Dated 09/25/23

STATE OF SOUTH DAKOTA

DEPARTMENT OF HUMAN SERVICES/DEPARTMENT OF SOCIAL SERVICES

3800 EAST HIGHWAY 34

c/o 500 EAST CAPITOL AVENUE

PIERRE, SOUTH DAKOTA 57501-3182

DEPARTMENT OF HUMAN SERVICES RATE METHODOLOGY

PROPOSALS ARE DUE NO LATER THAN NOVEMBER 30, 2026, 5 pm CST

RFP #: -26RFP20135 State POC: MARY REA EMAIL:MARY.REA@STA

TE.SD.US

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mailto:MARY.REA@STATE.SD.US mailto:MARY.REA@STATE.SD.US

1.0 GENERAL INFORMATION

1.1 PURPOSE OF REQUEST FOR PROPOSAL (RFP)

The purpose of this Request for Proposals (RFP) is to establish a contract with a qualified consultant to provide comprehensive rate-setting methodology and annual rate reviews using prospective rate adjustments for services delivered by home and community-based (HCBS) providers for the South Dakota Department of Human Services (DHS), including the Division of Long Term Services and Supports (LTSS) and the Division of Developmental Disabilities (DDD).

The selected Offeror will assist DHS in maintaining rate methodologies that are transparent, data-driven, fiscally responsible, and reflective of the costs associated with the efficient and effective delivery of services. The work will support DHS's responsibilities under South Dakota Codified Law Chapter 28-22, enacted through Senate Bill 147 (2017), which requires each category of covered service to undergo a comprehensive rate modeling analysis at least every five years and establishes specific requirements for the information and stakeholder involvement included in the rate modeling process.

The resulting contract will establish an ongoing rate review process consisting of:

1. A comprehensive rate methodology and rate modeling review at least once every five years for each service category; and

2. Annual rate reviews during the intervening years to evaluate changes in provider costs, labor market conditions, inflation, and other relevant factors and to determine whether adjustments to existing rates are warranted.

The contractor will provide DHS with the analysis, documentation, stakeholder facilitation, rate models, recommendations, and reports necessary to support DHS's rate-setting responsibilities, budget development, federal requirements, and communication with providers and other stakeholders.

Offerors may elect to submit a proposal for one, two, or all three of the service areas identified in the Scope of Work. Offerors are not required to submit a proposal for all service areas in order to be considered for an award.

For purposes of this RFP, the service areas are:

1. Long Term Services and Supports

2. Developmental Disabilities Services

3. In-Home Services

Offerors shall clearly identify in their proposal which service areas they are proposing to provide.

For each Scope selected, the Offeror shall demonstrate its qualifications, experience, proposed approach, staffing, timeline, and cost associated with completing the applicable work.

An Offeror's decision not to submit a proposal for a particular Scope will not, in itself, negatively affect the evaluation of the Offeror for any other Scope for which it submits a proposal. However, the Offeror must demonstrate that it possesses the qualifications and capacity necessary to successfully perform each Scope for which it submits a proposal.

1.2 ISSUING OFFICE AND RFP REFERENCE NUMBER

The Department of Human Services is the issuing office for this document and all subsequent addenda relating to it, on behalf of the State of South Dakota. The reference number for the transaction is RFP #-26RFP20135. This number must be referred to on all proposals, correspondence, and documentation relating to the RFP.

1.3 SCHEDULE OF ACTIVITIES (SUBJECT TO CHANGE)

RFP Publication

October 5, 2026

Offeror Questions Submitted October 16, 2026 by 5 pm CST Responses to Offeror Questions October 30, 2026 by 5 pm CST Proposal Submission November 30, 2026 by 5 pm CST Oral Presentations/discussions (if required) December 2026 Proposal Revisions (if required) January 2027 Anticipated Award Decision/Contract Negotiation February 2027

1.4 SUBMITTING YOUR PROPOSAL

All proposals must be completed and received by the Department of Human Services by the date and time indicated in the Schedule of Activities.

Proposals received after the deadline will be late and ineligible for consideration. An electronic copy of the proposal shall be submitted.

