HRFP2403 Specs_FINAL.doc

STATE OF IDAHO

THE DEPARTMENT OF HEALTH AND WELFARE

REQUEST FOR PROPOSAL (RFP)

Idaho Critical Access Hospital Quality Improvement Project

HRFP2403 / IPRO RFP585

Issue Date 07/23/2024

TABLE OF CONTENTS

Page

1RFP ADMINISTRATIVE INFORMATION

OVERVIEW

QUESTIONS

INSTRUCTIONS FOR SUBMISSION OF PROPOSALS

PROPOSAL FORMAT

PROPOSAL REVIEW, EVALUATION, AND AWARD

MANDATORY SUBMISSION REQUIREMENTS

Business Information Organization and Staffing

SCOPE OF WORK

APPENDIX A -- COST PROPOSAL AND BILLING PROCEDURE

APPENDIX B -- REPORTS

APPENDIX C – STATE OF IDAHO CONTRACT TERMS AND CONDITIONS

APPENDIX D -- RIDERS

APPENDIX E -- IDAHO TERMS AND CONDITIONS BACKGROUND AND LIMITATIONS

ATTACHMENT 1 -- OFFEROR QUESTIONS

ATTACHMENT 2 -- MODIFICATION AND EXCEPTION FORM

ATTACHMENT 3 -- PRE-PROPOSAL CONFERENCE REGISTRATION FORM

ATTACHMENT 4 -- STATE SIGNATURE PAGE

ATTACHMENT 5 -- COVER FORM

ATTACHMENT 6 – Idaho Flex Program Needs Assessment 2023 ATTACHMENT 7 – Idaho Flex Program Evaluation ATTACHMENT 8 -- Flex FY24 Grant Guidance ATTACHMENT 9 -- FY 24-28 Flex Program Structure ATTACHMENT 10 -- MBQIP 2025 Measures ATTACHMENT 11 -- MBQIP 2025 Information Guide ATTACHMENT 12 -- MBQIP 2025 Submission Deadlines ATTACHMENT 13 -- Progress Report/Year End Report Template Example

RFP ADMINISTRATIVE INFORMATION TC "RFP ADMINISTRATIVE INFORMATION" \f C \l "1"

Grants/Contracts Officer kristin.perry@dhw.idaho.gov

Submit Proposal to:

Submit electronically via IPRO Electronic Submission:

IPRO LOGIN

Pre-Proposal Conference Date/Time:

Pre-Proposal Conference Location:

Monday, 07/29/2024, 3:00 p.m. Mountain Time By WebEx only You must email the RFP Lead by the Pre-Proposal Registration Deadline to receive conference details. Late registrations will not be guaranteed to receive conferencing information. There will not be an in-person conference.

The Department conducts Virtual Electronic Bid Openings only.

OVERVIEW TC "1

OVERVIEW" \f C \l "1" 1.1 Purpose The Department’s Division of Public Health, Bureau of Rural Health & Primary Care is seeking a single Contractor to provide assessment, analysis, technical assistance, and support to improve Medicare Beneficiary Quality Improvement Project (MBQIP) measures in Idaho Critical Access Hospitals (CAHs).

1.2 Background Information The Medicare Rural Hospital Flexibility (Flex) Program was established by the Balanced Budget Act of 1997. The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) oversees the grant program. The purpose of Flex is to provide support for CAHs to encourage quality and performance improvement activities including stabilizing rural hospital finance, integrating emergency medical services (EMS) into their healthcare systems, incorporating population health, and fostering innovative models of healthcare.

The Department receives Flex funds to support Idaho CAHs to ensure residents in rural communities have continued access to high quality health care services.

MBQIP Program Background

MBQIP is a quality improvement initiative under the Flex grant program. The goal of MBQIP is to improve the quality of care provided in CAHs by increasing quality data reporting; then driving quality improvement activities based on the data. This project provides an opportunity for individual hospitals to benchmark their data, measure outcomes against other CAHs, and partner/network with other hospitals throughout the State around quality improvement initiatives.

FORHP frequently introduces updates to the MBQIP measures. Additional changes to these measures could be introduced; some existing measures may be retired, and other measures added.

Idaho has worked with Contractors over the past decade to provide benchmarking, in-person workshops, webinars, and one-on-one (1:1) technical assistance calls to provide MBQIP evidence-based tools and strategies to all twenty-seven (27) Idaho CAHs. Idaho has one hundred percent (100%) MBQIP participation. All twenty-seven (27) CAHs must report MBQIP measures to receive any type of Flex funding. Idaho CAHs continues to work to find more efficient ways to report and access the various sites for reporting, including:

· National Healthcare Safety Network;

· Hospital Quality Reporting (HQR) hqr.cms.gov (formerly QualityNet); and

· Health Care Quality Improvement System (HCQIS) Health Care Access Roles and Profile (HARP) (formerly Center for Medicaid and Medicare Services (CMS) Abstraction and Reporting Tool (CART).

There are other entities in Idaho that provide support to CAHs to improve quality and patient safety. The Department’s Idaho Bureau of Rural Health & Primary Care coordinates with Comagine Health, the current Quality Improvement Network - Quality Improvement Organization (QIN-QIO), the Department’s Healthcare Associated Infections (HAI) program, and the Idaho Hospital Association (IHA) to support their initiatives and ensure efforts are not duplicated. The Department also partners with the Northwest Hospital Alliance and Hospital Cooperative, Idaho’s two (2) regional CAH networks.

