Document ID: RFP 729 2500000349 Page: 1

Commonwealth of Kentucky

SOLICITATION

Modification: No Version #:

TITLE: Outwood ICF Management & Operations (C5859)

Date Issued:

02/11/2026 Record Date:

01/27/2026

Solicitation Closes Date:

04/09/2026 Time:

14:00

Solicitation No:

RFP 729 2500000349

Online Bidding Prohibited: No For Information Call:

David Locker 502-564-7736

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Bid Receiving

See Terms & Conditions for Bid Submission Instructions

Other KY

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__ 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 2500000349 Page: 2

Line Items

Commodity Group: Default

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

1 FY27 Management and Operations

Comm Code Comm Description Manufacturer Model # Manuf Part #

952PS PSC-HUMAN SERVICES

Extended Description Provide services to manage and operate Outwood Intermediate Care Facility/Individuals with ICF/IID Outwood, a state-owned intermediate care facility.

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

2 FY28 Management and Operations

Comm Code Comm Description Manufacturer Model # Manuf Part #

952PS PSC-HUMAN SERVICES

Extended Description Provide services to manage and operate Outwood Intermediate Care Facility/Individuals with ICF/IID Outwood, a state-owned intermediate care facility.

Shipping Information

Billing Information CHFS DBHDID - Administration & Financial Management

275 E Main Street 4CD

Frankfort KY 40601-0001

Document ID: RFP 729 2500000349 Page: 3

Submission Checklist

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

Item Technical Proposal Cost Proposal Oral Presentation, if necessary

Revised May 2025

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 be considered for the award.

All other items MUST be submitted prior to the award.

_____ SIGNED AND COMPLETED SOLICITATION –Section(s) 8.00 and 8.10 of this RFP (not required if submitting electronically)

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

Section(s) 8.00 and 8.10 of this RFP

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

Section(s) 8.00 and 8.10 of this RFP

_____ TRANSMITTAL LETTER – Section 8.20 of this RFP

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

(Section 8.00 of the Personal Service Contract Terms and Conditions of this RFP)

_____ REQUIRED AFFIDAVIT(S) – Section 8.20 of this RFP

*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

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2500000349 Final Outwood ICF Management & Operations (C5859) Total Pages: 53 https://www.merriam-webster.com/dictionary/seal

REQUEST FOR PROPOSAL

FOR

PERSONAL SERVICE CONTRACT

Cabinet for Health and Family Services (CHFS) Department for Behavioral Health, Developmental and Intellectual Disabilities Outwood ICF Management & Operations

RFP 729 2500000349

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 behalf of the Department for Behavioral Health, Developmental and Intellectual Disabilities

(DBHDID).

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.

1.00 Purpose and Background

It is the purpose of this Request for Proposal (RFP) for the Cabinet for Health and Family Services (CHFS), Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID) to obtain the contract services of a single entity to manage and operate Outwood Intermediate Care Facility/Individuals with Intellectual Disability (ICF/IID) (Outwood), a state owned intermediate care facility licensed to support up to eighty (80) people located on Highway 109, in Dawson Springs, Kentucky. The facility had an average daily census of 48 for the state fiscal year 2024 and 49 for the state fiscal year 2025. As of May 30, 2025, the census is 48 (Attachment B – Outwood Census Demographics).

2.00 Scope of Work

The Contractor is expected to provide a full range of residential services, including assessment, evaluation, and treatment of the residents of Outwood in accordance with the highest standards of care, humanitarian treatment that respects the dignity and rights of everyone, while extending treatment that is least restrictive to the liberty of the residents and maximizes their opportunities for independent living.

2.01 Required Services

A. Manage and operate Outwood Intermediate Care Facility/Individuals with Intellectual Disability (ICF/IID) (Outwood), a state-owned intermediate care facility licensed to support up to eighty (80) people located on Highway 109, in Dawson Springs, Kentucky.

B. Manage and operate Outwood to provide the highest possible quality of care to the individuals who reside at Outwood in a manner that ensures individuals’ dignity and respect, and ensure they are afforded supports and training in the least restrictive environment possible.

C. Provide, directly or through contract, competitive/supported employment/work training for all individuals residing at Outwood.

D. Maintain the quality of care and treatment services in accordance with 902 KAR 20:086 and 42 CFR 483, Subpart I, and in a manner acceptable to the Cabinet.

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E. Maintain compliance with the Strategic Action Plan (Attachment A) as approved in the 2006 Settlement Agreement between the Cabinet and the U.S. Department of Justice.

F. Maintain the types of services and supports, or equivalents, to meet the needs of the individuals and to ensure continuity of care is provided to all those residing at Outwood.

