Attachment A - Exhibit A-5-a - V2.xlsx
XLSX spreadsheet 27 KB Posted
- Attached to
- Preadmission Screening and Resident Review
- Solicitation number
- RFP-16853
- Issued by
- Leon County, Florida
About this file
This is an Exhibit A pricing file for the State of Florida, Agency for Health Care Administration's Preadmission Screening and Resident Review (PASRR) contract opportunity. The solicitation requests proposals from vendors to maintain and manage Florida's PASRR process, which encompasses Level I screenings prior to nursing facility admissions, Level II evaluations for individuals suspected of serious mental illness or intellectual disability, resident reviews to ensure appropriate placements, and education and training for all entities involved in the PASRR process. The vendor must operate a web-based system for receiving and reviewing Level I screenings and deploy qualified clinical staff to complete Level II evaluations statewide. Written questions were due September 17, 2026, at 2:00 p.m., with proposals due October 22, 2026, at 2:00 p.m. The anticipated notice of intent to award will be posted November 19, 2026. The contract term runs from January 1, 2027, through March 31, 2031 (four years and four months), with implementation required within 90 days of contract execution. The Agency anticipates awarding one contract and expects to obtain federal approval from the Centers for Medicare and Medicaid Services before contract execution.
The estimated annual contract amount is $2,443,430.00, with a total estimated value of $9,773,720.00 over the initial contract period. Respondents must propose a one-time implementation cost and fixed monthly costs for Years One through Four and renewal years using a fixed-price model with unit costs. A proposal guarantee of $977,372.00 and a performance bond of 10 percent of the total annual contract amount are required. Evaluation criteria distribute 130 technical points across nine submission requirements, including organizational structure and history, respondent qualifications, Level I screening ability, Level II evaluation ability, resident review ability, education and training, innovations and value-added services, implementation plan and timeline, and IT security rating (to be assessed through RiskRecon by Mastercard). State performance obligations are contingent upon annual legislative appropriation.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment A - Exhibit A-3-a.docx | DOCX document | |
| AHCA RFP 001-2627 - Addendum No. 1.pdf | ||
| Attachment A - Exhibit A-1.xlsx | XLSX spreadsheet | |
| Attachment A - Exhibit A-6.doc | DOC document | |
| Attachment A - Exhibit A-5-a.xlsx | XLSX spreadsheet | |
| Attachment A - Exhibit A-5 - Cost Proposal.xlsx | XLSX spreadsheet | |
| Attachment A - Exhibit A-3.docx | DOCX document | |
| Attachment A - Exhibit A-4.docx | DOCX document | |
| AHCA RFP 001-2627 - PASRR.pdf | ||
| Attachment A - Exhibit A-2.docx | DOCX document |
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Text version
Detailed Budget
| The following proposed detailed budget shall include costs required for providing the services specified in this solicitation, and shall support and justify the costs as provided in Exhibit A-5, Cost Proposal. | |||||
| DESCRIPTION OF EXPENSES | IMPLEMENTATION PERIOD | YEAR ONE OPERATIONS | YEAR TWO OPERATIONS | YEAR THREE OPERATIONS | YEAR FOUR OPERATIONS |
| DIRECT PERSONNEL | |||||
| Salaries: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Fringe Benefits: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Salaries Expense: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Temporary Personnel Services: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Contracted Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL DIRECT PERSONNEL: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| OTHER DIRECT | |||||
| Office Supplies: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Postage, Shipping, Fulfillment: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Software, Hardware: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Equipment Rental/Purchase: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Office Rent (Occupancy): | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Printing/Graphics (Materials): | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Travel – Training: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Travel – Other: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Telephone Charges: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Professional Services: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Advertising: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Training, Licensing, Recruiting: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Legal, Taxes, Miscellaneous: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL OTHER DIRECT*: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| DESCRIPTION OF EXPENSES | IMPLEMENTATION PERIOD | YEAR ONE OPERATIONS | YEAR TWO OPERATIONS | YEAR THREE OPERATIONS | YEAR FOUR OPERATIONS |
| CAPITAL | |||||
| Telecommunications Equipment: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Computer Equipment: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Furniture: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Installation/Construction: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CAPITAL*: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL DIRECT PERSONNEL: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL OTHER DIRECT: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CAPITAL: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CONTRACT EXPENSES*: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| DESCRIPTION OF EXPENSES | RENEWAL | |
