Facility's policies.
Section 3.15.2 The Contractor agrees to provide work clothing and equipment
appropriate to a Department offender's assignment to the same extent as provided to
Contractor inmates.
Section 3.15.3 The Contractor agrees to furnish Department offenders with climate
appropriate outerwear to the same extent as provided to Contractor inmates.
Section 3.15.4 Department offenders will be released in the clothing in which they
arrived or in Department -provided apparel.
Section 3.16 Transferable Items. Each party agrees to provide the other with a list of
allowable items that may be transferred with a Department offender.
Section 3.17 Compensation for Work. The Contractor agrees to provide Department
offenders who participate in Contractor employment the same reimbursement, if any, as
provided to Contractor inmates performing similar work.
Section 3.18 Discipline. The Contractor may discipline Department offenders in accordance
with the Contractor s rules and disciplinary procedures. The Contractor agrees to notify the
Department as soon as possible but not later than 72 hours after disciplining a Department
offender or after a referral for criminal charges In such cases, the Department reserves the right
to determine if the Department offender's misconduct should also be addressed through the
Department's violation and hearing processes.
The Contractor reserves the right to refer a Department offender's misconduct for new criminal
charges and the right to move Department offenders to more secure housing within the Facility
consistent with the Contractor's policies, procedures and prudent facility management
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practices. 1'he Contractor may require the Department to retake custody of any Departinent
offender whose behavior requires segregated or protective housing pursuant to this Contract.
The Department may request a Department offender be returned to the Department if the
Department offender's behavior or health requires segregated or protective housing pursuant to
this Contract.
Section 319 Facility Operations. The Contractor agrees to manage Deparhnent offenders
consistent with the management of Contractor inmates and in accordance with the law. The
Contractor agrees to maintain staffing levels at the Facility in sufficient numbers and rank to
maintain the safety of the public, staff, Contractor inmates, and Department offenders and to
reasonably carry out the provisions of this Contract.
Section 3.20 Religious Opportunity. 'l'he Contractor agrees to provide Department offenders
the same space and opportunity for religious services as provided to Contractor inmates.
Section 3.21 Telephone. The Contractor agrees to provide Department offenders access to
telephone services consistent with telephone services provided to Contractor inmates.
Section 3.22 Commissary and Mail. 'l'he Contractor agrees to provide Department offenders
commissary and mail services consistent with commissary and mail services provided to
Contractor inmates.
Section 3.23 Offender Funds. The Contractor agrees to administer Department offender
funds consistent with the fund administration provided to Contractor inmates. If, by mutual
Contract, the Contractor agrees to house Departinent offenders who are non -violators, the
Contractor then agrees to administer Department offender funds to include the appropriate
accounting process to accommodate statutorily mandated deductions.
Section 3.24 Visitation. The Contractor agrees to provide Deparhnent offenders visitation
opportunities consistent with those that are provided to Contractor inmates.
Section 3.25 Grievance Procedures. The Contractor agrees to handle initial Department
offender grievances consistent with Contractor inmate grievance procedures. The Department
agrees to handle appeals or additional reviews of Department offender grievances at the request
of the Contractor.
Section 3.26 Access to Courts. Contractor agrees to provide Department offenders in
Contractor's custody under this Contract meaningful access to the courts through: (a) the use of
court appointed attorneys to satisfy their Sixth Amendment right to counsel, (b) access to
contracted attorneys provided by the Department, and/or (c) access to legal resource materials
at the Facility. 1'he Contractor also agrees to provide Department offenders opportunity to
access legal materials at the Facility or to access the Department offender's attorney in
accordance with security and operating needs and consistent with access granted to Contractor
inmates.
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Section 3.27 Death of an Offender. The Contractor agrees to immediately notify the Contract
Coordinator by phone of any Department offender's death. See Attachment A. The Contractor
also agrees that the Department offender s death shall be reviewed by the coroner of the local
jurisdiction pursuant Contractor's policies and procedures. The Contractor also agrees to
provide the Department certified copies of the Department offender's death certificate, autopsy
report, file and medical records.
Section 3.28 Escape of an Offender. the Contractor agrees to immediately notify the
Contract Coordinator by phone if a Department offender escapes. See Attachment A. The
Contractor also agrees to immediately notify all local law enforcement agencies.