G. Implement, utilize, and maintain an electronic medical records system as required by the DBHDID. The software system, as required by DBHDID, integrates Medical Records, Admission/Discharge/Transfer, Accounts Receivable, Billing, and Pharmacy.

The Contractor may be required to implement additional electronic systems that are adopted by DBHDID facilities to maintain standardization. Any additional electronic system that the Contractor desires to utilize on-site for the facility should be approved through the DBHDID Commissioner’s Office prior to implementation.

The Contractor is expected to coordinate additional staffing, systems, programs, and equipment as necessary to ensure the facility complies with the requirements and operational procedures of regulatory agencies.

H. Provide, at a minimum, the following Supports and Services. Services are expected to be provided to individuals based on their personal goals, as identified in their person-centered service plan.

If needed, services are expected to include:

1. Communication Supports - Emphasis will be on increasing everyone’s ability to communicate with others using a broad range of communication techniques, including but not limited to verbal communication, sign language, and augmentative communication.

2. Personal Care Services - Training emphasis will be on support and activities of daily living.

3. Self-Determination—Each individual will receive support to facilitate supported decision-making and independence. This is expected to include assistance in regaining any rights currently restricted.

4. Support Coordination - Support Coordination is the process of coordinating resources to meet the individual’s needs based on the person-centered planning process. As applied to an individual plan, coordination encompasses obtaining direct services, linking services, identifying gaps in services, monitoring the individual's progress and satisfaction, and advocating for services.

5. Crisis Prevention Plan - A crisis prevention plan that addresses any potential crisis that impacts the health, safety, or welfare of an individual is expected to be developed by the Qualified Intellectual Disability Professional (QIDP) in coordination with other service providers.

The plan is expected to include prevention, reduction, and intervention strategies for unplanned critical situations for individuals, training and staff/personnel requirements, and the development of crisis response team(s).

All staff working at the ICF are expected to be trained on individual crisis prevention plans.

6. Behavioral Support - Have and maintain written Behavioral Support policies and procedures which define the behavior support techniques and procedures which may be used, including the hierarchy of interventions to be used with an emphasis on the use of positive approaches, use of emergency procedures, plan to reduce/eliminate physical restraints if currently used, functional analysis, data collection, and record keeping system, Behavior Support and Human Rights Committees. Behavioral Support is expected to be the systematic application of techniques and methods to influence or change a behavior in a desired way.

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Support is expected to be provided to assist the individual in learning new behaviors that are directly related to existing challenging behaviors or functionally equivalent replacement behaviors for identified challenging behaviors. It is also expected to be designed to equip the individual to communicate his/her needs and to participate in age-appropriate activities.

The behavioral support plan is expected to include the hierarchy of behavior interventions, ranging from the least to the most restrictive; reflect the use of positive approaches; and prohibit the use of:

a. Prone or Supine Restraints: Prone is any restraint that places the individual on their stomach, face down. Supine is any restraint that places the individual on their back, face up.

b. Corporal punishment: The application of painful stimuli to the body as a penalty for certain behavior, including, but not limited to, forced physical activity or exercise, hitting, pinching, the use of electrical shock or other infliction of pain, whether applied as part of a systematic behavioral support program.

c. Seclusion: The placement of an individual alone in a room or other area from which exit is prevented.

d. Verbal abuse: Screaming, swearing, name-calling, or other verbal activity that may cause damage to an individual’s self-respect or may reduce the individual’s dignity when observed or overheard by others.

e. Any procedure that denies visitation or communication privately with family, legal representative or advocate.

f. Any procedure that denies requisite sleep, shelter, bedding, food, drink, or use of bathroom facilities.

All individuals performing services under this contract are expected to be trained on the use of any behavior support plan.

When drugs, which are not necessary for a mental illness, are used for behavior, there is expected to be a plan for drug reduction or documentation that a drug reduction plan has been implemented and proven ineffective. The individual’s physician is expected to approve the drug reduction plan or provide documentation that the medication cannot be reduced.

7. Employment Services—Provide supported/competitive employment for all individuals residing in the ICF, either directly or through subcontract.

The Contractor is expected to ensure an individual is placed in an adult day training program only after his/ her team has concluded that supported employment cannot be adapted to his/her needs, as evidenced by trial placements, that health, skill, or behavioral deficits preclude placement, or that employment positions are not readily available at a particular time.

Placement in a non-integrated training program is expected to be transitional, limited to no more than six

(6) months, and based on the individual's needs. Individuals not in supported or competitive employment will receive training to remove barriers and develop skills necessary to work in the community.

