Attachment E. Response Requirments.docx
DOCX document 25 KB Posted
- Attached to
- Request for Response For Master Agreement For General Reference Laboratory Service Providers
- Solicitation number
- BD-18-1022-DMH08-8210C-28120
- Issued by
- Suffolk County, Massachusetts
About this file
This document is the Attachment E. Response Requirements for the Department of Mental Health's Request for Response for a Master Agreement for General Reference Laboratory Service Providers. The Department of Mental Health (DMH) is seeking to establish a pool of general reference laboratory service providers from which the five Areas of the Department can purchase clinical reference laboratory testing services as needed.
The document outlines the mandatory bidder requirements, including being qualified and certified under the Clinical Laboratory Improvement Act, being licensed as a Massachusetts Clinical Laboratory, being accredited by the College of Pathologists, being approved by the Substance Abuse and Mental Health Services Administration, and being certified to participate in the Medicare program. Bidders must also demonstrate at least 3 years of experience providing a wide range of laboratory testing services. The document details the required fiscal information, forms, and service specifications that bidders must provide in their responses.
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Department of Mental Health Request for Response For Master Agreement For General Reference Laboratory Service Providers
Attachment E
BIDDER’S QUALIFICATIONS AND SERVICE RESPONSE REQUIREMENTS
1. RFR Response Cover Sheet The Bidder must submit a completed RFR Response Cover Sheet that is located in the Attachment section of the COMMBUYS File for this Bid. The Cover Sheet must be signed by an individual authorized to negotiate for and execute the Contract on behalf of the Bidder. The Cover Sheet must specify the DMH Area for which the bidder is seeking to be qualified to serve or if the Bidder is seeking to be Qualified statewide, that should be indicated.
2. Bidder’s Qualifications and Service Response Requirements The Response must be in the following format:
· type-written 12 point Times New Roman font
· 8 ½ X 11 inch paper
· fully justified (print fully abuts both margins)
· one-inch margins
· single-spaced
· page numbers at bottom of each page.
3 Design of the Proposal
a. The Bidder must respond to each question/request for information in the Requirements Chart below in the order it is asked for in the chart.
b. Before responding to a question/request for information, a Bidder must insert in bold in a separate line the number and header of the question/request for information to which it is providing a response. For example:
1.1 Bidder Information
1.2 CLI
c. A Bidder must adhere to the page limits specified for the responses set forth in this Attachment. Attachments and other supporting documentation specifically requested in a Requirement are not counted in calculating if a response exceeds the stated page limit. However, attachments must be limited to those specifically asked for by the below Requirements as attachments. Any attachment that is submitted which is not specifically asked for will be removed from the response and will not be reviewed. All pages in excess of the stated limits will be removed from the response prior to review. All excess pages will be removed from the end of the relevant section.
A Bidder must provide a response to each requirement in the order asked for in this Attachment E.
| SPECIFICATION |
| REQUIREMENTS |
1. MANDATORY BIDDER REQUIREMENTS
1.1 Bidder’s Information
Name:
Address:
Contact Person:
Contact’s Telephone #:
Contact’s E-Mail Address:
DMH Area(s) Seeking to Serve or indicate if seeking to serve statewide:
Provide information
| 1.2 CLI. The Bidder shall be qualified and duly certified by the Clinical Laboratory Improvement Act of 1988 (CLI) |
| Indicate that you meet requirement and attach proof of the applicable certification |
| 1.3 MA Licensing. The Bidder must be licensed as a Massachusetts Clinical Laboratory licensed issued by the Department of Public Health (Clinical Laboratory Program) (Subsection 4.1.1) |
| Attach proof of the applicable license. |
| 1.4 Accrediation. Bidder must be accredited by the College of Pathologist |
| Attach Proof |
| 1.5 SAMHSA. Bidder must be approved by the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration and the National Institute of Drug Abuse. |
| Attach Proof |
| 1.6 Medicare. Bidder must be certified to participate in the Medicare program (Subsection 4.1.1) |
| Attach Proof |
| 1.7 JCAHO. The Bidder must be approved by the Joint Commission of Health Care Organizations JCAHO or other appropriate accrediting body. (Subsection 4.1.1) |
| Indicate applicable accrediting body and attach proof of approval. |
| 1.7 Experience. The Bidder must be in the business of general reference laboratory testing services for at least three (3) years, and be structured to provide a vast range of laboratory tests services, including, if applicable, to the DMH Areas listed above, phlebotomy services. (Subsection 4.1.2) |
| Describe experience; and your ability to provide a vast range of laboratory testing services, including, if applicable, phlebotomy. (Not to exceed two (2) pages in addition to the space below). Attach a list of laboratory testing services provided by the Bidder’s lab. |