Section 3.29 Non -Department Holds. The Contractor agrees to immediately notify the
Department of all non -Department holds if and when non -Department holds are placed on
Department offenders or when non -Department holds are closed or removed from Department
offenders as detailed in Attachment A.
3.29.1 The Contractor agrees to not transfer Department offenders to another
confinement facility pursuant to a non -Department hold until the Department's sanction
has been served, or the Department's hold or detainer is no longer valid.
3.29.2 The Contractor agrees not to transfer Deparlutent offenders detained in the
Facility to another confinement facility or Department institution pursuant to a non -
Department hold unless the Contractor has first obtained authorization from the
Violator Desk, the after -business Duty Officer, or the Contract Coordinator as detailed in
Attachment A.
3.29.3 The Department will not be financially responsible for any per diem or medical
costs accrued during time spent pursuant to a non -Department hold, other than costs
accrued during a sanction imposed by the Department.
Article IV
CONTRACTOR EMPLOYEES
Section 4.1 Independent Contractor. Each party agrees to perform its duties hereunder as
an independent contractor and not as an employee. Neither the Contractor nor any agent or
employee of the Contractor shall be deemed to be an agent or employee of the Department.
Neither the Department nor any agent or employee of the Department shall be deemed to be an
agent or employee of the Contractor. 1'he Contractor agrees to pay, when due, all required
employment taxes and income tax withholding including all Federal and State income tax and
local head tax on any monies paid pursuant to this Contract Neither the Contractor nor the
Department shall have authorization, express or implied to bind the other to any Contracts,
liability or understanding except as expressly set forth herein.
State of Washington K9581 (1)
Department of Corrections
Page 14 of 25
158362
Section 4.2 Personnel. 1'he Contractor agrees to retain sufficient personnel to deliver 24 hour
care and supervision to Department offenders, consistent with Contractor's policies and the
governing laws, as well as administrative and support service personnel for the overall
operation of the Facility The Contractor agrees to subject all applicants to a thorough
background check prior to their employment at the Facility.
Section 4.3 Training. Each Party agrees to train its employees in accordance with its own
policies and the law. Each Party also agrees to be responsible for all claims, damages, liability
and court awards (including costs, expenses and attorney fees) incurred against itself as a result
of any action or omission of its own employees, agents, subcontractors or assignees mcurred in
connection with the training
Article V
PREA COMPLIANCE
Section 5.1 Compliance. The Contractor agrees to maintain zero tolerance toward all forms of
sexual abuse and sexual harassment and to ensure that all of the Contractor's employees
vendors and volunteers who have contact with Department offenders comply with all federal
and state laws regarding sexual misconduct, including but not limited to:
Section 5.1.1 The Prison Rape Elimination Act of 2003 (PREA);
Section 5.1.2 The standards for adult prisons and jails or community confinement facilities,
whichever is applicable, as promulgated by the United States Attorney,
Section 5.1.3 RCW 72.09.225 or RCW 13.40.570, regarding sexual misconduct by state
employees, contractors;
Section 5.1.4 RCW 9A 44.010, regarding definitions,
Section 5.1.5 RCW 9A.44.160, regarding custodial sexual misconduct in the first degree; and,
Section 5.1.6 RCW 9A.44.170, regarding custodial sexual misconduct in the second degree.
Section 5.2 Monitoring. The Contractor agrees to provide to the Department documented
compliance with the federal PREA standards, and to allow the Department to monitor the
Facility's compliance.
Section 5.2.1 Monitoring may include, but is not limited to: site visits, access to facility data, and
review of applicable documentation
Section 5.2.2 The Department may terminate this Contract should the Contractor fail to provide
documentation that demonstrates that the Contractor is actively and effectively working toward
and is making substantive progress toward achieving compliance or should the Contractor fail
to maintain PREA compliance between auditing periods, after being given a reasonable
opportunity to cure.
Section 5.3 Termination. The Department may terminate this Contract should Contractor elect
to discontinue pursuit of PREA compliance or should the Contractor be found in
noncompliance through a PREA audit and fail to cure such noncompliance within the identified
time -frames or should the Contractor be found to be in egregious violation of PREA.