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8. Evaluation for institutionalization - Facilitate (according to KRS 202B) court-ordered evaluations for individuals in crisis to assess if criteria are met for temporary involuntary institutionalization for intensive assessment, treatment, and stabilization.

9. Access to Community – Ensure that individuals residing in Outwood are given ample and sufficient supports and services necessary to ensure they are able to become active members within the community, which will assist with enhancing their quality of life.

I. Perform the following Administrative and Operational Services as described below:

Licensure - Maintain the necessary standards for licensure of Outwood as an ICF pursuant to 902 KAR 20:086 and federal certification pursuant to:

1. 42 CFR 440.150 and 42 CFR 483, Subpart I. The Contract shall not use the ICF Homes for any other purpose.

2. Compliance - Comply with 908 KAR 3:010; 908 KAR 3:020; 908 KAR 3:030; 908 KAR 3:040; and applicable portions of 42 CFR 483.10 regarding resident funds.

3. Comply with all applicable standards, orders, or regulations issued pursuant to:

a. The Clean Air Act of 1970 (42 U.S.C. 1857 et seq.);

b. The Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.) as amended.

c. KRS 202A.400 Duty to Warn.

d. 920 KAR 1:070 Deaf and Hard of Hearing Services.

e. KRS 210.235 Confidential nature of records and HIPAA Privacy Rule, 45 CFR Parts 160 and 164, established under the Health Insurance Portability and Accountability Act, Public Law 104-191 (42 USC 1320d);

f. Drug-free workplace in accordance with 2 CFR Part 182.

g. KRS 620.030 Duty to report dependency, neglect or abuse.

h. KRS 209.030 Reporting of adult abuse or neglect.

i. Americans with Disabilities Act of 1990, 42 U.S.C. 12132, as amended; and

j. 2006 Federal Settlement Agreement between the Cabinet and the U.S. Department of Justice and the associated Strategic Action Plan and Outwood Transformation Plan and Strategic Action Plan (Attachment A) as approved in the 2006 Settlement Agreement between the Cabinet and the U.S. Department of Justice.

4. Evaluation - Conduct an evaluation of the overall effectiveness of the organization at least annually.

This evaluation is a process of self-assessment to evaluate solutions and potential improvements from different perspectives. The evaluation is expected to be data and outcome based. The Contractor is expected to implement an ongoing quality improvement plan and submit an analysis of its quality improvement plan, including performance outcomes, to the Department at the end of each quarter.

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5. Supports—Provide respectful support to all individuals in the homes and always protect each individual’s rights as provided by applicable Federal and State laws and regulations, including safeguarding and accounting for each individual’s personal funds and investing them in interest-bearing accounts.

6. Admissions – The Contractor is expected to ensure all admissions are approved in writing by the Director of the Division of Developmental and Intellectual Disabilities prior to admission, and promptly notify this Division of any planned discharges, including the projected date of and reason for discharge.

7. Individual Care and Treatment - Provide services to individuals living at the home in a manner that ensures dignity and respect for the person served, recognizes and supports cultural diversity, and is based on the goals of the person served. The Contractor is expected to ensure that individual care and treatment recognize the community as a valued resource, utilize funds of this contract in a flexible and cost-effective manner, make use of natural, generic, and specialized resources, evaluate services based on individual outcomes, and determine whether individual treatment needs can be met in an integrated community-based setting.

8. Patient Records Management - The Department mandates a person-centered approach to planning for services and supports that is reflected in a totally integrated plan and system of documentation.

Individual records are expected to be accessible and available to authorized personnel of the Cabinet.

The Contractor is expected to maintain the records necessary to fully disclose the extent of the services provided. These records are expected to be maintained for a period of at least five (5) years from the date of service and for any additional time as may be necessary in the event of an audit exception or other dispute.

The Contractor is expected to provide to the department or its authorized representative, as requested, information regarding any claims for services provided. The Contractor shall open records for review or copying by duly authorized representatives of the Cabinet for the purpose of auditing services for which program payments have been made and monitoring the health, welfare, and safety of individuals.

The Contractor shall ensure that the individual record includes the following:

a. Name, social security number, and MAID (Medicaid Assigned Identification) number;

b. Intake or face sheet.

c. Self-assessment.

d. Assessment summaries relevant to the service area (Residential Needs, Adaptive Skills).

e. Current support plan.

f. The training objectives for any support that facilitates the achievement of the individual’s chosen outcomes.

g. Staff notes or attendance records.

h. Emergency telephone numbers.

i. History of allergies with appropriate allergy alerts in the instance of severe allergies.

j. Individual medication records, including a copy of the prescription and medication logs, if medications are administered at the service site.

k. A recognizable photograph of the individual.