Current Idaho Flex Contracts

The Flex grant currently has a Contract with the University of Washington Center for Stewardship in Medicine (UW CSiM) to provide support for Idaho CAHs in antimicrobial stewardship. UW CSiM oversees weekly sessions with Idaho and other nearby states to provide technical assistance, best practices, and case studies support to CAHs in antimicrobial stewardship. This is the only quality improvement Contractor at present through the Idaho Flex grant.

QUESTIONS TC "2

QUESTIONS" \f C \l "1" 2.1 Restrictions on Communications

From the issue date of this RFP, until a Contract is awarded, or the RFP is cancelled, vendors are prohibited from communications regarding this RFP with Department staff, evaluation committee members, or other associated individuals, except the Department’s RFP Lead.

2.2 Pre-Proposal Conference

A non-mandatory pre-proposal conference will be held at the time indicated in the RFP Administrative Information Section, page 1 of this RFP. This will be your opportunity to ask questions of Department staff. All interested parties are invited to participate by an established call in number. To receive conference details, participants must register for the Pre-Proposal Conference no later than Friday, 07/26/2024, 12:00 p.m. Mountain Time by submitting the completed Attachment 3 -- Pre-Proposal Conference Registration Form via e-mail to the RFP Lead at kristin.perry@dhw.idaho.gov . Late registrations will not be guaranteed to receive conferencing information. Vendors are strongly encouraged to submit questions to the RFP Lead prior to the pre-proposal conference. Any oral answers given by the Department during the pre-proposal conference are unofficial and will not be binding on the State. Conference attendance is at the vendor’s own expense.

2.3 Questions and Vendor Proposed Modifications and Exceptions to Requirements, Terms, or Conditions

Questions must be submitted, by email, to the RFP Lead by the date and time indicated in the RFP Administrative Information Section, page 1 of this RFP in order to be considered. Vendors are strongly encouraged to submit any proposed questions, and or modifications to the requirements, terms, or conditions at this time. Written questions must be submitted using Attachment 1 -- Offeror Questions and requested modifications and or exceptions, must be submitted using Attachment 2 -- Modification and Exception Form. The RFP Lead is the only contact for this Solicitation. All correspondence must be in writing. Official answers to all written questions will be posted on the State’s eProcurement system (IPRO) as an amendment to this RFP.

2.3.1 Proposed modifications and exceptions to requirements, terms or conditions must contain the following:

a.

The rationale for the specific requirement being unacceptable to the party submitting the question (define the deficiency).

b.

Recommended verbiage for the State’s consideration that is consistent in content, context, and form with the State’s requirement that is being questioned.

c.

Explanation of how the State’s acceptance of the recommended verbiage is fair and equitable to both the State and to the party submitting the question.

2.3.2 The State will not consider any modifications or exceptions that are not identified specifically on Attachment 2 and that are submitted after the Question deadline.

2.3.3 The State has sole discretion to determine if the modifications or exceptions submitted by an Offeror would result in a material change or otherwise threaten the integrity of the procurement process. Pursuant to IDAPA 38.05.01.084, the State may only negotiate non-material modifications or exceptions. Modifications or exceptions which the State determines to be material, or which otherwise threaten the integrity of the procurement process, will not be accepted or negotiated.

2.3.4 Except as otherwise provided in the Solicitation document, including the State of Idaho Standard Contract Terms and Conditions (updated July 2024) the State will not consider modifications or exceptions to the requirements, terms, or conditions which are proposed after the Question deadline.

2.3.5 Proposals which condition the Proposal based upon the State accepting other terms and conditions not found in the RFP, or which take exception to the State’s terms and conditions, will be found non-responsive, and no further consideration of the Proposal will be given.

INSTRUCTIONS FOR SUBMISSION OF PROPOSALS TC "3

INSTRUCTIONS FOR SUBMISSION OF PROPOSALS" \f C \l "1" 3.1 General Instructions

3.1.1 Proposals must be submitted as detailed in 3.1.6 below. Except as otherwise addressed in this Solicitation, all submission materials must be submitted at the same time. If multiple submissions are received, only the latest timely submission will be considered.

3.1.2 Alternate proposals are not allowed.

3.1.3 All files must be in Microsoft Word, Excel or searchable PDF format. The only exceptions are Attachment 1 – Offeror Questions and Attachment 2 -- Modification and Exception Form which must be submitted in Word format. The electronic version must NOT be password protected or locked in any way.

3.1.4 All Offerors participating in this Solicitation must establish an account in the IPRO system as it is necessary in order to submit your response and award the resulting Contract(s). Establishing an account is free and only takes a few minutes.

3.1.5 Vendors are strongly encouraged to begin the process of submitting the response far enough in advance of the Closing Date to allow for resolution of technical difficulties. Be advised that the State is not responsible for a Vendor’s failure to timely submit a responsive submission due to any technical or technological difficulties. See IDAPA 38.05.01.61.

3.1.6 Both the Technical Proposal and the Appendix A - Cost Proposal and Billing Procedure must be submitted electronically through IPRO. Failure to input this data in IPRO will result in the Proposal being found non-responsive. Download the Excel spreadsheet titled “Appendix A – Cost Proposal and Billing Procedure” found in the Question Section of IPRO. Complete the spreadsheet, upload it back into IPRO in an Excel spreadsheet format. Upload your Technical Proposal into the appropriate Question Section in IPRO.

