DOH23-017 Addendum #3 QA- FINAL.pdf

Mission:

To protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.

Ron DeSantis Governor

Joseph A. Ladapo, MD, PhD

State Surgeon General

Vision: To be the Healthiest State in the Nation

Addendum #3 Questions and Answers

RFP DOH23-017

Local Early Steps Programs

DATE: March 04, 2025

TO: Prospective Vendors

FROM: Voncelia Meeks, Procurement Officer

Florida Department of Health Central Purchasing Office

SUBJECT: Addendum #3

The purpose of this addendum is to modify the Request for Proposal (RFP), and to answer questions received in accordance with Section 2.7, Questions, of the RFP. This addendum serves as notice of the following change(s):

Deletions are indicated by “strikethrough” or reference. Additions, updates or replacements are indicated by highlighting.

A. Modifications: The following modifications are made to the RFP:

The Department’s RFP DOH23-017, Local Early Steps Programs, has been modified to include corrections and additions and is replaced in its entirety with Revised DOH23-017, Local Early Steps Programs, attached hereto.

B. Responses to Questions received pursuant to Section 2.7, Questions: Please see the Department’s response to questions received by the due date outlined in Section 2.5, Timeline, of the RFP, below:

RFP DOH23-017

Local Early Steps Programs

# Question Answer

1. I would like to further ask, is the respondent to the RFP required to be enrolled in the Florida Market Place as a vendor?

Yes. See Section 4.5, Provider Registration, of Revised DOH23-017 attached hereto.

2. Is this RFP applicable to the lead agency of a specific LES Region or all LES Regions in the system? Are respondents from outside of Florida qualified to submit an RFP? Must the Respondent have a physical presence (office) in the State of Florida during the proposal period or can it have its office outside the State of Florida? It is understood that if the Respondent is awarded the contract it will seek to have a local office in the region it is to serve.

This RFP includes required Local Early Steps services in the Regional Service Areas shown in Exhibits D and E. Also see Section

3.3.2.7 for information on selection of a regional service area or areas in Exhibit A.

Yes, Respondents from outside of Florida will be considered but must have a physical location in the State of Florida. See the attached Revised DOH23-017, Section 3.3.2, TAB 2 – Technical Proposal with added Section 3.3.2.2.1.10.

3. I would like to know if the RFP is one specific LES Region or for all regions.

See answer to question #2.

4. I noticed Exhibit F, Regional Service Area Budget Allocation is missing. Please provide the exhibit.

Exhibit E end on page 154 of 198. Exhibit G begins on page 155.

See Revised DOH23-017 attached hereto.

5. Is there a requirement to have a physical facility in Florida?

Yes. See answer to question #2.

6. What is the expected census for the Program?

See Exhibit G, Referred and Enrolled Children by Regional Service Area, of Revised DOH23-017, attached hereto.

7. Can we bid on all regions? Is there a need to submit a separate bid for every region?

Yes.

Respondents can submit one Proposal but must complete one Proposed Budget Template, Exhibit B, for each Regional Service Area selected on Exhibit A, Regional Service Area(s) Selection and Narrative Form and demonstrate throughout the response to the RFP the ability to provide services in the Regional Services Area(s) selected. Refer to Exhibits A and B.

8. What are the requirements to provide in-person versus telephonic or virtual?

Refer to Section 3.3.2.4.9. of the RFP. Respondents are encouraged to read the RFP in its entirety for all requirements.

9. For the hard copy submission of the RFP, is it acceptable to send the documentation bounded or is loose leaf preferred?

The Department does not specify a preference for bound or loose leaf. See Section 3.2, Proposal Format, of the RFP.

10. Exhibit H Implementation Plan (RFP Response Only) –

RFP Section 3.3.2.5 (pages 157 – 164):

• Is Exhibit H used to complete Section 3.3.2.5? Please note there is no header for Exhibit H.

• What does RFP response only mean on page 157?

• Do we not complete the subsequent pages 158 – 164?

Yes. See Revised DOH23-017 for updates to the Exhibit H header.

RFP Response Only has been removed. See revised DOH23-017.

Yes, Exhibit H provides the templates for completing the Contract Plans described in Sections 3.3.2.5 and 3.3.2.6 of the Revised DOH23-017. The Performance Improvement Plan Template, on pages 167-168 in the Revised DOH23-017 are not required to be submitted as part of the response to the RFP.

The Contract Plans submitted by the Respondents will be used for evaluation purposes, and the final Plans may require modifications, upon agreement by both parties and approval by the Department, prior to execution of a contract.

11. Can a company participate in the RFP as a prime contractor without being a Medicaid provider if it subcontracts clinical responsibilities to qualified Medicaid providers?

No.

12. Is it sufficient for a company to demonstrate that its subcontractors meet Medicaid requirements, or must the prime contractor also hold Medicaid provider status?

No. The Respondent (prime contractor) must be a Medicaid provider, and any subcontractors that provide direct client services must be Medicaid providers.

13. If the prime contractor is required to have Medicaid provider status, what is the acceptable timeline for achieving this status after the contract award?

See Section 3.3.1.14 of the RFP the Revised DOH23-017. The application must be approved by the time the contract is executed, which is anticipated on or before July 1, 2025.

14. Would documentation of a pending Medicaid provider application be sufficient to meet this requirement during the proposal submission phase?

Yes. See Section 3.3.1.14. of the Revised DOH23-017.

15. Is the prime contractor required to handle Medicaid billing directly, or can this responsibility be delegated to subcontracted providers?

Section 3.3.1.14. requires the Respondent to be enrolled as a Florida provider prior to providing services. The RFP does not specify if the Respondent or a subcontractor would conduct Medicaid billing.

However, if the response anticipates using subcontractors for Medicaid billing, the Respondent would need to demonstrate oversight and monitoring of all subcontractors and ensure that Florida’s System of Payments Policy, including Payor of Last Resort, is followed.

16. Can a company bid solely to provide administrative, staffing, and management services while subcontracting clinical responsibilities to licensed Medicaid providers?

Yes.

17. Are there any restrictions on the scope of services a non- Medicaid provider can offer under this RFP?

Direct client services must be provided by Medicaid providers.

18. Does the Department have specific guidelines or expectations for the structure and terms of subcontractor agreements (e.g., duration, reporting requirements)?

Yes. See Attachment A, Task B.1.a.14) and Exhibit K, Subcontract Language Checklist, of Revised DOH23-017.

19. How will proposals be evaluated when the qualifications and requirements are met collectively by the prime contractor and its subcontractors but not individually by the prime contractor?

The proposals will be evaluated holistically using Attachment F, Evaluation Criteria, regardless of the use of subcontractors.

20. How should a company allocate costs for subcontracted services in the proposed budget?

See Attachment A, Section D.5. on page 74 and Exhibit B of Revised

DOH23-017.

21. Page 22 – Contract Plans and Reports: 3.3.2.6 – References five (5) operational plans, however, 3.3.2.6.1.

lists only four (4) plans. Please clarify if there is a fifth plan we need to address.

Language has been corrected to reflect four plans. See Revised DOH23-017 attached hereto.

22 Page 28 - 4.7 and Page 98 – Attachment H: has approximately 160 subcontractor agreements. Do you need a copy of all our subcontract agreements or just a list of them along with the contract template as referenced on Attachment H, page 98?

A list of the known subcontractors and a template(s) of the subcontract agreement(s) that will be used must be submitted. See Section 4.7, Subcontractors, and Attachment H, Subcontractors List Form.

23 Page 83 – Medicaid Provider. 3.3.1.14: Please clarify if you need only the Group Early Steps Medicaid numbers or if you also need the individual Medicaid numbers for all Early Steps Staff.

Attachment F on page 83 is referring to the Medicaid enrollment status of the Respondent.

24 Page 86 – Approach to Program Administration, Task 1.

3.3.2.4.1.: Includes the Approach to Continuity of Operations Plan and the Approach to Funding Resource Plan. However, both Plans are also listed on pages 89 and 90 (3.3.2.6.1.1 and 3.3.2.6.1.2.). Please clarify if they are needed in both sections.

The plans will be evaluated in both sections.

25. Page 100 - Attachment J. 3.3.2.1: Does the Response Submission Checklist require a signature? It is stated on attachment that it must be signed however there is no signature line on the form.

No. See Revised DOH23-017 attached hereto.

26. Page 83-Company Profile, section 3.3.2.2.2: Prior Experience form and Reference letters: What entities are considered acceptable references? Are the expectations for these letters to come from community providers that we contract with or partners that we collaborate with? Also is the letter of reference and all the criteria listed on page 84 to focus on our agency’s performance or the entity providing the reference?

The Department does not specify what entities are considered acceptable references.

References should be entities who have done business with or collaborated with the Respondent in the past and can speak to the capability of the Respondent to perform the required services.

The information provided on page 84 is related to the Respondent’s performance.

27. Due to the upcoming Presidents Day holiday on Monday, February 17th, and the potential for closures at Department of Health (DOH) offices, submitting proposals by mail may be challenging. Would it be possible to extend of the deadline to accommodate potential mailing delays?

See Addendum 2 to DOH23-017.

28. Page 23 – Proposed Budget 3.3.2.7.2: Please clarify if the budget we prepare, based on FY 2023-2024, will be the budget/allocation used for FY 25-26. Our current funding for FY 24-25 is a higher amount. Will there be a new funding allocation for FY25-26?

There will be a new allocation for Fiscal Year 2025-2026 which will be provided to awarded Respondents. See Exhibit F in Revised DOH23-

017. The budget submitted with the response to the RFP can be based on either Fiscal Year 2023-2024 or 2024-2025 allocations.

29. We cannot locate a very important RFP Exhibit, Exhibit F – Regional Service Area Budget Allocations. See page 91 of the Evaluation Criteria, 3.3.2.7.2. Can you let us know how we can get a copy of this Exhibit so that we can prepare the required proposed budget?

See the answer to Question #4.

30. Confirming here (Attachment A, Paragraph e) We must have x2 Provider Coaches with one being Lead or LIC? First, we want to confirm here and if so, is there any way to get a waiver for that?

a. We didn’t see any other requirements in terms of DOH/ESSO grand strategy, policy or any other requirements that would necessitate the need for an additional coach for the size of our LES which averages monthly caseload of around 800 (Ref:

Exhibit J–Staffing Qualifications

No, a waiver would not be allowable.

31. Attachment I Local ES Program Background Screening Attestation states in part that: ALL Provider staff assigned to perform services under the resulting contract must have a clear Level 2 Background Screening... just clarifying here..

this is just those that perform Direct Services and/or those listed in the updated Job Descriptions (JDs)? for:

Exhibit J “Staffing Qualifications & Responsibilities” a Level 2 is required for Child Find, Service Coordinators, PD&CC, FRS, Billing Specialist and Provider Coaches; is that correct? or are there others on the team that must have as well?

Refer to Section 4.11 Background Screening Requirements of Revised DOH23-017.

32. To whose attention should the sealed RFP Proposal be sent? It currently lists “Insert Name” in the Attention line.

The Procurement Officer, Vonceila Meeks. See Revised DOH23-017.

33. Current Child Outcomes Summary (COS) Implementation Guidance states that an entry rating must be completed for every child who is eligible for Early Steps by 30 months of age, and all children who receive an entry COS rating and have been enrolled in the program for six months must receive an exit rating. However, according to the current RFP - 2.9.2.2.3, all children are eligible for the entry and exit COS regardless of how long they receive Early Steps services. Is there an Early Steps procedural change in which the COS Entry now needs to be completed for children regardless of age, so that a COS Entry and COS Exit would need to be completed, even if a child has their Initial IFSP the day before their 3rd birthday.

In addition, would a COS Exit now need to be completed for all children, even if the family chooses to close the case with Early Steps the same day or the day after the Initial IFSP and COS Entry has been completed?

The Child Outcome Summary (COS) Implementation Guidance is currently being updated to reflect changes related to exit COS ratings.

The update will include new procedural changes that require local programs to complete an entry and exit COS for all eligible children.

34. If so, how will the rules for Impossible Response Errors be modified for children who do not have any meaningful time period between their COS Entry and COS Exit?

Specifically, the Child Outcomes Summary (COS) Implementation Guidance states that the answer to the Child Progress question cannot be No if a child maintain the same COS rating from COS Entry to COS Exit, as the child would have to acquire new skills to be able to keep the same rating because what is expected of older children developmentally is more than what is expected of younger children. This logic, which fits for children enrolled in Early Steps for 6+ months, would no longer be relevant if 2.9.2.2.3 represents a procedural change, in which there will now be circumstances when the COS Exit will have to be completed immediately after the COS Entry, without any time for the child to acquire new skills.

See answer to Queston 33.

If the child has not learned any new skills at the time of the exit, their age-expected level of functioning must be considered to have decreased.

35. If bidding for multiple LES Regions, do we need to provide a separate, complete submission for each one, including the items requested in Exhibit H?

See the answer to Question #7.

36. Should Exhibit H be filled out with actual results, specific to Funding Resource Plan Tabs 2 and 3, Public Awareness Plan, System of Family Involvement Plan and Report, Professional Development Plan and Report, Performance Improvement Plan Template? If no, are you simply looking for the respondent to re-state that each element will be included in the future plans/reports?

No. Actuals should not be reported as they occur in the future. See Section 3.3.2.6. of the RFP. The Respondent must describe the approach to these plans. The Performance Improvement Plan Template is informational and not required for the submission of the

RFP.

37. Page 157, Implementation Plan, Exhibit H (?): For existing LESs, there are no timeframes, tasks, milestones, etc. for implementation because the items on the list have all been in place for many years. What type of response are you looking for?

If all of the sections of the Implementation Plan are already implemented, then describe what is currently in place that meets the requirements in the RFP.

38. Section 4.7 (page 28) Subcontracts states a list should be provided on Attachment H, which also requires a contract template. Section 4.7 paragraph 2 then requires a copy of each signed subcontractor’s agreement in the next paragraph. This will be thousands of pages. Please clarify what is being requested.

See the answer to Question #22.

39. Discrepancies on page 11 of the RFP regarding Attachments I and J. Is Attachment I really Attachment M? Is Attachment J really Attachment N?

See Revised DOH23-017 attached hereto.

40. For an existing LES, Exhibit H will be a lengthy repeat of information already provided in Tab 2. Do you want this information repeated in the specified format or should we state “refer to Tab 2xx”?

Exhibit H is a component of Tab 2. Exhibit H has the format and required content needed for the plans requested in Tab 2. See Section 3.3.2.5 and Section 3.3.2.6. of the Revised DOH23-017.

41. Section 3.3.2.4.16.3. references Developing, implementing and maintaining a Quality and Performance Achievement Plan and Report. However, this report is not mentioned again in the remainder of the RFP. What is it?

Language has been updated for this section. See Revised DOH23- 017.

42. Professional Development is referenced on pages 20, 57, and 162 regarding staff. Lead coaches and FL-EPIC are also referenced, which is more common with subcontracted providers. Is the requirement intended to target staff or subcontracted providers or both?

Professional development is intended to support both staff and subcontracted providers.

43. Page 14, section 3.3.2.3.2.2 requests the % of time each key admin staff will devote to Early Steps. However, Exhibit B on page 110 lists a restriction stating each key admin staff must be listed as 100% to Early Steps and may not share their time between multiple parent company programs or multiple positions within the Early Steps Program. Which is correct?

Key administration staff must be listed as 1.0 FTE with their time allocated full time (100%) to the administration of the Early Steps Program. In Exhibit B, for any of the key administration staff positions the Respondent needs to show that they are 100% dedicated to the Early Steps Program.

44. Can a writable form of the Exhibit B Budget template with formulas be provided?

No, a writable form of Exhibit B is not available at this time.

45. How should tabs be integrated in the electronic copy of the proposal?

The Department does not specify, and this may be determined by the Respondent.

46. Are electronic signatures acceptable for the RFP submission, or must they be original signatures?

Yes. The Department will accept electronic signatures.

47. What is the timeline for external service providers to submit claims to the LES? Current contract requirements are 60 calendar days, RFP scope of services requires all claims data entered in ESDS in 15 calendar days from date of service (page 60, 18c).

The subcontracted provider has 60 calendar days from the date of denial to submit to the LES for payment. See Attachment A, Task B.1.15)f) of the Revised DOH23-017.

Yes, all claims data (service information) must be entered into the Early Steps Data System within 15 calendar days of a claims status change. See Attachment A, Task B.1.18)c).

48. Regarding financial consequences #44&45 – does the LES incur a financial consequence if external providers are not timely (within 7 days) of documenting service-related and claims-related data? Also, timeline for submission of claims in financial consequences #44&45 conflicts with question 4 listed above.

Yes, the Respondent (LES) will be held responsible for performance of all services, including internal and external providers for data entry.

The Department cannot clarify the second part of this question as it is not clear.

49. Regarding EXHIBIT I (page 165): Task 7: Procedural Safeguards, B.1.a.7(b) – there is no (b) in the Scope of Services, page 49. Should this be labeled as B.1.a.7.(a) in

EXHIBIT I?

See Revised DOH23-017.

50. Regarding EXHIBIT I (page 165): Task 8: Service Coordination Services, B.1.a.8(c)(i) – there is no (i) in the Scope of Services, page 50. Should this report be labeled as part of B.1.a.8.(d)?

See Revised DOH23-017.

51. Will the state be providing a statewide referral form to distribute to community partners who opt not to use the online referral link? (page 48 3c).

No. If the LES creates a referral form to distribute, then it must be approved by the Department’s Contract Manager prior to distribution.

52. Regarding 4.11 Background Screening Requirements (page 29), what are the requirements for a drug screening - are there different types of drugs that must be included; what is the threshold for pass/ fail; who and how will this be monitored; at what frequency?

See Section 4.11 and Attachment I of Revised DOH23-017. Please also refer to Chapter 435.04, Florida Statutes, Level 2 Screening Standards.

53. Does budget restriction #6 page 74 apply only to contract funds or is it also extended to third-party revenue? If so, how should time handling other data be funded, such as evaluation scheduling, when there is no ESDS component for this task?

The budget restrictions in Section D. 5. on page 74 applies to all funding for Local Early Steps services.

See Attachment A, Task B.1.A.18) a). Data entry into the ESDS is required through data entry or import. The cost for double data entry into a parent company system can be paid with any other funds except contract funds. However, the contract budget with all funding details will be reviewed and approved by the Department’s Contract Manager.

54. Is the Quality and Performance Achievement Plan and Report referred to on page 20 the same as the ESDS report documenting timeliness of Child Outcome data as indicated on 61, B.19) d)?

No. These items are not related. See Revised DOH23-017.

55. Where can we find ATTACHMENTS O and P? Current RFP ATTACHMENTS are A through N, and then Q.

See Revised DOH23-017. The Attachment O and Attachment P do not exist. Attachment Q should be Exhibit Q.

56. Must we submit all agreements with Medicaid Managed Care plans and private insurance plans or just one of each as an example?

See Section 3.3.2.4.17. A template of any agreement types should be submitted, in addition to a list of all the Medicaid and insurance plans with active agreements.

57. Must we submit all interagency agreements with local school districts related to transition, or just one as an example?

See answer to Question 56. A template of any agreement types should be submitted, in addition to a list of all the school districts with active agreements.

Failure to file a protest within the time prescribed in section 120.57(3), Florida Statutes, or failure to post the bond or other security required by law within the time allowed for filing a bond shall constitute a waiver of proceedings under Chapter 120, Florida Statutes.