DOH58071 BHIW National DPP Employer Coverage Technical Assistance - Cost Proposal Form.xlsx

XLSX spreadsheet 57 KB Posted

Attached to
Ohio Department of Health-Bureau of Health Improvement and Wellness-National Diabetes Prevention Program Employer Coverage Technical Assistance
Solicitation number
SRC0000033504
Issued by
Adams County, Ohio

About this file

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This is a Cost Proposal Form from the Ohio Department of Health (ODH) for the National Diabetes Prevention Program (National DPP) Employer Coverage Technical Assistance project, designated as DOH58071. The contract spans State Fiscal Years 2026-2028, with two primary contract periods (11/1/2025 - 6/30/2026 and 7/1/2026 - 6/30/2027) and an optional year (7/1/2027 - 6/29/2028). The project requires the selected vendor to conduct employer market analysis, engage in community conversations with employers and health plans, hold meetings with self-funded employers, develop work plans, submit technical assistance logs, quarterly work plan updates, quarterly data reports, and an annual project summary report.

The cost proposal form indicates a total proposed budget of $0 for all contract periods, suggesting this may be a grant-funded or cost-neutral initiative. The project's deliverables are comprehensive and focus on helping self-funded employers pilot the National Diabetes Prevention Program, with specific requirements including identifying potential employer partners, developing memorandums of understanding, creating employer-specific work plans, and collecting detailed data on program implementation, employee participation, and potential health plan coverage. The vendor will be required to provide monthly progress reports, conduct conference calls with ODH staff, and track metrics such as employee eligibility, enrollment, program completion, and risk reduction.

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Other files

File Type Posted
DOH58071 BHIW National DPP Employer Coverage Technical Assistance_ RFP.pdf PDF
Ohio Department of Health (ODH) Proposal Terms and Conditions 6.2025.pdf PDF

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Cost Proposal

Ohio Department of Health's Cost Proposal Form
Project Title: DOH58071- BHIW-SFY26-27-National Diabetes Prevention Program Employer Coverage Technical Assistance
Estimated Budget for State Fiscal Year (SFY) 2026 - 2027
Estimated Budget for SFY 2026 (Contract Period 1: 11/1/2025 - 6/30/2026)$ - 0
Estimated Budget for SFY 2027 (Contract Period 2: 7/1/2026 - 6/30/2027)$ - 0
Total Proposed Budget for Contract Period 1 & 2$ - 0
Estimated Budget for SFY 2028 (Optional Year 1: 7/1/2027 - 6/29/2028)$ - 0
Total Proposed Budget including Optional Years 1$ - 0
Total Overall Budget$ - 0
Offerors have the option of attaching a cost narrative to explain and justify costs, and to submit it as part of the Cost Proposal. A Cost Narrative may be advisable to explain any costs which the offeror has chosen to combine, to explain how hourly rates were achieved, or to make the connections between costs and the technical proposal.
If contract renewal options are exercised, the specific deliverables for the renewal period will be mutually defined and agreed upon prior to the conclusion of the current contract term.
DEL NO.Deliverables
Deliverable Due DateUnit CostUOMContract Period 1

SFY26 Usage 11/1/2025 - 6/30/2026 Contract Period 1 SFY26 Amounts 11/1/2025 - 6/30/2026 Contract Period 2 SFY27 Usage 7/1/2026 - 6/30/2027 Contract Period 2 SFY27 Amounts 7/1/2026 - 6/30/2027 Optional Year 1 SFY28 Usage 7/1/2027 - 6/29/2028 Optional Year 1 SFY28 Amounts

7/1/2027 - 6/29/2028Notes
1Participate in monthly conference calls with ODH staff and submit written monthly progress reports no later than 2 business days prior to each scheduled monthly conference call.Within 30 days after contract execution.$ - 0Amount$ - 0$ - 0$ - 0
2Submit an employer market analysis to identify self-funded employers within the vendor’s county or region that may be potential partners for the project. For each employer, the market analysis should include, but is not limited to:
a.Employer name.
b.Number of employees/beneficiaries.
c.Employer industry (e.g., government, construction, education, manufacturing, etc.).
d.Employee retention rates (if applicable).
e.Health insurance plan.
f.Existing wellness program offerings.
g.Number or percentage of employees with diabetes, if available
h.Details about any previous conversations the vendor had with the employer or health plan about DPP coverage. What was the outcome of the conversations? Was the employer or health plan interested? What were potential barriers or roadblocks?Within 60 days after contract execution.$ - 0Amount$ - 0$ - 0$ - 0
3Participate in community conversations with employers and health plans identified in the employer market analysis and submit meeting notes that outline who was present at the meeting, what was discussed, and next steps. If multiple meetings are held, meeting notes should be compiled into a single report.Within 5 months after contract execution.$ - 0Amount$ - 0$ - 0$ - 0
4Hold initial one-on-one meetings with 3 – 5 self-funded employers who are interested in participating in the pilot and submit meeting notes that outline who was present at the meeting, what was discussed, and next steps. Compile meeting notes into a single report.Within 7 months after contract execution.$ - 0Amount$ - 0$ - 0$ - 0
5Submit memorandums of understanding (MOU) from 2 self-funded employers to pilot the National DPP for 1 year. The MOU should include, but is not limited to:
a.An overview of the project.
b.Project expectations for participating employers (e.g., reporting requirements, meeting attendance, participation in ODH evaluation, expectation that the employer work toward covering the National DPP as a medical benefit at the end of the pilot, etc.).
c.Leadership support from participating employers (e.g., signatures from CEO, CMO, Human Resources Officer).
d.Health plan support, if applicable.6/29/26$ - 0Amount$ - 0$ - 0$ - 0
6In conjunction with the participating employers, their health plans, and partnering National DPP organizations, develop a work plan for each participating employer that outlines the steps the employer will take to:
a.Implement a pilot of the National DPP (e.g., explore program delivery options, assess employee needs/interests, establish pilot program enrollment and retention goals, identify eligible employees, conduct outreach to eligible employees and enroll them in the program, collect data and evaluate the pilot, etc.).
b.Analyze pilot program data to evaluate program implementation and inform coverage decisions.
c.Work with their health plan and organization leadership to add the National DPP as a covered medical benefit (e.g., build leadership support, design the medical benefit, etc.) once the pilot is complete.
Each work plan should be unique to the participating employer and should contain site specific information.6/29/26$ - 0Amount$ - 0$ - 0$ - 0
7Submit a monthly technical assistance (TA) log that should include, but is not limited to:
a.A description of group and/or individual technical assistance provided to the participating employers, health plans, and partnering National DPP organizations that month.
b.Name of employer, health plan, or partner requesting assistance.
c.Date of technical assistance.7/31/26, and monthly thereafter.$ - 0Amount$ - 0$ - 0$ - 0
8Submit quarterly work plan updates for each participating employer. The updates should include, but are not limited to:
a.A written description of work done over the past quarter to achieve the steps outlined in the work plan.
b.Successes and barriers experienced over the quarter.
c.Training, resources, or technical assistance needs.9/30/26, and quarterly thereafter.$ - 0Amount$ - 0$ - 0$ - 0
9Submit quarterly data reports that includes, but is not limited to, the following data points for each participating employer:
a.# of employees identified as eligible for the pilot, total and broken down by demographics
b.# of eligible employees referred to the program, total and broken down by demographics.
c.# of eligible employees enrolled in the program, total and broken down by demographics.
d.# of eligible employees that complete the program, total and broken down by demographics (completion according to the most recent Diabetes Prevention Recognition Program Standards).
e.# of sessions attended by eligible employees.
f.# of eligible employees that achieve risk reduction (according to the most recent Diabetes Prevention Recognition Program Standards).
g.# of DPP claims submitted to health plan (if applicable).
h.Amount ($) of reimbursement received from health plan (if applicable).

Quarterly Breakouts:

July – September 2026 data due 11/1/2026.

October – December 2026 data due 2/1/2027

January – March 2027 data due 5/1/2027.11/1/26, and quarterly thereafter$ - 0Amount$ - 0$ - 0$ - 0
10Submit an Annual Project Summary Report that summarizes all work performed under this contract, including accomplishments, challenges, lessons learned, data, TA provided and progress on activities.6/29/26, and annually thereafter.$ - 0Amount$ - 0$ - 0$ - 0
SFY Grand Totals$ - 0$ - 0$ - 0

Potential Offeror Information

Potential Offeror Supplier Information
Name of Organization:
State Supplier ID:
Address:
Contact Name:
Contact Name Title:
Phone:
Email:

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