Exhibit F - DEFINITIONS

1. Agreement means contract:  A binding agreement to provide services.
   
   
2. California Code of Regulations (CCR), Title 15 means the regulations that authorize the Director of the California Department of Corrections and Rehabilitation to contract for the provision of inmate health care.
   
   
3. California Department of Corrections and Rehabilitation (CDCR) means the State of California Department of Corrections and Rehabilitation, authorized by Penal Code, Section 5000 et seq., and the CCR, Title 15, to maintain the custody and care of California’s institutionalized public offenders.
   
   
4. California Victim Compensation and Government Claims Board means the State Board whose function is to resolve all claims for money or damages filed against State agencies under Government Code Section 900 et seq., before a lawsuit against a State agency can be pursued.
   
   
5. CDCR Medical Standards of Care means the official CDCR health care policy document used by the CDCR Health Care Managers and Chief Medical Officers (HCM/CMO) to distinguish the parameters of the delivery of health care services and treatment to the State of California inmates.
   
   
6. Community Health Facility means any facility, place or building which is organized, maintained and operated for the diagnosis, care, prevention and treatment of human illness, physical or mental, including convalescence and rehabilitation and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons, and to which the persons are admitted for a 24-hour stay or longer per Health and Safety Code, Division 2, Chapter 2, Article 1, Section 1250.
   
   
7. Contract means Agreement:  a binding agreement to provide services.
   
   
8. Contractor means Provider:  the physician and/or attending physician under locum tenens providing the medical specialty services under this Agreement, or the hospital, hospital’s allied professional health care staff or hospital’s physician and ancillary service contractors.
   
   
9. Correctional Treatment Center means a health facility with a specified number of beds within a State prison, county jail or California Youth Authority facility designated to provide health care to that portion of the inmate population not requiring general acute care level of services, but who are in need of professionally supervised health care beyond that normally provided in the community on an outpatient basis (CCR, Title 22, Division 5, Chapter 12, Article 1, Section 79516).
   
   
10. Day means calendar day, unless otherwise specified.
    
    
11. Director means the Director of the CDCR.
    
    
12. Discharge Summary means a brief recapitulation of significant findings and events of the patient’s hospitalization, patient’s condition on discharge and the recommendations and arrangements for future care (CCR, Title 22, Division 5, Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies, Chapter 1, Article 7, Section 70749).
    
    
13. Emergency Care Services means the immediate care or treatment necessary to prevent death, severe or permanent disability or to alleviate severe pain, including medically necessary crisis intervention for inmates suffering from situational crisis or acute episodes of mental illness, in accordance with CCR, Title 15.
    
    
14. Experimental or Investigational Treatment means any treatment, therapy, procedure, drug or drug usage, facility or facility usage, equipment or equipment usage, device or device usage, or supplies which are not recognized as being in accord with generally accepted professional medical standards, or as being safe and effective for use in the treatment of an illness, injury, or condition at issue.  Services which require approval by the federal government or any agency thereof, or by any state governmental agency prior to use, and where such approval has not been granted at the time the services were rendered, shall be considered experimental or investigational.  Services which themselves are not approved or recognized as being in accord with accepted professional medical standards, but nevertheless are authorized by law or a governmental agency for use in testing, trials, or other studies on human patients, shall be considered experimental or investigational.
    
    
15. Fiscal Year means the accounting period from July 1 through June 30 of the following year.
16. Health Care Manager (HCM)/Chief Medical Officer (CMO) means the CDCR Division of Correctional Health Care Services’ Deputy Director’s designee responsible for the day-to-day supervision of field health care operations, reporting directly to the Division of Correctional Health Care Services’ Health Care Regional Administrator for their respective institutions.  Health Care Managers are part of the institution’s executive management team and participate in institution executive staff meetings.  Health Care Managers may also be CMOs.  Health Care Managers are given full authority to grant prior authorization for the delivery of health care services rendered to prison inmates.
    
    
17. Health Care Review Subcommittee means the appointed CDCR officials authorized to review and approve health care services which are excluded from the CDCR Medical Standards of Care Policy.
    
    
18. Hospital means an institution which is licensed under all applicable State and local laws and regulations to provide diagnostic and therapeutic services for the medical diagnosis, treatment and care of injured, disabled or sick persons in need of acute inpatient medical and psychiatric or psychological care.
    
    
19. Inmate/Patient means the CDCR incarcerated public offender receiving health care services.
    
    
20. Inmate/Patient Data means any piece of information, administrative or medical, specific to an incarcerated public offender receiving medical or surgical treatment in a hospital or hospital outpatient surgery center.
    