All proposals must be signed, by an officer of the responder, legally authorized to bind the responder to the proposal. Proposals that are not properly signed may be rejected. The email subject should have the appropriate RFP Number and Title. Proposals should be addressed and labeled as follows:

REQUEST FOR PROPOSAL #-26RFP20135

PROPOSAL DUE November 30, 2026 STATE POC Mary Rea; Mary.Rea@state.sd.us

No proposal shall be accepted from, or no contract or purchase order shall be awarded to any person, firm, or corporation that is in arrears upon any obligations to the State of South Dakota, or that otherwise may be deemed irresponsible or unreliable by the State of South Dakota.

1.5 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND

VOLUNTARY EXCLUSION – LOWER TIER COVERED TRANSACTIONS

By signing and submitting this proposal, the offeror certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation, by any Federal department or agency, from transactions involving the use of Federal funds. Where the offeror is unable to certify to any of the statements in this certification, the bidder shall attach an explanation to their offer.

1.6 NON-DISCRIMINATION STATEMENT

The State of South Dakota requires that all contractors, vendors, and suppliers doing business with any State agency, department, or institution, provide a statement of non-discrimination. By signing and submitting their proposal, the offeror certifies they do not discriminate in their employment practices with regard to race, color, creed, religion, age, sex, ancestry, national origin or disability.

1.7 CERTIFICATION RELATING TO PROHIBITED ENTITY

For contractors, vendors, suppliers, or subcontractors who enter into a contract with the State of South Dakota by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, is not an entity, regardless of its principal place of business, that is ultimately owned or controlled, directly or indirectly, by a foreign national, a foreign parent entity, or foreign government from China, Iran, North Korea, Russia, Cuba, or Venezuela, as defined by SDCL 5-18A. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response. The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.8 RESTRICTION OF BOYCOTT OF ISRAEL

mailto:Mary.Rea@state.sd.us

For contractors, vendors, suppliers, or subcontractors with five (5) or more employees who enter into a contract with the State of South Dakota that involves the expenditure of one hundred thousand dollars ($100,000) or more, by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, has not refused to transact business activities, has not terminated business activities, and has not taken other similar actions intended to limit its commercial relations, related to the subject matter of the bid or offer, with a person or entity on the basis of Israeli national origin, or residence or incorporation in Israel or its territories, with the specific intent to accomplish a boycott or divestment of Israel in a discriminatory manner. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response. The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.9 MODIFICATION OR WITHDRAWAL OF PROPOSALS

Proposals may be modified or withdrawn by the offeror prior to the established due date and time.

No oral, telephonic, telegraphic or facsimile responses or modifications to informal, formal bids, or Request for Proposals will be considered.

1.10 OFFEROR INQUIRIES

Offerors may email inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the Schedule of Activities. Inquiries must be emailed to Mary Rea at Mary.Rea@state.sd.us with the subject line “RFP #

26RFP20135”.

The State will respond to offeror’s inquiries (if required) via e-mail. In addition, all inquiries and the State’s response will be posted on the state’s e-procurement system. Offerors may not rely on any other statements, either of a written or oral nature, that alter any specification or other term or condition of this RFP. Offerors will be notified in the same manner as indicated above regarding any modifications to this RFP.

1.11 PROPRIETARY INFORMATION

The proposal of the successful offeror(s) becomes public information. Proprietary information can be protected under limited circumstances such as client lists and non-public financial statements.

An entire proposal may not be marked as proprietary. Offerors must clearly identify in the Executive Summary and mark in the body of the proposal any specific proprietary information they are requesting to be protected. The Executive Summary must contain specific justification explaining why the information is to be protected. Proposals may be reviewed and evaluated by any person at the discretion of the State. All materials submitted become the property of the State of South Dakota and may be returned only at the State's option.

1.12 LENGTH OF CONTRACT

The anticipated contract period is five years.

1.13 GOVERNING LAW

Venue for any and all legal action regarding or arising out of the transaction covered herein shall be solely in the State of South Dakota. The laws of South Dakota shall govern this transaction.

1.14 DISCUSSIONS WITH OFFERORS (ORAL PRESENTATION/NEGOTIATIONS)

An oral presentation by an offeror to clarify a proposal may be required at the sole discretion of the State. However, the State may award a contract based on the initial proposals received without discussion with the Offeror. If oral presentations are required, they will be scheduled after the submission of proposals. Oral presentations will be made at the offeror’s expense.

This process is a Request for Proposal/Competitive Negotiation process. Each Proposal shall be evaluated, and each respondent shall be available for negotiation meetings at the State’s request.

