Final_RFP_729_1900000068_2_SO_FORM.PDF

Document ID: RFP 729 1900000068 Page: 1 of 4

Commonwealth of Kentucky

SOLICITATION MODIFICATION

Addenda: Yes Addenda #: 2

TITLE: Western State Hospital Dental Services

Date Issued:

10/16/18 Record Date:

2018-10-16

Solicitation Closes Date:

11/14/18 Time:

14:00

Solicitation No:

RFP 729 1900000068

Online Bidding Prohibited: Yes

For Information Call:

Vanessa Petrey 502-564-7049

Bid Receiving Location:

CHFS OATS Division of Procurement & Grant Oversight

BUYER

275 E Main Street 4E-C

Frankfort KY 40621

Vendor Customer Number:

Vendor Name:

Phone Number:

Fax Number:

Email Address:

Ordering

Address:

City, State, Zip:

Contact Name:

Contact Email:

Contact Phone Number:

Payment

Address:

City, State, Zip:

Contact Name:

Contact Email:

Contact Phone Number:

Ownership Type

__ Sole Proprietorship __ Partnership __ Corporation __ Other_________________________

SIGNATURE OF AUTHORIZED AGENT IS REQUIRED UNLESS RESPONSE

IS SUBMITTED ELECTRONICALLY. FAILURE TO SIGN SHALL RENDER

THE BID INVALID.

Signature X_________________________________________ FEIN#____________________ Date____________

All offers subject to all terms and conditions contained in this solicitation.

Document ID: RFP 729 1900000068 Page: 2 of 4

Line Items

Commodity Group: Default

Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt

1 FY19 Dentist (Part-time)

Comm Code Comm Description Manufacturer Model # Manuf Part #

94828 Dental Services

Extended Description Dental/Dental Hygienist services to be provided to Western State Hospital patients. These services are necessary to provide care to our patients/residents.

2 FY19 Dental Hygienist (Part-time)

Dental/Dental Hygienist services to be provided to Western State Hospital patients. These services are necessary to provide care to our patients/residents.

3 FY20 Dentist (Part-time)

Dental/Dental Hygienist services to be provided to Western State Hospital patients. These services are necessary to provide care to our patients/residents.

4 FY19 Dental Hygienist (Part-time)

Dental/Dental Hygienist services to be provided to Western State Hospital patients. These services are necessary to provide care to our patients/residents.

Shipping Information Billing Information

Document ID: RFP 729 1900000068 Page: 3 of 4

CHFS DBHDID - Administration & Financial Management

275 E Main Street 4CD

Frankfort KY 40621

CHFS DBHDID - Administration & Financial Management

275 E Main Street 4CD

Frankfort KY 40601-0001

Document ID: RFP 729 1900000068 Page: 4 of 4

Submission Checklist

The following items will be required to be submitted with bid:

Item Technical Proposal - 850 Points Cost Proposal - 100 Points

PROPOSAL SUBMISSION CHECKLIST

The vendor MUST include the following with the proposal submission.

If the items highlighted below are not submitted with the proposal submission, the Commonwealth MUST deem the proposal non-responsive and SHALL NOT consider for award.

All other items MUST be submitted prior to award.

_____ SIGNED SOLICITATION COVERPAGE (Section 8.01 of this RFP)

_____ *PROPOSED SOLUTION (TECHNICAL) UNDER SEALED COVER AND BY CLOSING DATE

Section(s) 8.00 and 8.01 of this RFP

_____ *PROPOSED SOLUTION (COST) UNDER SEALED COVER AND BY CLOSING DATE

Section(s) 8.00 and 8.02 of this RFP

_____ TRANSMITTAL LETTER – Section 8.01 of this RFP

_____ PROOF OF REGISTRATION WITH SECRETARY OF STATE BY A FOREIGN ENTITY

(Section 8.01 of this RFP)

_____ REQUIRED AFFIDAVIT(S) – Section 8.01 of this RFP

_____ PROOF OF LIABILITY, MALPRACTICE AND WORKERS COMPENSATION INSURANCE, AND

CERTIFICATES OF PROFESSIONAL (MEDICAL) AND CONTRACTUAL LIABILITY INSURANCE AT A

MINIMUM OF $1,000,000 PER INCIDENT AND $3,000,000 PER YEAR.

*The Commonwealth defines SEALED as “a closure that must be broken to be opened and that thus reveals tampering” (Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/seal

Document Description Page 4

1900000068 Western State Hospital Dental Services of 44 https://www.merriam-webster.com/dictionary/seal

Title Page

For

Western State Hospital Dental Services Solicitation No. – RFP 729 1900000068

Issued by

The Cabinet for Health and Family Services Office of Administrative and Technology Services

Division of Procurement and Grant Oversight

On Behalf Of

Department for Behavioral Health, Developmental and Intellectual Disabilities

Hereafter referred to as “Department”

SOLE POINT OF CONTACT

Vanessa Petrey Contract Specialist

275 East Main Street, 4E-C Frankfort, KY 40621

Telephone: 502-564-7736 ext. 3115 E-mail: Vanessa.petrey@ky.gov

Document Description Page 5 mailto:AlisonB.Simpson@ky.gov

This document constitutes a Request for Proposals for a Personal Service Contract from qualified individuals and organizations to furnish those services as described herein for the Commonwealth of Kentucky, Cabinet for Health and Family Services on the behalf of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

Offerors are advised that any personal service contract resulting from this RFP must comply with all applicable provisions of KRS 45A and KRS 12.210 prior to becoming effective.