3.1.7 The current versions of the State of Idaho Standard Contract Terms and Conditions and Solicitation Instructions to Vendors are incorporated by reference into this Solicitation, and attached or referenced in any resulting Contract, as if set forth in their entirety. Both documents can be downloaded at https://purchasing.idaho.gov/information-for-vendors/; or copies obtained by contacting the Division of Purchasing at 208-327-7465 or purchasing@adm.idaho.gov. Failure by any Offeror to obtain a copy of these documents shall in no way constitute or be deemed a waiver by the State of any term, condition or requirement contained in the referenced documents; and no liability will be assumed by the Department for an Offeror’s failure to consider the State of Idaho Standard Contract Terms and Conditions and Solicitation Instructions to Vendors in preparing its response to the solicitation.

SPECIAL TERMS PRECEDENCE: The State of Idaho Contract Terms and Conditions have been adapted for use by the Department of Health and Welfare and are included with this Solicitation as Appendix C.

3.2 Trade Secrets

Paragraph 28 of the Solicitation Instructions to Vendors describes trade secrets to “include a formula, pattern, compilation, program, computer program, device, method, technique or process that derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by other persons and is subject to the efforts that are reasonable under the circumstances to maintain its secrecy.” In addition to marking each page of the document with a trade secret notation (as applicable; and as provided in Paragraph 28 of the Solicitation Instructions to Vendors), Offerors must also:

3.2.1 Identify with particularity the precise text, illustration, or other information contained within each page marked “trade secret” (it is not sufficient to simply mark the entire page). The specific information you deem “trade secret” within each noted page must be highlighted, italicized, identified by asterisks, contained within a text border, or otherwise clearly delineated from other text/information and specifically identified as a “trade secret.”

3.2.2 Provide a separate document entitled “List of Redacted Trade Secret Information” which provides a succinct list of all trade secret information noted in your Proposal; listed in the order it appears in your submittal documents, identified by Page #, Section #/Paragraph #, Title of Section/Paragraph, specific portions of text/illustrations; or in a manner otherwise sufficient to allow the State’s procurement personnel to determine the precise text/material subject to the notation. Additionally, this list must identify with each notation the specific basis for your position that the materials be treated as exempt from disclosure and how material complies with the Public Records Law.

3.2.3 If your Technical Proposal contains trade secret information, you must also upload a redacted copy with all trade secret information removed or blacked out. The redacted copy must be uploaded into IPRO into the appropriate Question Section in IPRO with the word “redacted” in the file name.

3.3 Electronic Submission of Proposals 3.3.1 Proposals must be submitted through IPRO, at https://sms-idaho-prd.tam.inforgov.com/fsm/SupplyManagementSupplier/page/XiSupplyManagementSupplierPage?csk.SupplierGroup=LUMA. When submitting through IPRO, upload your Technical Proposal and Appendix A - Cost Proposal and Billing Procedure, and all other required submittal items in the appropriate Question Sections. Remember to submit an additional redacted version of the TECHNICAL PROPOSAL if you have identified trade secrets.

3.3.2 The Technical Proposal and Appendix A - Cost Proposal and Billing Procedure must be separate files submitted at the same time.

3.3.3 Offerors are further advised to upload response materials with descriptive file names, organized and consolidated in a manner which allows evaluators to efficiently navigate the Offeror’s response.

PROPOSAL FORMAT TC "4

PROPOSAL FORMAT" \f C \l "1" These instructions describe the format to be used when submitting a Proposal. The format is designed to ensure a complete submission of information necessary for an equitable analysis and evaluation of submitted Proposals. There is no intent to limit the content of Proposals.

4.1 Table of Contents

Include a table of contents in the Technical Proposal identifying the contents of each Section, including page numbers of major subsections.

4.2 Format Proposals shall follow the numerical order of this RFP starting at the beginning and continuing through the end of the RFP. Proposal Sections and subsections must be identified with the corresponding numbers and headings used in this RFP. Respond to RFP Sections marked with an evaluation code. In your response, restate the RFP Section and follow with your response.

Offerors are encouraged to use a different color font, bold text, italics, or other indicator to clearly distinguish the RFP Section from the Offeror’s response.

4.3 Evaluation Codes

(M) Mandatory Response - failure to respond to any (M) Section, or to comply with any mandatory specification or requirement, will render Offeror’s Proposal non-responsive and no further evaluation will occur.

(ME)

Mandatory and Evaluated Response - failure to respond to any (ME) Section, or to comply with any mandatory specification or requirement in an (ME) Section, will render Offeror’s Proposal non-responsive and no further evaluation will occur. Offeror must respond to these sections as directed; points will be awarded based on predetermined criteria.

(E) Evaluated Response - a response is desired and will be evaluated. If Offeror cannot meet the requirement, or chooses not to respond for any reason, zero (0) points will be awarded for the Section. If Offeror responds, points will be awarded based on predetermined criteria.

Note: Offerors are directed to IDAPA 38.05.01.074.03.a, as well as IDAPA 38.05.01.091.05, which allow the designated State official to waive minor informalities as well as minor deviations. The State also reserves the right to seek clarification on any M, ME or E requirement.

