AA - PASRR II RFB Main Document.docx

State of Wisconsin Wis. Statutes s.16.75

DOA-3070 (R05/2014)

BIDS MUST BE SEALED & ADDRESSED TO: |_| Remove from Vendor list for this commodity/service. (Return this page only.)

Bid envelope must be sealed and plainly marked in lower corner with due date and Request for Bid # S-0627 DCTS-17

REQUEST FOR BID

THIS IS NOT AN ORDER

VENDOR (Enter Name and Address below) Bids MUST be in this office no later than

Name (Contact for further information)

Greg Smith, DHSprocurement@wi.gov

Quote Price and Delivery FOB

Destination

Description

DEPARTMENT OF HEALTH SERVICES

REQUEST FOR BID No. S-0627 DCTS-17

Preadmission Screening and Resident Review (PASRR) Level II Screens

(Faxed or emailed bids not accepted.)

|_| We claim minority bidder preference [Wis. Stats. s. 16.75(3m)(b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact the Wisconsin Supplier Diversity Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.

|_| We claim disabled veteran owned business bidder preference [Wis. Stats. s. 16.75(3m)(b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Disabled Veteran Owned Businesses. Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact the Wisconsin Supplier Diversity Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.

|_| We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work Center Program, State Bureau of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-5462.

Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered in our bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States. |_| Yes |_| No |_| Unknown

In signing this bid we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit a bid; that this bid has been independently arrived at without collusion with any other bidder, competitor or potential competitor; that this bid has not been knowingly disclosed prior to the opening of bids to any other bidder or competitor; that the above statement is accurate under penalty of perjury.

We will comply with all terms, conditions and specifications required by the state in this Request for Bid and all terms of our bid.

Preadmission Screening and Resident Review (PASRR) Level II Screens This form can be made available in alternate formats to individuals with disabilities upon request.

This Request for Bid (RFB) is organized to help you determine if this is a business opportunity for your company. The following document and schedules contain information regarding what the State intends to purchase, how pricing should appear, and the process you must follow in order to submit a response to the RFB.

1. Review Section 1 – Introduction and Purpose to gain an understanding of what the State intends to purchase.

2. Review Section 2 – Mandatory Vendor Qualifications to learn what a company needs in order to be qualified to bid. This may include a specific license, certification or years of experience.

3. Review Section 3 – Mandatory Specifications, and Section 4 – Supplier Responsibilities to learn more about the details of the commodity or service needed. Read this section carefully and determine if you are able to meet ALL of the requirements. RFB requirements are mandatory and therefore if a bid will not meet a requirement, it is likely that the bid will be disqualified unless no Vendor can meet an individual RFB requirement.

4. The RFB provides instructions that describe the process you must follow to organize and submit your bid response. It also describes the process the State will use to determine the winning Vendor(s). If you decide to bid, be sure to review the Bid Procedure and Instructions section and the Selection and Award Process section.

5. If you are still interested in competing for the State’s business, provide your best cost per screen, complete all the Required Forms and Documentation as listed on Schedule 1-Vendor Checklist, and review the Mandatory Contract Terms and Conditions (Section 4).

6. Remember that your bid response is expected to be complete and accurate. DO NOT substitute your own materials in lieu of what is asked for in the RFB and DO NOT alter any of the required forms or Schedules Use the Vendor Checklist in Schedule 1 to make sure you have included all of the required forms and documentation.

7. Please note that your RFB response must arrive at the proper location on or before the due date and time. Late bids will be rejected.

8. If you have any questions, contact the Procurement Manager identified in this RFB.

Thank you for your interest in providing commodities and/or services to the State.