State of Washington K9581 (1)
Department of Corrections
Page 15 of 25
158362
Article VI
INDEMNIFICATION
Section 6. Indemnification Each party agrees to be responsible for the negligent acts or
omissions of its own staff Each party agrees to defend and indemnify the other party and its
elected and appointed officials, officers, employees and agents against all claims, losses,
damages, suits and expenses, including reasonable attorneys fees and costs, to the extent they
arise out of, or result from, the performance of this Contract by the indemnitor or its elected or
appointed officials, officers, employees and agents. 1'he indemnitor's duty to defend and
indemnify extends to, but is not limited to, claims by the elected or appointed officials, officers,
employees or agents of the indemnitor or of any contractor or subcontractor of indemnitor. The
indemnitor waives its immunity under Title 51 (Industrial Insurance) of the Revised Code of
Washington solely for the purposes of this provision and acknowledges that this waiver was
mutually negotiated. This provision shall survive the expiration or termination of this Contract.
Article VII
MISCELLANEOUS
Section 7.1 Existing State Law. this Contract shall not be construed to alter the legal
responsibilities of the Contractor or the Department with regard to the legal and fiscal
responsibility for confinement, care, and treatment of Department offenders under state law.
Section 7.2 Disputes. Disputes between the parties arising out of this Contract may be
submitted to arbitration if the parties are unable to resolve them through conference. No
disputes may be submitted to arbitration without the consent of both parties. Nothing in this
section is intended to limit either party's access to any and all courts of law of this state or
country.
Section 7.3 Equal Employment Opportunity. The parties ascribe to the principles of equal
employment opportunity Neither is responsible for ensuring that the other is in compliance
with equal employment statutes or policies.
Section 7.4 Invalidity and Severability. To the extent that this Contract may be executed
and performance of the obligations of the parties may be accomplished within the intent of the
Contract, the terms of this Contract are several. Should any terra or provision of this Contract be
declared invalid or become inoperative for any reason, such invalidity or failure shall not affect
the validity of any other terra or provision of this Contract In the event that any provision of
this Contract is held invalid, that provision shall be null and void. However, the validity of the
remaining provisions of the Contract shall not be affected thereby.
Section 7.5 Jurisdiction and Venue. 1'he laws of the State of Washington and the rules and
regulations issued pursuant to them shall be applied m the interpretation, execution and
State of Washington K9581 (1)
Department of Corrections
Page 16 of 25
158362
enforcement of this Contract. Venue for any legal action related to the perfotmance or
interpretation of this Contract shall be in the Superior Court in Thurston County, Washington.
Section 7.6 Scope of Contract. This Contract and any appendices or exhibits to it incorporate
all the contracts, covenants, and understandings between the parties. No prior contract or
understandings, verbal or otherwise, of the parties or their agents shall be valid or enforceable
unless embodied in this Contract. 1'his Contract shall not be altered, changed, or amended
except by mutual consent of the parties in writing
Section 7.7 Compliance with Applicable Laws. 'l'he parties agree at all times during the
performance of their obligations of this Contract to strictly adhere to all applicable federal and
state laws and regulations.
Section 7.8 Audit. At no additional cost, all records relating to the Contractor's performance
under this Contract shall be subject at all reasonable times to inspection, review, and audit by
the Department, the Office of the State Auditor, and federal and state officials so authorized by
law, in order to monitor and evaluate perfonnance, compliance, and quality assurance under
this Contract. The Contractor shall provide access to its facilities for this purpose. Any
overpayments discovered in the course of such audits, after notice to the Contractor, may be
withheld from future payments.
IN WITNESS WHEREOF, the undersigned duly authorized officers have subscribed
their names on behalf of the State of Washington and the Contractor.
MASON COUNTY STATE OF WASHINGTON
DEPARTMENT OF CORRECTIONS
Casey Sali' •ury, Sheriff
BOARD OF COMMISSIONERS
MASON COUNTY, WASHINGTON
DATE Gary Banning, Contract Administrator
DATE
Terri Jeffreys, Chairman DATE
Tim Sheldon, Commissioner DATE
Randy Neatherlin, Commissioner DATE
Approved by•
The Office of the Attorney
General on November 4, 2015.