2. FISCAL REQUIREMENTS
2.1 Sound Fiscal Condition.
ATTACH: Financial statements for the last three (3) years audited by a certified public accountant. Financial statements should include, but not be limited to, annual income and net worth (assets and liabilities, including a breakdown of liquid and non-liquid assets).
(Subsection 4.2.1)
| 2.2 Debarment (Subsection 4.2.5) |
| Indicate if your organization is now or has ever been subject to a state or federal debarment order. If your organization has been subject to a debarment order, specify the date and the circumstances surrounding it. |
| 2.3 Liability Coverage (Subsection 4.3) |
| Describe how you meet the requirements of Subsection 4.3. |
3. FORMS
| 3.1 Required Forms (Subsection 4.4) |
| Attach, unless otherwise indicated the following forms which are included in the Bid’s COMMBUYS Attachment File. |
ATTACH:
An executed Standard Contract Form (2 Originals) An executed Commonwealth Terms and Conditions (1 original)* An executed Massachusetts Form W-9 (1 original)* A Contractor Authorized Signatory Listing (1 original). (Note: both pages are required, with the second page notarized) Authorization for Electronic Funds Payment (1 Original)* RFR Cover Sheet Supplier Diversity Program Plan Form #1; and Business Reference Form – Bidder must provide three (3) business references related to the general reference laboratory services it provides. The references must be entities that currently use the Bidder’s services or did so in the past year.
*Note: If a Bidder has already submitted to DMH or another Commonwealth agency signed Terms and Conditions, Form W-9, and/or Authorization for Electronic Funds Payment as listed above and such are on record with the Office of the Comptroller, it does not need to submit another. If any of these forms are not included in a response, DMH will verify that they are on record with the Office of the Comptroller.
| 3.2 Optional Form (Subsection 6.4) |
| Bidders are strongly encouraged to participate in the Commonwealth Prompt Payment Discount Initiative. To do so, a Bidder must complete and attach the Prompt Payment Discount Form included in the Bid’s COMMBUYS File |
4. SERVICE SPECIFICATIONS
| 4.1 Service Area. A Bidder may elect to provide services to one or more DMH Areas or to provide services statewide. A provider must be able to provide services to all DMH locations and facilities within the DMH Area(s) the provider selected or if the bidder selected statewide to all DMH locations and facilities located in the state. |
| For the DMH Area(s) you selected above or for the State if Statewide was selected, describe why you picked the geographic area you did and why your laboratory is best suited to provided services to the selected geographic area. (Response limited to two (2) pages) |
| 4.2 Service Specifications (Section 5.) |
| Please affirm that you can provide the services as described in the following Subsections: |
| Phlebotomy Services, if applicable to your bid. See Attachment B. Subsection 5.2 |
All services and ancillary items provided under the MA must be in compliance with all Federal, State and local laws rules and regulations and must meet the normal industry standard for whatever is being provided. Subsection 5.3
Service Specifications (Subsection 5.3)
a. 24 hrs a day, 365 days a year
b. lab manuals/directions
c. in-service education
d. laboratory representatives
e. laboratory consultations
f. quality assurance support
g. sales representative
h. single source for billing
i. Pick-up schedule
j. STAT Services
k. Test panels
l. patient reports
m. specimen integrity
n. report access
o. Emergency back-up
Items and Supplies Subsection 5.4
Reporting of Test Results Subsection 5.5
4.3 Measures of Successful Performance.
Briefly describe how you plan on tracking the information specified in Subsection 5.8 of the RFR (not to exceed one (1) page)
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