Electronic Visit Verification SSJF - Bid-35745 SPO approved.pdf

Sole Source Justification Form

Version 7.01 Page 1 of 6

Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

Sole Source Justification Form - Part I Section I - General Information

Department/Bureau/Section: Division of Rehabilitation Services (DRS)/Bureau of Home and Community-Based Supports (BHCBS)

Need Identified Date: Nov 22, 2022 Supply/Service Need By Date: Jul 1, 2023

Project Title: Electronic Visit Verification (EVV) System

Vendor: Sandata Technologies LLC

Provide a description of the supplies or services required:

The DRS Bureau of Home and Community-Based Supports requires continuation of electronic timekeeping system services for providers in the Home Services Program.

Value: Estimated Value of Initial Term, this Change Order or Amendment: 2,500,000

Will this Sole Source amend a Professional or Artistic Services contract? Yes No

*Sole Source may not be used for amendments for Professional or Artistic Services if the amendment would increase the value by more than 5% of the initial award or extend the term by more than 60 days.

Type: New Sole Economically Feasible Source

Section II - Proposed Term

One-Time Purchase Term Contract

Estimated Contract Begin Date: Jul 1, 2023

Estimated Contract End Date: Jun 30, 2024

Number of Potential Renewals:

Length of Each Renewal in Months:

Total Value of All Renewals:

If a Term Contract, does the term, including renewals, exceed 12 months? Yes No

Section III - Funding Source Select the type of funding to be used (Check all that apply): State Appropriate Funds Federal Funds Other (Explain):

Section IV - Sole Source Justification

This purchase is economically only available from a single source primarily because it is: (If "Other" explain in one sentence)

Items are Copyrighted or Patented and the Items are Only Available from the Holder

Are there secondary justification(s) for this sole source? Yes No

Another justification that this purchase is only available from a sole source is because it is:

Software License/Upgrade/Maintenance

Another justification that this purchase is only available from a sole source is because it is:

Federal/State Grant Requires Contract with Vendor

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Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

Section V - Purchase History

Has the Agency or University Purchased these supplies or services in the past? Yes No

Term Term From Term To Value Description Contract Number Type

1 7/16/2013 06/30/2018 28,717,593 Electronic Visit Verification System (including startup costs 46AS069131 RFP

2 7/1/2018 6/30/2023 17,500,000 Electronic Visit Verification System 46AS069131 Renewal

If more than 10, or if other comments, explain:

Section VI - Business Rationale

1. Provide a detailed explanation of the need for the supplies or services:

The DHS Division of Rehabilitation Services operates the Home Services Program (HSP), a Medicaid Waiver Program designed to prevent the unnecessary institutionalization of Illinoisans with disabilities. With the provision of tailored services and supports offered by Individual Providers, usually of their choice, HSP Customers are able to remain in their homes. The EVV system was first required by the Illinois SMART Act and under the federal 21st Century CURES Act, all providers of Home care services are to be using EVV. The system works such that when an Individual Provider arrives at a Customer's Home, he or she must call into the EVV system to record start time. When a Provider is set to depart a Customer's home, he or she must call out using the EVV system; records from DHS are securely transmitted to vendor Sandata to help Sandata recognize established relationships between eligible customers and providers.

Sandata then securely transmits records of visits for each provider which are used to calculate the pay for the period in question and that info is transmitted for creation of payroll records that get processed. Therefore, the Sandata system helps ensure timely and accurate payment to over 40k providers throughout the state. DRS is currently preparing a Request for Proposal (RFP) for release, and seeks to keep the current system (developed through a competitive procurement) in place an additional year to provide sufficient time to solicit, award and negotiate a new contract for an EVV system to be utilized by HSP providers. This is needed because the business rules and data exchange interfaces between DHS and Sandata are already set up to transmit information back and forth in near-real time which prevents disruptions in service/ program operation and payment for our providers to comply with the currently effective collective bargaining agreement as well as federal and state law while going through the procurement process for a new EVV contract.

The Sandata system is integral to ensuring timely and accurate payment of providers. In FY22 HSP processed more than $740 million in payments to more than 35,000 HSP providers based on timekeeping within the EVV system. Without the system remaining in place while an RFP is released, there could be disastorous consequences and innumerable grievances from providers for a lack of timely payment and audit findings for the same .

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Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

2. Provide a list and describe in detail the specifications required to satisfy the need:

The attached business rules were developed following a competitive procurement, specifically to meet the needs/regulations of our program. Timely data exchange is necessary to keep the Electronic Visit Verification system up to date. Customer and provider information can change at any time. A near real-time exchange from the DHS case management system with the Sandata web service allows for all this information to be imported by the Sandata system. A set of transactions have been established to accomplish this goal. One of the main data exchanges is that of approved visits. Twice a week, approved visits are swept by Sandata and sent via a secure file transfer to DHS. DHS utilizes these visits to create payment records for individual providers and pass those records to the DHS Payroll system. It would not be feasible for another vendor to be awarded a contract and build the necessary business rules and interfaces to work with DHS in addition to effectively training providers and customers on how to use a new system prior to the expiration of the current contract.

The system is being supported as is until a solicitation (RFP) is completed.

3. Provide detail explaining the justification selected in Section IV to explain why the requested supplies or services are the only ones available that can satisfy the agency or university requirements?

The Sandata EVV system was originally built for DHS as the result of a competitive bidding process and the resulting business rules specifically match DRS rules and policy. No other vendor can be procured and a contract awarded prior to the expiration of the current contract . DRS is, however, finalizing an RFP for release and intends to competitively procure the next contract. The EVV system has been used by DHS since January 1, 2014, and it payment of Individual Providers has been dependent on DHS staff reconciling the records in the system with paper timesheets submitted by providers since July 1, 2014. The system was developed pursuant to the Illinois SMART ACT (PA 97-0689, § 5-5f(g). If there is no EVV system in place while DRS prepares an RFP then Individual Providers will not be paid, leading to grievances pursuant to the collective bargaining agreement. Additionally, Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services (PCS) and home health services (HHCS) that require an in-home visit by a provider no later than 1/1/2023. The Sandata system is the only one with specific business rules and interfaces built for HSP. No other vendor could come in and build a system and have DRS customers and providers trained to use it before the given the time constraints.

4. What are the unique features of the supplies or services that are not available in any other product or by any other vendor? Provide specific quantifiable factors/qualifications:

Referring to the attached business rules, which are set to match HSP program rules and policies, including but not limited to limitations on number of hours worked per day, limitations consistent with the Customer's service plan on type of service that can be provided to a particular customer, and whether the provider is authorized to provide the level of service being provided.

5. Has the Agency or University considered alternative supplies or services to satisfy their need? Yes No

5a. If no, why weren't alternatives evaluated?

The pricing was obtained through a competitive procurement 10 years ago and includes fees for maintenance and an annualized cost for calls made to the system. DHS initially paid around 28 million for the Sandata contract in the initial term. DHS is using rates from the currently existing contract, with no need for set up, back conversion of data, training of providers and customers, or any other initiation items. The rate is based solely on the annual maintenance fee coupled with the cost of the combined calls that come into the system.

A new vendor would require a much higher price due to implementation and training/development costs being added. With the system already in place, the startup costs are not necessary.

In regards to the competitive procurement, it was our understanding that a joint purchase was being completed by HFS for them, DHS and Aging however we later found out HFS did not get CPO permission prior to their RFP beginning. Once DHS was able to review the HFS RFP and in talking with HFS, DHS realized the HFS contract cannot meet our needs.

6. Are there resellers or distributors?

Yes No N/A

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Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

7. What efforts were made to get the best possible price (i.e. did the agency/university negotiate) and how did you determine the price for this purchase is considered fair and reasonable?

The only EVV system designed to support Home and Community Based Waiver outside of the Sandata system was recently procured by the Illinois Department of Healthcare and Family Services. Due to the infancy of the agreement and procurement prohibitions from engaging the vendor, it is unknown if the pricing will be fair or reasonable in meeting the large scale needs of the Home Services Program. Prior to the execution of the Sandata contract over a decade ago, market research was conducted and it was determined there were no large scale systems that would support the volume of providers.

The pricing breakdown for this sole source contract will be the same as in the existing contract, however the sole source contract will have a budget of $2.5m for one (1) year (costs were $3.5m in FY23). This amount is an estimate, because the bulk of the expenses are usage-based and dependent on the number of calls logged by the system. The $1M decrease for this contract is based on the fact that the no material changes to the EVV system will be needed in FY24, unlike previous years.

Budget breakdown is as follows:

Usage-based costs $2,200,000 Technical Implementation $232,667 Datawarehouse Fee $23,760 Yearly Maintenance Fee $43,573 Total $2,500,000

8. Will this purchase obligate the State to this vendor for future purchases such as maintenance, licensing or continuing need?

Yes No

9. What will be the financial or other impact to the State if this sole source is not approved and a competitive bid is required?

If this is not approved, DRS will be without an EVV system as required by state and federal law, and DRS would also be without a system to effectively monitor hours worked by providers in the Home Services Program, and thus an ability to timely and accurately pay providers.

10. Is there any additional information you would like to add to justify this sole source?

DRS is finalizing an RFP for release to procure a replacement EVV system. This is Sole Source only needed to ensure the current system remains in place while DRS goes through the procurement process and is necessary to ensure timely and accurate payment to providers as required by the collective bargaining agreement and state and federal law.

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Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

Section VII

Requesting Department Representative

Requesting Department Signature Required

I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed.

Date Apr 26, 2023

Printed Name David A. Kuriniec E-mail Address David.Kuriniec@illinois.gov

Phone Number 618-697-4339

State Agency Bureau/Division Head or University Purchasing Director Approval and Signature Required

I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed. (All prior form fields will lock once this e-signature is completed)

E-mail Address Jean.Sandstrom@illinois.gov

Phone Number 217-557-9298 Date Apr 26, 2023

Printed Name Jean Sandstrom

Agency Bureau/Division Head or University Purchasing Director and Not a Designee

SPO Approval and Signature Required

I have reviewed and understand the contents of this Sole Source Justification and agree with the State Agency or University determination.

I have reviewed and understand the contents of this Sole Source Justification and do not agree with the State Agency or University determination. As a result, the State Agency or University must explore other sourcing methods to satisfy their need.

State Purchasing Officer Signature Phone Number 217-720-6771 Date Apr 27, 2023

Printed Name Kylie D. Carter E-mail Address Kylie.Carter@Illinois.gov

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Bulletin Reference Number 23-444DHS-CENOF-B-35745

Requesting Agency/University Illinois Department of Human Services

Sole Source Justification Form - Part II Section I - General Information

Project Title Electronic Visit Verification (EVV) System

Vendor Sandata Technologies LLC

Initial Date of Procurement Bulletin Posting

Was a Sole Source hearing held per 30 ILCS 500/20-25?

Yes - Complete Section II and III below (Section II will only be visible when this option is selected)

No - Section II not required, go to Section III below Section III - CPO Approval and Signature Required

Based on my review, I authorize the Agency/University to proceed in accordance with the published Notice referenced above.

Based upon my review, I authorize the Agency/University to proceed with the following Changes.

Based on my review, the Agency/University is not authorized to proceed with this sole source as presented and my recommendation is that it be cancelled.

Other

CPO Signature CPO Phone 217-558-2231

Printed Name Ellen H. Daley Date

CPO E-mail Ellen.H.Daley@illinois.gov

Version 7.01 Page of Sole Source Justification Form - Part I Section I - General Information Will this Sole Source amend a Professional or Artistic Services contract?

If yes, what was the original contract value?

*Sole Source may not be used for amendments for Professional or Artistic Services if the amendment would increase the value by more than 5% of the initial award or extend the term by more than 60 days.

Section II - Proposed Term If a Term Contract, does the term, including renewals, exceed 12 months?

If yes, provide a detailed justification including any economic benefit received for agreeing to a multi-year term:

Section III - Funding Source Select the type of funding to be used (Check all that apply):

Section IV - Sole Source Justification Are there secondary justification(s) for this sole source?

Section V - Purchase History Has the Agency or University Purchased these supplies or services in the past?

Term Term From Term To Value Description Contract Number Type Section VI - Business Rationale

1. Provide a detailed explanation of the need for the supplies or services:

2. Provide a list and describe in detail the specifications required to satisfy the need:

3. Provide detail explaining the justification selected in Section IV to explain why the requested supplies or services are the only ones available that can satisfy the agency or university requirements?

4. What are the unique features of the supplies or services that are not available in any other product or by any other vendor? Provide specific quantifiable factors/qualifications:

5. Has the Agency or University considered alternative supplies or services to satisfy their need?

5a. If yes, name the alternative vendors whose supplies or services were evaluated:

5b. If yes, what were the alternatives for each vendor and why were they unacceptable? Be specific with regard to features, characteristics, requirements, capabilities and compatibility:

5c. Explain how the market evaluation was conducted?

*This evaluation is to determine available options within a market. If the evaluation is to determine quality or best suited option, this is not the appropriate source selection. Under no circumstances shall the evaluation consist of testing alternative options. These activities must be conducted in a competitive transparent environment (i.e. IFB or RFP).

5a. If no, why weren't alternatives evaluated?

6. Are there resellers or distributors?

7. What efforts were made to get the best possible price (i.e. did the agency/university negotiate) and how did you determine the price for this purchase is considered fair and reasonable?

8. Will this purchase obligate the State to this vendor for future purchases such as maintenance, licensing or continuing need?

8a. If yes, please provide details regarding future obligations and/or needs:

9. What will be the financial or other impact to the State if this sole source is not approved and a competitive bid is required?

10. Is there any additional information you would like to add to justify this sole source?

Section VII Requesting Department Signature Required I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed.

State Agency Bureau/Division Head or University Purchasing Director Approval and Signature Required I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed. (All prior form fields will lock once this e-signature is completed) SPO Approval and Signature Required Sole Source Justification Form - Part II Section I - General Information Was a Sole Source hearing held per 30 ILCS 500/20-25?

Section II - Sole Source Hearing Details The State posted to the Illinois Procurement Bulletin a description of the State's need, the justification for the sole source decision, and information regarding the opportunity to submit comments and testify at a public hearing. Notice of the hearing was also posted outside of the hearing room 48 hours prior to the hearing.

The public hearing was conducted for the purpose of receiving testimony regarding the sole source determination. The Hearing Officer recommends the following:

The following relevant documents are attached:

Section III - CPO Approval and Signature Required 9.0.0.2.20101008.1.734229 Ellen.H.Daley@illinois.gov

The system is being supported as is until a solicitation (RFP) is completed.

A new vendor would require a much higher price due to implementation and training/development costs being added. With the system already in place, the startup costs are not necessary.

In regards to the competitive procurement, it was our understanding that a joint purchase was being completed by HFS for them, DHS and Aging however we later found out HFS did not get CPO permission prior to their RFP beginning. Once DHS was able to review the HFS RFP and in talking with HFS, DHS realized the HFS contract cannot meet our needs.

The pricing breakdown for this sole source contract will be the same as in the existing contract, however the sole source contract will have a budget of $2.5m for one (1) year (costs were $3.5m in FY23). This amount is an estimate, because the bulk of the expenses are usage-based and dependent on the number of calls logged by the system. The $1M decrease for this contract is based on the fact that the no material changes to the EVV system will be needed in FY24, unlike previous years.

Budget breakdown is as follows:

Usage-based costs $2,200,000 Technical Implementation $232,667 Datawarehouse Fee $23,760 Yearly Maintenance Fee $43,573 Total $2,500,000