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l. Legally adequate consents for the provision of services or other treatment, including those requiring emergency attention.

m. Individualized Educational Plan (IEP), if applicable; and

n. Social history.

9. The Contractor is expected to maintain all information necessary for the delivery of an individual’s services in a cumulative and readily accessible individual record. Entries in the records of an individual served are expected to be legible and include the date (month, day, and year), the time when provided, and the individual provider’s signature, along with the date and title appropriate to the service being provided.

Symbols and abbreviations used in making record entries are expected to be identified in a legend that is available to individuals who have access to the records. The use of an Electronic Medical Record (EMR) is acceptable; however, a hard copy of the full medical record is expected to be made available upon request by the department or other state or federal agencies in response to licensure and certification surveys or investigations.

10. The Contractor is expected to have and follow policies and procedures that allow the record to be available to the individual and his family or legal representative.

11. Confidentiality - The Contractor shall maintain the confidentiality of the individual’s record and other personal information by ensuring that an individual served, or their legal representative, as appropriate, decides when to share that information. The Contractor shall also ensure the record’s safety from loss, destruction, or use by unauthorized persons.

12. Incident Reporting - Report incidents to DBHDID in accordance with the current Facility Risk Management Protocol for ICF/IIDs.

13. Permits, Licenses, and State Registration - The Contractor is expected to procure all necessary permits and licenses and abide by all applicable laws, regulations, and ordinances of the United States, the Commonwealth, and political subdivisions in which work under this contract is performed.

14. Training – Provide orientation, competency-based training, and at least semi-annual in-service training to all staff as appropriate to their responsibilities. All training must be documented in staff personnel records, including the date, time, type of training, and competency measure. Training shall include, at a minimum, the following: CPR/First Aid, Medication Administration, Medications and Seizures, Crisis Prevention, Abuse/Neglect/Exploitation Prevention, Supported Employment, and the Rights of Persons with Intellectual Disabilities. Core Training, which covers Values, Attitudes, and Stereotypes; Building Community Inclusion; Person-Centered Planning; Positive Behavior Support; Human Sexuality and Persons with Disabilities; Self-Determination, and Strategies for Successful Teaching, is expected to be completed within six (6) months of hire.

15. Olmstead – The Contractor shall participate in the implementation of the Olmstead Plan (Attachment E), as evidenced by the adoption of policies and their implementation consistent with the policies and procedures of the Department and the Office of Civil Rights. Regular status reports regarding the implementation of the Olmstead plan and individuals who may be impacted by this decision shall be provided to the Department.

16. Participate with DBHDID in the development and implementation of a patient/guardian satisfaction survey. Survey results may be used in evaluating contractor performance. Surveys are expected to be submitted to the Director of the Division of Developmental and Intellectual Disabilities.

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J. General Programmatic Services

The Contractor shall provide all services and supports as identified through the assessment and person-centered treatment planning process and be consistent with the ICF/IID’s regulatory requirements cited in Section 2.01 D and the Strategic Action Plan (Attachment A). A full array of services is expected to be provided, which are differentiated to meet the wide range of individual needs. The Contractor is expected to perform the following general programmatic services as described:

1. Initiate services beginning with a self-assessment survey by the individual or his or her family and the identification of preferences, personal goals, and needed services.

2. The Inter-Disciplinary Team (IDT) is expected to adhere to the following meeting timeframes for new admissions:

a. Initial meeting within twenty-four (24) hours of admission.

b. IDT Planning Conference within seven (7) days after admission.

c. IDT review of Individual Learning Plan (ILP) within fourteen (14) days after admission.

d. IDT review of ILP within twenty-eight (28) days of admission and monthly thereafter.

3. Within thirty (30) days of initiation of service, the Contractor is expected to ensure assessments are completed in each of the following areas:

a. Physical examination and health assessment (within fourteen (14) days of admission).

b. Dental examination and health assessment of oral hygiene practices completed within the past six (6) months.

c. Social evaluation that includes a social and developmental history, delineation of the type and frequency of social interactions, and descriptions of the individual’s social support network.

d. Psychological evaluation completed within the past three (3) years, which includes an assessment of emotional and intellectual status.

e. Functional assessment of adaptive behavior or independent living skills.

f. Educational or vocational evaluation completed within the past year. Vocational assessments should identify an individual’s work interests, skills, and related behaviors, as well as current and potential employment options.

g. Medication and immunization history.

h. Screenings for nutritional, vision, auditory and speech, and language

i. When indicated by screening results, comprehensive evaluations in the area in which needs were identified are to be obtained within sixty (60) days of admission unless they have been completed within the past year.