A contract, based on this RFP, may or may not be awarded. Any contract award from this RFP is invalid until properly approved and executed by the Finance and Administration Cabinet and filed with the Legislative Research Commission, Government Contract Review Committee.

ADDENDUM 1 – October 15, 2018

This addendum is to add the attachments as referenced in this RFP.

1.00 Purpose and Background

The purpose of this Request for Proposal is to provide a part-time Dentist, and a part-time Dental Hygienist for the patients/residents at Western State Hospital (WSH) and Western State Nursing Facility (WSNF) (collectively referred to as Western State Hospital (WSH). These services are flexibly designed to meet the individual needs of the facility patients/residents. There is no guarantee of a specific number of cases or service hours. Service hours are based on the needs of the Facility, and the availability of state and/or federal funds.

Estimated hours per week:

Dentist – 5 hours Dental Hygienist – 5 hours

The five (5) hours per week shall be concurrent in one (1) day per week for a minimum of fifty (50) weeks per year.

WSH will provide as much advanced notice of staffing need and scheduled appointments as possible. It is realized by both parties that emergency situations do occur.

Western State Hospital is a 175 bed acute care psychiatric facility, with a 144 bed Skilled Nursing Facility (Western State Nursing Facility) located in Hopkinsville, Kentucky. Western State Hospital is regulated by The Joint Commission, Centers for Medicare and Medicaid Services (CMS), the CHFS Office of the Inspector General, as well as various clinical and professional organizations to provide routine and emergency medical procedures and/or services.

2.00 Scope of Work

A. Responsibilities

1. The Contractor shall:

a. Assign only those individuals that are licensed or certified in their respective skill levels. All individuals must be adequately trained and shall meet appropriate licensure requirements of the Commonwealth of Kentucky.

b. Provide an individual to perform the functions of a part-time Dentist.

c. Provide an individual to perform the functions of a part-time Dental Hygienist.

Document Description Page 6

d. Be responsible for the salary, benefits, withholding of state/federal taxes, etc. of those individuals.

e. Be responsible for the billing of Medicaid, Medicare, and other third party payors in accordance with the facility’s practice.

f. Utilize the equipment available in the dental lab housed in Western State Hospital needed to perform required dental services for the patients/residents of Western State Hospital and Western State Nursing Facility.

g. In conjunction with facility staff, make necessary and appropriate requests and/or determinations regarding the use of physical or mechanical restraints for the patient/resident of Western State Hospital and/or Western State Nursing Facility.

2. The Dentist shall:

a) Have and maintain a license to practice dentistry through the Kentucky Board of Dentistry.

b) Provide supervision of dental auxiliary staff, as needed.

c) Provide appropriate referrals to other sources, as needed. If the referral to a specialist requires transportation of the WSH/WSNF patient, the facility will be responsible for the transport and cost.

d) Participate in training programs implemented by Western State Hospital/Western State Nursing Facility for the direct care staff and auxiliary, as needed.

e) Provide direct comprehensive general dentistry services to the patients/residents of WSH to include, but not limited to, the following:

1) Oral exams;

2) Cleanings;

4) Fillings;

5) Fluoride treatments;

6) Sealants;

7) Extractions, and

8) Any other indicated dental treatment services.

f) Maintain documentation of appropriate medical records and progress notes on patients examined, including maintaining a personal provider note pad, leaving original of all provider notes with the facility for scanning into MediTech records, and maintaining a provider copy for individual provider records.

g) Consult with facility physician(s) regarding advisability of treatment, if necessary upon review of the patient’s chart and medical history.

h) Order and provide follow-up medication in concurrence with the facility’s primary care physician.

i) Participate in and preparation of interventional hemostasis products (IHP’s), if necessary.

j) Assist in monitoring the inventory of dental supplies and equipment.

k) Provide information to facility staff relating to ordering dental supplies and equipment.

Document Description Page 7

3. The Dental Hygienist shall:

a) Have and maintain certification to practice as a dental hygienist through the Kentucky Board of Dentistry.

b) Assess the dental condition and needs of the patients.

c) Provide patient screening procedures that include, but not limited to, the following:

1) Medical history reviews;

2) Dental charting;

3) Perio-charting, and

4) Patient vital signs.

d) Deliver direct care to patients which may include, but not limited to the following:

1) Established dental hygienist procedures; and

2) Routine treatment procedures such as cleaning, polishing, x-rays, application of sealants, and fluorides.

e) Provide chair side assistance to the dentist in the performance of special tests, procedures, and complex treatments.

f) Maintain documentation of appropriate medical records and progress notes on patients examined, including maintaining a personal provider note pad, leaving original of all provider notes with the facility for scanning into MediTech records, and maintaining a provider copy for individual provider records.

g) Assist with, or institute emergency measures for sudden adverse developments during treatment of patients.

