41NHA-S4038 - Attachment A- PACE Technical Proposal Questions.docx

Ann Jensen, Administrator Division of Nevada Medicaid

Stacie Weeks, JD, MPH, Director Nevada Health Authority

Attachment A – Technical Proposal Questions This Request for Proposal (RFP) attachment outlines the Technical Proposal Questions that Contractors must answer in their Technical Proposal responding to this Solicitation. Contractors will be evaluated on the quality and completeness of their responses to the questions, and responses should demonstrate the Contractor’s full understanding of all contractual requirements contained in Scope of Work.

The Contractor must provide a response to each question in this attachment. As prompted by the question, Contractors are expected to discuss their:

1. Approach to addressing the issue in the narrative question, highlighting how their approach will (a) allow the Contractor to fulfill the contractual requirements, (b) align with outlined program goals, and (c) represent innovation and/or best practices;

1. Capabilities to implement their proposed approach, which could include organizational structure, staffing resources, operational infrastructure, intended approach to engaging subcontractors, established operational protocols, and technology infrastructure and resources (e.g., IT systems and system capabilities); and

1. Experience related to the issue in the narrative question that illustrates how the Contractor has successfully addressed this issue in contexts comparable to those required of PACE in Nevada.

Contractors should not assume that the individuals involved in the evaluation process are familiar with any current or past work activities with the State or in other states.

Responses to each question should be complete and may not reference responses provided to other questions in the Technical Proposal.

When citing relevant experience, the Contractor must clearly state what program(s), state(s), and year(s) the experience comes from and how it will translate to PACE in Nevada and to the issues discussed in the question. In responding to a question, if the Contractor will use a subcontractor to fulfill any part of the response, the Contractor must specify this arrangement, which will also be listed in Attachment B - PACE Service Delivery Arrangements. Contractors with experience delivering Medicaid PACE are strongly encouraged to use examples from this experience whenever possible. Contractors without relevant PACE experience may provide examples from a comparable health services programs.

For each designated Service Area included in the RFP, bidders must demonstrate through their proposal:

· Capacity and organizational readiness to operate PACE services within the Service Area(s) identified.

· Ability to meet the minimum requirements outlined in the RFP and Scope of Work.

NVHA may request clarifications or additional documentation during the evaluation but will not consider proposals for areas outside the predefined Service Areas announced in this solicitation.

When providing data in a response, Contractors must include a brief description of each data measure, why it is a relevant measure of impact for the example provided, and a brief explanation of the data methodology (including sample size, where appropriate).

Contractors must adhere to the requirements outlined in Section 9.2 of the RFP. Each question has a maximum number of points available and are outlined in the table below.

Technical Proposal Question Scoring:

Total (not including bonus) 100 70

Technical Proposal Questions Overall Experience

Required elements:

· Number of years in business and summary of organizational growth;

· Organizational mission and governance structure;

· Corporate headquarters and Nevada-based operations locations, as applicable;

· Detailed prior experience delivering primary care, acute care, long term services and supports (LTSS), home and community-based services (HCBS) care, managed care, or PACE services;

· Populations served, including seniors, individuals with disabilities, or medically complex adults, supported by demographic and outcomes data;

· Clear description of how prior experience will translate to Nevada’s regulatory, demographic, and geographic conditions;

· Description of internal systems used to monitor quality, compliance, participant safety, and regulatory adherence across programs;

· Disclosure of suspensions, termination, penalties, or corrective action plans, including dates, reasons, and documented resolutions.

Operational Plan

Responses must address:

· Proposed PACE center location zip code, rationale for location selection, and facility readiness;

· Analysis of population needs in Service Area, including anticipated demand for PACE services;

· Summary of direct and subcontracted service arrangements, including oversight mechanisms, monitoring processes, and contractual accountability requirements;

· Transportation service model, including fleet design, routing strategy, participant safety protocols, capacity for long-distance transport, and staffing strategies;

· Strategies to ensure timely access to specialty providers in limited-access regions;

· Operational readiness plan and start-up timeline with milestones for facility preparation, staffing, enrollment process, and regulatory certification;

· Staffing structure, including the complete interdisciplinary team, recruitment strategies for hard-to-fill roles, staff retention plans, and contingency staffing strategies for rural areas (if applicable);

· Description of technology used to reduce barriers to care, such as telehealth, remote monitoring, scheduling tools, etc.;

· Identification of risks across operations plan and detailed mitigation strategies specific to Service Area(s) selected.

