Attachment A - Exhibit A-4.docx

EXHIBIT E-6

Technical Proposal Attestation

EXHIBIT A-4

SUBMISSION REQUIREMENTS AND EVALUATION CRITERIA COMPONENTS (TECHNICAL RESPONSE)

TABLE OF CONTENTS

INSTRUCTIONS TO RESPONDENTS FOR THE COMPLETION OF EXHIBIT A-4

All respondents to this solicitation shall utilize Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), for submission of its response and shall adhere to the instructions below for each Submission Requirement Component (SRC).

Respondents shall not include website links, embedded links, and/or cross references between SRCs.

Each SRC contains form fields. Population of the form fields with text will allow the form field to expand and cross pages. Text responses must be formatted for 8-1/2’ x 11” paper, single-spaced, and in a size 11 Arial font. NOTE: SRC form fields are not limited to a specific character count. However, the information should be presented judiciously and concisely, while providing sufficient detail to enable a thorough evaluation.

Respondents may provide attachments to support their response including, but not limited to, tables, charts, and exhibits. Attachments are acceptable for any SRC response with a form field but must be referenced in the form field for the respective SRC and located behind each respective SRC response. Respondents shall name and label attachments to refer to respective SRCs using the SRC identifier number (Example: SRC 2).

Note: In addition to the complete, electronic PDF copy of this Exhibit, the Respondent should submit its response to each SRC in a separate electronic folder that is labeled with the SRC number. The electronic folder for each SRC response should contain the response to the SRC along with all attachments applicable to the SRC.

Agency evaluators will be instructed to evaluate the responses based on the narrative contained in the SRC form fields and the associated attachment(s), if applicable.

Each response will be independently evaluated and awarded points based on the criteria and points scale using the Standard Evaluation Criteria Scale below unless otherwise identified in each SRC contained within Exhibit A-4.

STANDARD EVALUATION CRITERIA SCALE

The SRCs in Exhibit A-4 may not be retyped and/or modified and must be submitted in the original format.

FAILURE TO SUBMIT EACH REQUIRED FORM IN ITS ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE RESPONSE.

FAILURE TO SUBMIT AN SRC MAY RESULT IN REJECTION OF THE RESPONSE.

FAILURE TO SUBMIT EACH REQUIRED SRC TEMPLATE IN ITS ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE RESPONSE.

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

RESPONDENT NAME:

SRC 1: ORGANIZATIONAL STRUCTURE AND HISTORY

The Respondent shall demonstrate its capability to provide the services specified in Attachment B, Scope of Services, by describing its organizational structure, history, staffing levels, and staff qualifications. At a minimum, the description should include:

1. The Respondent's organizational structure, ownership, affiliations, and location(s).

2. The Respondent's corporate organizational chart, and a depiction of where the services described in Attachment B, Scope of Services, fall within the organizational structure.

3. Background information on the Respondent’s corporation, the size, and resources, to include:

a. Date established

b. Ownership (public company, partnership, subsidiary, etc.)

c. Corporation's Federal Employer Identification Number (FEIN) and Florida Corporate Charter Number

d. Corporation's primary line of business

e. Total number of employees, including the number of employees located in Florida Attachments are limited to:

· An organizational chart of the Respondent

· List of its physical location(s)

Response:

Score: No points will be awarded for this SRC.

SRC 2: RESPONDENT QUALIFICATIONS

The Respondent shall demonstrate its capability to provide the services specified in Attachment B, Scope of Services, by describing its relevant experience providing services similar in nature to those described in Attachment B, Scope of Service. Details should include a list of all contracts related to services similar in nature to those described in this RFP within the last five (5) years, and should include, at a minimum:

1. Relevant experience with designing, developing, and implementing a similar program.

2. Relevant experience maintaining a similar program.

3. Staff resources, position titles, licenses, qualifications, number of Respondent staff, and utilization of subcontractors used to complete the project.

Response:

Evaluation Criteria:

1. The adequacy of the Respondent’s relevant experience with designing, developing and implementing a similar program to the requirements outlined in Attachment B, Scope of Services.