Note: Available dental equipment includes basic dental office equipment such as, a steam sterilizer, a dental chair, a cavitron, and an x-ray processor. Additional equipment may be acquired by the hospital and is subject to prior approval and availability of funds. Western State Hospital has an available Dental Lab for the contractor to utilize to perform required services. (Please see Attachment A for a current list of on-site equipment housed with the Dental Lab at WSH, and the approximate purchase dates of each).

B. Meet all HIPAA requirements and maintain The Joint Commission, Centers for Medicare and Medicaid Services, and a Kentucky license from the Kentucky Board of Dentistry, throughout the contract term.

C. Insurance

Have and maintain malpractice liability insurance in the amount of no less than $1,000,000 (policy limit) and comprehensive general insurance in the amount of no less than $1,000,000 per individual claim, and $3,000,000 in the aggregate (policy limit). In the event that any insurance coverage lapses or is modified in any way, the contractor shall notify the facility in writing within five (5) days.

D. Mandatory Requirements for Facility Contracted Staff

No individual providing services under this contract shall start to work without the required credentials stated below.

Document Description Page 8

For each applicant recommended for consideration to provide services through this contract, the contractor shall provide individual’s (1) application to include required license/certification, as appropriate, and (2) evidence of the following credentials:

1. Proof of Liability, Malpractice and Workers Compensation Insurance, and certificates of professional (medical) and contractual liability insurance at a minimum of $1,000,000 per incident and $3,000,000 per year.

2. Submit documentation of licensure to practice as a Dentist/Dental Hygienist in the Commonwealth of Kentucky in accordance with current Kentucky Revised Statutes (KRS) requirements.

3. A statement certifying acknowledgement that the Department for Behavioral Health, Developmental and Intellectual Disabilities shall not be liable for any employee insurance associated with the contract awarded from this Solicitation, including, but not limited to medical malpractice.

4. A statement certifying that all individuals providing services under this contract for any given skill level shall possess at least the minimum credentials for that skill level.

5. Record Checks: A current and satisfactory criminal and nurse aide abuse registry check in accordance with KRS 216.793, KRS 27A.300, KRS 17.151 and 902 KAR 20:410, Section 5(5).

Current is within the last thirty (30) days. Satisfactory is with no convictions or outstanding charges which would constitute a felony conviction under 902 KAR 20:410, Section 5(5).

A criminal record check shall be completed through the Kentucky State Police Information Center or the Administrative Office of the Courts. The State Justice Cabinet approves both. If an individual providing services under the contract has resided or worked in a state other than Kentucky a satisfactory records check shall be required of those states as well.

A check of the Kentucky Nurse Aide Registry shall also be completed. If the contract is with an individual, the contractor shall be responsible for the records, criminal, and abuse checks. This information shall be maintained by the Facility Human Resources Department and be on file prior to work assignment.

All individuals providing services under this contract shall be subject to a fingerprint-supported state and FBI check under the KARES Kentucky Applicant Registry and Employment Screening Program (KARES). To enroll in KARES, please go to http://chfs.ky.gov/os/oig/kares/.

6. Purified Protein Derivative (PPD/TB skin) Test: Evidence of a current PPD (TB skin) test or Blood Assay for Mycobacterium tuberculosis (BAMT). If a current PPD test or BAMT is not available, the contractor shall provide this service at no charge to the individual.

7. Cardiac Pulmonary Resuscitation certification (CPR): Evidence of CPR certification, if required of the position.

8. Drug Testing: Pursuant to 908 KAR 3:190 evidence that individuals recommended to provide services through this contract have successfully completed a ten (10) panel, plus Oxycodone drug test (“Pre-appointment testing”) within the last 30 days. Pursuant to 908 KAR 3:190, section 10, paragraph (1) “… the department shall, at a minimum, test for”:

(a) Marijuana; (g) MDMA (Ecstasy);

(b) Cocaine; (h) Methadone;

(c) Opiates; (i) Benzodiazepines;

(d) Amphetamines; (j) Barbiturates, and

Document Description Page 9 http://chfs.ky.gov/os/oig/kares/

(e) Phencyclidine; (k) Oxycodone.

(f) Morphine;

Costs associated with conducting pre-employment drug testing of prospective test-designated individuals shall be borne by the contract agency.

Pursuant to 908 KAR 3:190, the DBHDID may require random or reasonable suspicion drug testing of individuals providing direct care services under this contract.

9. OIG LEIE Record Check: In accordance with the Social Security Act sections 1128 and 1156, the Federal Office of Inspector General maintains a List of Excluded Individuals and Entities (LEIE) which shall be reviewed prior to allowing contract agencies or personnel to work within WSH or WSNF. Any contract agency or contract personnel included in such list shall be prohibited from operation in connection with this contractual agreement. The website address for the LEIE is http:// exclusions.oig.hhs.gov.

10. A statement certifying that the contractor and any dentist/dental hygienist provided for services is not currently and will not be an excluded Medicare/Medicaid provider, and from the Office of Inspector General, List of Excluded Individuals/Entities (LEIE).

11. Evidence of a minimum of three (3) years of experience providing temporary employment services if offeror is a company or organization.

12. Submit a current resume for all individuals that will provide services under this contract. Resume must include education, qualifications, previous work assignment, including length of stay, and three references.

13. Completed WSH Dental/Dental Hygienist credentialing application, KAPER form, and required items listed for credentialing process (See Attachment B).