PROPOSAL REVIEW, EVALUATION, AND AWARD TC "5

PROPOSAL REVIEW, EVALUATION, AND AWARD" \f C \l "1" 5.1 Overview

The objective of the State in soliciting and evaluating Proposals is to ensure the selection of a firm or individual that will produce the best possible results for the funds expended.

5.1.1 All Proposals will be reviewed first to ensure that they meet the Mandatory Submission Requirements of the RFP as addressed in Sections noted with an (M) or (ME). Any Proposal(s) not meeting the Mandatory Submission Requirements may be found non-responsive.

5.1.2 Evaluation Criteria

Technical Proposal:

Mandatory Submission Requirements Met Pass/Fail

Business Information (Section 7) 166 points

Organization and Staffing (Section 8) 166 points

Scope of Work (Section 9) 268 points

Cost Proposal:

Cost Proposal and Billing Procedure (Appendix A) 400 points

Total Points 1000 points

5.2 Technical Proposal

5.2.1 The Technical Proposal will be reviewed first on a “pass” or “fail” basis to determine compliance with those requirements listed in the RFP with an (M) or (ME). All Proposals which are determined by the Department, in its sole discretion, to be responsive in this regard will continue in the evaluation process outlined in this Section.

5.2.2 The Technical Proposal will be reviewed, evaluated, and scored by one (1) or more Technical Proposal Evaluation Committee(s).

5.2.3 The scores for the Technical Proposal will be normalized as follows: The Technical Proposal with the highest overall total technical score will receive a score of six hundred (600) points. Other Technical Proposals will be assigned a portion of the maximum score using the formula:

X raw score of Technical Proposal being evaluated highest raw technical score

5.3 Oral Presentations/Demonstrations 5.3.1 Oral demonstrations will not be conducted for this RFP.

5.4 Appendix A - Cost Proposal and Billing Procedure 5.4.1 The Appendix A - Cost Proposal and Billing Procedure will be reviewed first to determine if it meets the mandatory requirements of the RFP. All Proposals which are determined by the Department, in its sole discretion, to be responsive in this regard will continue in the evaluation process outlined in this Section.

5.4.2 The Appendix A - Cost Proposal and Billing Procedure will only be evaluated for Offerors who receive the top three (3) technical scores.

5.4.3 The scores for the Appendix A - Cost Proposal and Billing Procedure will be normalized as follows: The cost evaluation will be based on the total cost proposed for required services as itemized in Appendix A. The Proposal with the lowest One (1) Year Total will receive a score of four hundred (400). Other Proposals will be assigned a portion of the maximum score using the formula:

X Lowest Cost Proposal and Billing Procedure Cost Proposal and Billing Procedure being evaluated

5.5 Responsibility

Pursuant to IDAPA 38.05.01.081, the RFP Lead may, in the State’s sole discretion, conduct a review to determine if the apparent high point Offeror is responsible. As part of the responsibility review, the RFP Lead may:

5.5.1 Require the apparent high point Offeror to provide credit or financial reports to the satisfaction of the Department.

5.5.2 Require the apparent high point Offeror to provide a reference list and contact the Offeror’s references, which may include sending references a reference questionnaire.

5.5.3 Conduct other responsibility reviews at the discretion of the RFP Lead.

Failure to provide requested documentation may result in the Offeror being deemed non-responsible. Nothing herein shall prevent the State from using other means to determine Offeror’s responsibility.

5.6 Award

Award of Contract will be made to the responsive, responsible Offeror whose Proposal receives the highest number of total normalized points.

MANDATORY SUBMISSION REQUIREMENTS TC "6

MANDATORY SUBMISSION REQUIREMENTS" \f C \l "1" A complete response begins with the mandatory items identified in this list and the following Sections. NOTE: THIS CHECKLIST IS PROVIDED AS A COURTESY ONLY; OFFERORS ARE RESPONSIBLE FOR SUBMITTING ALL MANDATORY SECTIONS, ATTACHMENTS, SUBMITTAL ITEMS, ETC., REGARDLESS OF WHETHER THEY ARE IDENTIFIED IN THIS LIST.

(M) State Signature Page: Upload a completed, signed, Attachment 4 -- State Signature Page in the appropriate Question Section of IPRO.

(M) Cover Form: Upload a completed, signed, Attachment 5, Cover Form in the appropriate Question Section of IPRO

(M) Acknowledgement of Amendments: If the RFP is amended, the Offeror must acknowledge each amendment with a signature on the acknowledgement form provided with each amendment. Failure to return a signed copy of each amendment acknowledgement form with the Proposal may result in the Proposal being found non-responsive. See IDAPA 38.05.01.52. Upload a completed, signed, Acknowledgement of Amendments form in the appropriate Question Section of IPRO.

Section 7: Provide a response to all (E) (M) and (ME) Sections, and any other required submittal items.

Section 8: Provide a response to all (E) (M) and (ME) Sections, and any other required submittal items.

Section 9: Provide a response to all (E) (M) and (ME) Sections, and any other required submittal items.

(ME) Appendix A - Cost Proposal and Billing Procedure: Offerors are required to upload their Appendix A – Cost Proposal and Billing Procedure in the Question Section in IPRO in an Excel spreadsheet format.

Technical Proposal: Offerors are required to upload their Technical Proposal in the Question Section in IPRO.

