ESBD_428405_1750274882475_HHS0016010 Claims Processing.pdf

HHS Procurement and Contracting Services

IFB DOCUMENT

PCS 137

Page 1 of 21 Revised 12/06/2022

Invitation for Bid (IFB) Check one: Formal Informal

IFB No.: Issue Date: Response Due Date:

HHS001610 06/18/2025 07/22/2025

Formal responses may be mailed to the address in Section 4.4. E-mail and electronic responses submitted through the HHS Online Bid Room will only be accepted if indicated in the solicitation.

Response may NOT be submitted by Fax.

Contact Information:

Purchaser: Taylor Naiser Email: Taylor.Naiser@hhs.texas.gov

Submit Response Online to, if applicable:

https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room (You must be registered to submit online.), OR Mail Response, if applicable:

Hand Delivery:

Health and Human Services Commission

Attn: Bid Room Coordinator Procurement and Contracting Services

1100 W 49th St. MC: 2020 Austin, TX 78714-9166

OR

Overnight/Express/Priority Mail

Delivery:

Health and Human Services Commission

Attn: Bid Room Coordinator Tower Building Room 108 1100 W 49th St. MC: 2020

Austin, TX 78756 OR Email Response to:

pcsbids@hhsc.state.tx.us

Ship to or Service Delivered to Location:

Dept Family and Protective Services 4900 N Lamar Blvd Austin, TX 78751

Source of Authority CPA/POD DIR Other:

By signing this document, respondent certifies that prices shown on this quote are true and correct.

Should this bid/offer result in a Purchase Order, respondent agrees to comply with all “Terms and Conditions,” which are attached and incorporated into this document.

Check below if preference claimed under Texas Administrative Code (TAC), Title 34, Part 1, Chapter 20, Subchapter D, Division 2, Rule § 20.306:

□ Goods produced or offered by a Texas bidder that is owned by a Texas resident service-disabled veteran

□ Goods produced in Texas or offered by a Texas bidder that is not owned by a Texas resident service-disabled veteran

□ Agricultural products grown in Texas

□ Agricultural products offered by a Texas bidder

□ Services offered by a Texas bidder that is owned by a

Texas resident service-disabled veteran

□ Services offered by a Texas bidder that is not owned by a Texas resident service-disabled veteran

□ Texas Vegetation Native to the Region

□ USA produced supplies, materials, or equipment

□ Products of persons with mental or physical disabilities

VENDOR / RESPONDENT MUST COMPLETE ALL

ITEMS

Signature of Vendor or Authorized Representative

Print Name

(Must be manually signed; failure to sign will disqualify response.)

Texas Vendor Identification No. (or Federal

Employer’s ID):

Name of Business

Street Address City-State-Zip Code https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room mailto:pcsbids@hhsc.state.tx.us

Solicitation No. HHS001610 PCS 137

□ Products made of recycled, remanufactured, or environmentally sensitive materials including recycled steel

□ Energy Efficient Products

□ Rubberized asphalt paving material

□ Recycled motor oil and lubricants

□ Products produced at facilities located on formerly contaminated property

□ Products and services from economically depressed or blighted areas

□ Vendors that meet or exceed air quality standards

□ Recycled or Reused Computer Equipment of Other

Manufacturers

□ Foods of Higher Nutritional Value.

Telephone Number Fax Number E-Mail Address *By signing this bid, bidder certifies that if a Texas address is shown as the address of the bidder, bidder qualifies as a Texas Bidder as defined in Tex. Gov’t Code § 2155.444(c)(2).

AWARD NOTICE: The State reserves the right to make an award on the basis of low line-item bid, low total of line items, or in any other combination that will serve the best interest of the State and to reject any and all bid items in the sole discretion of the State.

1. INTRODUCTION AND PURPOSE OF IFB

The Health and Human Services Commission (HHSC) Procurement and Contracting Services (PCS) on behalf of the Department of Family and Protective Services (DFPS) is issuing this Invitation for Bid (IFB) to solicit Respondents to enter into a contract with DFPS to provide Claims Processing Services. The awarded Respondent(s) (Contractor) will process claims for the benefit of Adult Protective Services (APS) clients on behalf of DFPS.

DFPS may enter into multiple contracts with more than one Respondent in all DFPS Regions 1-11 (See Section 16 for Map). A Respondent may be awarded a contract to serve a single or multiple DFPS Regions.

Attachments to this IFB:

• Exhibit A – HHS Solicitation Affirmations

• Exhibit B – DFPS Uniform Terms and Conditions (UTCs)

• Exhibit C – DFPS Supplemental and Special Conditions

• Exhibit D – Pricing Sheet and Minimum Qualifications

• Exhibit E – Respondent Reference Form

• Exhibit F – Online Bid Room

• Exhibit G – Historically Underutilized Business (HUB) Subcontracting Plan (HSP)

Requirements

• Exhibit H – Sample Form 2282V

• Exhibit I – Sample Form 2311

• Exhibit J – Sample Form 4116X

Class and Item:

953-27 Claim Processing 961-16 Claims Processing Services

2. AGENCY OVERVIEW

The Health and Human Services Commission (HHSC) was created in 1991 to oversee and coordinate the planning and delivery of health and human services in Texas. It is established pursuant to Chapter 531, Texas Government Code and is responsible for oversight of Texas Health and Human Services agencies (HHS agencies). As a result of the consolidation due to House Bill 2292 (HB2292), some of the contracting and procurement activities for HHS agencies have been assigned to the PCS section of HHSC. As such, HHSC/PCS will administer the initial stages of the procurement process, prior to the contract award, including IFB announcement and publication, handling of communications from the Respondent, as well as managing the receipt and evaluation of valid responses for final review and evaluation.