No individual providing services under this contract shall start to work without the required credentials stated above. This information shall be sent to a designee at the facility level and be approved prior to work assignment.

Candidates presented by the contractor for the services defined in this contract shall be screened by the contractor and the facility and deemed qualified and suitable by the Facility Director or designee in accordance with the provisions of this contract. The contractor shall coordinate interviews between the candidates and the Facility. The contractor shall be responsible for all cost relating to interviews and relocation. The Facility Director shall have right of refusal of any applicant for any reason.

E. Orientation

Individuals selected to provide services shall attend required facility orientation training prior to working in patient treatment areas. The cost incurred shall be the responsibility of the contractor and not that of the facility.

F. Facility Policies and Procedures

The contractor shall ensure that individual(s) providing services under this contract abide by DBHDID Facility Policies and Procedures. Facility Policies and Procedures are on file in the Facility Human Resources Department with changes posted to facility bulletin boards, as appropriate.

G. Outside Employment

Document Description Page 10

1900000068 Western State Hospital Dental Services of 44 http://exclusions.oig.hhs.gov http://exclusions.oig.hhs.gov

During the first thirty (30) days of signing a contract, the contractor shall provide the facility director, or designee, with a list of individual providing services under the contract who have outside employment, indicating the individual’s name and place of employment. Subsequently, the contractor shall provide the facility director, or designee, with an updated list of individuals with outside employment on a quarterly basis.

H. Non-Compete Clauses against Commonwealth Prohibited

Contractor acknowledges that the Commonwealth considers these contracts temporary in nature and desires to use state employees to staff the various facilities to the extent possible. Contractor acknowledges and agrees that any non-compete agreement it may have with a staff person offered to provide services under this Contract will not prohibit that person from accepting a job offer from the Commonwealth after any expiration or termination of the contract, and to the extent such any non-compete contract may say otherwise, it will be void and unenforceable as against the Commonwealth and any person offered state employment.

2.01 Reporting Requirements

The contractor shall:

1. Provide detailed written reports, evaluations and special reports related to dental services in the manner and format set by the facility upon request.

2. Provide a monthly report, by the 15th day of the month following the services, reflecting number of hours provided per date, total number of hours, and total costs, to include a cumulative total number of hours and total cost for the dental position and the dental hygienist position throughout the contract term.

3. Maintain adequate records for audit in accordance with General Accepted Accounting Principles (GAAP) standards and state and federal regulations.

4. Records shall be available for audit or review by the Cabinet for Health and Family Services and Medicaid Services during the contract period and for a minimum of five (5) years after expiration of the contract.

Reporting requirements shall be submitted to the Facility Medical Director (and/or designee).

2.02 Pricing and Payment Requirements

The contractor shall provide monthly invoice for services rendered to the Facility Business Office at the end of the monthly period. Invoices shall be submitted by the 15th day of the month following the services provided on the PSC Invoice Form. Supporting information will be reviewed by the Facility Business Office staff. The billing information received from the contractor will be reconciled to copies of the time records that have been approved by the appropriate department staff. Follow-up will be performed on discrepancies. Contract information will be referenced to any clarification. The Facility Business Office should be contacted for any questions, concerns, or problems with billing issues.

Pursuant to KRS 45A.695, no payment shall be made on any personal service contract unless the individual, firm, partnership, or corporation awarded the personal service contract submits its invoice for payment on a form established by the Government Contract Review Committee, in accordance with Section 3.08 Payment, herein.

Document Description Page 11

The basis of payment will be an hourly rate per position based on the cost proposal form submitted with this RFP. Hourly rate is all-inclusive. Travel costs or training costs will not be reimbursed.

2.03 CHFS Responsibilities

The Facility will:

1. Assist the contractor in acquiring information and providing services relevant to treatment of patients/ residents.

2. Provide appropriate clinical staff to authorize treatments.

3. Provide the contractor as much advance notice of staffing needs and appointment as possible. It is realized by both parties that emergency situations do occur.

4. Review invoices for accuracy, provide monitoring of contract performance and completion of contractual requirements.

5. Provide monitoring of contract performance and ensure completion of contractual requirements.

2.04 Staffing Services

Notwithstanding any other provision of this Contract to the contrary, for any and all staffing or personnel services provided pursuant to this Contract, the Contractor expressly agrees to, and hereby acknowledges, the following:

1. Nothing in this Contract shall be construed, in any way, as granting to any individual providing services under the Contract any of the claims, privileges, or rights established or recognized under KRS Chapter 18A or KAR Title 101.

2. At no point shall any individual providing services under this Contract be considered a full-time or part-time employee of CHFS, for any purpose, including but not limited to unemployment, taxes, withholding, health insurance, liability, retirement, workers’ compensation, vacation, sick or other leave, the Family Medical Leave Act, accrued benefits, evaluations, or any other purpose. At all times, any such individual shall be considered and deemed to be an employee of the Contractor or deemed to be an independent contractor of the Contractor.

3. Any individual providing services under this Contract shall, at all times, be adequately trained and qualified to perform the services required herein.

4. Any individual providing services under this Contract shall, at all times, be legally and adequately certified or licensed within the Commonwealth of Kentucky to perform the services required herein and shall be in good standing with any necessary certification or licensure authority. At no time shall any such individual be under investigation, under suspension, under a condition of practice, or under a limitation on the scope of practice from any necessary certification or licensing authority. In the event of any such restriction, the Contractor shall immediately notify CHFS of the restriction.