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4. Within thirty (30) days of admission, the individual’s team is expected to synthesize the results of all assessments into a comprehensive individualized plan, utilizing the person–centered planning process.

5. The designated QIDP is expected to review the individual’s plan monthly to ensure that it has been implemented and continues to meet the individual's needs. This documented review analyzes data on the individual’s progress toward achieving the behavioral objectives' criteria and progress toward achieving service objectives. Copies are expected to be in the individual’s home.

6. The person-centered planning team is expected to review and revise the individual plan at least annually unless problems or changes in the individual’s status call for review and revision more frequently.

7. At least annually, the individual is expected to be reassessed in the following areas unless such assessment is determined unnecessary by the team: a physical and health examination, dental examination, an evaluation of cognitive and emotional function, an assessment of adaptive behavior or independent living skills, educational or vocational evaluation.

2.02 Individual Outcomes and Expected Benchmarks

1. Individuals, with any needed assistance from their team, will explore community-based, non-congregated activities and the use of natural supports to aid in participation.

As evidenced by: Interviews with individuals, family, guardians, staff, and individuals’ records.

Benchmark: Seventy-five percent (75%) of individuals in the sample receive support to participate in the life of the community; the balance of the sample has documentation demonstrating that the individual is not receiving support to participate in the life of the community based upon personal preference/choice, but that this has been explored at length with them.

2. Individuals will explore and establish a supportive employment plan.

Benchmark: One hundred percent (100%) of individuals will be made aware of options for obtaining paid work through visits, training, and other means. Individuals interested in pursuing supported employment will have an established plan to accomplish the goal. For individuals who prefer not to pursue supported employment, this will be clearly documented in the individual’s record, along with educational activities provided to remove barriers and to promote active participation in the community

As evidenced by: Individuals’ records. Interviews with individuals, family, guardians, and staff.

Benchmark: Fifty percent (50%) of individuals interested in obtaining paid work participate in supported employment; the remaining individuals interested in working have documentation (or other evidence) demonstrating that they are not participating in supported employment but are instead participating in a structured day program or regular volunteer work geared towards employment.

2.03 Organizational Outcomes and Expected Benchmarks

The organization demonstrates a systematic approach to continuous quality improvement in the areas of (1) individual safety, (2) individual rights, and (3) medication/healthcare.

As evidenced by: Quality Improvement (QI) plan; analysis of QI plan with actions taken to address identified areas for improvement; incident reports, individuals’ records, satisfaction surveys, complaint/grievance protocol, and records.

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Benchmark: The Quality Improvement Plan addresses the organization’s identified areas needing improvement.

Periodic (quarterly) reporting to be submitted on specific plans to address needs, progress, reassessment, and revisions.

2.04 Outwood ICF Staffing Requirements

A. It is expected to be the Contractor’s prerogative to determine the number of staff required and to organize staff in whatever manner that satisfies the delivery of quality services to ensure continued licensure in accordance with Section 2.01 D.

1. Adherence to the approved staffing plan is expected to be utilized in performance evaluations.

2. The Contractor is expected to maintain an employee personnel policy and procedures manual that includes the agency’s philosophy and gives information regarding salary ranges, vacation and leave procedures, health insurance, retirement benefits, opportunities for continuing education, and grievance procedures. Individuals providing services under contract shall be guaranteed at least the minimum wage.

3. The Contractor is expected to have adequate personnel to meet the needs of individuals on a twenty-four

(24) hour basis. The number and classification of personnel required are expected to be based on the number of individuals, the amount and kind of personal care, nursing care, supervision, and program needed to meet the needs of the individual as determined by the person’s team, and the services required by regulations listed in Section 2.01 D and this RFP.

B. The Contractor shall follow all local, state, and federal guidelines relative to employees with infectious diseases.

C. A written job description is expected to be maintained for everyone providing services under this contract, which describes the individual’s duties and responsibilities. The Contractor is expected to review the job description at least annually and revise, as needed.

D. The Contractor is expected to evaluate the performance of everyone providing services under this contract according to job description specifications at the completion of the Contractor’s designated probationary period and at least annually thereafter.

E. The Contractor is expected to report staffing information to include the number of staff, individual employee information such as name, position, salary or hourly rate, and any additional detail required, upon request of the

DBHDID.

F. The Cabinet reserves the right to have the Contractor replace any individual performing services under this contract at the ICF without cause. The Contractor is expected to notify the DBHDID two (2) weeks prior to replacing any key staff, including the Facility Director and Medical Director.

G. Mandatory Requirements

The Contractor is required to provide the following credentials for any individual designated to provide services under this contract prior to beginning work at Outwood:

1. Record Checks: All individuals providing services under the contract shall have 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) before beginning work. 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). In the Commonwealth of Kentucky, there are only two approved sources for criminal record data.

One is the Information Center, operated by the Kentucky State Police, and the second is 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 also be required of those states.

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A check of the Kentucky Nurse Aide Registry shall be completed for all individuals providing services under the contract. If the contract is with an individual, the Contractor is expected to be responsible for conducting criminal and abuse checks. This information shall be maintained by the Human Resources Department and be on file prior to work assignment.

The individuals providing services under the contract shall not have been convicted or have current charges outstanding that would constitute a felony conviction under 902 KAR 20:410, Section 5(5)(c).

All individuals providing services under this contract shall be subject to a fingerprint-supported state and FBI check under the Kentucky Applicant Registry and Employment Screening Program (KARES).

2. CPR and PPD Required Tests: Any individual providing services under the contract shall present evidence of current cardiopulmonary resuscitation certification (CPR) before beginning work. Individuals providing services under the contract must also have a current Purified Protein Derivative (PPD/TB skin) test or Blood Assay for Mycobacterium tuberculosis (BAMT). If a current PPD test or BAMT is not available, Contractor shall provide this service at no charge to the individual. The Contractor shall retain evidence of staff (CPR) certification.

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

3. Drug Testing: 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. The contractor shall bear all costs associated with conducting random and reasonable suspicion drug testing.

2.05 Subcontractors

All Subcontractors are expected to be pre-approved by the Cabinet for Health and Family Services prior to commencing services or work for Outwood.

2.06 Financial and Administrative Requirements

A. Sales Tax - The Contractor shall pay any sales, use, and personal property taxes arising out of this contract and the transactions completed thereby. Any other taxes levied on this contract, the transaction, or the equipment or services delivered pursuant shall be borne by the Contractor.

B. Year-End Audit—A year-end audit is expected to be conducted, and a settlement is expected to be made between both parties, remitting any balances due to either party to the limits of the total amount of the contract and the budgetary restrictions outlined above, regardless of the amount of expenses incurred.

The Contractor is expected to arrange for an annual audit of operations by an independent Certified Public Accountant. The audit report is expected to apply the cost principles and budgetary restrictions contained within this contract and is not expected to present prohibited costs as allowable expenses of the facility. The Department is expected to be notified and approve the prospective auditor and audit fee before commencement of any audit work.

The audit fee will be considered an allowable expense and is to be paid by the Contractor, who will then submit it on the monthly billing to the Department. If the audit fee or auditor is not acceptable to the Department, Department staff is expected to arrange for an audit of contract operations, with any audit cost being borne by the Department.

The audit firm is expected to be an independent certified public accounting firm, as defined under Kentucky law.

The audit report is expected to be prepared, identifying all sources of income and amounts derived from each source, and verifying, according to generally accepted accounting standards, the Contractor’s actual operating expenditures related to the facility for the contract period, applying the cost principles and budgetary restrictions described herein.

The audit is expected to be a specific engagement designed to assess the financial transactions of the contract, and it should not be part of any other audit that the Contractor may have performed.

The audit is expected to include all facility operations. Upon acceptance of the audit report, a settlement is expected to be made between the parties, with each party remitting any outstanding balances to the extent of the total contract

Document Phase Document Description Page 14 amount. The agreement between the Contractor and auditor is expected to provide access to all audit reports, working papers, and other documents created during the audit process. The Department may review these materials to ensure that sufficient audit work has been performed to support the accuracy of the audit report.

C. Collections - The Contractor is responsible for collecting all available sources of revenue to the maximum extent possible, in accordance with federal and state rules, regulations policies and guidelines, and to identify all revenue dollars by program (e.g., Medicaid, Social Security, S.S.I.) and amounts in the ICF’s end-of-year Statement of Operations as well as to render monthly the amounts collected to show on the monthly billing statement.

It is expressly understood that all revenues received by the ICFs from Medicare, Medicaid, clients and/or families, and other responsible parties shall be the sole property of the Cabinet. These revenues shall be excluded from all reimbursable costs under this contract and shall be returned to the Cabinet. It is further understood that these funds shall be segregated from other funds of the Contractor and that any interest thereon shall be the sole property of the Commonwealth.

Room and Board Charges shall be set by the Cabinet as required by KRS 210.710- 210.760. Ancillary charges shall be set by the Contractor and approved by the Cabinet on a basis of utilization. The rates shall be set so as not to penalize the Cabinet by a lower cost or charges aspect of Medicaid Reimbursement.

Any revenue lost due to the Contractor’s failure to meet Medicaid and or third-party timely billing shall be reported on the monthly billing as a reduction to reimbursable expense. It is expressly understood that these Medicaid revenues are essential to the operations of the Cabinet and that failure to collect these funds has a direct impact upon the ability to reimburse the Contractor for services rendered.

D. Cost Reports – Pursuant to 907 KAR 1:025, an annual cost report for Outwood ICF/IID shall be submitted.

The Department will provide the necessary technical assistance for preparing the cost report. The Contractor shall provide the required cost and other data to the Commonwealth within sixty (60) days of the end of the state fiscal year (June 30th).

E. Insurance Requirements – The Contractor shall have and maintain required insurance throughout the contract term as detailed below:

1. Medical Malpractice and Liability Insurance at a minimum of $1,000,000 per incident and $3,000,000 per year. The cost of the medical malpractice liability insurance is a non-reimbursable expense and shall be borne by the Contractor as part of their management fee.

2. Worker’s Compensation Insurance payments in accordance with state and federal guidelines.

3. The Cabinet shall be responsible for obtaining fire, boiler, machinery, and extended coverage insurance on the facility and premises.

4. The Cabinet shall maintain insurance coverage on certain information systems equipment. The equipment covered will be purchased with state funds, carry a CHFS inventory sticker, and be listed on the Department’s inventory.

The Contractor is expected to provide the DBHDID, Division of Administration and Financial Management, with copies of all medical malpractice and liability, comprehensive general, and property insurance policies affecting Outwood within thirty (30) days of contract award. Copies of any policy changes, whether in types or amount of coverage or insurance companies, are expected to be submitted to the Department within ten (10) calendar days of the status change.

F. State Vehicle Lease - The Cabinet currently has a fleet of vehicles leased from the Finance and Administration Cabinet of the Commonwealth of Kentucky for utilization in connection with the operation of Outwood. The

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Cabinet agrees to assign the lease to the Contractor, allowing the Contractor to use the vehicles during the duration of this contract. The Contractor shall not be responsible for maintaining general liability insurance on said vehicles and Cabinet-owned vehicles. The Contractor shall be responsible for reimbursing the Cabinet for the cost of excess liability coverage insurance on vehicles used for transporting patients. All vehicle maintenance required for the said vehicles is expected to be performed under the terms of the lease agreement between the Cabinet and the Finance and Administration Cabinet and assigned to the Contractor.

The Contractor may lease any additional vehicles not available from the Finance and Administration Cabinet as required for patient transport and facility operation. The Contractor will be responsible for insuring said vehicles.

All state-owned fleet vehicles shall only be operated by the following: state employee or employee of the Contractor carrying out official business for the operation of the facility, who is twenty-one (21) years of age and possesses a valid driver’s license. The Contractor is responsible for verifying and keeping a copy of each operator’s driver’s license, with a verification check on a yearly basis. Employees of the Contractor are required to report any changes in the status of their driver’s license. All passengers of fleet vehicles must be residents/patients, employees, or individuals conducting official business for the facility. Family members and friends of residents/patients or employees cannot be transported in fleet vehicles. Exceptions can be made in an emergency or if permission has been received from the Finance and Administration Cabinet, Director of Fleet Management, and a liability waiver has been signed.

2.07 Property Responsibilities

A. Access and Safety

1. The Department’s authorized representatives are expected to have free access to Outwood to observe and inspect its operation at any time, with or without notice. The Contractor is expected to cooperate with the representatives by sharing all Outwood records, including financial and other relevant information, upon request.

2. The Contractor is expected to compile and maintain all records deemed necessary by the Department for proper monitoring and auditing of its performance of functions under the contract. When agencies receive formal or written advice from the DBHDID regarding improvements in the quality of supports for individuals, the agency shall document evidence that action has been taken in response to the DBHDID's advice within the specified timeframe.

3. The Contractor is expected to maintain Outwood and the premises in good and satisfactory condition and, at the termination of the contract, return the control of the facilities and premises to the State in as good a condition as when received, fair wear and tear accepted.

4. The Contractor shall not do, or permit to be done, any act or thing, which will invalidate any insurance on the building or other improvement to be maintained on the premises in such a condition or so used and occurred that the same will not be insurable. The Contractor shall not do, or permit to be done, any act or thing that will cause a building code violation.

5. Each room shall have a fire control and evacuation plan that is practiced at least quarterly for each shift or personnel, with all staff and individuals participating. Drills are expected to be held at different times of the day and evening.

B. Fixed Assets

1. Verify inventory as of the date of transfer, acknowledge receipt thereof, and maintain a current inventory of all equipment used at Outwood.

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2. Identify the ownership of furnishings, fixtures, and equipment purchased from contractual funds as property of the Commonwealth, except purchases made from corporate funds.