HHSC/PCS directs the execution of the award of the contract resulting from this IFB.

http://www.statutes.legis.state.tx.us/Docs/GV/htm/GV.531.htm http://www.legis.state.tx.us/tlodocs/78R/billtext/html/HB02292F.htm

DFPS will administer the contract.

3. DEFINITIONS

• Appendix – Additional information and/or forms that is available in the back of this IFB document.

• Bidder– Entity or individual that submits a response to an IFB. See Respondent.

• Contract – A written document referring to promises or agreement for which the law establishes enforceable duties and remedies between a minimum of two parties.

• Contract Term – The period of time during which the Contract will be effective from begin date to end, or renewal date. The contract term may or may not be the same as the budget period.

• Debarment – An exclusion from contracting or subcontracting with state agencies on the basis of cause set forth in Title 34, Texas Administrative Code, Chapter 20, Subchapter G, and the System of Award Management (SAM).

• Deliverables – Goods or services contracted for delivery or performance.

• Due Date – Established deadline for submission of a document or deliverable.

• Effective Date – The date the contract term begins.

• Respondent – Entity or individual that submits a response to an IFB. See Bidder.

• Scope of Work – A statement that defines specific services to be performed.

• IFB – The process of notifying prospective Contractors of an opportunity to provide goods or services to the State. It is used interchangeably with ‘solicitation’ in this IFB.

• Subcontractor – An entity hired by an awarded Contractor to perform a portion of the scope of work by the entity contracting with DFPS as a result of this IFB. The Contractor remains entirely responsible for performance of all requirements of the Contract through monitoring the subcontractor’s performance.

• Unit Rate – Payment mechanism for services that are paid at a set rate per unit of service; for example, plumbing repair services at a prescribed rate per hour.

• Vendor – A Contractor that provides goods and services that are typically procured through the open market.

• Vendor Identification Number (Vendor ID No.) – Fourteen-digit number needed for any entity to contract with the State of Texas, and which must be set up with the State Comptroller’s Office. It consists of a ten-digit Vendor ID No. (IRS number, state agency number, or social security number) + check digit + 3-digit mail code.

4. INSTRUCTIONS TO RESPONDENTS

Before submitting a response to this IFB, read the ENTIRE IFB including Exhibit B - DFPS Uniform Terms and Conditions. Failure to read any part of this IFB will not relieve an awarded Contractor of their contractual obligations.

Failure to comply with this section may result in disqualification of a

Respondent’s Application.

Responses to this IFB will be received until the date and time shown above. Incomplete or late responses will not be considered.

The preferred methods of response are online bid portal or via email. Responses will be emailed to pcsbids@hhsc.state.tx.us or via the HHS Online Bid Room (see Exhibit F). Faxed responses will not be accepted. Responses sent to any other email address will not be accepted.

If submitting by hand delivery, overnight/express/priority delivery, all documents should be submitted on a single USB drive and must be in Microsoft office® formats (Word® and Excel®, as applicable) or in a form that may be read by Microsoft office® software. Any documents with signatures shall be submitted as an Adobe® portable document format (PDF) file. HHSC is not responsible for documents that cannot be read or converted. Unreadable responses may be, in HHSC’s sole discretion, rejected as nonresponsive.

The Response must include all documentation required by this Solicitation.

1. Submit one (1) USB drive of the complete response package

2. The USB drive must be enclosed in properly documented and sealed envelope or sealed carton.

3. The envelope or carton must be properly labeled, on the face or top of each, with the following:

a. Respondent’s name;

b. Contact name for response;

c. Phone number for response contact;

d. Solicitation number from the cover page of this Solicitation; and

e. HHSC/PCS purchaser name (Questions, Section 5).

Responses to this solicitation may be submitted in original hard copy to the address below. An authorized officer of the Respondent must manually sign submittal.

Hand Delivery Overnight/Express/Priority Mail Delivery

Health and Human Services Commission Attn: Bid Room Coordinator Procurement and Contracting Services 1100 W 49th St. MC: 2020 Austin, TX 78756

Health and Human Services Commission Attn: Bid Room Coordinator Tower Building Room 108 1100 W 49th St. MC: 2020 Austin, TX 78756

Fax responses will NOT be accepted. Emailed responses and responses submitted electronically through the HHS Online Bid Room will be accepted. Emailed responses mailto:pcsbids@hhsc.state.tx.us must be submitted to pcsbids@hhsc.state.tx.us. For instructions on registration and use of the HHS Online Bid Room, (see Exhibit F). Online, electronic responses must be submitted to https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room.

HHSC/PCS will not be responsible for failure of electronic equipment or operator error. Late, illegible, incomplete, or otherwise non-responsive submissions will not be considered. HHS will not be held responsible for any solicitation response that is mishandled prior to receipt by DFPS. DFPS will not be responsible for any technical issues that result in late delivery, inappropriately identified documents, or other submission error that may lead to disqualification (including substantive or administrative) or nonreceipt of the Respondent’s proposal.