TABLE OF CONTENTS

BID COVER PAGE (FORM DOA-3070)

INSTRUCTIONS FOR VENDORS

SCHEDULE 1 - Vendor Checklist SCHEDULE 2 - Budget Form SCHEDULE 3 - Qualifications and Requirements Matrix SCHEDULE 4 - Work Plan, Organization, and Staffing SCHEDULE 5 - Key Personnel SCHEDULE 6 - Evaluation and Notice of Appeal Rights - John Doe SCHEDULE 7 - Evaluation and Notice of Appeal Rights - Jane Doe

APPENDIX A - PASRR-Related Definitions APPENDIX B - PASRR Decision Tree APPENDIX C - PASRR Level II Screens Completed In CY 2016 by County APPENDIX D - Time Estimates for Completion of a Full and Abbreviated Level II Screen APPENDIX E – (not used) APPENDIX F - Preadmission Screen and Resident Review (PASRR) Level I Screen APPENDIX G - Clinical Example/Test Case - John Doe APPENDIX H - Clinical Example/Test Case - Jane Doe

Definitions and Acronyms For the purposes of this Request for Bid and resulting Contract(s), the following definitions of terms shall apply, unless otherwise indicated. Additional PASRR-related definitions are included in Appendix A – PASRR-Related Definitions.

Introduction and Purpose Purpose and Scope of the Request for Bid The purpose of this Request for Bid (RFB) is to solicit Vendors to perform Federally required Preadmission Screening and Resident Reviews (PASRR) to evaluate current and prospective nursing home residents in Wisconsin on behalf of the Wisconsin Department of Health Services. Using this bidding process, the Department plans to contract with a Supplier for a team of professionals to conduct PASRR Level II screens for prospective and current nursing home residents who have a serious mental illness or an intellectual/developmental disability.

Nursing facilities or hospitals will alert the Supplier of the need to perform a PASRR Level II Screen. The screening process will include a physical exam, medical history, a functional status evaluation, and other required elements. Existing data that appears to be valid, reliable, and reflects current functioning may be utilized for completion of some or all of the required data elements. Using information from the screens and reviews, the teams will make a determination of each person’s need for nursing facility placement and the person’s need for specialized services. Also, the team will identify treatment needs for each person screened or reviewed. After completing the Level II Screen, the Supplier will notify the person who was evaluated, the referring nursing home or hospital, and the county of responsibility of the evaluation results and the person’s identified treatment needs.

The Supplier will receive the cost per screen fee for completing PASRR Level II screens for persons suspected of having or who have an intellectual/developmental disability or a serious mental illness and who are located in any county in Wisconsin.

Past contract volumes are included in Appendix C – PASRR Level II Screens Completed In CY 2016 by County. Compensation is based on completed screens. DHS does not guarantee it will purchase any specific quantity or dollar amount. Bids that require a minimum number of commodities or services be ordered will be disqualified. There will be no guarantee to purchase any specific quantity, or pay any minimum Contract price during the term of the Contract.

Background/History On November 30, 1992, the Federal Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS), published final rules to implement Pre-Admission Screening and Annual Resident Review (PASRR) requirements for all current and prospective nursing facility residents. The regulations, published at 42 CFR Parts 405, 431, 433, and 483, require an evaluation of all prospective nursing facility admissions who are suspected of having a serious mental illness or an intellectual/developmental disability, regardless of their source of payment. Current nursing home residents, irrespective of their payment source, who may have a mental illness or an intellectual/developmental disability are also required to be evaluated if they experience a significant change in condition/status (a change in Federal law effective October 19, 1996 replaced the annual resident review requirement with this requirement). PASRR requirements apply only to Medicaid-certified nursing facilities. PASRR requirements do not apply to state-licensed only nursing homes, Medicare only certified skilled nursing facilities (SNFs), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID, formerly ICFs/MR), or Community Based Residential Facilities (CBRFs).

The purposes of PASRR are to:

1. Evaluate persons seeking admission to nursing facilities and current nursing facility residents to determine if they have a serious mental illness or an intellectual/developmental disability;

2. Identify the person’s strengths and needs;

3. Determine if the person needs specialized psychiatric rehabilitation services to address his/her mental illness issues or specialized services to address his/her mental illness or intellectual/developmental disability issues (see Appendix A – PASRR-Related Definitions);

4. Determine if the person needs a placement in a nursing facility versus placement in an inpatient psychiatric hospital, institution for mental diseases (IMD), intermediate care facility for individuals with intellectual disabilities (ICF/IID, formerly ICF/MR) or a community setting (e.g., group home); and

5. Notify the person or the person’s legal representative and other appropriate parties of the results of the evaluations and the determinations.

