9-RFP Instructions and Checklist 25CR162.docx

Utah Department of Health and Human Services

DHHS91286

Outreach and Healthcare Access for Substance Use Disorders Application Instructions

Responses should contain only documentation requested in this solicitation. DHHS will not review information submitted by a vendor that is not requested in this solicitation.

Document Submission Instructions

1. Complete and submit Form #1, IRS Form W-9 unless the Offeror has a current DHHS contract, or has had a DHHS contract within the past year, in which case one is not required.

2. Complete and submit Form #2a: Conflict of Interest Disclosure Statement

OR

Complete and submit Form #2b: Governmental Entity Conflict of Interest Certification (for government agencies, political subdivisions, municipalities, public schools, etc.).

3. Submit Form #3 Budget Utilization Form.

4. Submit documentation that your company meets the minimum mandatory requirement of having current registration with the State of Utah, Department of Commerce, Division of Corporations and Commercial Code. This registration is required to be maintained for the duration of any contract awarded.

5. Submit documentation that your company meets the minimum mandatory requirement of having at least 3 years of experience assisting consumers with Medicaid enrollment (SOW 3.1(2)).

6. Submit documentation that your company meets the minimum mandatory requirement of having at least 2 years of experience working with substance use treatment agencies, substance use community organizations, and carceral facilities to provide outreach and enrollment assistance to individuals with or who are at risk of developing opioid and/or stimulant use disorders (SOW 3.1(3)).

7. Submit a proposal narrative according to the following instructions.

Proposal Narrative Instructions

Section 1: Cover Page

1. Name of the applicant and its mailing address, telephone, and email address.

2. Name and title of the Offeror’s primary contact person responsible for management and implementation of this contract, if awarded.

3. Proposal abstract: An abstract of your proposal, not to exceed 250 words.

Section 2: Scorable Technical Criteria (TC). In this section, applications shall provide a narrative describing how they will meet the scope of work. To do so, provide the following:

1. TC 1: Describe how you will perform public education and outreach activities designed to engage individuals with opioid and stimulant use disorders and their families. (SOW 4.1(1)).

2. TC 2: Describe how you will work closely with DHHS, local authority treatment providers, the Utah Support Advocates for Recovery Awareness, and other community treatment programs, including criminal justice agencies, and to develop educational materials and to schedule outreach events (SOW 4.1(2)).

3. TC 3: Describe how you will ensure that information is appropriate for, and that outreach is provided to, homeless individuals and those involved in the criminal justice system. Describe how you will engage with criminal justice systems. (SOW 4.1(3)).

4. TC 4: Please briefly describe the company infrastructure and services used to deliver healthcare enrollment assistance to consumers. How would a consumer initiate getting enrollment assistance with your agency? Please provide a summary of the enrollment assistance process a consumer can expect when they seek services with your company. (SOW 4.1(4), 4.1(5)).

5. TC 5: Describe how you will conduct enrollment services in rural areas within 60-mile radius of the contractor's office and employ a health access assistant to conduct outreach activities and to assist clients in enrollment services for Box Elder, Cache, and Weber Counties. (SOW 4.1(6), 4.1(7)).

6. TC 6: Describe how you will support individuals through the entirety of the enrollment process, including follow up with individuals within three weeks of enrollment to verify payment of first premium, that the individual has set an appointment with a primary care physician, and has received their insurance card (SOW 4.1(9)).

7. TC 7: Please provide a brief overview of the curriculum/content the company uses or would plan to develop and use to facilitate train-the-trainer trainings on enrollment navigation for SUD service providers. If available, please provide a small sample of any relevant materials that would be used in these trainings. (SOW 4.1(12)).

8. TC 8: Describe how you will ensure your services reach the intended population to be served, including (1) adults aged 18 and older, at risk of developing, or who currently have, an opioid or stimulant use disorder and who do not currently have Medicaid or other insurance coverage; and (2) youth aged 12 to 17, at risk of developing, or who currently have, an opioid or stimulant use disorder and their legal guardian(s) and who do not currently have Medicaid or other insurance coverage. (SOW 2.1).

9. TC 9: Submit a budget justification narrative. This should be a one page summary describing the budget proposed in Form #3 Budget Utilization Form.