5. Upon request, the Contractor shall provide CHFS with any documentation that CHFS believes is necessary to establish compliance with the requirements of this provision.

6. Any individual providing services under this Contract must not have a conviction for, or have any charges currently pending for, any criminal offense that would constitute either a felony or a

Document Description Page 12 misdemeanor offense in the jurisdiction in which the criminal offense occurred or is alleged to have occurred. In the event of any such charge or conviction, the Contractor shall immediately notify CHFS of the charge or conviction.

7. Any individual providing services under this Contract must not be included on any formal registry or listing that is required by law and which relates to abuse, neglect, sexual offenses, or other inappropriate practices or which, in any way, prohibits their employment for or performance of the services required herein, including but not limited to the nurse aid abuse registry and the Child Abuse Prevention and Treatment Act registry. In the event of any such listing or registration, the Contractor shall immediately notify CHFS.

8. Any individual providing services under this Contract must not be prohibited or debarred from providing services or participating in any state or federal governmental program, including but not limited to the Medicare and Medicaid programs. In the event of any such prohibition or debarment, the Contractor shall immediately notify CHFS.

9. Prior to any staff of the Contractor performing services under the Contract, the CHFS must approve such staff and authorize them to perform the required services. Specifically, in all cases, the Contractor shall present potential staff, along with documentation of all required credentials and other requested information, to the appropriate CHFS individuals for review and approval. The CHFS expressly reserves the right to disapprove of, disqualify, or reject any staff provided by the Contractor to provide services under this Contract, for any reason. In such event, the Contractor shall present additional potential staff to perform the services, for review and approval by CHFS.

10. The CHFS expressly reserves the right to immediately disqualify or prohibit the continued use of any staff of the Contractor that has been provided to perform services under the Contract, if, in the discretion of CHFS, it is determined that the continued use of such staff is not in the best interests of CHFS, that such staff fails to meet any of the requirements imposed by this Contract, or that such staff of the Contractor has violated any state or federal law or violated any policies and procedures of CHFS. In such event, the Contractor shall immediately discontinue the use of such staff to perform services under the Contact and shall thereafter present additional potential staff to perform the services, for review and approval by CHFS.

11. Any decision whether or not to fill any staffing vacancies, any decision to provide space in any required facility orientation, any decision to contact or request staffing services from the Contractor, and any decision whether or not to use this Contract to fill any staffing vacancies shall rest entirely and exclusively in the discretion of the CHFS. Under no circumstances is the Contractor guaranteed any work under this Contract; the Contractor is merely an authorized provider of the services detailed herein. The CHFS hereby reserves the right to contract with any other vendor, to perform the services described in this Contract.

12. In the event that multiple contracts are awarded for provision of the services detailed herein, the CHFS is authorized, in its sole discretion, to contact or request services from any vendor and shall not be required to contact vendors in any particular order with regard to performing any services detailed herein.

13. In no event shall any employee or independent contractor of the Contractor be deemed to be a third-party beneficiary of this Contract.

14. Each of the provisions within this Section is specifically subject to the general indemnification provisions of this Contract.

15. It is expressly acknowledged that the contractor is performing services as an independent contractor. The contractor will receive a form 1099-MISC and will not receive a form W-2.

Document Description Page 13

3.00 Evaluation Criteria

Organizations/Individuals interested in responding to this RFP must submit the following information, in the order specified below:

A. Technical Proposal

1. Qualifications: 450 points

Provide:

a. An Organizational or Individual Background - Briefly describe history, organizational structure (if applicable), ownership structure, and names of principals (if applicable). Include any information that may be of value to CHFS in evaluating your Proposal.

b. A list of service lines provided by you or your organization and the dates of operation.

c. A detailed explanation of your or your organization’s experience in dentistry.

d. A description of any litigation, including any arbitration, mediation or legal action by a medical patient, related to medical services provided by you or your organization within the past 3 years of this RFP’s issuance date.

e. A list of your clients where the contractual relationship was not completed and was severed for reasons other than convenience. Provide a brief explanation of any severed relationships, and the names and contact information of the project manager, excluding any medical patient.

f. Describe any other asset, expertise, experience, data or technology that provides you or your organization with a competitive edge or advantage.

2. Methodology for Performing Required Services: 250 points

Provide:

A. A statement of philosophy for you or your organization as it pertains to serving and supporting individuals with developmental and intellectual disabilities. Specifically address how this philosophy will be implemented in terms of providing Dental Services to Western State Hospital/Western State Nursing Facility patients.

B. A written program narrative describing in detail the following:

1. Services offered; and

2. Methods and protocols for service delivery, including methods used to reduce restraint usage.

C. Written policies and/or system procedures related to:

1. Patient care polices which address:

a. A description of the services the provider will provide directly and those provided through subcontractor agreements;

b. Guidelines for the medical management of health problems which include the conditions requiring medical consultation or patient referral; and

c. Procedures for the annual review and evaluation of the services provided by the provider.