All solicitation responses become the property of HHSC after submission and will not be returned to Respondent. It is the Respondent’s responsibility to appropriately mark and deliver the solicitation response to HHSC by the specified date. A U.S. Postal Service (USPS) postmark or round validation stamp; a mail receipt with the date of mailing, stamped by the USPS; a dated shipping label, invoice of receipt from a commercial carrier; or any other documentation in lieu of the on-site time stamp WILL NOT be accepted.

Response must include all required information/documents for this specification but may contain additional information considered pertinent by Respondent. HHSC/PCS reserves the right to reject any or all responses.

Procurement Schedule

Calendar of Events Due Date IFB Release Date 06/18/2025 Respondent’s Written Questions Due Date 06/30/2025 Deadline for to Post Written Answers 07/10/2025 IFB Submission Deadline 07/22/2025 Anticipated Contract Start Date 09/01/2025

5. QUESTIONS

The sole point of contact for inquiries concerning this IFB is:

Purchaser’s name: Taylor Naiser E-mail address: Taylor.Naiser@hhs.texas.gov

Questions may also be submitted directly to the sole point of contact through the HHS Online Bid Room (see Exhibit F).

Direct all communications relating to this IFB to the HHSC/PCS point of contact named above. All other communications between a Respondent and HHS agency staff concerning this IFB are prohibited. In no instance is a Respondent to discuss cost information contained in a response with the HHSC/PCS point of contact or any other staff prior to response evaluation. Failure to comply with these requirements may result in Response disqualification.

mailto:pcsbids@hhsc.state.tx.us https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room https://hhs.texas.gov/doing-business-hhs/contracting-hhs/hhs-online-bid-room mailto:Taylor.Naiser@hhs.texas.gov

6. HHSC/PCS AMENDMENTS AND ANNOUNCEMENTS REGARDING THIS IFB

HHSC/PCS will post all official communication regarding this IFB on the ESBD website, including the notice of award for IFBs exceeding $25,000. HHSC/PCS reserves the right to revise the IFB at any time. Any changes, amendments, or clarifications will be made in the form of written responses to Respondent questions, amendments, or addendum issued by HHSC/PCS on the ESBD website. Respondents should check the website frequently for notice of matters affecting the IFB.

7. HISTORICALLY UNDERUTILIZED BUSINESS (HUB) REQUIREMENTS

An evaluation of potential subcontracting opportunities was conducted for this contract in accordance with Texas Government Code Section 2161.252, and it was determined that this contract does not contain any probable subcontracting opportunities. Therefore, DFPS is not requiring a HUB Subcontracting Plan (HSP) be submitted with Respondent’s proposal.

However, if Respondent determines the need to subcontract, (or hire 1099 employees) for any services, equipment, materials and/or supplies to fulfill the terms of this contract, the Respondent must inform the HHSC Point of Contact listed in the General Information section within five (5) business days of the solicitation posting to the Electronic State Business Daily, so that the solicitation may be updated. The Respondent must submit a complete HUB Subcontracting Plan with its proposal to be considered responsive. The HSP form may be accessed at:

https://comptroller.texas.gov/purchasing/vendor/hub/forms.php.

If after the contract award the Contractor determines a need to subcontract for any services, equipment, materials, and/or supplies, the Contractor must contact DFPS for prior approval and request a review of its HUB Subcontracting Plan in accordance with the good faith effort requirements found in 34 Texas Administrative Code Section §20.285. The Contractor may not utilize a subcontractor without prior written approval from the DFPS.

You are encouraged to contact the DFPS HUB Coordinator for HUB Program or HSP questions.

Texas Department of Family and Protective Services DFPS HUB Coordinator E-mail: dfpshub@dfps.texas.gov

8. ESTIMATED QUANTITIES

Neither HHSC/PCS nor DFPS guarantees the acquisition of any quantities of goods or services during the term of the Contract. "Quantity" information is provided only as a guideline for preparing the response. The quantity information should not be construed as representing anticipated or actual quantities that will be ordered.

9. NEGOTIATION, EXCEPTIONS OR ASSUMPTIONS

Negotiations are prohibited under the IFB procurement method under most circumstances, and even then, the scope of permissible negotiations is limited and may not result in a material change to the scope of work or specifications as advertised in this IFB.

Respondents should NOT submit exceptions to this IFB which could result in disqualification of a https://comptroller.texas.gov/purchasing/vendor/hub/forms.php mailto:dfpshub@dfps.texas.gov

Response. No changes to a Response can be made after the submission deadline.

No assumptions should be included in a Response. The inclusion of assumptions could result in disqualification of a Response. Instead, a Respondent should advance assumptions and seek clarification of a section of this IFB, any Exhibits or attachments, in the form and manner required in Section 10 Questions or Requests for Clarification.

10. QUESTIONS OR REQUESTS FOR CLARIFICATION

This solicitation allows participants to ask HHSC questions or request clarifications.

Questions are required to be submitted, prior to the deadline to the sole point of contact, Section 5.

11. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES (DFPS) MISSION

The mission of DFPS is to protect children, the elderly, and people with disabilities from abuse, neglect, and exploitation by working with clients, families, and communities.

12. IFB PURPOSE AND BACKGROUND

The purpose of the Adult Protective Services (APS) Program is to protect older adults and persons with disabilities from abuse, neglect, and exploitation by investigating and providing or arranging for services as necessary to alleviate or prevent further maltreatment. The awarded Contractor will provide Claims Processing services that benefit eligible DFPS clients. DFPS makes payments to APS clients and contracts with vendors to provide services to APS clients, as determined by DFPS. The Contractor will facilitate payment between DFPS and those vendors and/or the APS clients.