Trade Secret Redactions: If applicable, the Offeror must upload a redacted copy of Technical Proposal and list of Trade Secret redactions, as detailed in Section 3.2.2

Insurance: Review the required types and levels of insurance—these are mandatory requirements. If you do not already have the required types and levels of insurance, you are strongly encouraged to contact your insurance representative to find out if you will be able to obtain the required insurance. (The Offeror should not purchase additional insurance in reliance of being awarded a Contract). If you are awarded a Contract, failure to provide proof of the required insurance will be grounds for termination of the Contract. DO NOT SUBMIT WITH PROPOSAL.

Business Information TC "7 Business Information" \f C \l "1" 7.1

(E) Business Profile

Provide a profile of your business including Offeror’s business history, description of current service area, and customer base.

7.2

(E) Experience

Describe in detail your knowledge and experience in providing services similar to those required in this RFP including:

7.2.1 Experience working with CAHs in quality improvement;

7.2.2 Expertise in clinical quality and patient safety; and

7.2.3 Expertise in MBQIP measures.

7.3 Faith-based Organization

If you are a faith-based organization describe how you will:

7.3.1 Segregate Contract funds in a separate account if federal funds;

7.3.2 Serve all participants without regard to religion, religious belief, refusal to hold a religious belief, or refusal to actively participate in a religious practice;

7.3.3 Ensure that State-referred clients’ participation in religious activities, including worship, scripture study, prayer or proselytization, is only on a voluntary basis;

7.3.4 Notify participants of the religious nature of the organization, their right to be served without religious discrimination, their right not to take part in inherently religious activities, their right to request an alternative provider and the process for doing so;

7.3.5 Ensure that Contract funds are not expended on inherently religious activities; and

7.3.6 Comply with applicable terms of 42 CFR Parts 54 and 54a, and 45 CFR 260 and 1050.

Organization and Staffing TC "8 Organization and Staffing" \f C \l "1" Describe your qualifications to successfully complete the requirements of the RFP by providing a detailed response to the following:

8.1

(E) Project Lead

Identify the person who will be the dedicated Project Lead if Offeror is awarded a Contract. Provide a description of the proposed Project Lead’s experience and qualifications. You may submit a resume in response to this Section.

8.2 (ME) Key Personnel and Qualifications

Provide a list of key management, customer service and other roles to be used in the fulfillment of the Contract (in addition to the Project Lead). Provide role descriptions, including requisite qualifications and experience of the person(s)/role(s) identified, as well as an explanation of how the person in that role will contribute to the project. Your response should demonstrate the extent to which you have the expertise to accomplish the Scope of Work including:

8.2.1 The Department prefers the Contractor have at least one (1) presenter who is a Registered Nurse (RN) who understands the MBQIP measures when reaching out to share best practices and presenting information to CAH Quality Improvement staff.

8.2.2 The Department prefers the Contractor have at least one (1) person who is able to analyze data and identify targets for improvement for individual CAHs and the state.

8.3 Subcontractors

If the Offeror utilizes any entity other than the entity submitting the Proposal to provide any of the services required by this RFP, the relationship between the two (2) entities is considered that of a contractor-subcontractor for the purpose of this Section, regardless of whether a relationship is based on an actual written Contract between the two (2).

8.3.1 If you intend to utilize subcontractors, describe the extent to which subcontractors will be used to comply with Contract requirements.

8.3.2 Include each position providing service and provide a detailed description of how the subcontractors are anticipated to be involved under the Contract (including requisite qualifications/experience).

8.3.3 If applicable, provide resumes for those subcontractors who will be managing and or directly providing services under the Contract.

8.3.4 Include a description of how the Offeror will ensure that all subcontractors and their employees will meet all requirements.

8.3.5 Offerors must disclose the location of the subcontractor’s business office and the location(s) of where the actual work will be performed.

8.3.6 If you do not intend to utilize subcontractors, provide a statement to that effect.

Note: The information provided for subcontractors, if any, will be evaluated as part of the Key Personnel and Qualifications section 8.2 above.

SCOPE OF WORK (SOW) TC "9

SCOPE OF WORK" \f C \l "1" All Sections of the SOW are required Contract services. Use this Proposal outline as part of your response to the RFP by restating each Section number and then providing your response. Keep in mind, the evaluators will be scoring your Proposal based on the methodologies proposed and the completeness of the response to each item listed below. Describe how you will meet each requirement marked (ME) Mandatory Evaluated and (E) Evaluated by describing, in detail, your organization’s qualification and experience (rather than simply restating the question or confirming compliance without additional supporting information); as well as how your organization plans to meet SOW requirements detailed in this RFP. The Proposal should address methodologies, pertinent timelines, personnel, activities, and other pertinent information in order to implement the SOW successfully to achieve full compliance with all tasks and deliverables. Offerors must identify any information or resources needed from the Department in order to perform any of the work. By providing a response to this Solicitation, you affirm you agree to and will comply with the following requirements.

I. GENERAL REQUIREMENTS

A. The Contract is funded by the Medicare Rural Hospital Flexibility (Flex) Grant awarded August 3, 2023, in the amount of seven hundred thirty-eight thousand four hundred dollars and zero cents ($738,400.00) through the Health Resources and Services Administration (HRSA).

B. The Contract supports the Idaho Department of Health and Welfare Strategic Plan and the Division of Public Health priorities.