2. Handling and disposal of all infectious, pathological, and contaminated waste.

3. The use of physical and mechanical restraints that will be used within the clinic.

Policies should include methods used to minimize the use of physical and chemical restraints. If applicable, provide two years of historical data related to the use of physical

Document Description Page 14 and chemical restraints for dental services rendered by the provider or your agency for individuals with developmental and/or intellectual disabilities.

4. Any functions related to the storage, handling, and administration of drugs and biological specimens,

3. Personnel Specifications: 150 points

A. Provide a detailed staffing pattern consistent with the requirements of Section 2.00.

Information should include:

1. Organizational chart, if applicable;

2. Job descriptions for each job title, including minimum qualifications;

3. If applicable, proposed staffing, and allocation of responsibility and accountability; to include but not be limited to each key person on the project team including brief resumes if necessary:

a. The role each person will play in Western State Hospital/Western State Nursing Facility:

b. Describe your or the proposed staff's direct prior experience in providing the requested services, the number of years of relevant experience, the level of responsibility, the individual’s core competencies, educational background and experience in serving individuals with intellectual and developmental disabilities; and

c. A written assurance that the key individuals listed and identified will be performing the work and will not be substituted with other personnel or reassigned away from Western State Hospital/Western State Nursing Facility without the Department’s prior approval.

The total available points for Technical proposal is 850. Proposals must achieve a score of 510 in order to proceed to Cost evaluations.

B. Cost Proposal

1. Submittal Requirements:

CHFS will evaluate the cost submittal requirements based on the following evaluation factors:

The bidder should complete Attachment C, Line Item Detail for the same periods referenced above and a budget narrative explaining basis for cost estimates. Bidders will be evaluated on an eighteen (18) month budget submission. The bidder’s cost proposal shall include all costs involved in the delivery of the services required under Section 2.00 for the patients of Western State Hospital/Western State Nursing Facility.

Contractors are cautioned not to make assumptions when submitting cost proposals. If clarifications are needed, please submit questions during the Q&A period to ensure all cost assumptions are confirmed or clarified. Costs left out of a proposal based on an assumption will not be negotiated in at time of award.

The cost proposal shall consist of an hourly rate to provide needed dental services on-site at Western State Hospital and Western State Nursing Facility. Hourly rate shall be all inclusive.

No travel costs or training costs will be reimbursed under this agreement. Please take this into consideration when proposing an hourly rate.

The cost proposal with the lowest price will receive the maximum score. The other cost proposal scores will be determined by dividing the lowest price by the price offered in other proposals and then multiplied by the number of available points. EXAMPLE: Assume 50 points are available for cost and Firm A offers the lowest price of $10. Firm A receives 50 points. Assume Firm B offers a price of $12. Firm B receives 42 points per the following calculation: 10/12 = .83 x 50 = 41.7.

C. Oral Presentations

Document Description Page 15

If determined necessary, oral presentations will be worth 300 points.

D. Evaluation Point Grid

TECHNICAL

Qualifications: 450 points

Methodology for Performing Required Services: 250 points

Personnel Specifications: 150 points

Total Technical 850 points

The total available points for Technical proposal is 850. Proposals must achieve a score of 510 in order to proceed to Cost evaluations.

COST

Overall Cost 100 points

Total Cost 100 points

ORAL PRESENTATIONS, if necessary 300 points

4.00 Schedule of RFP Activities

The following schedule presents the major activities associated with the RFP distribution, written questions and proposal submission. The Commonwealth reserves the right at its sole discretion to change the Schedule of Activities, including the associated dates and times.

Release of RFP October 8, 2018 Written Questions due by: 2:00pm October 22, 2018 Anticipated Commonwealth Response to Written Questions October 29, 2018 Proposals Due by: 2:00pm November 14, 2018 All bidders are cautioned to be aware of the security in the CHR Building located at 275 East Main Street, Kentucky. All bids shall be time stamped in the Division of Procurement and Grant Oversight no later than the due date and time defined in this Solicitation. In person or courier delivered bids in response to this Solicitation shall be delivered to Division of Procurement and Grant Oversight, Mailstop 4E-C. Delays due to building security checks shall not be justification for acceptance of a late bid.

*NOTE: ALL TIME REFERENCES ARE TO THE EASTERN TIME ZONE.

5.00 Offeror’s Conference

Not applicable.

6.00 Point of Contact

The Sole Point of Contact listed on the Title Page immediately preceding the Table of Contents shall be the sole point of contact throughout the procurement process. All communications, oral and written (regular mail, express mail, electronic mail or fax), concerning this procurement shall be addressed to the Sole Point of Contact.

From the issue date of this RFP until a Contractor(s) is selected and the selection is announced, Contractors shall not communicate with any other Commonwealth staff concerning this RFP.

7.00 Questions Regarding this RFP

Document Description Page 16

Questions must be submitted in writing to the Agency Contact. The Commonwealth will respond to salient questions in writing by issuing an Addendum to the Solicitation. The Addendum shall be posted to the Commonwealth’s eProcurement page.

8.00 Proposal Submission

Each qualified offeror shall submit only one (1) proposal. Alternate proposals shall not be allowed.

Failure to submit as specified shall result in a non-responsive proposal.

The vendor should complete the "Vendor" box on the face of the solicitation. An authorized representative of the vendor shall sign where indicated on the face of the solicitation. If the solicitation is not signed the proposal shall be deemed non-responsive.