13. SCOPE OF WORK (SOW) TO BE PERFORMED

DFPS will enter into a contract with a Contractor in a region or multiple regions to provide Claims Processing Services.

Claims Processing is the timely writing and processing of payments on behalf of DFPS for goods and services that benefit eligible DFPS clients. Client eligibility is determined by DFPS. There will be no direct client contact by the Contractor in the provision of this service; therefore, no special client characteristics need to be considered.

13.1. Contractor Responsibilities

Contractor must have an intake process to handle referrals. For each DFPS Region, the Contractor will pay the vendor of the goods or services that the DFPS APS Caseworkers have sent a Service Authorization (DFPS Form 2311) to the Contractor for processing of these payment on behalf of DFPS.

13.1.1. Service Authorization Form (DFPS Form 2311)

A. Ability to Accept Referrals

DFPS will authorize services via DFPS Form 2311, Service Authorization Form, forwarded as part of a disbursement packet. The DFPS Contract Manager will send the authorization electronically from a DFPS regional contract e-mail box address. However, the Contractor must be able to accept Form 2311 by any means, including but not limited to:

1. E-mail;

2. Fax;

3. U.S. Mail; and

4. Hand Delivery or Commercial Delivery Service

B. Maintain Support Resources Contractor must maintain all necessary support resources to receive, process, and document claims, including but not limited to:

i. Fully operational computer(s) and software compatible with DFPS technology;

ii. Sufficient technological capacity to handle all aspects of the claims processing service;

iii. Working telephone;

iv. Internet service; and

v. Working accessible and secure email capacity.

C. Document Referral

Contractor must be able to document the time and date that the Contractor received the disbursement packet consistent with the manner of receipt of the request by:

i. Maintaining the email (with a clearly visible receipt date and time notation);

ii. Utilizing a Time and Date stamp on the Form 2311; and

iii. If disbursement packets are found to be inaccurate or incomplete during the Quality Assurance, reference section 13.2.1, review the Contractor must document the initial receipt date and time and the final acceptance date and time.

13.2. Claims Processing

13.2.1. Disbursement Packet Quality Assurance (QA) Review

The Contractor must conduct a QA review of the disbursement packet prior to making the disbursement. QA review includes, but is not limited to, confirming that the Contractor has accurate and complete information needed to process a disbursement.

A. Information needed to make the disbursement – The disbursement packet will consist of Form 2311 and Invoice documents containing information supporting the amount due and whom to pay such as, but not limited to, the following information:

i. Who to pay;

ii. The vendor identification number for those goods and services as agreed upon by both parties;

iii. The exact amount of the disbursement, as designated in the

Form 2311;

iv. Where to send the disbursement; and

v. Any special instructions.

B. The Contractor must follow up with the APS Contract Manager, no later than close of business (COB) the day following receipt of the disbursement packet, to obtain required information or make corrections to Form 2311.

13.2.2. Process Accurate Payments

The Contractor must ensure disbursements made on behalf of DFPS are accurate as specified on the referral Form 2311 and documents in the disbursement packet received. Determination of accuracy includes but is not limited to ensuring:

A. Each requested disbursement is made payable to the correct party;

B. Each requested disbursement is for the exact amount requested;

C. The processing of each Form 2311 complies with any special instructions from DFPS;

D. The processing of each disbursement meets the time specifications outlined in the Check Processing Timetable below; and E. Each requested disbursement is sent to the specified party as required in the Form 2311.

13.2.3. Process Timely Payments

The Contractor must ensure disbursements made on behalf of DFPS are made timely as specified below.

Check Processing Time

Type of Disbursement

Receipt Time of an Accurate & Complete Service Authorization Form

Time by Which the Disbursement Must Be Processed and Out of Contractor’s Office

Regular Disbursement

Between 8 am & 5 pm

No later than the next business day

Reissuance Between 8 am & 5 pm

No later than the next business day

Disbursement at Contractor’s Office

Between 8 am & 5 pm

No later than the next business day.

Emergency Disbursement*

Between 8 am & 3 pm

Via overnight service, the same day received, before close of business

Emergency Disbursement* After 3 pm

Via overnight service, no later than the next business day

*Designated by making an overnight request at the sole discretion of DFPS.

13.2.4. Reconcile Disbursements

Contractor is responsible for reconciling disbursements issued and claimed against the actual funds expended.

The Contractor must adjust any returned disbursements that have not cleared the Contractor’s account, within 60 (sixty) days of issuance, in the next billing cycle as a credit adjustment. The Contractor may retain the initial administrative fee but may not charge an additional administrative fee.

13.3. Required Record Keeping

The Contractor must maintain records and must be able to promptly produce an easily legible hard copy of any records, if requested to do so by and for DFPS. The required records that must be maintained by Contractor include but are not limited to:

13.3.1. Transaction Records

Each individual transaction record must include all applicable documents to include the entire disbursement packet, including, but not limited to:

A. Documentation of the receipt and disposition of each disbursement packet

• Documentation of time and date initial disbursement packet received;

• Documentation of any follow-ups to include requests for additional information or reissuances received; and

• Documentation of time and date disbursement was released.

B. Form 2311 and receipts or invoices to support and reconcile disbursements;

C. Documentation to support overnight processing with the time and date sent indicated;

D. Additional documentation to support the disbursement was released to

DFPS staff at the Contractor’s office to include:

• Name, title, and signature of person receiving disbursement;

and

• Check number.

E. All supporting documentation.

13.3.2. Other Records

The Contractor must maintain all other records necessary to support disbursements made on behalf of DFPS. Such other records must include but are not limited to:

• Processed/Cancelled Checks

• Billing Documentation

• Any Contract-related emails or other written notifications/communications internal to Contractor or between Contractor and any external entities (including DFPS).

13.3.3. Required Reports

DFPS may from time-to-time request reports from the Contractor as needed to support the Claims Processing Service. The Contractor must comply with any report request made by the DFPS Contract Manager.

13.4. Transition Planning

At the end of the contract term, including any renewals or other contract termination or cancellation, the Contractor shall in good faith and in reasonable cooperation with the Department, aid in transition to any new arrangement or provider of services.

Unless otherwise directed in writing by DFPS, the Contractor must process all disbursement packets received by the Contractor through the end date of the Contractor’s Contract with DFPS.

14. HOURS AND DAYS SERVICES ARE TO BE PERFORMED

The Contractor must be available during regular working hours from 8 a.m. to 5 p.m.

Monday through Friday except on State Holidays. A list of State Holidays can be found at the following link: http://www.hr.sao.texas.gov/Holidays

For holidays that show “Skeleton Crew Required” or “Optional” Contractor must have enough employees on duty to conduct the business necessary to meet the requirements.

The Contractor shall provide substitutes for any workers not present for work. The Contractor shall provide relief personnel as necessary to ensure that the requirements of this contract are performed/accomplished as required.

15. MINIMUM QUALIFICATIONS

This section addresses the minimum requirements for the Contractor. For purposes of this solicitation, including all attachments, the term Contractor includes the Contractor itself, whether an individual or other legal entity, as well as all key personnel and principals (both individuals and legal entities) constitute the Contractor. The Contractor must meet or exceed the minimum qualifications, including the following:

15.1. Business Experience Requirements

Contractor, or its key personnel, responsible for the management of the Claims Processing Services program must have three (3) years of full-time successful relevant business experience such as:

• Handling claims processing for a State Agency;

• Providing services similar to those in this solicitation;

• Meeting timeframes similar to those in this solicitation, or

• Processing multiple client requests of a confidential and sensitive nature.

15.2. Minimum Financial Requirements

The Contractor, or its key personnel, responsible for the financial and accounting aspects of the provision of the Claims Processing Services must have three (3) years successful relevant financial experience. Relevant financial experience must include:

• Managing and accounting for the amount of funds equal to the minimum sufficient financial resource indicated in Section 3, Utilization and Compensation, Paragraph 3.2.2; and http://www.hr.sao.texas.gov/Holidays

• Maintaining a billing and payment process.

15.3. Sufficient Resources

The Contractor will maintain the requisite qualifications, experience, personnel, and the financial and other necessary resources to perform the Contractor's duties and obligations as required by, and in the manner required by, the awarded Contract.

15.4. Financial Resources

Contractor should expect a two-month delay between the time the Contractor incurs costs and the time that DFPS reimburses for disbursements issued.

Contractor must have sufficient financial resources, defined as cash or cash equivalent resources that are sufficiently liquid and available to the Contractor, which meets or exceed the total amount for desired DFPS region(s) to be served. The following establishes the initial two (2) month minimum sufficient financial resource requirements for each DFPS region.

Minimum Sufficient Financial Resources

DFPS

Region

Minimum Needed To Meet Two-(2) Month Requirement

01 $225,514.88 02 $449,630.51 03 $196,038.65 04 $45,670.49 05 $100,068.43 06 $141,180.14 07 $70,548.07 08 $66,265.14 09 $122,726.80 10 $389,770.81 11 $34,769.56

Total $1,842,183.48

In its proposal, the Respondent must submit evidence of the ability to fund 60 days of operations without payment from the Department. Acceptable methods include but are not limited to, bank account records, value of CD, line of credit, current financial statement, etc.

16. DFPS REGIONS - SERVICE LOCATIONS

A Respondent may provide services in one, some or all in DFPS Regions (for map, see http://www.dfps.state.tx.us/contact_us/map.asp).

http://www.dfps.state.tx.us/contact_us/map.asp

17. COST OF SERVICES

Respondents must propose an administrative fee to provide these services on Pricing Sheet and Minimum Qualifications (Exhibit D).

18. CONTRACT TERM

18.1. Initial Contract Term: The initial term of Contract is from September 1, 2025, through August 31, 2030.

Contractor must provide services specified in this Statement of Work by the contract execution date.

The awarded Contract does not constitute nor imply a commitment on the part of HHSC/PCS or DFPS to purchase additional services from the Contractor in the future.

18.2. Extension Option: DFPS, at is sole option and subject to availability of funding, may extend the Contract beyond the initial term and all renewal periods, if any, for up to one year as necessary to ensure continuity of service, to process a new solicitation, to secure a new contract, for purposes of transition to a new Contractor, or as otherwise determined by DFPS.

This extension, if exercised, will require the Contractor to continue performing services in accordance with the Contract requirements and all terms and conditions.

19. PRICING INFORMATION

19.1. Pricing Structure

Prices offered, as part of the Respondent’s response, must be firm, fixed prices for the term of the Contract.

The pricing must be submitted only using Exhibit D - Pricing Sheet based on the description and the unit of measure(s) provided for each line item. The unit prices must include all Solicitation requirements, including, but not limited to, labor, equipment, materials, supplies and all related expenses.

20. INVOICING AND PAYMENTS

No payment will be made without the submission of accurate and proper invoices to DFPS based on completed services requests.

Invoices must be received at the DFPS designated location and in the format identified by DFPS in accordance with the Texas Prompt Payment Act (see Texas Government Code Chapter 2251).

20.1. Invoicing Process

The Contractor will submit to DFPS a total bill each month in the format prescribed by the Department and will accept as payment in full the contracted unit rate. No payment whatsoever shall be made under this Contract without the prior submission of detailed, correct invoices submitted to the Regional

Contract office.

20.2. Instructions for Invoicing DFPS

All billing documents must be developed specific to the month of service which includes a completed and signed/dated Pre-bill For Delivered Services Report, Form 4116 (Purchase Voucher), and when applicable a Delivered Services Input (Form 2016) and all supporting documentation requested by the Department. The invoicing forms and associated completion tasks are explained below:

20.3. Pre-bill for Delivered Services

Each month, the Contractor will receive a DFPS pre-bill. This report lists all authorizations active during the previous month of service (applicable month shown in the upper right corner). A client may be listed more than once on the pre-bill. The administrative fee authorized for each disbursement will be reflected as a separate line item for the applicable client;

The Contractor will enter the following information on the pre-bill next to the name of each client that received services on the line consistent with the applicable service code and begin/end dates found on the Form 2311 provided in the disbursement packet:

• Rate: As applicable, enter the actual disbursement amount or administrative fee if disbursement was accurate and timely.

• Quantity: 1

• Fee Paid: leave blank.

• Amount: Same as Rate entry.

20.3.1. Form 4116X (Purchase Voucher)

The Contractor must complete State of Texas Purchase Voucher, Form 4116x by entering:

• #19. Service Month and Year;

• #13 & #23. Total Amount being claimed; and

• #24. Name and Phone Number of person that prepared the billing

20.3.2. Supplemental Claims

Claims for services provided in a prior month and not yet billed for Clients who received services, but the name does not appear on the pre-bill, the Contractor should follow the process for submitting a supplemental claim. The Contractor completes a Form 4116X (see above) and completes a Delivered Services Input (Form 2016) entering the following information:

A. Service Month/Year (in upper right);

B. Client Last Name; As listed on Form 2311 C. Client First Name; As listed on Form 2311 D. Client Number Same as Person I.D. on Form 2311;

E. Service Code: As listed on Form 2311;

F. Unit Type (leave blank);

G. Rate (Actual disbursement amount or administrative fee when disbursement was accurate and timely);

H. Quantity: 1;

I. Fee Paid (leave blank);

J. Amount: Same as Rate entry K. County; As listed on Form 2311;

L. 2311 Begin Date As listed on Form 2311; and M. 2311 Term Date As listed on Form 2311.

20.3.3. Method of Billing Submission

A completed Form 4116X, Form 2016, Pre-Bill and all disbursement packets (copies of Form 2311/invoices/supporting documentation) for each transaction being claimed, are to be scanned and emailed in the order they appear in the Pre-bill, to the contract manager.

20.3.4. Due Date

Billing documents must be received by DFPS no later than the 15th of the month following the month of service delivery. A Contractor's failure to submit invoices on time may be considered by DFPS as a contract compliance issue and in evaluating whether to renew or terminate the contract.

20.3.5. Provider Statement

The Contractor will receive a Provider Statement that identifies each client and the amounts paid under claims processing services.

21. INSURANCE

The Respondent agrees to comply with Insurance requirements in the DFPS Vendor Uniform Terms and Conditions (Exhibit B).

Contractor will immediately provide written notice to DFPS of any material changes to any document submitted under this Section; such notification also includes cancellation of coverage before the expiration date (i.e., end if policy period) of the applicable document.

22. REMEDIES AND DISPUTES

Contractor agrees to comply with the remedies and dispute requirements in the DFPS Vendor Uniform Terms and Conditions (Exhibit B) and with the following:

22.1. Contractor agrees and understands that DFPS may pursue tailored contractual remedies for noncompliance with the Contract. At any time and at its discretion, DFPS may impose or pursue one or more remedies for each item of noncompliance and will determine remedies on a case-by-case basis. DFPS’s pursuit or non-pursuit of a tailored remedy does not constitute a waiver of any other remedy that DFPS may have at law or equity.

22.2. DFPS will notify Contractor in writing of specific areas of Contractor performance that fail to meet performance expectations, standards, or schedules, but that, in the determination of DFPS, do not result in a material deficiency or delay in the implementation or operation of the services.

22.3. DFPS will notify Contractor in writing of specific areas of Contractor performance that fail to meet performance expectations, standards or schedules, but that, in the determination of DFPS, do not result in material deficiency or delay in the implementation or operation of services.

Contractor will, within three (3) business days (or another date approved by

DFPS) of receipt of written notice of non-material deficiency, provide the DFPS requestor a written response that:

A. Explains the reasons for the deficiency, awarded Contractor’s plan to address or cure the deficiency, and the date and time by which the deficiency will be cured; or

B. If Contractor disagrees with DFPS’s findings, explain their reasons for disagreeing with the findings.

22.4. DFPS will notify Contractor in writing of specific areas of Contractor performance that fail to meet performance expectations, standards or schedules, but that, in the determination of DFPS, do not result in material deficiency or delay in the implementation or operation of services.