C. The Contractor must provide a point of contact to the Contract Monitor. If a change in staffing occurs during the Contract timeframe, the Contractor must notify the Contract Monitor within thirty (30) calendar days of the change.

D. The Contractor must receive prior written approval from the Department for any deviations from the budgeted services/activities. The Contractor is financially responsible for costs deemed unallowable or unapproved by the Contract Monitor.

E. For the general monitoring of the Contract, the Contractor must maintain and have available for review all reporting and evaluation data and information for activities, and financial data as specified in the Records and Data section of the State’s Terms and Conditions.

F. The purpose of the Contract is to provide assessment, analysis, technical assistance, and support to improve Medicare Beneficiary Quality Improvement Project (MBQIP) measures for Idaho’s Critical Access Hospitals (CAHs).

G. The Contractor must adhere to the Federal Office of Management and Budget (OMB) Circular 2 CFR 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, located at https://federalregister.gov/a/2013-30465.

H. Ownership of Information: The Department and the United States Department of Health and Human Services must have unlimited rights to own, possess, use, disclose, transfer, or duplicate all information and data, copyrighted or otherwise, developed, derived, documented or furnished by the Contractor under the Contract.

II. DEFINITIONS

A. Critical Access Hospital (CAH) - A designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS). Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997 (Public Law 105-33) in response to a string of rural hospital closures during the 1980s and early 1990s. At present, there are twenty-seven (27) Idaho CAHs.

B. Medicare Beneficiary Quality Improvement Project (MBQIP) – The Federal Office of Rural Health Policy (FORHP) through HRSA created MBQIP. The goal of MBQIP is to improve the quality of care provided in CAHs, by increasing quality data reporting by CAHs and then driving quality improvement activities based on the data. This project provides an opportunity for individual hospitals to look at their own data, measure their outcomes against other CAHs, and partner with other hospitals in the state around quality improvement initiatives to improve outcomes and provide the highest quality care to every one of their patients.

C. Rural Quality Improvement Technical Assistance (RQITA) Telligen Resource Center – Created to help rural healthcare organizations overcome challenges and improve healthcare and quality of care using data, measurement, and improvement activities. RQITA is funded by FORHP to provide support to state Flex programs and their CAHs on MBQIP.

D. Flex Monitoring Team (FMT) - A consortium of the Rural Health Research Centers at the Universities of Minnesota, North Carolina-Chapel Hill, and Southern Maine, funded by the FORHP to evaluate the impact of the Flex Grant Program. https://www.hrsa.gov/rural-health/grants/rural-hospitals/flex. FMT provides the quarterly MBQIP data reports to state Flex programs.

E. Project - A series of activities that leads to one (1) or more outcomes. A project may consist of a cohort of hospitals meeting quarterly to share best practices and implement changes, a learning collaborative or learning action network, or a cohort of hospitals who are implementing a Plan Do Study Act (PDSA) - style project.

F. Output - Measures that an activity occurred; steppingstones used to move forward.

1. Example: Number of meetings, education programs, webinars provided.

G. Outcome - Measurable change resulting from an activity or series of activities. Outcomes can be short-term, intermediate, and long-term.

1. Example provided in the FY24 Flex Guidance: Revenue Cycle Management project.

a).

Short-term Outcome: Effects that occur more immediately, typically during the first year.

i.

Reduced registration errors as a percent of total registrations.

ii.

Increased percentage of point-of-sale.

b).

Intermediate Outcome: Effects that may occur in the first one to two (1-2) years.

i.

Reduced percentage of claims denied.

ii.

Increased percentage of denied claims re-billed.

iii.

Improved clean claims rate.

c).

Long-term Outcome: Effects that may occur after three (3) years.

i.

Improved days’ net revenue in accounts receivable (Critical Access Hospital. Measurement and Performance Assessment System [CAHMPAS]).

ii.

Greater days cash on hand (CAHMPAS).

iii.

Improved current ratio (CAHMPAS).

H. Impact - The result or effect that is attributed to a project or program. Impact is often used to refer to higher level effects of a program that occur in the medium or long term and can be intended or unintended, positive, or negative.

1. Example: Improved financial stability of CAHs, reducing risk of closing or losing service lines.

III. (E) CONTRACT SERVICES AND ACTIVITIES

A. The Contractor must:

1. Work with Department, when developing work products, conducting project activities, and submitting deliverables.

2. Within fifteen (15) calendar days of the Contract effective date, participate in a Contract implementation meeting, via conference call or WebEx facilitated by the Department, to review Contract requirements and timelines.

A. Describe how you will meet this requirement. The Contractor must provide an annual statewide needs assessment to determine Idaho CAHs most in need of improvement and areas to target to improve overall quality and performance. Assessment activities may include but are not limited to reviewing and analyzing available Idaho MBQIP data from RQITA-Telligen, FMT, and other sources, and collecting input from Idaho stakeholders through surveys, meetings, committees, or other approaches.

C. Describe how you will meet this requirement. The Contractor must develop two (2) CAH-specific quality cohort projects (see definition of project above). These projects are a series of activities with baselines, goals, results, and measurable outcomes (short, intermediate, and long-term). Reporting intermediate and long-term outcomes will be pending Contract extension. The Flex projects consist of determining each cohort of hospitals (minimum of five [5] most in need and/or interested in the topics).