3. Obtain at least three bids for the purchase of capital equipment valued at over $2,500 if the purchase is made with state contractual funds. The awarding of the purchase will be made in accordance with Commonwealth Procurement policies.

4. Submit capital equipment purchases exceeding $5,000 to the DBHDID Division of Administration and Financial Management, which may approve and process the order or may authorize the Contractor to purchase directly. Furthermore, all supplies, furnishings, fixtures, and equipment supplied by the Department shall remain the property of the Commonwealth.

5. Notify the Department’s inventory officer of acquisition or impending disposal of state property.

6. Maintain all equipment supplied by the state agency for use at Outwood in a good and satisfactory condition, fair wear and tear accepted, including all vehicles owned by the Commonwealth, except that if equipment, furniture or fixture additions or replacements are required for licensure, the Department may authorize the required additional expenditures, and reimburse the Contractor for the actual costs upon receiving expenditure documentation.

7. Use all vehicles provided under this contract only for Outwood and the care/protection of its individuals, except in case of an emergency. It is understood that the use of all specialized vehicles is at the sole risk and responsibility of the Contractor.

8. Maintain records of all repairs and maintenance work completed.

C. Building and Maintenance

Routine maintenance and repairs to Outwood shall be the responsibility of the Contractor whenever they are not covered by the warranty of the General Contractor or suppliers.

The Contractor is expected to complete all routine preventive maintenance checks in accordance with the warranty and manufacturer's specifications.

Improvements and/or modifications to Outwood not exceeding $2,500 are expected to be the responsibility of the Contractor and are reimbursable as part of the operating budget.

Improvements and/or modifications exceeding $2,500 are expected to be requested in writing (except in emergency situations) and approved by the Department prior to the expenditure of state funds.

The Contractor shall bear the cost of any repairs required because of the Contractor’s failure to follow the Manufacturer’s routine maintenance requirements.

No changes to existing facility structure or land shall be made by the Contractor without the full knowledge and express written consent of the Department.

2.08 Information Technology Requirements

A. Electronic Health Record Technology Incentive Program: The Contractor shall comply with all applicable provisions of 42 CFR 495.

B. Any Commonwealth computers assigned to the vendor by COT are prohibited from adding any vendor-licensed software on those assigned Commonwealth computers.

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C. Any vendor computers must be procured and licensed by the vendor.

2.09 Reporting Requirements

A. Submit all reports to the DBHDID Commissioner’s Office or designated DBHDID representative at BHDIDAFMReporting@ky.gov.

B. Submit quarterly reports as designed by the DBHDID regarding progress made on achievements that show how the Contractor is achieving the expected Performance Outcomes.

C. Submit other reports as requested by the DBHDID for proper monitoring and auditing of performance of functions under this contract, upon request.

D. Submit copies of any insurance policy changes, whether in type or amount of coverage or insurance companies, to the DBHDID within ten (10) calendar days of the status change.

2.10 Transition/Turnover Requirements

In the event DBHDID requires a transition after non-renewal, expiration of contract, or termination by either party, DBHDID shall notify the Contractor at the same time DBHDID serves notice of the non-renewal or termination, by either party. The outgoing Contractor shall provide the detailed transition documents to DBHDID at no additional cost. The following are the specific transition requirements:

A. Orderly Transition of Work.

The outgoing Contractor shall be responsible for the efficient and orderly transition of work and the accuracy of data in coordination with the new Contractor. DBHDID shall ensure the new Contractor's cooperation to facilitate a smooth transition.

B. Transition Plan.

The outgoing Contractor shall provide a detailed transition document sixty (60) days prior to contract expiration or within ten (10) days after written notification by DBHDID of the initiation of a transition due to a reason other than contract expiration.

1. Delivery of Detailed Transition Plan. Upon receipt of the detailed transition document from DBHDID, DBHDID shall review the document and, within fourteen (14) calendar days, provide written instructions to the outgoing Contractor regarding the packaging, documentation, delivery location, and delivery date of all records necessary to ensure an orderly transition.

2. If DBHDID determines upon review that the Transition Plan is missing necessary information, DBHDID shall provide the Contractor with written instructions as to the information that is still needed, and the Contractor shall amend the Transition Plan to include the necessary information.

C. Non-Compete.

To ensure continuity of care during any transition period, all non-compete agreements affecting direct care staff shall be waived to allow employees to continue serving residents, regardless of which entity holds the management contract

2.11 CHFS Responsibilities

The Cabinet for Health and Family Services may:

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A. Conduct periodic, scheduled, and unannounced inspections of the facility throughout the term of the contract.

B. Perform a…