Responses must include:

· Capacity to fully fund start‑up costs, including PACE center renovation or build‑out or renovation, transportation fleet acquisition, technology infrastructure, and initial workforce recruitment;

· Ability to sustain projected operating losses prior to reaching break‑even enrollment;

· Strategies for managing high-cost drivers, such as transportation, clinical staffing shortages, and limited provider workforce;

· Documentation of available liquidity, reserves, financial guarantees, credit lines, or investor support, including the source and terms of each funding option;

· Prior experience operating high‑risk or fully capitated programs, including program type, state, years of operation, and financial performance outcomes;

· Financial systems readiness, including accounting processes, encounter tracking, payment systems, reporting capability, audit preparation, and fraud, waste, or abuse controls;

· Disclosure of any previous financial sanctions, solvency actions, penalties, or corrective action plans, including cause, correction steps taken, and long-term structural improvements;

· Description of internal financial oversight processes and enterprise risk management structures.

Responses must address:

· Approach to implementing a data‑driven Quality Improvement Program, including performance indicators, benchmarking strategies, and reporting cycles;

· Key policies governing care coordination, interdisciplinary team operations, participant safety, and service delivery;

· Processes for identifying quality deficiencies, analyzing root causes, developing corrective actions, and verifying effectiveness;

· Methods for incorporating participant feedback, grievances, Serious Occurrence trends, and equity considerations into the quality improvement cycle;

· Strategies to monitor and improve care delivery in rural and frontier regions of Nevada, as applicable

· Description of technology and analytics tools used to support QIP activities;

· Specific quality goals for the first three years of Nevada PACE operations.

Responses must address:

· Established with community‑based providers, hospitals, clinics, tribal entities, or senior service organizations and three letters of support from those entities.

· Clear demonstration of service delivery feasibility, including transportation logistics, rural staffing models, continuity of care strategies, and technology‑enabled services;

· Capacity to meet all PACE regulatory requirements in rural settings, including emergency preparedness, specialty access, and interdisciplinary team coverage;

· A phased implementation timeline specifically tailored to rural population needs, including enrollment targets, outreach plans, PACE center preparation, and service deployment strategies;

· Identification of rural-specific operational risks and comprehensive mitigation strategies;

· Clear description of how the Bidder’s investment in rural or frontier communities aligns with Nevada’s stated rural health priorities and long-term sustainability goals.

1. Complex Case Scenarios

For each scenario below, the Bidder must provide a structured, comprehensive response detailing how its PACE program will manage the participant’s complex needs.

Each scenario response must include:

· Immediate actions taken in the first 72 hours

· Full interdisciplinary team action plan, including detailed care plan with authorized services, frequency and expected outcomes

· Housing stability and safety plan, if relevant

· Transportation strategy and barriers mitigation

· Risk mitigation strategies

· Proposed measurable outcomes within 90 days

· Rationale for all major care decisions, referencing best practices, PACE regulations, and/or evidence-based guidelines

· Name: Laura

· Age: 83

· Health Conditions: Congestive heart failure, COPD, insulin‑dependent diabetes, moderate dementia, osteoarthritis, severe vision impairment, and depression.

· Social Factors:

· Lives alone in subsidized senior housing.

· Recently received an eviction notice due to safety concerns (leaving the stove on, hoarding behavior).

· Limited family support; adult daughter lives out of state.

· Miss medical appointments due to transportation challenges.

Presenting Issue The participant arrives at the PACE center after multiple recent ED visits for shortness of breath and uncontrolled blood sugar. Home health aides report unsafe living conditions, medication mismanagement, and increasing confusion.

· Name: Jose

· Age: 74

· Health conditions: Hypertension, chronic pain, Type 2 diabetes, generalized anxiety disorder, panic episodes, mild cognitive impairment, chronic insomnia.

· Social factors:

· Lives alone in an upstairs apartment

· Recently lost a close friend, leading to worsening isolation

· Declining hygiene and nutrition due to fear of leaving home.

· Misses medical appointments because panic symptoms occur when he attempts to go outside.

Presenting Problem The participant has experienced four panic attacks in one week, leading to EMS calls. Home care aides report that he has stopped taking medications regularly, rarely eats meals, and cries frequently. The participant refuses to attend the adult day center due to fear of “something bad happening.”

4070 Silver Sage Drive, Carson City NV 89701 | nevadamedicaid.nv.gov 4070 Silver Sage Dr., Carson City, NV 89701 | nvha.nv.gov Page 2 image1.jpg image2.jpg