Under the current process (diagram attached as Appendix B – PASRR Decision Tree), nursing facility staff or hospital discharge planners perform Level I Screens (see Appendix F – PASRR Level I Screen). The Level I Screen identifies persons who are suspected of having a serious mental illness or an intellectual/developmental disability based on criteria established by the Federal regulations and the Department’s policies (e.g., the person receives psychotropic medications to reduce symptoms of delusional thoughts and auditory hallucinations). Only the PASRR Supplier is authorized to complete Level II Screens for persons who are referred for a Level II Screen via an accurately completed Level I Screen for a preadmission screening or a “change of status” resident review.

Note: The Level I Screens are not completed accurately in all cases. The PASRR Supplier must be reasonably sure that facts and conclusions in the Level I Screen are accurate prior to completing a Level II Screen. The Supplier will not be reimbursed for Level II Screens for which they failed to verify the accuracy of the Level I Screen. Work under this Contract includes discussions with nursing facility or hospital staff and related work to determine the necessity of a Level II Screen.

Any current or prospective nursing facility resident suspected of having a mental illness or an intellectual/developmental disability based on a Level I Screen must be referred to the Supplier for a Level II Screen. The Supplier will perform the Level II Screen to determine if the person has a serious mental illness or an intellectual/developmental disability, and if so, then the Supplier will make a determination about the appropriateness/need for nursing facility placement as well as the need for specialized services. The Supplier will be expected to work closely with the prospective/current nursing facility and the county of responsibility.

The process permits an exemption from a Level II Screen for certain short-term admissions. However, the process does not permit any permanent exemptions from a Level II Screen of persons who are suspected of having a serious mental illness or an intellectual/developmental disability.

On January 2, 1997, the Department informed Wisconsin Medicaid-certified nursing facilities that they must make a referral for a Level II Screen “change in status” review under the following situations:

a) A person who is admitted under a permissible short-term exemption (e.g., for a post-hospitalization recuperative care stay for up to 30 days) and needs to stay longer beyond the timeframe for the permissible exemption must have a resident review no later than ten (10) days beyond the permitted timeframe;

b) A person whose medical/physical condition improves to a level to cause the nursing facility to suspect that the person’s needs could be met in an appropriate community setting, as described in the PASRR regulations and preamble, must have a resident review;

c) A person who previously received a PASRR review and was found to need specialized services must receive a resident review if his/her level of independent functioning improves such that he/she no longer requires continuous and aggressive treatments and services to address limitations in independent functioning caused by the person’s mental illness or intellectual/developmental disability;

d) A person whose independent functioning now is significantly limited as a result of a mental illness or an intellectual/developmental disability, but previously was not significantly limited, must receive a resident review;

e) If the responses to all questions #1 - 5 in Section A of the Level I Screen for a person at the time of his/her admission to a nursing facility are checked “no” but the response to one or more of these questions should have been “yes” that person must receive a resident review; or

f) A person who previously received a PASRR review and was found to need specialized services must receive a resident review if his/her level of independent functioning declines due to a marked and permanent deterioration in his/her cognitive functioning due to dementia or health status such that he/she is unable to participate or benefit from specialized services.

In Wisconsin, the Department of Health Services (DHS) has overall responsibility for the administration of health care funding, primarily through the Division of Medicaid Services (DMS), and the administration of services through the Division of Care and Treatment Services (DCTS). DHS is subdivided into program divisions and bureaus, each responsible for a specific area of services to be provided to citizens of the State.