Acknowledgment of Addenda

It is the vendor's responsibility to check the web site for any modifications to this solicitation. Vendors are encouraged to acknowledge each addendum by signing and submitting the latest addendum with their response. However, signing the face of the solicitation as indicated above constitutes the vendor’s acknowledgement of an agreement to be bound by the terms of all addenda issued.

Failure to specifically acknowledge addenda will not excuse the vendor from adhering to all changes to the requirements of the solicitation set forth therein nor provide justification for any pricing changes.

All submitted technical and cost proposals shall remain valid for a minimum of six (6) months after the proposal due date.

Proposals shall be submitted in the following separate sealed* parts, under separate cover: The Technical Proposal, the Cost Proposal, and the Proprietary Information, if applicable.

The Technical Proposal should include one (1) hard copy marked original technical and three technical thumb/flash drives marked “Technical Copy* (in Microsoft Word, Microsoft Excel or PDF format ONLY).

Do not include embedded documents, hyperlinks or hyperlinks to videos.

The Cost Proposal should include one (1) hard copy marked original cost and three cost thumb/flash drives marked “Cost Copy* (in Microsoft Word, Microsoft Excel or PDF format ONLY). Do not include embedded documents, hyperlinks or hyperlinks to videos.

If applicable, any Proprietary Information should include one (1) hard copy marked original proprietary and three proprietary thumb/flash drives marked “Proprietary Copy* (in Microsoft Word, Microsoft Excel, or PDF format ONLY). Do not include embedded documents, hyperlinks or hyperlinks to videos. Please be advised, Cost proposals shall not be considered proprietary. Cost proposals must be submitted in accordance with Sections 3 and 8.02.

*The Commonwealth defines SEALED as “a closure that must be broken to be opened and that thus reveals tampering”. (Merriam-Webster Dictionary, http://www.merriam-webster.com/ dictionary/seal)

Should differences be determined to exist between the hardcopy proposal and the electronic version, the hardcopy shall prevail. Pricing shall only be provided in the Cost Proposal. DO NOT

SUBMIT ANY PRICING INFORMATION IN THE TECHNICAL PROPOSAL.

All proposals must be received no later than the date and time indicated in Section 4.00.

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Proposal shall be submitted to the Contract Specialist listed on the title page. The outside cover of the package containing the technical proposal shall be marked:

The outside cover of the package containing the cost proposal shall be marked:

Western State Hospital Dental Services

RFP 729 1900000068

TECHNICAL PROPOSAL

Name of Offeror

The outside cover of the package containing the cost proposal shall be marked:

Western State Hospital Dental Services

RFP 729 1900000068

COST PROPOSAL

Name of Offeror

If applicable, the outside cover of the package containing the proprietary proposal shall be marked:

Western State Hospital Dental Services

RFP 729 1900000068

PROPRIETARY PROPOSAL

Name of Offeror

ELECTRONIC OR FACSIMILE PROPOSALS SHALL NOT BE CONSIDERED.

8.01 Format of Technical Proposal

The Technical Proposal should be arranged and labeled in the manner set forth below.

Transmittal Letter – a Transmittal letter shall be submitted on Offeror’s letterhead, and signed by an agent authorized to bind the Offeror. The Transmittal letter shall include the following:

a. A statement that deviations are included, if applicable.

b. A statement that proprietary information is included, if applicable.

c. A statement that, if awarded a contract as a result of this Solicitation, the Offeror shall comply in full with all the requirements of the Kentucky Civil Rights Act, and shall submit all data required by KRS

45.560 to 45.640.

d. A sworn statement that, pursuant to KRS 11A.040, that Offeror has not knowingly violated any provisions of the Executive Branch Code of Ethics.

e. A statement certifying that the price in this proposal was arrived at independently without collusion, consultation, communication, or agreement as to any matter relating to such prices with any other Offeror or with any competitor.

f. A statement affirming that the Offeror is properly authorized under the laws of the Commonwealth of Kentucky to conduct business in this state and will remain in good standing with the Office of the Kentucky Secretary of State for the duration of any awarded contract resulting from this Solicitation.

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g. The name, address, telephone number, fax number and email address and website address, if available, of the contract person to serve as a point of contact for day-to-day operations.

h. Subcontractor information to include the name of the company, address, telephone number and contact name, if applicable.

i. Foreign entity’s organization number issued by the Secretary of State in a certificate of authority or a statement of foreign qualification, if applicable.

Completed and Signed Solicitation and Addenda – An authorized representative MUST complete and sign the Solicitation form and include the following:

a. “Vendor” box and “Remit To” box must be completed.

b. Vendor shall indicate ownership type.

c. Vendor shall provide “FEIN” if applicable.

d. Vendor shall provide date the form is completed and signed.

e. Signed face of the most recent Addenda, if applicable.

Signed and Notarized Required Affidavit for Bidders or Offerors - available at the following link:

http://finance.ky.gov/services/forms/Pages/default.aspx

Signed and Notarized Required Affidavit for Bidders, Offerors and Contractors Claiming Resident Bidder Status – if applicable. Available at the following link:

http://finance.ky.gov/services/forms/Pages/default.aspx

*Offerors not claiming Resident Bidder Status need not submit this affidavit.