1. Topics may be revisited each year depending on results of the needs assessment to ensure it is still the most valuable for Idaho CAHs. The Department may request the Contractor provide more or less than two (2) projects in future years based on funding and need. Year 1 must have two (2) simultaneous cohort projects. Suggested topics are identified below (see III.C.1.a. i-iii and b. i.-iii). The method, frequency, and specifics of implementation is to be determined by the Contractor and is subject to approval by the Department. The Contractor must create content and marketing for these projects, whenever possible, that are Idaho-specific and CAH-relevant. The Contractor must troubleshoot challenges where the facilities are underperforming and provide suggestions and best practice tools and strategies for quality improvement.

a).

CAH Quality Cohort 1 (Social Drivers of Health [SDOH]) led by the Contractor to provide targeted tools and strategies specific to CAHs to report and support SDOH initiatives. Potential outcomes to include but are not limited to:

i.

Short-term: Increase in screening rate of patients for SDOH ii.

Intermediate: Increase in community partnerships to provide resources/services for patients who screen positive for SDOH

iii. Long-term: Increase in resources/services provided to patients who screen positive for SDOH b).

CAH Quality Cohort 2 (Health Equity [HE]) led by the Contractor to provide targeted tools and strategies specific to CAHs to report and support HE initiatives. Potential outcomes to include:

i.

Short-term: Increase in compliance with five (5) health equity domains of CMS Hospital Commitment to HE structural measure ii.

Intermediate: Increase in the number of CAHs whose managers use collected data and other available resources to identify inequities

iii. Long-term: Leaders routinely assess quality interventions and processes to address identified inequities

IV. RECORDS AND DOCUMENTATION

A. The Contractor must:

1. Submit a description, curriculum, and an agenda for each cohort to the Department within ninety (90) calendar days after the Contract effective date.

2. Provide any required pre-cohort materials to participants ten (10) calendar days prior to the launch of the cohort release.

3. Develop and implement a pre- and post- assessment for each cohort to measure participant knowledge change.

4. Provide a list of the results of the pre- and post- assessments to the Department fifteen (15) calendar days after cohort completion.

5. Collect and report outcome data by CAH and cohort aggregate.

6. Submit participant attendance lists (including, but not limited to, first and last name, title, organization, and email) to the Department quarterly.

7. Develop and administer an evaluation after each cohort to determine the effectiveness of the cohort content and delivery model.

V. QUALITY ASSURANCE

A. The Contractor must provide and maintain a Quality Assurance Plan that documents the processes to be used in ensuring the quality of contracted services.

1. The Quality Assurance Plan must address all activities outlined in the scope of work and include methods for monitoring internal systems and processes and utilizing quality assurance information to improve services.

2. The Quality Assurance Plan must be finalized in conjunction with the Department within thirty (30) calendar days after the Contract effective date.

VI. TRANSITION PLAN

A. The Contractor must provide and maintain a Transition Plan that complies with the requirements of the Contract. The objectives of the Transition Plan are to minimize disruption of services provided to the Department and to provide for an orderly and controlled transition of the Contractor's responsibilities to a successor if the Contractor cannot complete the responsibilities of the Contract. The final Transition Plan must be negotiated with the Department upon Contract termination.

VII. ADDITIONAL PHASES/WORK ASSIGNMENTS

A. The Department may request that the Contractor provide additional services directly related to the contracted services. This may include, but is not limited to, additional reports, workshops, cohorts, or webinars. The Department will contact the Contractor if additional services are required. The Contractor must work with the Department to develop a work plan and budget based on the additional services.

APPENDIX A -- COST PROPOSAL AND BILLING PROCEDURE TC "APPENDIX A -- COST PROPOSAL AND BILLING PROCEDURE" \f C \l "1" (ME) Appendix A “Cost Proposal and Billing Procedure” must be downloaded from IPRO, completed and uploaded back into the Question Section in IPRO in an Excel spreadsheet format.

The Offeror must provide a fully-burdened rate which must include, but not be limited to, all operating and personnel expenses, such as: overhead, salaries, administrative expenses, profit, and supplies.

There will be no Administrative Fee to the Contract Purchase Order (CPO) resulting from this Solicitation per Paragraph 5 of the State of Idaho Standard Contract Terms and Conditions.

Part 1. Cost:

The Contract resulting from this RFP will be a FIRM FIXED FEE, INDEFINITE QUANTITY Contract.

The "Estimated Number of Units" shown in the cost matrix found in the Question Section of this RFP posting in IPRO is the Department's best estimate of units that may be experienced during the first year of the Contract. Estimated quantities are for evaluation and award purposes, based on the Department’s best estimate, and are not binding on the Department. Offerors must input their Cost Per Unit information (numbers only) in the blue cells. The Total Cost of Service will be automatically calculated by multiplying the Cost Per Unit by the Estimated Number of Units. This is the total amount proposed for performing all requirements under the Contract for one (1) year. Offerors must not alter the format of, or any numbers contained in, any matrix. Any Proposal not complying with this requirement will be deemed non-responsive and will receive no further consideration for award of a Contract.

Costs must remain firm throughout the life of the Contract, unless otherwise agreed to by the Department and modifications will only be considered under extenuating circumstances.