State of Washington K9581 (1)
Department of Corrections
Page 17 of 25
158362
A 1'1 EST (Clerk):
Julie Almanzor DATE
Approved as to form by:
Contractor's Attorney DATE
State of Washington K9581 (1) Page 18 of 25
Department of Corrections 158362
Attachment A
DOC Contact Information
Violator
•
Pre
extraordinary
Medical
-Authorization
Issues
medical
for
expenses
DOC
Additional
•
Nurse
360-725-8733
contact
Desk-24/7
during
business
hours:
•
Pre -Authorization
for non-
•
NurseDesk@docl.wa.gov
Forniulary
•
Fax: 360-586-9060
medications
•
Report
of emergent
offender
issue
medical
Violator
Issues
DOC
Violator
Desk
•
To
transfer
Monday
-Friday
(except
Holidays):
7:00
am-5:00
•
Notification
request
a
of
additional
of violator
non-
•
1-855-584-6528
pm
DOC
sentence/sanction
• Violatordesk@doc.wa.gov
confinement
•
When
calli
ig outs 'de
of hours listed
call
the
DOC
•
Notification
of
violator
Warrants
Desk and
ask to speak to the CCD
Section
discipline/new
charges
Duty
Officer.
•
Notification
detainers/
of
holds
any non-
DOC
DOC
Secretary
Warrant
DOC
Warrants
• 360-725-8888
Desk-24/7
Concerns after
normal
business
hours
DOC
Warrants
Desk-24/7
For example:
offenders
under
DOC
Warrants
Desk
will
f
efer
to the appropriate
Duty Officer
issues
to
DOC
• 360-725-8888
supervision
or
related
staff
or
DOC
equipment
Violator
Medical
Billing
Medical
Disbursement
Unit
for
for
DOCHQMedicalRAB@docl.wa.gov
•
Requests
reimbursement
•
medical
care not
included
in
the
•
360-725-8298
offender
base
rate.
•
Fax: 360-586-1320
DOC
Contract
Coordinator
Dianne
Ashlock
• Contract
concerns/issues
Monday
-Friday
(except
Holidays):
8:00
am-5:00
pm
•
Death
of
a Violator
Escape
• Work
After
360-725-8315
hours/holidays
360-507-6040
• Violator
•
• dianne.ashlock@doc.wa.gov
Last updated 8/11/2015
State of Washington K9581(1)
Department of Corrections
Page 19 of 25
158362
Attachment B
Pre -authorization and Medical Billing Instructions
The County, City, or Tribal entity (hereinafter Contractor) must obtain pre -authorization
through the Department's Utilization Management Office for all health care beyond what is
normally provided to Contractor's inmates. This includes, but is not limited to, notification of
Department offenders who are on specialty/high cost medications for long-term or chronic
conditions such as Hepatitis C, HIV, Multiple Sclerosis or any other condition that requires the
consistent administration of medications during the Department offender's confinement.
In the case of an emergency, when pre -authorization is not feasible, the Contractor must notify
the Department's Utilization Management Office as soon as possible, but no later than 4 hours
after transporting the Depattinent Offender to an emergency room or other medical facility and
before any hospital admission.
The following information must be included with notifications:
• 1he date and time the Department offender left Contractor's facility because of the
medical event;
• The name of the hospital or medical facility;
• 1'he medical issue/reason for trip; and,
• The date and time the offender returned to Contractor's facility, if applicable.
Please notes If ANY hospitalization of a Deparlinent offender results in an inpatient event then
the Department, if properly notified, will apply for Medicaid coverage under the Affordable
Care Act and the Contractor will not be billed for qualifying services. However, the Contractor
must notify the Department of the hospitalization and follow the emergency notification and
pre -authorization process so that a Medicaid application can be initiated for the event. The
Department must open a claim within 90 days of the date of service.
the Department is not obligated to reimburse the Contractor for medical care or treatment
provided to a Department offender without the Department's pre -authorization or notification
within the 4 hour timeframe specified m the contract.
Pre -authorization requests for extraordinary medical care, including pertinent medical records,
and other supporting documentation, must be faxed to the Department's Utilization
Management Office at (360) 586-9060.
'the Department's Utilization Management Office is available via telephone to assist Contractor
24 hours a day and 7 days per week.
State of Washington K9581 (1)
Department of Corrections
Page 20 of 25
158362
• From 8 a.m. - 4:30 p.m. Monday — Friday (except holidays), the Nurse Desk is available
at NurseDesk@docl.wa.gov or (360) 725-8733.
• After normal business hours and during holidays, please call (360) 725-8733. The call is
forwarded to the on -call UM Nurse Emails may not be returned until the next business
day.