    
21. In Personam Jurisdiction means a court has power over a particular defendant.
    
    
22. Locum Tenens means a free benefit to professional liability insurance policies which provides policyholders forty-five (45) free days, (more or less, depending on carrier) for substitute physicians to perform the duties of the policyholder while he/she is on vacation or temporarily away from the office.  A locum tenens shares the limits of liability with the named insured (Provider) and is identified on the evidence of valid coverage.
    
    
23. May means permissive.
    
    
24. Medically Necessary means health care services that are determined by the attending physician to be reasonable and necessary to protect life, prevent significant illness or disability, or alleviate severe pain, and are supported by health outcome data as being effective medical care (CCR, Title 15, Division 3, Chapter 1, Subchapter 4, Article 8, Section 3350(b), Provision of Medical Care and Definitions).
    
    
25. Non-Essential Services means a nonemergency/scheduled admission for medical services when the inmate’s condition permits adequate time to schedule the necessary diagnostic workup and/or initiation of treatment, in accordance with CCR, Title 15.
    
    
26. Patient Day means a day in which an inmate/patient occupies an inpatient bed as of the midnight census.  If both admission and discharge occur on the same day, the day is counted as one patient day.
    
    
27. Penal Code Section 5054 means the section of law which grants the Director of the CDCR the authority and responsibility for the custody and care of California’s institutionalized public offenders.
    
    
28. Physician means a person licensed to practice medicine or osteopathy in the State of California.
    
    
29. Prescription Drugs means all drugs which, under State or federal law, require the written prescription of a doctor, dentist, podiatrist or osteopath or any medicinal substance which is required to bear the legend “Caution:  Federal Laws prohibit dispensing without a prescription” under the federal Food, Drug and Cosmetic Act.
    
    
30. Prescription Order means the request by a physician for each separate drug or medication and each authorized refill of such request.
    
    
31. Prior Authorization means the required advance authorization granted by the CMO/HCM or his/her designated representative.
    
    
32. Provider means Contractor:  the physician and/or attending physician under locum tenens providing the medical specialty services under this Agreement, or the hospital, hospital’s allied professional health care staff or hospital’s physician and ancillary service contractors.
    
    
33. Shall means mandatory.
    
    
34. Should means suggested or recommended.
    
    
35. Skilled Nursing Care means skilled supervision and management of a complicated or extensive plan of care for an inmate/patient initiated and monitored by a physician in which there is a significantly high probability that complications would arise without the skilled supervision or implementation of the treatment program by a licensed nurse or therapist.
36. State means the State of California.
    
    
37. State Administrative Manual (SAM) means the manual which provides the policies and procedures and the uniform guidance for governing the fiscal and business management affairs of the State of California.
    
    
38. Subcontractor means any person or entity that has entered into an agreement with said Provider, either expressed or implied, for the specific purpose of performing any service under this Agreement.
    
    
39. Total Patient Days means the total inpatient days from the day of admission to, but not including, the day of discharge.
    
    
40. Transfer Order means the written document, issued and signed by the inmate/patient’s attending physician, which notes the medications, treatment, and diet orders for the CDCR institution and provides instructions to the inmate/patient in order to maintain continuity of care.  A transfer order is prepared when an inmate/patient is discharged from the hospital and is returning to a CDCR institution.
    
    
41. Transfer Summary means the written document which precedes or accompanies an inmate/patient upon an inmate/patient’s discharge from the hospital to a skilled nursing or intermediate care facility, Correctional Treatment Center, or to the distinct skilled nursing or intermediate care service unit of the hospital where continuing care will be provided.  The transfer summary, signed by the attending physician, includes the following information relative to the inmate/patient’s
    1) diagnosis; 2) hospital course; 3) medications; 4) treatments; 5) dietary requirements; 6) rehabilitation potential; 7) known allergies; and 8) treatment plan.
    
    
42. Urgent Care means a non-emergency admission or occurrence where timely evaluation and treatment is required for medical/psychiatric attention and/or hospitalization, but there is no immediate threat to loss of life or limb.
    
    
43. Utilization Management (UM) means a strategy designed to ensure that health care expenditures are restricted to those that are needed and appropriate by reviewing inmate/patient’s medical records through the application of defined criteria and/or expert opinion.  It assesses the efficiency of the health care process and the appropriateness of decision making related to the site of care, its frequency and its duration, through prospective, concurrent, and retrospective utilization reviews.

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