The State reserves the right to negotiate on any and/or all components of every proposal submitted. From the time the proposals are submitted until the formal award of a contract, each proposal is considered a working document and as such, will be kept confidential. The negotiation discussions will also be held as confidential until such time as the award is completed.

2.0 STANDARD CONTRACT TERMS AND CONDITIONS

Any contract or agreement resulting from this RFP will include the State’s standard terms and conditions as listed below, along with any additional terms and conditions as negotiated by the parties:

2.1 The Contractor will perform those services described in the Scope of Work, attached hereto as

Section 3 of the RFP and by this reference incorporated herein.

2.2 The Contractor’s services under this Agreement shall commence on __________________ and end on ___________________, unless sooner terminated pursuant to the terms hereof.

2.3 The Contractor will not use State equipment, supplies or facilities. The Contractor will provide the

State with its Employer Identification Number, Federal Tax Identification Number or Social Security Number upon execution of this Agreement.

2.4 The State will make payment for services upon satisfactory completion of the services. The TOTAL

CONTRACT AMOUNT is an amount not to exceed $________________. The State will not pay Contractor's expenses as a separate item. Payment will be made pursuant to itemized invoices submitted with a signed state voucher. Payment will be made consistent with SDCL ch. 5-26.

2.5 The Contractor agrees to indemnify and hold the State of South Dakota, its officers, agents and employees, harmless from and against any and all actions, suits, damages, liability or other proceedings that may arise as the result of performing services hereunder. This section does not require the Contractor to be responsible for or defend against claims or damages arising solely from errors or omissions of the State, its officers, agents or employees.

2.6 The Contractor, at all times during the term of this Agreement, shall obtain and maintain in force insurance coverage of the types and with the limits as follows:

A. Commercial General Liability Insurance:

The Contractor shall maintain occurrence based commercial general liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each occurrence. If such insurance contains a general aggregate limit, it shall apply separately to this Agreement or be no less than two times the occurrence limit.

B. Professional Liability Insurance or Miscellaneous Professional Liability Insurance:

The Contractor agrees to procure and maintain professional liability insurance or miscellaneous professional liability insurance with a limit not less than $1,000,000.00.

C. Business Automobile Liability Insurance:

The Contractor shall maintain business automobile liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each accident. Such insurance shall include coverage for owned, hired and non-owned vehicles.

D. Worker’s Compensation Insurance:

The Contractor shall procure and maintain workers’ compensation and employers’ liability insurance as required by South Dakota law.

Before beginning work under this Agreement, Contractor shall furnish the State with properly executed Certificates of Insurance which shall clearly evidence all insurance required in this Agreement. In the event a substantial change in insurance, issuance of a new policy, cancellation or nonrenewal of the policy, the Contractor agrees to provide immediate notice to the State and provide a new certificate of insurance showing continuous coverage in the amounts required. Contractor shall furnish copies of insurance policies if requested by the State.

2.7 While performing services hereunder, the Contractor is an independent contractor and not an officer, agent, or employee of the State of South Dakota.

2.8 Contractor agrees to report to the State any event encountered in the course of performance of this Agreement which results in injury to the person or property of third parties, or which may otherwise subject Contractor or the State to liability. Contractor shall report any such event to the State immediately upon discovery.

Contractor's obligation under this section shall only be to report the occurrence of any event to the State and to make any other report provided for by their duties or applicable law. Contractor's obligation to report shall not require disclosure of any information subject to privilege or confidentiality under law (e.g., attorney-client communications). Reporting to the State under this section shall not excuse or satisfy any obligation of Contractor to report any event to law enforcement or other entities under the requirements of any applicable law.

2.9 This Agreement may be terminated by either party hereto upon thirty (30) days written notice. In the event the Contractor breaches any of the terms or conditions hereof, this Agreement may be terminated by the State at any time with or without notice. If termination for such a default is effected by the State, any payments due to Contractor at the time of termination may be adjusted to cover any additional costs to the State because of Contractor's default. Upon termination the State may take over the work and may award another party an agreement to complete the work under this Agreement. If after the State terminates for a default by Contractor it is determined that Contractor was not at fault, then the Contractor shall be paid for eligible services rendered and expenses incurred up to the date of termination.