Signed and Notarized Required Affidavit for Bidders, Offerors and Contractors Claiming Qualified Bidder Status – if applicable. Available at the following link:

http://finance.ky.gov/services/forms/Pages/default.aspx

*Offerors not claiming Qualified Bidder Status need not submit this affidavit.

Response to the Technical Portion of the RFP – Please provide a detailed response to the technical requirements outlined in Section 3.00(1)(A). No cost information shall be provided in the technical portion.

8.02 Format of Cost Proposal

The Cost Proposal must be submitted under separate cover from the Technical Proposal and must be arranged and labeled in the manner specified in Section 3.00(2)(A). The proposal with the lowest price receives the maximum score. The remaining proposals with the next lowest price receives points by dividing the lowest price by the next lowest price and multiplying that percentage by the available points.

8.03 Certification Regarding Debarment and Suspension

In accordance with Federal Acquisition Regulation 52.209-5, the Offeror shall certify, by signing the Solicitation, that to the best of its knowledge and belief, the Offeror and/or its Principals is (are) not

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1900000068 Western State Hospital Dental Services of 44 http://finance.ky.gov/services/forms/Pages/default.aspx presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any state or federal agency.

For the purposes of this certification, “Principals”, means officers, directors, owners, partners, and persons having primary management or supervisory responsibilities within a business entity (e.g., general manager, plant manager, head of subsidiary, division, or business segment, and similar positions.

9.00 Rules of Procurement

To facilitate this procurement, various rules have been established. These are described in the following paragraphs.

Offerors should review and comply with the General Conditions and Instructions for Solicitation/Contract listed under “Response to Solicitation” located on the eProcurement web page at http://finance.ky.gov/services/policies/Documents/FAP%20110-10-00.pdf

The procurement process will provide for the evaluation of proposals and selection of the winning proposal in accordance with state law and regulations. KRS Chapter 45A of the Kentucky Model Procurement Code provides the regulatory framework for the procurement of services by state agencies.

9.01 Technical Proposal Evaluation

CHFS will evaluate the proposal based on Section 3.00(1)(B). Each Offeror is responsible for submitting all relevant, factual and correct information with their offer to enable the evaluator(s) to afford each vendor the maximum score based on the available data submitted by the Offeror. Past Offeror Performance may be considered in the award of this Contract. Offerors with a record of poor performance in the last twelve

(12) months may be found non-responsible and ineligible for award.

9.02 Cost Proposal Evaluation

CHFS will evaluate the proposal based on Section 3.00(2)(B).

Offeror shall only provide cost on the attached Cost Proposal Form; otherwise, the proposal may be deemed non-responsive.

9.03 Right to Reject/Waiver of Minor Irregularities

The Commonwealth reserves the right at its discretion to reject any and all offers. The Commonwealth also reserves the right at its discretion to waive informalities and minor irregularities in offers received.

9.04 Clarification of Proposals

The Commonwealth reserves the right at its discretion to request additional information as may reasonably be required for selection and to reject any proposals for failure to provide additional information on a timely basis.

The Commonwealth reserves the right to conduct discussions with any Offeror who has submitted a proposal to determine the Offeror’s qualifications for further consideration. Such discussions shall not disclose any information derived from proposals submitted by other Offerors.

9.05 Best and Final Offers

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The Commonwealth reserves the right at its discretion to request a Best and Final Offer (BAFO) for technical and/or cost proposals. Offerors are cautioned to propose their best possible offers at the outset of the process, as there is no guarantee that any Offeror will be allowed an opportunity to submit a Best and Final technical and/or cost offer.

9.06 Vendor Response and Public Inspection

This RFP specifies the format, required information and general content of proposals to be submitted in response to the RFP. CHFS shall not disclose any portions of the proposals prior to contract award to anyone outside CHFS, representatives of the agency for whose benefit the contract is proposed, representatives of the federal government, if required, and the members of the evaluation committee.

After a contract is awarded in whole or in part, the Commonwealth shall have the right to duplicate, use, or disclose all proposal data submitted by Offerors in response to this RFP as a matter of public record.

Any and all documents submitted by an Offeror in response to the RP shall be available for public inspection after contract award pursuant to the Kentucky Open Records Act, KRS 61.870 to 61.884 (“the Act”). When responding to a request to inspect records submitted in response to this RFP, the Commonwealth will not redact or withhold any information or documents unless the records sought are exempt from disclosure pursuant to KRS 61.878 or other applicable law. Similarly, no such documents shall be exempt from public disclosure, regardless of the Offeror’s designation of the information contained therein as “proprietary,” “confidential,” or otherwise, except in cases where the requested documents (or information contained therein) would be excluded from application of the Act under KRS 61.878(1)(c).

The Commonwealth of Kentucky shall have the right to use all system ideas, or adaptations of those ideas, contained in any proposal received in response to this RFP. Selection or rejections of the proposal will not affect this right.

9.07 Reciprocal Preference for Kentucky Resident Bidders and Preferences for a Qualified Bidder

The scoring of bids/proposals is subject to the reciprocal preference for Kentucky resident bidders and preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries (See KRS 45A.490(1), (2), 45A.492, 45A.494 and KAR 200 5:410).

Vendors not claiming resident bidder or qualified bidder status need not submit the corresponding affidavit.

Determining the…