Denials - If the Department denies the authorization for extraordinary medical care,
Contractor(s) may appeal the Department's decision by submitting a written request with the
supporting documentation to the Department's Utilization Management Office at
NurseDesk@doctwa.gov.
Pharmaceuticals and Non -Formulary Requests
The Department may reimburse for prescription medications that are consistent with the
Offender Health Plan and Formulary. Restricted formulary and non -Formulary medication
must be pre -authorized by submitting a request to the Department's Utilization Management
Office either via email at NurseDesk@docl.wa.gov or fax at 360-586-9060. The non -formulary
request (NFR) forum is available online at:
http://www doc.wa.gov/family/offenderlife/docs/DOC13-091.pdf
Formulary medications are medically necessary medications that require no further Department
approval for use, provided the criteria listed in the Department's Formulary are met.
Preauthorization —Restricted Formulary and non -Formulary medications may be prescribed
however, the Department will only authorize these medications if the specific criteria necessary
for approval are met. Medications in this category require preauthorization by the
Department's Utilization Management Office to be considered for reimbursement.
When a Contractor determines that the administration of a restricted Formulary or a non-
Founulary medication is medically necessary for the continuous management of a significant
medical or mental health condition, the Contractor should proceed based on his/her
professional clinical judgment. However, to be considered for reimbursement, a restricted
Formulary/non-Formulary medication request must be approved by the Department's
Utilization Management Office as soon as feasible, but not later than 3 days after beginning the
medication.
Denials - If the Department denies the request to use restricted Formulary medication and/or
non -Formulary medication, the Contractor may still be reimbursed for medications
administered to a Department offender while awaiting the Department's decision on the
State of Washington K9581 (1)
Department of Corrections
Page 21 of 25
158362
Contractor's appeal of a Department denial for reimbursement by submitting a written request
and any supporting documentation to the Department's Utilization Management Office.
Medical Billing
It is the responsibility of the Contractor to process payment for all bills prior to sending them to
the Department for reimbursement. However, if the Contractor is unable to make payment for
direct billings, the Contractor may send a written request to the Department to process payment
on the behalf of the Contractor. Requests may be submitted via fax (360) 586-1320 or via email to
DOCHQMedica1RAB@DOCI.WA.GOV. Contractors must mclude a copy of the original
medical bill with the request.
The Department will respond to the Contractor's written request for assistance with payment
of a direct billing(s) not later than 7 business days of receipt. Contractors shall instruct the
billing entity to NOT send a medical bill directly to the Department.
Contractors shall submit monthly medical billings electronically to the Department's Medical
Disbursement Unit at DOCHQMedicalRAB@DOCI.WA.GOV. Monthly itemized invoices for
services provided onsite by the Contractor should mclude the previous month's services.
Contractors must submit billings for offsite services within 30 days of the date of service.
The Deparinient understands that occasionally a monthly invoice may include medical bills
from the previous month(s) However, in an effort to ensure an efficient and accurate billing
process, Contractors will submit bills one month at a time, whenever possible.
Itemized billing statements must be submitted following the fonmat of the DOC's Medical
Billing Reimbursement Form, Attachment C, with the supporting documentation attached,
when applicable Incomplete or missing data or supporting documentation may result in delays
or denial of payment.
Contractors unable to submit billing via email, must fax bills to:
Department of Corrections
Medical Disbursement Unit
Fax: (360) 586-1320
Monthly billings must include:
• A coversheet with all pertinent details including:
(1) The medical facility name, the medical facility's Federal Tax ID number, including
the name of the contact at the medical facility, the medical facility's contact's phone
number, and either an email or fax number
(2) The total amount being billed;
(3) The month, date and year of service;
State of Washington K9581 (1)
Department of Corrections
Page 22 of 25
158362
(4) The contact information for the Contractor's billing staff (including a phone number
and an email address or fax number), and,
(5) 1'he address for where to submit the payment, an invoice number (this is the
Contractor s internal mvoice tracking number).
• Any itemized charges must include:
(1) I'he name of the Department offender;
(2) The Department offender's DOC# and DOB;
(3) the reason for the charges; and,
(4) The total amount of the charges.
Note: If the Contractor is requesting reimbursement for services paid to an onsite or offsite
medical provider(s), a copy of the original healthcare claim form paid by the Contractor must
also be included.