The specific areas of DHS involved in the administration of the PASRR process and related processes are:

1. The Division of Care and Treatment Services (DCTS) administers the community forensic programs and services, Client Rights Office, the Bureau of Prevention Treatment and Recovery (BPTR), the State inpatient mental health facilities, and the State facilities for individuals with intellectual/developmental disabilities. The BPTR is responsible for implementation and improvement of statewide policy and services for people with mental health and substance abuse. BPTR works with and through Wisconsin counties, service providers, and advocacy associations. BPTR is responsible for writing and providing technical assistance in the implementation of the State administrative rules related to mental health and substance abuse treatment issues. The BPTR provides training, oversight and monitoring of the PASRR screening process for individuals in and individuals seeking admission to nursing facilities and is responsible for the monitoring of the PASRR contract.

2. The Division of Medicaid Services (DMS) administers the health care financing program, Medicaid (also known as Medical Assistance or Title XIX).

3. The Division of Public Health (DPH) provides public health services to the people of Wisconsin that address communicable and chronic diseases; health promotion; environmental, occupational, and family and community health; emergency medical services; and injury prevention. The Division is also responsible for issuing birth, death, marriage and divorce certificates, and collects statistics related to the health of Wisconsin residents. Within the DPH, the Bureau of Aging and Disability Resources (BADR) is responsible for the development of policy and the management of programs that serve aging adults, persons with physical disabilities, or who are blind or visually impaired, deaf or hard-of-hearing, those in need of adult protective services, and persons who need or receive information about or access to community-based long-term support through an Aging and Disability Resource Center.

4. The Division of Quality Assurance (DQA) is the State survey and certification agency and is responsible for regulating and licensing more than 40 different programs, facilities, and caregivers that provide health and residential care. The Division of Quality Assurance’s Bureau of Nursing Home Resident Care surveys all nursing facilities in the State for compliance with both State and Federal laws and regulations covering nursing facilities, including the PASRR regulations.

The Division of Care and Treatment Services has set forth the following program goals:

1. To ensure compliance with the Federal PASRR statutes at 42 USC 1396r (e) (7), Federal PASRR regulations at 42 CFR 483.100 – 483.138, applicable Federal directives and guidance related to the PASRR requirements, and State of Wisconsin PASRR policies.

2. To provide training and technical assistance to nursing facility staff to increase their knowledge of the PASRR requirements and ability to correctly complete the PASRR Level I Screen.

This Contract was last bid in 2013, and awarded to Behavioral Consulting Services, Inc. of Grafton WI. The current per screen rate is $183.83.

Appendix C - PASRR Level II Screens Completed In CY 2016 by County and Appendix D - Time Estimates for Completion of a Full and Abbreviated Level II Screen provide added contract activity detail.

Contract Term Term The Contract shall be effective on the execution date of the accompanying Contract and shall run for one (1) year from that date, with an option by mutual agreement of the DHS and the Supplier to renew for an additional five (5) one-year terms.

Transition The incumbent Supplier will be responsible to finish all reviews on which work has commenced by June 30, 2017. The Supplier awarded this Contract will be responsible for all un-started reviews effective July 1, 2017. DHS will provide the awarded Supplier all necessary documents needed to begin screening process.

Number of Contracts It is the intention of the Department to award one statewide Contract for the services required in this solicitation. However, the Supplier(s) shall not have exclusive rights to provide all services covered under the Contract during the term of the Contract(s) or any extension thereof.

Procurement Manager All communication and/or questions on all matters regarding this Bid must be made in writing and refer to Request for Bid number S-0627 DCTS-17 and be directed to the DHS Procurement Manager: Greg Smith at DHSprocurement@wi.gov.

Any contact or communication with any employee or officer of the State of Wisconsin concerning this RFB except the Procurement Manager is strictly prohibited from the date this RFB is released until the date the notice of intent to award is issued. The Procurement Manager may authorize in writing contact or communication with another State employee or officer as circumstances dictate. Vendors who hold a current Contract with DHS may continue to communicate with the appropriate Contract Administrator regarding the performance of that current Contract.