Part 2. Billing Procedure:

The Contractor must provide an invoice upon completion of each deliverable within the quarterly due dates:

September – November – due December 15th December – February – due March 15th March – May – due June 15th June – August – due August 31st The Contractor must ensure information provided in the reports aligns with invoices submitted during the reporting time frame.

Invoices will be processed for payment no later than thirty (30) calendar days once all required documentation is received. Invoices received without the required documentation will be returned to the Contractor for resubmission. No invoice will be accepted or paid without required documentation.

The invoice must include, but is not limited to:

a. All Contract services delivered during the billing period, identified by each item as reflected in the cost matrix and the total for each.

b. Total amount of direct and indirect costs billed for the billing period.

c. Contract number

d. Dates of service

e. Contractor name, address, phone number and or email address

f. Invoice number or unique identifier from the Contractor

Invoices and reports are to be submitted: [Information will be provided upon Contract award] Final invoices and reports must be submitted to the Department no later than August 31st of the current program year. Invoices received without the required report(s)/documentation will be returned to the Contractor for resubmission with the required final report(s)/documentation.

APPENDIX B -- REPORTS TC "APPENDIX B -- REPORTS" \f C \l "1" Report Description: Idaho CAH Statewide Needs Assessment – The report must identify and include: 1) benchmark MBQIP measures for all Idaho CAHs, 2) identify those most in need of support, 3) identify MBQIP measures most in need of improvement, 4) CAH de-identified data, and 5) graphs and visualizations, when possible, to be shared transparently with Idaho CAHs as needed.

Report Format: Microsoft Word Report Due Date: Annually, by no later than the end of January for the Flex Federal Fiscal Year (FFY) September 1-August 31.

Report Description: Idaho CAH Quality Cohort Report - The report must include: 1) attendee roster to include but not limited to title, organization, email, 2) a summary of content provided and any best practices shared, 3) a recording of any presentations provided, 4) the outcome data collected and reported by CAH and cohort aggregate (see workplan template in report format for progress report and year-end report as depicted in Attachment 13, 5) if a CAH is underperforming, the reason why must be reported, and 6) external summary – information to share with decisionmakers and CAHs not involved in the cohort to showcase case studies, lessons learned, and best practices.

Report Format: To be agreed upon between the Department and Contractor. Must include but not be limited to completion of the workplan template (report format) as depicted in Attachment 13. The Contractor will only be responsible for intermediate and long-term outcomes if the contract is extended for future years.

Report Due Date: As outlined below for the Flex Federal Fiscal Year (FFY) September 1-August 31:

· Idaho CAH Quality Cohort Report: March 1st - Progress report to align with Idaho’s reporting to HRSA for the Flex Non-Competing Continuation

· Idaho CAH Quality Cohort Report: August 31st - to align with Idaho’s reporting to HRSA for the Flex Year-End and Performance Measurement Improvement Systems (PIMS) Report

APPENDIX C – STATE OF IDAHO CONTRACT TERMS AND CONDITIONS TC "APPENDIX C – STATE OF IDAHO CONTRACT TERMS AND CONDITIONS" \f C \l "1" Article 1 – General Terms and Conditions

1.1. Definitions. Except as defined otherwise in this Contract, the following terms shall have the following meanings, whether capitalized or not, unless the context requires otherwise. Terms not defined within this Contract shall have the meanings defined in Idaho Code section 67-9203 and in IDAPA 38, title 05, chapter 01, Rules of the Division of Purchasing.

1.1.1. “Agency” means the board, commission, department, agency, or office of the State receiving the Property provided by the Contractor pursuant to this Contract.

1.1.2. “Contract” means this written agreement between Contractor and the State for the acquisition of property, which may be the result of a solicitation, and which may include the Solicitation or specification document and the accepted portions of the bid or proposal and other documents as identified herein, unless the context means one or more agreements with other contractors or for the acquisition or other property.

1.1.1. “Contractor” means the offeror, bidder, or proposer selected under the Solicitation to enter a contract with the State and identified as the Contractor in the heading above in this Contract.

1.1.2. “Data Breach” means any unauthorized access to or acquisition of Non-Public State Data following a Security Incident that compromises the security, confidentiality, or integrity of the Non-Public State Data, or the ability of the State to access the Non-Public State Data.

1.1.3. “Non-Public State Data” means State Data that is not subject to distribution to the public as public information. It is deemed to be sensitive and confidential by the State because it contains information that is exempt by statute, ordinance or administrative rule from access by the general public as public information. Non-Public State Data includes, but is not limited to, Personal State Data.

1.1.4. “Personal State Data” means State Data, which alone or in combination with other data, includes information relating to an individual that identifies the individual by name, identifying number, mark, or description that can be readily associated with a particular individual and which is not a public record. Personal State Data includes but is not limited to the following personally identifiable information (PII): government-issued identification numbers (e.g., Social Security, driver’s license, passport); financial account information, including account number, credit or debit card numbers; Protected Health Information (PHI) relating to a person; or education records covered by the Family Educational Rights and Privacy Act (FERPA), as amended, 20 U.S.C. 1232g, records described at 20 U.S.C. 1232g(a)(4)(B)(iv).

1.1.5. “Property” means goods, services, parts, supplies, and equipment, both tangible and intangible, including but not limited to, designs, plans, programs, systems, techniques, and any rights or interests in such property.

1.1.6. “Protected Health Information (PHI)” means individually identifiable health information held or transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium.