DOH23-036 Addendum 2_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

Florida Department of Health Division of Administration • Bureau of General Services 4052 Bald Cypress Way, Bin B-07 • Tallahassee, FL 32399

PHONE: 850-245-4199

FloridaHealth.gov

Accredited Health Department Public Health Accreditation Board

Addendum #2

ITN DOH23-036

DATE: July 19, 2024

TO: Prospective Vendors

FROM: Voncelia Meeks, Procurement Officer

Florida Department of Health Central Purchasing Office

SUBJECT: DOH23-036 Addendum #2

The purpose of this addendum is to modify Attachment L and to answer questions received in accordance with Section 2.8, Questions, of the ITN. 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: Page 81 has been modified to correct the heading of Attachment L, Background and Drug Screening Attestation, of the ITN, and is hereby replaced in its entirety.

B. Responses to Questions received pursuant to Section 2.8, Questions: Please see the

Department’s response to questions received by the due date outlined in Section 2.6, Timeline, of the ITN, below:

Questions and Answers

Fiscal Fiduciary Agent for HIV Patient Care and Treatment Services

# Question Answer

1.

Is the Fiduciary Agent permitted to also be a direct Service Provider ?

No.

2.

Will the Fiduciary Agent or a contracted entity of the Fiduciary Agent be required to perform programmatic and fiscal monitoring currently provided by the state ?

Yes, the Fiduciary Agent will be required to provide programmatic and fiscal monitoring of their subcontracted service providers with oversight and technical assistance from the Department.

3.

What is the expectations of the Fiduciary Agent regarding entering Services into AIMS, completing the area and statewide RSR ?

The Fiduciary Agent will be responsible for coordinating and collecting data required for the statewide Ryan Program Services Report (RSR) and entering them into a data system approved by the Department.

4.

With a capped Admin cost on the Fiduciary Agent will the subcontractors be permitted administrative costs to cover their costs of submitting bills etc.?

It is allowable for the Fiduciary Agent to share part of its administrative costs with subcontractors performing administrative activities. Direct Service agreements must be billed only at the established fees.

5.

What location and room number will it be held ? See Section 2.6 Timeline

6.

Please confirm the total number of points for the ITN? See Section 4.1.1. Scoring of Technical Replies

7.

Please describe fiduciary role related to Part B planning bodies? The Fiduciary Agent may provide information to the Department , but does have a direct role related to Part B.

8.

Will the local planning bodies continue to exist? Yes.

12.

3.3.2.1.2 Respondent’s ability to meet qualifications to provide required services. Please provide a written definition of “qualifications” required to provide services.

Please refer to Section 3.3.1 Mandatory Requirements.

13.

3.3.2.1.3 Respondent’s evidence that they are qualified. Please list acceptable “evidence.”

Any documentation that proves or supports the Respondent’s statement of being able to meet the experience and qualifications.

14.

Please describe the difference between items 3.3.2.1.2 & 3.3.2.1.3

Item 3.3.2.1.2 is a description of qualifications, whereas item 3.3.2.1.3 is evidence of what is described.

15.

Monthly sweeps do not seem feasible since billing is in arrears, can quarterly sweeps be considered?

Quarterly sweeps may be discussed during the negotiations.

16.

Are reallocations between service categories across jurisdictions or current lead agency level?

The Department is unable to answer at this time, as the question is not clear.

17.

On page 35, #6 & #7 Required client level data are identical, is that an error?

No. The claim codes in number 6 are required to match the same set of data points required in number 7.

18.

On page 36 states, “ Process electronic claim submissions for COB between primary and secondary payors.” Please provide specific and detailed information regarding this requirement.

Attachment A, Scope of Services section B.1.a.1.g.2 refers to the successful respondent’s system to identify alternate payor(s) for clients and adjudicate the claims between the alternate payor(s) and the Department to maintain the Department as the payor of last resort.

19.

Because the Fiduciary Agent will not be able to implement a competitive bid process prior to entering a contract, will the current providers continue providing services?

• If so, will the contacts be for a specified period or on a month-to-month basis?

• Will the Fiduciary take over the current contracts?

• Will current lead agencies be required to support transition of contracted providers?

There is nothing requiring or precluding a competitive bid process for contracting direct service providers. There is nothing requiring or precluding the Fiduciary Agent from contracting with the current providers. It is the intent of the Department to avoid interruption in services to any clients. Transition of existing services will be discussed during negotiations.

20.

Text in the Budget Narrative form states the following: “ What's important for this section is the total number of units of service which can be delivered based on the unit rate.” It is not clear how the Department will determine this based on the budget for fields (which according to the ITN should not be altered. Please provide more information regarding the expectation for this section and include examples given the following:

•There is no standard unit rate for service categories.

•Some service categories have multiple rates based on procedure (e.g. Dental and Ambulatory), actual cost (e.g.