VendorNet Registration Registration on the State of Wisconsin’s VendorNet System (http://vendornet.state.wi.us) is available free of charge to all businesses and organizations. By registering on VendorNet, a Vendor may register for a Vendors list for any commodity or service the Vendor is interested in providing to the State. VendorNet also provides automatic email notification each time a State Agency, including University of Wisconsin System campuses, posts a Request for Bid with an estimated value over $50,000 in their designated commodity and or service area(s). Only registered Vendors with a valid email address at the time an RFB is posted will receive email notifications of amendments. Vendors who obtain the RFB from a third party, through the State of Wisconsin Public Notices website, or by any other means assume the responsibility for checking for updates to the RFB.

Reasonable Accommodations The Department will provide reasonable accommodations, including the provision of informational material in an alternative format for qualified individuals with disabilities upon request. If a Vendor needs accommodations at the outset of this solicitation process, please contact the Procurement Manager.

Mandatory Vendor Qualifications All Vendor qualifications included in Schedule 3 – Qualifications and Requirements Matrix, Section A are mandatory. Failure to meet a qualification will disqualify your Bid. However, DHS reserves the right to waive any qualification if no Vendor is able to satisfy that qualification.

Before the award of any Contract, the Department shall be satisfied that the Vendor has sufficient qualified resources available for performing the work described in this Bid. It is the Vendor’s responsibility to acquaint the Department with these qualifications by submitting appropriate or supporting documentation.

Mandatory Vendor qualifications are listed in and are to be responded to using Schedule 3 – Qualifications and Requirements Matrix, Section A.

Mandatory Specifications All requirements included in Schedule 3 – Qualifications and Requirements Matrix, Section B are mandatory. These requirements must be met at no additional cost above the pricing provided in the Bid. All specifications are defined as minimum mandatory requirements unless otherwise stated. Failure to meet any mandatory requirement will result in the disqualification of the Bid. In the event that no Vendor is able to meet an individual mandatory requirement, the State reserves the right to continue the review of Bids and to select the Bid that most closely meets the requirements specified in this RFB.

Mandatory specifications are listed in and are to be responded to using Schedule 3 – Qualifications and Requirements Matrix, Section B.

Supplier Responsibilities The following requirements will be stated in the Contract subsequent to this RFB:

B. The Supplier must ensure that all staff in its employ (directly, under contract, subcontract, or through other arrangement) receive initial and ongoing training to ensure the accurate completion of PASRR Level II Screens.

C. The Supplier will ensure that all its employees and contracted agents comply with all applicable client rights under State and Federal statutes and regulations.

D. The Supplier must complete all referred Level II Screens within the time frames required. For persons who have a serious mental illness, the evaluation team must include, at a minimum, a psychiatrist and a QMHP (as defined in Appendix A – PASRR-Related Definitions; a psychiatrist meets the qualifications of a QMHP and may complete the entire evaluation without the involvement of another QMHP). For persons who have an intellectual/developmental disability, the evaluation team must include, at a minimum, a person who meets the qualifications of a QIDP (as defined in Appendix A).

1. Each preadmission screen must be completed and a determination made in writing as soon as possible, but no later than eight (8) working days after the Level I Screen is received.

e. If the responses to all questions # 1 - 5 in Section A of the Level I Screen for a person at the time of his/her admission to a nursing facility are checked “no” but the response to one or more of these questions should have been “yes”; or

f. A person who previously received a PASRR review and was found to need specialized services must receive a resident review if his/her level of independent functioning declines due to a marked and permanent deterioration in his/her cognitive functioning due to dementia or health status such that he/she is unable to participate or benefit from specialized services.

Note: Department policies require a resident review on a biennial basis for persons who received a Full Level II Screen and were found to need specialized services or specialized psychiatric rehabilitative services; these resident reviews must be completed within the calendar quarter of the previous Level II Screen.

E. The Supplier must contact the county liaison (a listing of the “county PASRR liaisons” will be provided to the Supplier) at the time of a referral for a preadmission screen and when the determinations are made for all current and prospective nursing facility residents who have a serious mental illness or an intellectual/developmental disability. In addition, whenever the determination of a person’s need for nursing facility placement is “no,” the Supplier must contact the PASRR Contract Administrator within 24 hours after making such a determination.