| YEAR ONE OPERATIONS | RENEWAL | |
| YEAR TWO OPERATIONS | RENEWAL | |
| YEAR THREE OPERATIONS | RENEWAL |
YEAR FOUR OPERATIONS
| DIRECT PERSONNEL | |||||
| Salaries: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Fringe Benefits: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Total Salaries Expense: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Temporary Personnel Services: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Contracted Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Personnel: | $0.00 | $0.00 | $0.00 | $0.00 | |
| TOTAL DIRECT PERSONNEL: | $0.00 | $0.00 | $0.00 | $0.00 | |
| OTHER DIRECT | |||||
| Office Supplies: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Postage, Shipping, Fulfillment: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Software, Hardware: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Equipment Rental/Purchase: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Office Rent (Occupancy): | $0.00 | $0.00 | $0.00 | $0.00 | |
| Printing/Graphics (Materials): | $0.00 | $0.00 | $0.00 | $0.00 | |
| Travel – Training: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Travel – Other: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Telephone Charges: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Professional Services: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Advertising: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Training, Licensing, Recruiting: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Legal, Taxes, Miscellaneous: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | |
| Other Direct: | $0.00 | $0.00 | $0.00 | $0.00 | |
| TOTAL OTHER DIRECT*: | $0.00 | $0.00 | $0.00 | $0.00 | |
| DESCRIPTION OF EXPENSES | RENEWAL | ||||
| YEAR ONE OPERATIONS | RENEWAL | ||||
| YEAR TWO OPERATIONS | RENEWAL | ||||
| YEAR THREE OPERATIONS | RENEWAL |
YEAR FOUR OPERATIONS
| CAPITAL | ||||
| Telecommunications Equipment: | $0.00 | $0.00 | $0.00 | $0.00 |
| Computer Equipment: | $0.00 | $0.00 | $0.00 | $0.00 |
| Furniture: | $0.00 | $0.00 | $0.00 | $0.00 |
| Installation/Construction: | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 |
| Other Capital: | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CAPITAL*: | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL DIRECT PERSONNEL: | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL OTHER DIRECT: | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CAPITAL: | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL CONTRACT EXPENSES*: | $0.00 | $0.00 | $0.00 | $0.00 |
| *The Agency reserves the right to request the return of any hardware, software, equipment and furniture purchased by the successful Vendor using funds from the resulting Contract. In the event the Agency does not desire to have the hardware, software, equipment and furniture returned, the successful Vendor may retain said ownership. |
Respondent Name
Authorized Official Signature Date
Authorized Official Printed Name
| Authorized Official Title |
| The Agency will evaluate renewal year proposals as part of the evaluation and scoring process. Proposed cost will be applied in the event the resulting contract is renewed. |
| Exhibit A-5-a (V2), Detailed Budget, shall not include a cost that exceeds the maximum contract amount listed in Attachment A, Instructions and Special Conditions, Section 1., Instructions, Sub-Section1.1, Overview, Item 13., Type and Amount of Contract Contemplated. A response which contains a cost proposal that exceeds the Agency’s maximum contract amount will be rejected. |
| Failure to submit, Exhibit A-5-a (V2), Detailed Budget, signed by an authorized official may result in the rejection of response. |
&"Arial,Bold"&14EXHIBIT A-5-a (V2)
DETAILED BUDGET && RATE CARD
&"Arial,Bold"AHCA RFP 001-26/27, Attachment A, Exhibit A-5-a (V2), Page &P of &N
Rate Card The following Rate Card shall be used to propose costs for any changes or modifications requested by the Agency that require additional staff commitments beyond what is required by the Contract.
Note: Hourly rates shall remain fixed for the first two (2) years of the Contract. For the remaining Contract term, including renewal years, the Vendor's hourly rate pricing shall not increase by more than five percent (5%) per Contract year, beginning in Contract Year 3.
| No. | Position Title | Position Description | Minimum Certifications & Qualifications | Hourly Rate |
| 1 | $0.00 | |||
| 2 | $0.00 | |||
| 3 | $0.00 | |||
| 4 | $0.00 | |||
| 5 | $0.00 | |||
| 6 | $0.00 | |||
| 7 | $0.00 | |||
| 8 | $0.00 | |||
| 9 | $0.00 | |||
| 10 | $0.00 | |||
| 11 | $0.00 | |||
| 12 | $0.00 | |||
| 13 | $0.00 | |||
| 14 | $0.00 | |||
| 15 | $0.00 | |||
| 16 | $0.00 | |||
| 17 | $0.00 | |||
| 18 | $0.00 | |||
| 19 | $0.00 | |||
| 20 | $0.00 | |||
| 21 | $0.00 | |||
| 22 | $0.00 | |||
| 23 | $0.00 | |||
| 24 | $0.00 | |||
| 25 | $0.00 | |||
| 26 | $0.00 | |||
| 27 | $0.00 | |||
| 28 | $0.00 | |||
| 29 | $0.00 | |||
| 30 | $0.00 |
&"AriL,Bold"&14EXHIBIT A-5-a (V2)&"AriL,Regular" &"AriL,Bold"DETAILED BUDGET && RATE CARD
&"Arial,Bold"AHCA RFP 001-26/27, Attachment A, Exhibit A-5-a (V2), Page &P of &N
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