Attachment E - Vendor Operations Performance Report Card.docx

DOCX document 23 KB Posted

Attached to
Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684
Solicitation number
RFP 746 2500000254 3
Issued by
Elliott County, Kentucky

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Vendor Operations Performance Report Card Summary

This document is a Vendor Operations Performance Report Card developed by the Commonwealth of Kentucky's Department for Medicaid Services (DMS) for the financial management services contract supporting Participant-Directed Services in 1915(c) Home and Community Based Services Medicaid waiver programs. The report card establishes 44 performance requirements across multiple operational categories that the selected vendor must meet throughout the contract term, which begins February 1, 2027. The performance requirements encompass agenda and meeting minute preparation (distribution within two business days), auditing capabilities, call center operations (toll-free access Monday-Friday, 8:00 a.m. to 6:00 p.m. Eastern Time), change control processes (implementation within three business days for CMS requirements and thirty calendar days for standard changes), corrective action plan development (within twenty-four hours for deficiencies), and document standards requiring written responses to DMS inquiries within two calendar days.

Additional performance requirements address payment distribution (biweekly minimum), account reconciliation with specified documentation, quarterly Business Improvement Plan assessments (within fifteen business days of quarter end), annual Business Improvement Plan and Quality Improvement Plan submissions (sixty calendar days prior to year-end), project management framework compliance, quarterly quality assessment reporting (within thirty calendar days), RAID documentation (within two business days of identification), various call center reporting metrics (due by the fifteenth of the following month), monthly complaint and performance monitoring reports, employee onboarding completion (within thirty days), annual security assessments and SSAE 18 audits, organizational chart submissions, staffing level maintenance at ninety percent or higher, staff replacement notification with three candidate resumes (within thirty calendar days of vacancy), EVV and payroll issue resolution (within three business days with daily updates thereafter), system maintenance problem correction (within five business days), and continuous web availability (24/7/365 except for approved downtime).

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Other files

File Type Posted
Attachment C - Commonwealth Office of Technology (COT) Requirements.docx DOCX document
Attachment A - KOG Integration Version 2.1.7.docx DOCX document
Attachment G - BAA Sample - Standard - updated 05.21.2025.docx DOCX document
Attachment D - Vendor Pre-Operational Performance Report Card.docx DOCX document
Attachment B - Instructions_TechnicalGuide_V3.7 2024.pdf PDF
Final_RFP_746_2500000254_1_SO_FORM.PDF PDF
Final_RFP_746_2500000254_3_SO_FORM.PDF PDF
Cost Proposal - Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs - RFP 746 2500000254.xlsx XLSX spreadsheet
Attachment F - Penalties.docx DOCX document
Final_RFP_746_2500000254_2_SO_FORM.PDF PDF

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Attachment E: Vendor Operations Performance Report Card

Report Card #
Category
Report Card Performance Requirement
Status (Met/Not Met)
1.B.001
Agenda and Minutes
Prepare agendas and other materials (as appropriate) and distribute agendas and materials two (2) business days prior to the event.

Prepare meeting minutes for all Vendor-led or DMS-requested meetings and distribute within two (2) business days of the meeting event.

Provide sufficiently qualified business and technical staff to document decisions, actions, and minutes from each meeting.

1.B.002
Auditing
Perform audits as requested.
1.B.003
Call Center Establishment
Provide toll-free telephone and facsimile access to support program initiatives Monday through Friday (excluding Federal holidays) during, at minimum, the hours of 8:00 a.m. through 6 p.m. Eastern Time.
1.B.004
Change Control – CMS Requirements
Implement changes to accommodate any CMS requirements related to rebate management within three (3) business days, at no additional cost to DMS. This is situational and is determined on a case-by-case basis by DMS.
1.B.005
Change Control-Process
Perform systems maintenance and modifications, as specified in this RFP, for all component parts of the solution, as required by DMS within the mutually agreed-upon timeframes.

Document new Change Control items within two (2) business days from the date that the Change Control items are identified.

Provide a full impact assessment within ten (10) business days from the date that the Change Order is logged.

1.B.006
Change Control - Process Time Limit
Process DMS-required changes (CCMs) within thirty (30) calendar days, unless otherwise approved.
1.B.007
Change Control- Request Tracking
Maintain a Change Control Process that tracks requests.
1.B.008
Corrective Action Plan - Development
Develop a Corrective Action Plan, subject to DMS approval, in writing within twenty-four (24) clock hours for each identified deficiency that cannot be corrected within the same business day.
1.B.009
Document Standards
For any performance falling below a Commonwealth-specified level, the Vendor should explain the problems and identify the corrective action to improve the rating. The Vendor should provide a written response to DMS inquiries within two (2) calendar days.
1.B.010
Payment - Distribution
Paychecks or EFTs should be issued to employees, at a minimum, every other week, on a certain identified date, which Vendors should specify in advance. (For example, every other Friday or the 14th and 30th.)
1.B.011
Payment - Reconciliation
Reconcile account statements and submit with documentation to DMS on a certain identified date, which Vendors should specify in advance.
1.B.012
Program Management - Business Improvement Plan Assessment
Present a quarterly assessment of the Business Improvement Plan (BIP) within fifteen (15) business days following the end of each quarter throughout the life of this contract. An agenda should be provided to DMS five (5) business days in advance of the presentation for approval.
1.B.013
Program Management - Business Improvement Plan Creation
Prepare an annual BIP and submit the proposed plan to DMS at least sixty (60) calendar days prior to the end of each calendar year.
1.B.014
Program Management - Project Management Framework
Work with DMS to review and continuously improve processes, tools, templates, and standards to meet the needs of the project

Ensure all staff adhere to the plans/processes as defined in the DMS Project Management Framework. DMS approval is required for any exceptions.