Contractor will, within three (3) business days (or another date approved by DFPS) of receipt of written notice of non-material deficiency, provide the DFPS requestor a written response that:

A. Explains the reasons for the deficiency, Contractor’s plan to address or cure the deficiency, and the date and time by which the deficiency will be cured; or

B. If Contractor disagrees with DFPS’s findings, explain their reasons for disagreeing with the findings.

22.5. The Contractor’s noncompliance may result in delayed payment or non-payment as determined by DFPS.

22.6. At its discretion, DFPS may require Contractor to submit a detailed written plan (the “Corrective Action Plan”) to correct or resolve an issue, deficiency, or a breach of the Contract.

22.7. A detailed explanation of the reasons for the cited deficiency;

22.8. Contractor’s assessment or diagnosis of the cause; and

22.9. A specific proposal to cure or resolve the deficiency.

22.10. The Corrective Action Plan must be submitted by the deadline set forth by

DFPS’s request for a Corrective Action Plan. The Corrective Action Plan is subject to approval by DFPS, which will not unreasonably be withheld.

Respondent will prepare additional written reports for DFPS when requested and in the format required by DFPS.

Respondent will comply with the DFPS Vendor Uniform Terms and Conditions (Exhibit B) and DFPS Vendor Supplemental and Special Conditions (Exhibit C).

23. REFERENCES

Respondents must submit with response a list of business references (minimum of three) for which they have provided similar services for in the last two years – see Respondent Reference Form (Exhibit D). Respondent’s references should include at a minimum the company name, company point-of-contact, phone number, address, city, state, zip code and description of services provided, including language(s) interpreted (see Respondent Reference Form (Exhibit D). Failure to submit required list of references may cause response to be disqualified. HHSC/PCS may contact any or all references prior to an award.

Any negative response may result in disqualification of the Respondent’s submittal.

24. EXECUTIVE ORDER 48 COMPLIANCE

On November 19, 2024, Governor Greg Abbott issued Executive Order No. GA-48 relating to the hardening of state government (EO 48).

Pursuant to DFPS’s Uniform Terms and Conditions (UTCs), and in compliance with EO 48, the Respondent must certify that it is not, and, if applicable, any of its holding companies or subsidiaries, is not:

1. Listed in Section 889 of the 2019 National Defense Authorization Act (NDAA);

2. Listed in Section 1260H of the 2021 NDAA;

3. Owned by the government of a country on the U.S. Department of Commerce’s foreign adversaries list under 15 C.F.R. § 791.4; or

4. Controlled by any governing or regulatory body located in a country on the U.S.

Department of Commerce’s foreign adversaries list under 15 C.F.R. § 791.4.

In its proposal, the Respondent must provide a copy of its corporate structure, which should include any owners, holding companies, and subsidiaries, and any relevant documents to show that it does not meet any of the above-listed criteria.

25. MINOR INFORMALITY OR WITHDRAWAL OF RESPONSE

Responses may be withdrawn from consideration at any time prior to the response submission deadline. A written request for withdrawal must be made to the HHSC/PCS sole point of contact. A Respondent has the right to amend its response at any time and to any degree by written notice of changes or corrections in a sealed letter or carton to the Response Coordinator prior to the response submission deadline. HHSC reserves the right to waive minor informalities in a response and award a contract that is in the best interests of the State of Texas. A minor informality may include, but is not limited to, a minor irregularity or error such as a clerical error in the production of copies of the response. When HHSC determines that a response contains a minor informality, HHSC will notify the Respondent of the irregularity or error and will provide the Respondent the opportunity to correct.

26. EVALUATION Any negative result concerning submission information, references or forms may cause response to be disqualified.

26.2. In evaluating responses to determine the best value for the State, HHSC/PCS may consider information related to past contract performance/results of a Respondent including, but not limited to CPA’s Vendor Performance Tracking System.

26.3. All responses will be evaluated in a standard manner and will be rated according to the following criteria:

26.3.1. COST OF SERVICES SPECIFIED IN IFB

Costs of services are significant in the overall evaluation of the responses. However, DFPS is not obligated to select the lowest cost response. The award will be made to the Respondent(s) https://gov.texas.gov/uploads/files/press/EO-GA-48_Hardening_State_Government_FINAL_11-19-2024.pdf http://www.window.state.tx.us/procurement/prog/vendor_performance/ whose responses are most advantageous to DFPS cost and other factors considered.

26.3.2. EXPERIENCE AND PERFORMANCE RECORD

DFPS reserves the right to consider Respondent’s experience with this agency or contact individuals or businesses, whether private or governmental, which might have information bearing on the performance record of Respondents.

26.3.3. CAPABILITIES

Evaluation will be based upon your response to this IFB, overall experience, and Respondent’s capabilities with particular emphasis on the degree of supervision and number of employees that will be provided to perform this Contract.

27. AWARD

27.1. DFPS has the right to make one or more awards on the basis of a low line item, low total (group or groups) or in any other combination, to the lowest Respondent meeting or exceeding all advertised specifications, performance requirements, and terms and conditions, that will best serve the interests of the State. DFPS will be sole judge of “the best interest of the State.”

27.2. A contract award or awards will be made to the lowest-bid Respondent(s) after

DFPS is satisfied that the Respondent has met stipulations contained in this IFB, and that the Respondent can perform per specifications, terms, and conditions. DFPS may also opt not to issue an award with regard to this IFB.