Health Insurance Cost Assistance & Emergency Financial Assistance service type (e.g. Home & Community Based Services – DME fee, medical supply fee, and provider fee) . Other services list fee schedules in the service unit description or “TBD” Current or future unit rates may vary based on the geographical service area .

•It seems reasonable to assume that the Department will determine that some overlap between current provider networks and any new networks will be required. If this is correct, there would potentially need to be multiple rates per category. Additionally, current provider rates and any administrative allowances would need to be provided to applicants. Please provide current unit rates, fees and provider admin allowances. Also, Is it acceptable to list TBD and discuss how rates will be derived in the narrative.

The Department understsands that rates may vary across the state for each service category. Respondents must determine what unit rate will be used to help in establishing the total units of service for each category as a baseline.

21.

How does the Florida prompt payment factor in to this ITN?

The Department and the Fiduciary Agent shall adhere to the Department’s Contract Payment requirements which currently appear in the Department’s Standard Contract Document (version 6-2024), subject to revision and modification, in Section II.B. Contract Payment: 3.

22.

Will the 1/12 advance payment health exemption for nonprofits be available/applied to this ITN?

See Title 45, Subtitle A, Subchapter A, Part 75.305 Advance payment of funds to a grant recipient or subrecipient is not a standard operating procedure and is authorized by the Department’s Division of Administration, Bureau of Finance and Accounting under limited conditions.

23.

Item 3.3.3.1.2 requires the applicant to have “Sufficient cash and/or credit available to make timely payments of all invoices from direct service providers for a minimum of three months.”

• This conflicts with requirements set forth in the Office of Management and Budget’s release of the

No, the Department is not revising the ITN.

See Title 45, Subtitle A, Subchapter A, Part 75.305 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75#75.335 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75#75.335

Uniform Administrative Requirements codified by HHS in 45 CFR part 75 and incorporated into the Ryan White HIV/AIDS Program National Monitoring Standards for RWHAP Part B Recipients, Division of State HIV/AIDS Programs, HIV/AIDS Bureau (HAB) in June 2022 which states the following: in Section K: Fiscal Procedures.

• “ K.1. Recipients and subrecipients must be paid in advance, provided they maintain or demonstrate the willingness to maintain both written procedures that minimize the time elapsing between the transfer of funds and disbursement and financial management systems that meet the standards for fund control and accountability as established in 45 CFR Part 75.”

• Will this ITN be revised to reflect this requirement?

The Department and the Fiduciary Agent shall adhere to the Department’s Standard Contract Document (version 6-2024), subject to revision and modification; Section II. Method of Payment.

24.

3.3.1.1.2.: Will an advance to the fiduciary agent be allowable and considered under the contract?

See See Answer to Question #22

25.

3.3.1.1.4.: Can the service provider network include purchase order or vendor relationships or will this be limited to formal contracting?

Purchase Orders with terms and conditions established or a formal agreement can be used with prior approval of the Department.

26.

3.3.2.1.5.: Which funding streams are to be included in this allocation process?

See Section 1.4 Background.

27.

3.3.2.1.5.: Will this allocation be affected by different start/end dates for funding streams? How many of them overlap?

No

28.

3.3.2.1.5.2.: Will the geographical areas be defined by the state or by the fiduciary agent? Will re-allocation across geographical areas be allowable?

The State will define the geographical areas. Yes. Reallocation across geographical areas will be allowable.

29.

3.3.2.1.8.: What is considered timely payment of invoices? See the Department’s Standard Contract Document (version 6-2024), subject to revision and modification, in Section II.B. Contract Payment.

30.

3.3.2.1.11: Can the electronic data system replace CAREWare for the purposes of entering client services and RSR reporting?

Yes, at the discretion of the Department. This may be discussed during the negotiation.

31.

3.4.: How many total copies of the reply are required for submission, including for evaluators?

See Section 3.4 Copies of Replies

32.

5.12: Attachment L Background and Drug Screening Attestation o The attachment is missing from the ITN document. Please furnish a copy of this attachment.

o Please clarify if subcontracted provider organizations will need to adhere to Level 2 background and drug screening requirements for all employees or if this only applies to employees allocated to the contracts?

See Section A . Modifications

33.

5.18: Will subcontracts with providers need to mirror the terms and conditions of the Department’s Standard Contract?

The subcontractor will need to adhere to the same standards of the Department.

34.

B.1.a.4. Please provide minimum expectations for the Provider Manual.

The successful respondent will work directly with the Department to determine the contents of the Provider Manual.

35.

B.1.a.7. Please clarify whether fiduciary agent will be responsible for all three components of the national Monitoring Standards (Program, Fiscal, Universal).

Yes, with oversight and technical assistance from the Department.

36.

B.1.h.3.: What are the required elements of the Program Terms and Subcontractor/Direct Service Provider reports?

Elements are listed in the most current HRSA HAB RWHAP Part B Manual.

Reporting methodologies could be discussed during the negotiations.

https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/resources/part-b-program-manual.pdf

37.

B.1.f.3.: Will the state retain Provide Enterprise read-only licenses for Part B provider staff?

The successful respondent will exchange eligibility and utilization data electronically with the Department’s program management software.

Licensing and access to the Department’s system may be discussed during negotiation.

38.

B.1.j.: Per the HRSA Hab RWHAP Part B Manual, client satisfaction is a component of Clinical Quality Management and not within the scope of service for fiduciary responsibilities. Can this task be omitted from the Scope of Work?

No. The Fiduciary Agent will require and coordinate the collection of client satisfaction data from service providers.

39.

When will a working template for the budget narrative become available?

An Excel format of Attachment B, Budget Narrative, may be accessed via the following link:

https://www.floridahealth.gov/about/administrative-functions/purchasing/index.html

40.

Section 1a – Who is the Department’s Information Security Manager (ISM) or designee?

The Information Security Manager (ISM) reports to the Chief Information Officer within the Office of Information Technology, Florida Department of Health.

41.

Section 1b – Please clarify how we can verify the certification of a third-party security auditor? Certified by which entity? There are many vendors and no appropriate way for us to vet the services offered. Additional guidance on how we should be securing these audits would be helpful.

This question is in reference to Attachment H APPLICATION, DATA SECURITY, AND CONFIDENTIALITY. Therefore, the Office of Information Technology must answer it.

42.

Section 1c – Please confirm if SOC Report 2 Type 2 is a requirement of this contract for the fiduciary agent, approved vendors, or both. Will any documentation be accepted in lieu of SOC Report 2 Type 2.

This question is in reference to Attachment H APPLICATION, DATA SECURITY, AND CONFIDENTIALITY. Therefore, the Office of Information Technology must answer it.

https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/resources/part-b-program-manual.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/resources/part-b-program-manual.pdf https://www.floridahealth.gov/about/administrative-functions/purchasing/index.html https://www.floridahealth.gov/about/administrative-functions/purchasing/index.html

43.

Will service or cost caps be defined by the state or defined locally through the procurement process? For example: Mental Health is limited to no more than 26 units per client, per year.

Emergency Financial Assistance will be “short-term,” and defined as limited to no more than 6 vouchers, payments, or prescriptions per client, per year. Food bags or grocery store vouchers will be limited to no more than $50 per client, per month. Oral Health will have a cost cap of $2,000 per client, per year.

See Answer to Question #4

44.

Will Medical Transportation services include rideshare? Yes.

45.

What is the anticipated date for final unit of service definitions?

This will be discussed during negotiations.

46.

Will statewide service standards be developed for each service category prior to the implementation of this contract?

Yes, the Department is currently developing service standards for each category, and these may be discussed during negotiations.

47.

Will direct service providers be offered administrative allowance? See Answer to Question #4.

48.

An increase to the federal de minimis rate will take effect October 1, 2024. Will the fiduciary agent be able to negotiate a change to the administrative allowance under this rule change?

No. The administrative allowance is set by the terms of the HRSA Ryan White HIV/AIDS Program Part B federal legislation.

49.

How often will the methodology be reviewed to determine priorities for new service categories?

The Fiduciary Agent’s role is to develop and modify statewide service delivery based on planning body feedback received from the Department, which maintains the responsibility for planning and priority setting.

50.

What is the fiduciary agent’s role and responsibility in assessing priorities and allocation recommendations for each area at the local level? Who retains responsibility for this?

The Fiduciary Agent’s role is to develop and modify service delivery based on planning body feedback received from the Department, which maintains this responsibility.

51.

How many bank accounts does the Department anticipate requiring?

The Department will not require the successful respondent to maintain any specific number of bank accounts. The Department will require the successful respondent to maintain proper accounting for all funds received.

52.

Would the Department please consider extending the due date by two weeks to accommodate for the extra time printing and shipping incurs?

Not at this time, however the Department reserves the right to extend the timeline, when it deems necessary.

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.

ATTACHMENT L

BACKGROUND AND DRUG SCREENING ATTESTATION

I hereby attest that all Provider staff assigned to perform services under the resulting contract will have completed the following prior to rendering services under the provided contract.

1. A Level 2 background and drug screening, which must not be older than 5 years.

2. A Level 2 background screening with results that did not reveal any disqualifying offense identified by section 435.04, Florida Statutes.

I certify I have full authority to legally bind Respondent to the provisions of this Reply.

Signature of Authorized Representative* Date

*An authorized representative is an officer of the Respondent’s organization who has legal authority to bind the organization to the provisions of the Reply. This usually is the President, Chairman of the Board, or owner of the entity. A document establishing delegated authority must be included with the Reply if signed by someone other than the President, Chairman or owner.