2.10 This Agreement depends upon the continued availability of appropriated funds and expenditure authority from the Legislature for this purpose. If for any reason the Legislature fails to appropriate funds or grant expenditure authority, or funds become unavailable by operation of law or federal funds reductions, this Agreement will be terminated by the State. Termination for any of these reasons is not a default by the State nor does it give rise to a claim against the State.

2.11 This Agreement may not be assigned without the express prior written consent of the State. This

Agreement may not be amended except in writing, which writing shall be expressly identified as a part hereof and be signed by an authorized representative of each of the parties hereto.

2.12 This Agreement shall be governed by and construed in accordance with the laws of the State of

South Dakota. Any lawsuit pertaining to or affecting this Agreement shall be venued in Circuit Court, Sixth Judicial Circuit, Hughes County, South Dakota.

2.13 The Contractor will comply with all federal, state and local laws, regulations, ordinances, guidelines, permits and requirements applicable to providing services pursuant to this Agreement, and will be solely responsible for obtaining current information on such requirements.

2.14 The Contractor may not use subcontractors to perform the services described herein without the express prior written consent of the State. The Contractor will include provisions in its subcontracts requiring its subcontractors to comply with the applicable provisions of this Agreement, to indemnify the State, and to provide insurance coverage for the benefit of the State in a manner consistent with this Agreement. The Contractor will cause its subcontractors, agents, and employees to comply, with applicable federal, state and local laws, regulations, ordinances, guidelines, permits and requirements and will adopt such review and inspection procedures as are necessary to assure such compliance.

2.15 Contractor hereby acknowledges and agrees that all reports, plans, specifications, technical data, miscellaneous drawings, software system programs and documentation, procedures, or files, operating instructions and procedures, source code(s) and documentation, including those necessary to upgrade and maintain the software program, and all information contained therein provided to the State by the Contractor in connection with its performance of services under this Agreement shall belong to and is the property of the State and will not be used in any way by the Contractor without the written consent of the State. Papers, reports, forms, software programs, source code(s) and other material which are a part of the work under this Agreement will not be copyrighted without written approval of the State.

2.16 The Contractor certifies that neither Contractor nor its principals are presently debarred, suspended, proposed for debarment or suspension, or declared ineligible from participating in transactions by the federal government or any state or local government department or agency.

Contractor further agrees that it will immediately notify the State if during the term of this Agreement Contractor or its principals become subject to debarment, suspension or ineligibility from participating in transactions by the federal government, or by any state or local government department or agency.

2.17 Any notice or other communication required under this Agreement shall be in writing and sent to the address set forth above. Notices shall be given by and to ___________________ on behalf of the State, and by ________________, on behalf of the Contractor, or such authorized designees as either party may from time to time designate in writing. Notices or communications to or between the parties shall be deemed to have been delivered when mailed by first class mail, provided that notice of default or termination shall be sent by registered or certified mail, or, if personally delivered, when received by such party.

2.18 In the event that any court of competent jurisdiction shall hold any provision of this Agreement unenforceable or invalid, such holding shall not invalidate or render unenforceable any other provision hereof.

2.19 All other prior discussions, communications and representations concerning the subject matter of this Agreement are superseded by the terms of this Agreement, and except as specifically provided herein, this Agreement constitutes the entire agreement with respect to the subject matter hereof.

3.0 SCOPE OF WORK

The selected Offeror shall provide comprehensive rate-setting methodology and annual rate review services for designated programs and services administered by the Department of Human Services. The work shall be performed in accordance with applicable state and federal laws, regulations, waiver requirements, Medicaid requirements, and Department policies, including South Dakota Codified Law Chapter 28-22.

The Offeror shall develop and maintain a systematic approach that allows DHS to conduct a comprehensive rate-setting methodology for each service category at least every five years, with annual reviews conducted during the intervening years.

The following project management and administrative provisions shall apply to all work performed under this

Scope of Work:

• The Offeror shall assign a project manager for the contract who will be responsible for all project deliverables.

• The Offeror shall provide DHS with the project manager’s email address, office phone number, and cellular phone number.

• The Offeror’s project manager shall provide DHS with the names and contact information for other staff assigned to the contract.

• Unless otherwise specified, all materials shall be transmitted electronically, including by email, secure

FTP, or another secure means approved by DHS when sharing protected information.

• The Offeror shall not publicly present or otherwise release materials developed under this contract until the materials have been reviewed and approved by DHS.