F. Except for Partial and Abbreviated Level II Screens (defined in Appendix A – PASRR-Related Definitions), each Level II Screen must include at least one direct observation of or interview with the person who is being evaluated. For completion of a Full Level II Screen for persons who have a serious mental illness, a face-to-face psychiatric evaluation must be completed by a Board-certified psychiatrist, a physician who has satisfactorily completed the Board’s specialized training requirements in psychiatry, or a physician who is participating in a psychiatric residency program and whose work is reviewed and countersigned by a Board-certified psychiatrist. Note: The Department’s policies and procedures permit the use of existing data that is accurate and reflects current functioning, which may obviate the requirement of a direct observation for some screens.

Also, for each Full Level II Screen both for persons who have a serious mental illness and for persons who have an intellectual/developmental disability, the Supplier must involve the person; the person’s legal representative, if the person has one; and the person’s family if the person or his/her legal representative agrees to family participation and the family is available.

G. The Supplier must document all evaluation findings using a Department-approved format or a Department-approved form.

H. The Supplier must ensure that an evaluation summary and notice of appeal rights document or other Department approved document is written for each completed Level II Screen and that a team member presents, in person, a copy of the evaluation summary and an interpretation of the evaluation results and recommendations to the person who was evaluated (or his/her legal representative, if he/she has one). If a person or his/her legal representative is not available to meet with the team member (i.e., the legal representative lives in another state or the screen was completed without a direct observation of the person per Department policies and procedures), then the team member is to document the bona fide efforts made to involve the person or his/her legal representative. The team member must mail the evaluation summary via registered or certified mail to the person or his/her legal representative. If a person or the person’s legal representative refuses to sign the notice of appeals rights, then the team member is to document the bona fide efforts made to inform the person or the legal representative of the evaluation summary and notice of appeal rights and the date(s) of these attempts to present the evaluation summary and notice of appeal rights to the person or legal representative.

I. Within 21 calendar days after the Level II determinations are made by the Supplier, the Supplier must mail or give photocopies of applicable portions of a Level II Screen to the person or his/her legal representative, to the county PASRR liaison, nursing facility, and hospital that have a right to receive PASRR information without the person’s prior informed consent. “Applicable portions” are determined by the Contract Administrator.

J. The Supplier must scan each person’s Level II Screen and upload the scanned document to the Department’s data warehouse, as well as enter all information contained on each person’s Level II Facesheet into the Department’s data warehouse.

K. Record retention. The Supplier must store and safeguard all PASRR records against loss, destruction, or unauthorized use consistent with the Federal HIPAA regulations, Wis. Stat. § 51.30, Wis. Admin. Code § DHS 92, and Subpart C of 45 C.F.R. § 164 (Security Rule) with respect to electronic protected health information, which provide requirements related to confidentiality of treatment records. All PASRR records must be kept for at least a seven-year period following the date of completion of the Level II Screen. In the event that the contract is not renewed, the Supplier must submit all PASRR records to the Department.

The Supplier must purchase and maintain encryption software using FIPS 140-2 certified software and algorithms for all electronic information on any storage device that contains protected health information and/or personally identifiable information related to a person who received a PASRR Level I or Level II Screen. In addition, the Supplier must use FIPS 140-2 certified software and algorithms to send any electronic information containing protected health information and/or personally identifiable information related to a person who received a PASRR Level I or Level II Screen.

L. The Supplier must respond immediately to all on-site inquiries from the Department and make all records available to the Department. The Supplier must respond within three (3) working days to all inquiries from the Department that require materials to be mailed to the Department. All records must be made available to the Department.

1. Licensed physician (or licensed physician assistant or nurse practitioner, as permitted by State statutes and regulations) to perform a history and physical as required by the Federal PASRR regulations;

1. Licensed psychologist to perform a psychometric evaluation as required by the Federal PASRR regulations; and

c. Sign language or foreign language interpreter if the person receiving the PASRR Level II Screen primarily uses sign language or a foreign language.

N. Technical Assistance The Supplier shall provide technical assistance to nursing facility staff, hospital staff, staff of counties of responsibility and others as needed to ensure:

· The accurate completion and submission of Level 1 Screens.

· The correct identification of the State/county of residence/responsibility.

· The status of Level II screens currently being completed.

· The status of Level II screens completed in the past.

Costs related to the provision of technical assistance must be included in the per screen cost.

O. Performance Management The Supplier shall ensure and document they are meeting all contract requirements by submitting all required documentation and complying with ongoing monitoring including but not limited to random sampling, site visits, and performance reports.

· The Supplier shall provide semi-annual contract activity reports to the Contract Administrator. At a minimum, the number of the Level II Screens for which a psychiatrist was needed to be sent out to complete the mental status exam must be included in the report. Other data elements may be included as mutually agreeable between the Supplier and Contract Administrator.

· The Supplier must perform evaluations that are accurate, meaning that the evaluations are valid reliable and reflect current functioning. The inter-rater agreement comparing the Supplier’s PASARR determinations and Department employees PASARR determinations must be 95% or greater. Supplier may not perform more than ten evaluations annually that are demonstrated to be inaccurate. Failure to perform accurate evaluations will be grounds for contract cancellation.

CONTRACT TERMS AND CONDITIONS

The Department reserves the right to negotiate these terms and conditions when it is in the best interest of the State to do so. Vendors may not submit their own Contract document as a substitute for the State’s Terms and Conditions.

Vendors must accept all terms and conditions or submit point-by-point exceptions along with proposed alternative or additional language for each point. The State may or may not consider any of the Vendor’s suggested revisions. Any changes or amendments to any of the terms and conditions will occur only if the change is in the best interest of the State. Pricing submitted should assume that no changes to these terms and conditions will be accepted.

If a Contract document is executed as a result of this procurement, additional terms and conditions may be contained in that document and negotiated at that time.

Order of Precedence In the event of Contract award, the contents of this RFB (including all schedules), RFB addenda and revisions, the Bid response from the successful Vendor as accepted by the Procuring Agency, and any additional terms agreed to in writing by the parties shall be incorporated into the Contract. Failure of the successful Vendor to accept these elements into the Contract will result in the cancellation of the Contract award.

In the event of conflict with the incorporated elements of the Contract, the following order of precedence will prevail:

1. Business Associate Agreement (if applicable, see Section 5.10)

2. Final Signed Contract, including all attachments.

3. Official Purchase Order.

4. The State’s RFB, including all schedules, addenda, and revisions.

5. The Vendor’s RFB Response as accepted by the State of Wisconsin.

Modifications of Contract The resulting Contract must only be used to purchase services within the scope and intent of the original Request for Bid. Any modifications made to the resulting Contract must fall within the scope of the Bid. All modifications must be made in writing and signed by both parties.

Standard Terms and Conditions The State of Wisconsin Standard Terms and Conditions (DOA – 3054) and Supplemental Standard Terms and Conditions for Procurements for Services (DOA – 3681) shall apply to this solicitation and subsequent award, in addition to the Terms and Conditions specified in this solicitation.

Payment Terms, Schedule and Invoicing Supplier will be paid per completed screen and will invoice monthly. Invoices must be submitted on the Department-approved invoice form to the Department’s Contract Administrator. The invoice shall reflect all of the prices and discounts established for the items in this Contract. Other submission requirements will be outlined in the Contract.

A Level II Facesheet must be submitted electronically through the DHS-approved database for each Level II Screen claimed to have been completed and included in the invoice. A copy of the PASRR Level I form also must be submitted to the Department through the database for each preadmission screen completed and for each person who had not been screened previously and has now received a resident review.

Only properly submitted invoices will be officially processed for payment. Final payment may not be made until work has been accepted by the Department. Prompt payment requires that Supplier invoices be clear, complete, and itemized showing:

a) Supplier name

b) Supplier phone and fax number

c) Remit to address

d) Dates of services

e) Invoice amount calculated using the completed number of eligible screens in the billing period multiplied by the contract…