2. The adequacy of the Respondent’s relevant experience maintaining a similar program to the requirements outlined in Attachment B, Scope of Services.

3. The adequacy of the Respondent’s description of staff resources, position titles, qualifications, number of Respondent staff, and utilization of subcontractors used to complete the project.

Score: This section is worth a maximum of 15 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 3: RESPONDENT ABILITY TO RECEIVE AND REVIEW LEVEL I SCREENINGS

The Respondent shall demonstrate its ability to ensure that Level I screenings are completed prior to all new admissions to a nursing facility, as defined in Rule 59G-1.040, F.A.C, and outlined in Attachment B, Scope of Services, Section I., Service(s) to be Provided, Sub-section E., Services Provided by the Vendor, Item 2., Level I Screenings. Details should include, at a minimum:

1. Policies and procedures to receive and review Level I screening requests submitted by Agency-delegated Level I screeners.

2. Clinical criteria that shall be used in determining whether the Level I screening results in a positive or negative Level I.

3. Demonstration of a web-based system with the ability for Level I screeners to complete and submit Level I screenings.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s policies and procedures to receive and review Level I screenings.

2. The adequacy of the clinical criteria submitted to determine if Level I screenings should result in a positive or negative Level I.

3. The adequacy of the web-based system for completion and submission of Level I screenings.

4. The adequacy of the respondent’s ability to provide all Level I Screening requirements outlined in Attachment B, Scope of Services.

Score: This section is worth a maximum of 20 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 4: RESPONDENT ABILITY TO COMPLETE LEVEL II EVALUATIONS

The Respondent shall demonstrate their ability to complete Level II Evaluations in accordance with the requirements specified in Rule 59G-1.040, F.A.C., 42 CFR Sections 483.100-483.138, and outlined in the Attachment B, Scope of Services, Section I., Service(s) to be Provided, Sub-section E., Services Provided by the Vendor, Item 3., Level II Evaluations. Details should include, at a minimum:

1. Policies and procedures to complete Level II Evaluations.

2. The experience and expertise of the clinical staff completing the Level II Evaluations.

3. Clinical criteria to confirm the suspicion of serious mental illness and/or intellectual disability and to determine if specialized services are needed.

4. Demonstration of a web-based system with the ability to receive all documentation necessary for Level II evaluations.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s policies and procedures to complete Level II evaluations.

2. The adequacy of the levels and experience of the clinical staff needed to complete Level II Evaluations.

3. The adequacy of the clinical criteria submitted to confirm suspicion of serious mental illness and/or intellectual disability and to determine if specialized services are needed.

4. The adequacy of the web-based system to receive all documentation needed for Level II Evaluations.

5. The adequacy of the respondent’s ability to provide all Level II Evaluation requirements outlined in Attachment B, Scope of Services.

Score: This section is worth a maximum of 25 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 5: RESPONDENT ABILITY TO COMPLETE RESIDENT REVIEWS

The Respondent shall demonstrate their ability to complete Resident Reviews in accordance with the requirements specified in Rule 59G-1.040, F.A.C, and outlined in Attachment B, Scope of Services, Section I., Service(s) to be Provided, Sub-section E., Services Provided by the Vendor, Item 4., Resident Reviews. Details should include, at a minimum:

1. Policies and procedures to complete Resident Reviews.

2. The appropriate clinical staff licensed in the State of Florida who meet the qualifications specified in Attachment B, Scope of Services, Section I., Service(s) to be Provided, Sub-section E., Services Provided by the Vendor, Item 16., Staffing Requirements.

3. Clinical criteria to confirm the suspicion of serious mental illness and/or intellectual disability and to determine if specialized services are needed.

4. Demonstration of a web-based system with the ability to receive all documentation necessary for Resident Reviews.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s policies and procedures to complete Resident Reviews.

2. The adequacy of the levels and experience of the clinical staff needed to complete Resident Reviews.

3. The adequacy of the clinical criteria submitted to confirm suspicion of serious mental illness and/or intellectual disability and to determine if specialized services are needed.

4. The adequacy of the web-based system to receive all documentation needed for Resident Reviews.

5. The adequacy of the respondent’s ability to complete all Resident Review requirements outlined in Attachment B, Scope of Services.