1.B.015
Program Management - Quality Assessments
Present quarterly results regarding quality assessment of each functional area to DMS within thirty (30) calendar days of the end of the quarter.
1.B.016
Program Management - Quality Improvement Plan
Prepare an annual Quality Improvement Plan (QIP) and submit at least sixty (60) calendar days prior to the end of the calendar year.
1.B.017
Project Management - RAID Documentation
Document new risks, issues, key decisions, and action items within two (2) business days from the date they are identified. This includes clearly documenting the risk, issue, decision, and/or action item, establishing an owner, and establishing a target due date.
1.B.018
Reporting - Ad Hoc Reports
Provide ad hoc reports within the timeframe defined in the RFP requirements.
1.B.019
Reporting - Audit Results
Deliver an audit report to DMS within thirty (30) calendar days of an individual audit.
1.B.020
Reporting - Call Center - Answer Speed
Provide Call Center reports by the 15th of the following month, including average answer speed in seconds.
1.B.021
Reporting - Call Center - Call Abandonment
Provide Call Center reports by the fifteenth (15th) of the following month, including Call abandonment rate and average abandon time.
1.B.022
Reporting - Call Center - Downtime Expected
Provide Call Center reports by the fifteenth (15th) of the following month, including total clock hours of daily call center access and any downtime experienced.
1.B.023
Reporting - Call Center - Inquiry Method
Provide Call Center reports by the fifteenth (15th) of the following month, including total number of inquiry requests received via telephone, facsimile, and USPS.
1.B.024
Reporting - Call Center - Talk Time
Provide Call Center reports by the fifteenth (15th) of the following month, including average ACD talk time per call of total calls handled.
1.B.025
Reporting - Complaints
Report monthly total number, type, and detail of each complaint from Members and Providers.
1.B.026
Reporting - Performance Monitoring
Continuously monitor and produce a monthly report during Operations & Maintenance (O&M) for the following items:

• The system website response time should be within five (5) seconds for ninety-nine percent (99%) of the time.

• System response time should be less than or equal to five (5) seconds for all inquiry and update screens, as measured on the production environment.

• Contract Requirements failures.

1.B.027
Reporting - Report Card Delivery
Produce and deliver report card on performance.
1.B.028
Employee Onboarding
The onboarding process of a new employee should not take longer than thirty (30) days, unless the FMA can attest to delays outside of their control such as incomplete packet submission, the submission of inaccurate employee information or delays by the employee to submit required background checks.
1.B.029
Security - Annual Risk Assessment
Perform risk assessment every three hundred and sixty-five (365) calendar days.
1.B.030
Security - SSAE Audit
Annual SSAE 18 audit.
1.B.031
Security - Third Party Assessment
Perform a third party security assessment every three hundred and sixty-five (365) calendar days.
1.B.032
Staffing - Organizational Change
Submit organization chart annually or within thirty (30) business days of change.
1.B.033
Staffing - Staff Duty Reallocation Plan
Within ten (10) business days of receiving an individual’s resignation notice, the Vendor’s notice to terminate an individual, or a position becomes vacant, the Vendor should provide a detailed plan specifying how work is to be completed until replacement staff is hired. DMS reserves the right to approve or reject the plan.
1.B.034
Staffing - Staff Replacement Notification
Provide resumes to DMS for the top three (3) candidates within thirty (30) calendar days after a vacancy occurs.
1.B.035
Staffing - Staffing Levels
Ensure the appropriate experienced staffing level is maintained throughout the project to ensure objectives are met on time and with quality.

Maintain staffing levels throughout the project at ninety percent (90%) or more of the Staffing Plan.

Ensure Vendor staff have the appropriate experience and are dedicated to the project in accordance with the approved Staffing Plan and their role in the Project Plan.

1.B.036
Staffing - Vacancy Notification
Provide written notification to DMS of anticipated vacancies of key staff within two (2) business days of receiving the individual’s resignation notice, the Vendor’s notice to terminate an individual, or the position becomes vacant.
1.B.037
System Performance - Call Center
Adhere to the Call Center guidelines outlined in the contract.
1.B.038
System Performance – EVV & Payroll Issues
Resolve any issues related to EVV and payroll within three (3) business days. If resolution is not possible within that timeframe, the Vendor should provide updates to DMS on the situation every 24 hours until resolved.
1.B.039
System Performance - File Delivery
Deliver claims files following every other Friday claims process cycle at a minimum.
1.B.040
System Performance - Help Desk Availability
Help desk available Monday through Friday (excluding Federal holidays) during, at minimum, the hours of 8:00 a.m. through 6 p.m. Eastern Time.
1.B.041
System Performance - Maintenance Problem Creation
Correct system maintenance problems within five (5) business days or correction date approved by DMS.
1.B.042
System Performance - Member Profile Update
Update member profiles, including demographics as needed.
1.B.043
System Performance - Staff Access
Maintain the system so that DMS and all staff have access to it within agreed upon response times.
1.B.044
System Performance - Web Availability
Access to web (for DMS, employees, participants) twenty-four (24) hours, seven (7) days a week, three hundred and sixty-five (365) days (24/7/365) a year, except for approved down time.

File details come from the government source that posted it. Updated .