• Supporting documentation including verification of the Department's detainer/hold; any
authorizations from the Utilization Management Office; all Health Insurance Claim
Forms, including those that are needed for medical insurance claims, i.e. the CMS 1500
or the LB 04; and, invoices from community providers showing what was billed
including the documentation of what the Contractor paid.
o When Contractor is requesting reimbursement for medications Contractor must
also provide a copy of the original pharmacy bill to include the Department
offender's name the medication name, the dosage and quantity provided and
the amount Contractor previously paid for the medication(s).
• Credits for returned prescriptions — Contractors wanting credits for returned
medications, must document those "credits following the supporting documentation
guidelines with clear demarcation as a CREDIT.
Once the Department has completed its' medical bill verification process and is ready to process
payment, the Contractor will be notified by email or fax of any denials or credits.
For billing questions or concerns, please email DOCHOMedlcalRAB@DOCI.WA.GOV.
HIPAA
HIPAA —'l'he Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects the
privacy of individually identifiable, protected health information
this law allows for the exchange of this information between the Department and the
Contractor for the purpose of billing and payment which allows the Contractor to provide the
required back-up documentation regarding the Department offender's health information and
State of Washington K9581 (1)
Department of Corrections
Page 23 of 25
158362
treatment activities for support of payment purposes (See CFR 45 § 164.506). HIPPA also
clarifies the standard for use and disclosure for correctional institutions and other law
enforcement custodial situations in CFR 45 §1.64.51.2.
State of Washington K9581 (1)
Department of Corrections
Page 24 of 25
158362
Offender Housing Invoice
(Month) 2015
Total Amount ($00.00)
(County/City/Tribal) Jail
(Street Address)
(Address) (Phone number)
Jail Bed Reimbursement Form
BILL TO: WA State Department of Corrections
Attn: Violator Desk
PO Box 41149
Olympia, WA 98504
Attachment C
Daily Bed Day Rate: $65.00
(360) 725-8620
DOCViotatorhedbilIings<=DOC1.WA.GOV
Name
DOC #
DOC
Confinement
Start
Sanction/
date
DOC
End/Transfer
Sanction
out
Date
Days
Billed
DOC
Total
Amount
DOC
Billed
to
Total # °f
DOB
Doe,
Jane
123456
01/15/89
7/19/2015
7/21/2015
2
$130.00
Smith,
Johnny
121212
02/26/62
7/8/2015
7/20/2015
12
$780.00
County
Boarder
Days:
Exchange
Jahnsen, Doe
555555
10/31/92
08/01/15
08/01/15
-1
-565.00
13
$845.00
TOTAL
Medical Reimbursement Form
.
Name -
- -
DOCg
Dale
Butt
of
-
Date of Service.
Medical
Ninny&Strength
Facility
or
EX
..
EX Quantity
Days
or ft of
Reason forTreatmentor
- - Rio
Named
Cootrador.
-Staff
Contacting
Doc
Medial
:.
DaitkTimenf
Cooled with
DOCAfedid
staff
Name of
DOC
Aledital
Staff
Contacted
Copy
Na
ReyutsiAnadfed,$
-
avnibble1Y,Nor
of Approved
Fnmmlarp
NIA
Copy of
Offvte
medical
pro id
Claimfcrm
` and.'or
Amount
Cepa),Paid
by0tk.arr,
ifanp
of
Contractor
Amonnl
Paid by
Amount
Billed
;DOC
to
Doe,
Jane
123156
I915/1959
7202015
Gabapatin30\1GTab
Spills
1211561
Elmer
Phud
7/20/2015;
1234pm
Tammy
Milian1
1
$ 1.00
$ 12.50
$ 11.50
Smilh,Johnny
121112
2/26/1962
-. 7/102015
-
5
meph'sHelane!
- 7days
Chest Pain
Erin
-
Rogers
7/10%2015;
IQ am
.Lisa
Russell,
Tutty
NIA -
-
Y
$ -
$?,SW,
$ 7400,00
Jahnsen, Doe
555555
10/31/1992
81/2015
R'allaWallaGeneral
Hmpitzl
5weeks
Foreign Object
Removal
Billie
Cohn
8p12013,4:10
pm
Sarah
Nichols
NIA
Pending
$ 100
$ 5,000.00
$ 9,996.00
State of Washington K9581 (1)
Department of Corrections
Page 25 of 25
158362