Score: This section is worth a maximum of 25 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 6: RESPONDENT ABILITY TO PROVIDE EDUCATION, TRAINING, AND ONGOING TECHNICAL ASSISTANCE

The Respondent shall demonstrate their ability to provide education, training, and ongoing technical assistance to Agency staff and all entities involved in the PASRR process. Details should include, at a minimum:

1. Policies and procedures to provide education, training, and on-going technical support for the entire PASRR process to all entities involved.

2. Detailed education and training plan for on-going, face-to-face and web-based training.

3. The appropriate staffing levels to conduct face-to-face and web-based training state-wide to all entities involved in the PASRR process.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s policies and procedures to provide education, training, and technical assistance.

2. The adequacy of the training and education plan.

3. The adequacy of the staffing levels to provide state-wide training on an on-going basis.

4. The adequacy of the respondent’s ability to complete all training and technical assistance requirements outlined in Attachment B, Scope of Services.

Score: This section is worth a maximum of 20 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 7: INNOVATIONS AND VALUE-ADDED SERVICES

The Respondent should demonstrate its ability to provide innovative, data-driven approaches for PASRR process improvement and may offer value-added services to enhance the PASRR process.

For the purposes of this SRC, “value-added services” are defined as PASRR process-related services that are offered in addition to the services required in Attachment B, Scope of Services; increase the value of the Contract to the Agency; and are offered by the Respondent at no additional cost to the Agency. At a minimum, the Respondent should address innovations and/or value-added services around the following PASRR process elements:

1. Use of the PASRR in care planning, care coordination, and community transitions.

2. Use of PASRR data and insights to improve the PASRR program and patient outcomes.

NOTE: If selected for award, the Agency reserves the right to accept or reject any and all innovations and value-added services proposed by the Respondent in this Exhibit A-4.

Response:

Evaluation Criteria:

1. The adequacy of the Respondent’s innovations and/or value-added services to use PASRR in care planning, care coordination, and community transitions.

2. The adequacy of the Respondent’s innovations and value-added services for developing a data-driven approach to PASRR program improvement.

Score: This section is worth a maximum of 10 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 8: IMPLEMENTATION PLAN AND TIMELINE

The Respondent should demonstrate their ability to be operational within ninety (90) days of Contract execution. Details should include, at a minimum:

1. Implementation plan and timeline for full operation.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s implementation plan and timeline.

2. Respondent’s ability to be fully operational within 90 days of contract execution.

Score: This section is worth a maximum of 10 points. Each of the above components are worth the maximum points provided in the Standard Evaluation Criteria Scale.

SRC 9: SECURITY RATING SCORE

In accordance with Attachment B, Scope or Services, Section X., Information Technology, Sub-Section T., the Agency will conduct an initial IT security risk score scan on the respondent, using the “Cyber Rating” as provided by RiskRecon by Mastercard, as well as periodic or continuous security monitoring, at the Agency's expense, to enable the Agency to effectively measure and mitigate the successful respondent’s security risks. If awarded, the respondent will work with the Agency’s Cyber Security Rating Provider (RiskRecon by Mastercard) to define the relevant respondent assets providing Agency services.

NOTE: The respondent is not required to submit any narrative response or documentation for this SRC.

Evaluation Criteria:

The adequacy of the Respondent’s IT security by determining whether the Respondent has received:

a. An “A” Cyber Rating by RiskRecon by Mastercard;

b. A “B” Cyber Rating by RiskRecon by Mastercard;

c. A “C” Cyber Rating by RiskRecon by Mastercard; and

d. A “D” or “F” Cyber Rating by RiskRecon by Mastercard.

Score: This Section is worth a maximum of 5 raw points as outlined below. If the respondent receives a “D or F” rating, 0 points will be assigned:

a. 5 points for an “A” Cyber Rating;

b. 4 points for a “B” Cyber Rating;

c. 3 points for a “C” Cyber Rating; and

d. 0 points for a “D” or “F” Cyber Rating.

AHCA RFP 001-26/27, Exhibit A-4, Page 7 of 7