• The Offeror shall provide DHS, upon request, source materials developed during the course of the project. Ownership and use of such materials shall be governed by Section 2.15 of this RFP.

• DHS shall share available data and decisions in a timely manner. Timelines established for the Offeror are dependent upon timely sharing of data and decisions by DHS.

In addition to the comprehensive five-year methodology reviews and annual rate reviews described below, the Offeror shall provide the following rate development and implementation services as applicable to the service areas awarded.

A. Comprehensive Five-Year Rate Methodology Reviews For each service category scheduled for a comprehensive review, the Offeror shall conduct a full evaluation of the existing rate-setting methodology and develop recommendations for any necessary modifications.

The methodology review shall be sufficiently detailed to allow DHS to understand and document how each component of the rate is established and how the methodology supports the cost of delivering the service.

Consistent with SDCL Chapter 28-22, the comprehensive review shall include, as applicable:

• Review and analysis of current and available provider cost report data;

• Review of service delivery requirements and the actual activities necessary to provide the service;

• Review of staffing requirements, including staffing ratios, productivity assumptions, staffing mix, wages, benefits, turnover, and other relevant workforce factors;

• Review of training, certification, and credentialing requirements associated with the service;

• Analysis of current labor market conditions and other relevant market factors;

• Review of inflationary trends and relevant cost indices;

• Review of administrative, supervisory, program support, facility, technology, transportation, and other reasonable costs associated with service delivery;

• Review of utilization and service volume data, as appropriate;

• Review of geographic or other factors that may affect the cost of service delivery;

• Review of applicable state and federal statutes, regulations, waiver requirements, policies, and other current or impending changes that may affect service delivery or provider costs;

• Review of the existing rate-setting methodology and identification of assumptions that may no longer accurately reflect the cost of providing the service;

• Comparison to relevant external benchmarks, peer state methodologies, or other appropriate market information when available and useful;

• Development or refinement of transparent rate-setting models and rate components;

• Identification of rate variances between the current reimbursement and the rate indicated by the methodology;

• Development of prospective rate recommendations consistent with applicable federal requirements; and

• Identification of any data limitations, assumptions, risks, or policy considerations that may affect the rate recommendation.

The Offeror shall work collaboratively with DHS to determine appropriate assumptions and methodology components and shall clearly document the rationale and supporting data for each major component of the proposed rate methodology.

B. Annual Rate Reviews During years in which a service is not undergoing a comprehensive five-year methodology review, the Offeror shall conduct an annual rate review for each applicable service category.

The annual review shall adjust the rates in a prospective fashion and evaluate whether the existing methodology and rates remain reasonable based on changes since the most recent comprehensive methodology review. At a minimum, the annual review shall consider:

• Changes in provider costs and available cost report information;

• Changes in wages, benefits, and labor market conditions;

• Appropriate inflationary factors and cost indices;

• Changes in staffing requirements or service delivery practices;

• Changes in utilization or service volume when relevant;

• Changes in other significant cost components;

• Current and anticipated state and federal policy changes;

• Changes in program or service requirements;

• Market conditions affecting the availability of qualified providers; and

• Other factors identified by DHS or the Offeror that may materially affect the cost of providing the service.

The annual review shall compare the current reimbursement rate to the rate supported by the approved methodology and adjusted prospectively, identify any variance, and provide DHS with a written recommendation regarding whether rate adjustment is warranted as well as the fiscal impact.

The annual review is intended to maintain the currency of the rate methodology between comprehensive five-year reviews and shall not replace the required comprehensive methodology review.

C. Stakeholder and Provider Workgroups The Offeror shall facilitate an inclusive workgroup process for each comprehensive rate methodology review consistent with SDCL 28-22-3.

The Offeror shall:

• Develop agendas and meeting materials;

• Present the proposed methodology, assumptions, data, and rate components in a manner understandable to providers and other stakeholders;

• Facilitate discussion and obtain stakeholder input;

• Document questions, concerns, recommendations, and areas of disagreement;

• Evaluate stakeholder feedback and identify changes to the methodology or assumptions that may be warranted;

• Distinguish between stakeholder recommendations and the Offeror's technical recommendations; and

• Prepare comprehensive documentation of the workgroup process.

The workgroup process shall be designed to provide meaningful opportunity for provider input while maintaining the independence and technical integrity of the rate analysis.

D. Rate Methodology Documentation and Reports For each comprehensive methodology review, the Offeror shall produce a detailed written report that documents the methodology, data sources, assumptions, calculations, stakeholder process, findings, and recommendations.

At a minimum, the report shall include:

• Executive summary;

• Description of the service and service delivery model;

• Description of the current rate methodology;

• Data sources and data validation;

• Cost assumptions and supporting rationale;

• Staffing assumptions;

• Wage and benefit assumptions;

• Productivity assumptions;

• Administrative and program support assumptions;

• Other applicable cost components;

• Inflation and market factors;

• Relevant state and federal requirements;

• Stakeholder engagement and workgroup activities;

• Summary of stakeholder feedback;

• Proposed rate methodology;

• Detailed rate calculations;

• Comparison of current rates to recommended rates;

• Rate variance analysis;

• Identification of limitations and assumptions;

• Recommendation based on analysis; and

• Appendices containing supporting documentation and rate model outputs.

The Offeror shall provide DHS with electronic copies of all final reports, supporting analyses, data files, rate models, meeting materials, and other documentation developed under the contract.

E. Annual Rate Review Documentation For each annual rate review, the Offeror shall provide a concise but sufficiently detailed report documenting:

• The service reviewed;

• The current rate and methodology;

• Data reviewed;

• Changes in costs, wages, inflation, market conditions, or service requirements;

• Relevant changes in state or federal requirements;

• Calculation of the updated rate or rate range supported by the methodology;

• Comparison to the current reimbursement rate;

• Identification of any rate variance;

• Recommendation based on analysis; and

• Supporting documentation and assumptions.

The annual reports shall be structured consistently from year to year to allow DHS to readily compare changes in costs, methodologies, and rates over time.

F. Services Included in the Initial Scope The initial scope of the contract shall include one, two, or all three of the following service categories. DHS may modify the sequencing or timing of individual reviews based on operational needs, available data, legislative direction, federal requirements, or other factors. In addition, DHS may add additional services or remove services from the rate methodology review as needed to align with evolving program priorities, operational constraints, or stakeholder input.

1.

5 Year Rotating Comprehensive Review SDCL 28-22 Required for Targeted Provider Rates

Service Area Next Review Cycle Services included

Developmental Disabilities Services 2027 • Community Support Providers (CSPs)

• Intermediate Care Facilities (ICFs)

In-Home Services 2027

• Personal Care

• Homemaker

• Adult Companion

• Chore Services

• Respite Care

• Nursing

Long Term Services and Supports Services 2028 • Assisted Living

2.

Annual Rate Review SDCL 28-22 Required for Targeted Provider Rates

Service Area Services included

Developmental Disabilities Services • Community Support Providers (CSPs)

• Intermediate Care Facilities (ICFs)

In-Home Services

• Personal Care

• Homemaker

• Adult Companion

• Chore Services

• Respite Care

• Nursing

Long Term Services and Supports Services • Assisted Living

3.

5 Year Rotating Comprehensive Review for Non-Targeted Provider Rates

Service Area Next Review Cycle Services included

Developmental Disabilities Services 2027

• Family Support Companion Care (New)

• Family Support Personal Care (New)

• Family Support Respite Care (New)

5 Year Rotating Comprehensive Review for Non-Targeted Provider Rates

Service Area Next Review Cycle Services included

Long Term Services and Supports Services

• Community Living Home

• Structured Family Caregiving

• Residential Respite Care

• Adult Day

• Meals

Developmental Disabilities Services 2030 • Conflict Free Case Managers (CFCM)

• Family Support Coordinator

4.

Annual Rate Review for Non-Targeted Provider Rates

Service Area Services included

Developmental Disabilities Services

• Family Support Companion Care (After 2027)

• Family Support Personal Care (After 2027)

• Family Support Respite Care (After 2027)

Long Term Services and Supports Services

• Community Living Home

• Structured Family Caregiving

• Residential Respite Care

• Adult Day

• Meals

Developmental Disabilities Services

• Conflict Free Case Managers (CFCM)

• Family Support Coordinator

These services include services provided through the following:

• LTSS Home & Community Based Options and Person-Centered Excellence (HOPE) Waiver;

• DRS Assistive Daily Living Services (ADLS) Waiver;

• LTSS State Funded Services;

• DD Community, Hope, Opportunity, Independence, Careers, Empowerment, Success (CHOICES)

Waiver;

• DD Family Support 360 Waiver;

• Medicaid Private Duty Nursing; and

• Medicaid Home Health Nursing Services.

The Offeror shall evaluate whether the methodologies for the same or substantially similar services across programs should be aligned, differentiated, or otherwise structured based on program requirements, service delivery models, participant populations, staffing requirements, or other relevant factors.

G. Rate Review Schedule

The Offeror shall work with DHS to establish and maintain a multi-year rate review schedule identifying the comprehensive methodology review year and annual review activities for each service category.

The schedule shall be sufficiently flexible to accommodate changes in federal or state requirements, new service models, significant changes in market conditions, legislative direction, or other circumstances warranting an earlier or more frequent comprehensive review.

Any new service model identified by DHS as requiring a rate methodology shall be evaluated using a comprehensive rate modeling process prior to implementation, consistent with SDCL 28-22-1.

H. Data, Models, and Transparency The Offeror shall use credible, current, and relevant data sources and shall clearly identify the source, date, methodology, and limitations of data used in each analysis.

All rate models shall be transparent and sufficiently documented for DHS staff to understand the methodology, assumptions, calculations, and resulting rates. The Offeror shall provide DHS with working electronic rate models and supporting calculations in a format that permits DHS to review and, when appropriate, update the models.

The Offeror shall recognize that information gathered through the rate modeling process is subject to the public-record requirements of SDCL 28-22-2.

I. Budget and Legislative Support The Offeror shall provide technical assistance to DHS in interpreting rate methodology findings and preparing information necessary to support the Department's budget process and annual reporting responsibilities.

The Offeror may be asked to:

• Explain rate methodology findings to DHS leadership;

• Prepare tables, charts, and summaries for budget development;

• Assist with legislative presentations or responses;

• Provide technical clarification regarding rate recommendations;

• Assist DHS in responding to provider questions regarding methodology and rate recommendations; and

• Update analyses when material changes in assumptions, data, or policy occur; and

J. Technical Assistance and Ongoing Consultation Throughout the contract period, the Offeror shall provide ongoing consultation to DHS regarding rate methodology and rate-setting issues. This may include technical questions, interpretation of methodology components, emerging market conditions, changes in federal requirements, proposed service changes, or other issues that could affect the development or sustainability of provider reimbursement rates.

The Offeror shall work collaboratively with DHS staff and shall ensure that DHS maintains sufficient understanding and documentation of the methodologies developed under the contract to support continuity between comprehensive reviews.

The Offeror shall provide support for waiver amendments, including Appendix K applications and negotiations with the Centers for Medicare & Medicaid Services (CMS), when requested by DHS.

4.0 PROPOSAL REQUIREMENTS AND COMPANY QUALIFICATIONS

4.1 The offeror is cautioned that it is the offeror's sole responsibility to submit information related to the evaluation categories and that the State of South Dakota is under no obligation to solicit such information if it is not included with the proposal. The offeror's failure to submit such information may cause an adverse impact on the evaluation of the proposal.

4.2 Offeror's Contacts: Offerors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc. to the buyer of record indicated on the first page of this RFP. Offerors and their agents may not contact any state employee other than the buyer of record regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements. Offerors and their agents who have questions regarding this matter should contact the buyer of record.

4.3 Provide the following information related to at least three previous and current service/contracts, performed by the offeror’s organization, which are similar to the requirements of this RFP.

a. Name, address and telephone number of client/contracting agency and a representative of that agency who may be contacted for verification of all information submitted;

b. Dates of the service/contract; and

c. A brief, written description of the specific prior services performed and requirements thereof.

5.0 PROPOSAL RESPONSE FORMAT

5.1 An electronic document(s) shall be submitted.

5.1.1 All proposals must be completed and received in the South Dakota Department of Human Services by the date and time indicated in the Schedule of Activities. Proposals received after the deadline will be late and ineligible for consideration.

5.1.2 One (1) electronic proposal must be submitted to the South Dakota Department of Human Services.

5.1.3 Due to security concerns the State will not accept electronic proposals on portable media so Offerors must provide a secure location where the State can electronically download the Offeror’s proposal(s). The secure location should be sent to Mary Rea as point of contact. This secure location can be a SFTP site, an encrypted FTP site or a webpage using SSL, if files are only downloaded and nothing has to be uploaded.

5.1.4 No proposal shall be accepted from, or no contract or purchase order shall be awarded to any person, firm or corporation that is in arrears upon any obligations to the State of South Dakota, or that otherwise may be deemed irresponsible or unreliable by the State of South Dakota.

5.1.5 The proposal should be page numbered and should have an index and/or a table of contents referencing the appropriate page number.

5.2 All proposals must be organized and tabbed with labels for the following headings:

5.2.1 RFP Form. The State’s Request for Proposal form (1st page of RFP) completed and signed.

5.2.2 Executive Summary. The one-to-two-page executive summary is to briefly describe the offeror's proposal. This summary should highlight the major features of the proposal. It must indicate any requirements that cannot be met by the offeror. The reader should be able to determine the essence of the proposal by reading the executive summary.

Proprietary information requests should be identified in this section.

5.2.3 Detailed Response. This section should constitute the major portion of the proposal and must contain at least the following information:

5.2.3.1 A complete narrative of the offeror's assessment of the work to be performed, the offeror’s ability and approach, and the resources necessary to fulfill the requirements. This should demonstrate the offeror's understanding of the desired overall performance expectations.

5.2.3.2 A specific point-by-point response, in the order listed, to each requirement in the

RFP. The response should identify each requirement being addressed as enumerated in the RFP.

5.2.3.3 A clear description of any options or alternatives proposed.

5.2.4 Cost Proposal. Cost will be evaluated independently from the technical proposal.

Offerors may submit multiple cost proposals. All costs related to the provision of the required services must be included in each cost proposal offered.

See section 7.0 for more information related to the cost proposal.

6.0 PROPOSAL EVALUATION AND AWARD PROCESS

6.1 After determining that a proposal satisfies the mandatory requirements stated in the Request for Proposal, the evaluator(s) shall use subjective judgment in conducting a comparative assessment of the proposal by considering each of the following criteria:

6.1.1 Cost

6.1.2 Experience and Reliability

6.1.3 Expertise of Personnel

6.1.4 Method of Performance

6.2 Experience and reliability of the offeror's organization are considered subjectively in the evaluation process. Therefore, the offeror is advised to submit any information that documents successful and reliable experience in past performances, especially those performances related to the requirements of this RFP.

6.3 The qualifications of the personnel proposed by the offeror to perform the requirements of this RFP, whether from the offeror's organization or from a proposed subcontractor, will be subjectively evaluated. Therefore, the offeror should submit detailed information related to the experience and qualifications, including education and training, of proposed personnel.

6.4 The State reserves the right to reject any or all proposals, waive technicalities, and make award(s) as deemed to be in the best interest of the State of South Dakota.

6.5 Award: The requesting agency and the highest ranked offeror shall mutually discuss and refine the scope of services for the project and shall negotiate terms, including compensation and performance schedule.

6.5.1 If the agency and the highest ranked offeror are unable for any reason to negotiate a contract at a compensation level that is reasonable and fair to the agency, the agency shall, either orally or in writing, terminate negotiations with the contractor. The agency may then negotiate with the next highest ranked contractor.

6.5.2 The negotiation process may continue through successive offerors, according to agency ranking, until an agreement is reached, or the agency terminates the contracting process.

7.0 COST PROPOSAL

Cost will be evaluated independently from the technical proposal. Offerors may submit multiple cost proposals. All costs related to the provision of the required services must be included in each cost proposal offered. The cost proposal must be submitted in a separate document labeled “Cost Proposal”.

Offerors may submit a cost proposal for:

• Long Term Services and Supports Services;

• Developmental Disabilities Services;

• In-Home Services; or

• Any combination of the three service areas.

Offerors are not required to submit a cost proposal for all three services The cost proposal shall clearly identify the total cost associated with each service proposed. Costs shall be sufficiently detailed to allow DHS to understand the anticipated costs associated with the comprehensive five-year methodology reviews, annual rate reviews, stakeholder/workgroup activities, reports, rate models, and other deliverables identified within the applicable service(s).

If an Offeror proposes to provide more than one service, the Offeror shall identify the cost for each service separately. If the Offeror proposes a reduced cost or other pricing consideration for being awarded multiple services, that pricing shall be clearly identified as an optional combined-scope price in addition to the individual service costs.

DHS may award services independently and is not required to award multiple services to the same Offeror. The cost proposal for each service shall therefore represent the Offeror's complete cost to perform that service independently.