During the life of the Contract, DFPS reserves the right to solicit for services that would normally be performed/accomplished using the Contract if it deems that by doing so would be in the best interest of the State.

28. PROTEST PROCEDURES

Texas Administrative Code, Title 1, Part 15, Chapter 391, Subchapter C outlines HHSC’s respondent protest procedures.

29. CONFIDENTIAL OR PROPRIETARY INFORMATION

29.1. Respondent’s Requirements Regarding Disclosure

Proposals and contracts are subject to the Texas Public Information Act (PIA), Texas Government Code Chapter 552, and may be disclosed to the public upon request. Other legal authority also requires HHSC to post certain contracts and Solicitation responses on its public website and to provide such information to the Legislative Budget Board for posting on its website.

Under the PIA, certain information is protected from public release. If Respondent asserts that information provided in its Solicitation Response is exempt from disclosure under the PIA, Respondent must:

1. Mark Original Proposal

a. Mark the Original Proposal, on the top of the front page, with the words

“CONTAINS CONFIDENTIAL INFORMATION” in large, bold, capitalized letters (the size of, or equivalent to, 12-point Times New Roman font or larger); and https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=1&pt=15&ch=391&sch=C&rl=Y https://statutes.capitol.texas.gov/Docs/GV/htm/GV.552.htm

b. Identify, adjacent to each portion of the Solicitation Response, that Respondent claims is exempt from public disclosure, the claimed exemption from disclosure (NOTE: no redactions are to be made in the Original Solicitation Response).

2. Certify in Original Solicitation Response – Exhibit A – HHS Solicitation Affirmations

a. Certify, in the designated section of the Exhibit A – HHS Solicitation

Affirmations, Respondent’s confidential information assertion and the filing of its Public Information Act Copy; and

b. Submit Public Information Act Copy of Proposal

i. Submit a separate “Public Information Act Copy” of the Original Proposal (in addition to the original and all copies otherwise required under the provisions of this Solicitation).

ii. The Public Information Act Copy must meet the following requirements:

1. The copy must be clearly marked as “PUBLIC INFORMATION ACT COPY” on the front page in large, bold, capitalized letters (the size of, or equivalent to, 12-point Times New Roman font or larger);

2. Each portion Respondent claims is exempt from public disclosure must be redacted (blacked out); and

3. Respondent must identify, adjacent to each redaction, the claimed exemption from disclosure. Each identification provided as required in Subsection (c) of this section must be identical to those set forth in the Original Proposal as required in Subsection (a)(2), above. The only difference in required markings and information between the Original Proposal and the “Public Information Act Copy” of the proposal will be redactions - which can only be included in the “Public Information Act Copy.” There must be no redactions in the Original Proposal.

By submitting a response to this Solicitation, Respondent agrees that, if Respondent does not mark the Original Solicitation Response, provide the required certification in the HHS Solicitation Affirmations, and submit the Public Information Act Copy, Respondent’s Solicitation Response will be considered to be public information that may be released to the public in any manner including, but not limited to, in accordance with the Public Information Act, posted on the HHS public website, and posted on the Legislative Budget Board’s public website.

If any or all Respondents submit partial, but not complete, information suggesting inclusion of confidential information and failure to comply with the requirements set forth in this section, HHSC, in its sole discretion and in any solicitation, reserves the right to (1) disqualify all Respondents that fail to fully comply with the requirements set forth in this section, or (2) to offer all

Respondents that fail to fully comply with the requirements set forth in this section additional time to comply.

Respondent should not submit a Public Information Act Copy indicating that the entire proposal is exempt from disclosure. Merely making a blanket claim that the entire proposal is protected from disclosure because it contains any amount of confidential, proprietary, trade secret, or privileged information is not acceptable, and may make the entire Solicitation Response subject to release under the PIA.

Solicitation Responses should not be marked or asserted as copyrighted material. If Respondent asserts a copyright to any portion of its proposal, by submitting a proposal, Respondent agrees to reproduction and posting on public websites by the State of Texas, including HHSC and all other state agencies, without cost or liability.

HHSC will strictly adhere to the requirements of the PIA regarding the disclosure of public information. As a result, by participating in this solicitation process, Respondent acknowledges that all information, documentation, and other materials submitted in the Solicitation Response in response to this Solicitation may be subject to public disclosure under the PIA. HHSC does not have authority to agree that any information submitted will not be subject to disclosure.

Disclosure is governed by the PIA and by rulings of the Office of the Texas Attorney General. Respondents are advised to consult with their legal counsel concerning disclosure issues resulting from this process and to take precautions to safeguard trade secrets and proprietary or otherwise confidential information.

HHSC assumes no obligation or responsibility relating to the disclosure or nondisclosure of information submitted by Respondents.

For more information concerning the types of information that may be withheld under the PIA or questions about the PIA, refer to the Public Information Act Handbook published by the Office of the Texas Attorney General or contact the attorney general’s Open Government Hotline at (512) 478-OPEN (6736) or toll-free at (877) 673-6839 (877-OPEN TEX). To access the Public Information Act Handbook, visit the attorney general’s website at http://www.texasattorneygeneral.gov.

http://www.texasattorneygeneral.gov/ http://www.texasattorneygeneral.gov/ http://www.texasattorneygeneral.gov./

Appendix A – RESPONDENT CHECKLIST FOR SUBMISSION OF RESPONSE The following is checklist of certain required and requested items in this IFB to assist the Respondent in responding to this IFB.