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Agreement Number 85-10-0004 <br />Assignment and Outsourcing of Jail Operations <br />Overall management and operation of the facility housing federal detainees may not be <br />contracted out without the prior express written consent of the Federal Government. <br />Medical Services <br />The Local Government shall provide federal detainees with the full range of medical careinsidethedetentionfacility.The level of care inside the facility should be the same as <br />that provided to state and local detainees.The Local Government is financially <br />responsible for all medical care provided inside the facility to federal detainees.This <br />includes the cost of all medical,dental,and mental health care as well as the cost of <br />medical supplies,over the counter prescriptions and,any prescription medications <br />routinely stocked by the facility which are provided to federal detainees.The cost of all <br />of the above-referenced medical care is covered by the federal per diem rate.However, <br />if dialysis is provided within the facility,the Federal Government wi!I pay for the cost of <br />that service. <br />The Federal Government is financially responsible for all medical care provided outside <br />the facility to federal detainees.The Federal Government must be billed directly by the <br />medical care provider not the Local Government.In order to ensure that Medicare rates <br />are properly applied,medical claims for federal detainees must be on Centers for <br />Medicare and Medicaid (CMS)Forms in order to be re-priced at Medicare rates in <br />accordance with Title 18,USC Section 4006.The Local Government is required to <br />immediately forward all medical claims for federal detainees to the Federal Government <br />for processing. <br />All outside medical care provided to federal detainees must be pre-approved by the <br />Federal Government.In the event of an emergency,the Local Government shall <br />proceed immediately with necessary medical treatment.In such an event,the Local <br />Government shall notify the Federal Government immediately regarding the nature of <br />the federal detainees illness or injury as well as the types of treatment provided. <br />Medical care for federal detainees shall be provided by the Local Government in <br />accordance with the provisions of USMS,Publication 100-Prisoner Health Care Standards <br />(www.usmarshals.qov/prisoner/standards.htm)and in compliance with USMS Inspection <br />Guidelines,Form USM-218 Detention Facility Investigative Report.The Local <br />Government is responsible for all associated medical recordkeeping. <br />The facility shall have in place an adequate infectious disease control program which <br />includes testing of all federal detainees for Tuberculosis (TB)as soon as possible after <br />intake (not to e×ceed 14 days).When Purified Protein Derivative (PPD)skin tests are <br />used,they shall be read between 48 and 72 hours after placement. <br />TB testing shall be accomplished in accordance with the latest Centers for Disease <br />Control (CDC)Guidelines and the result promptly documented in the federal detainee=s <br />Page 4 of 11