March 10, 2026

TO: ALL OFFERORS

FROM: Rick Williamson Management Analyst III

SUBJECT: ADDENDUM #1 – HSS 26-061 Medical School Partnership

ADDENDUM #1

THE ATTACHED SHEETS HEREBY BECOME APART OF THE ABOVE-MENTIONED

SOLICITATION.

1. Addendum to RFP – RESPONSES TO VENDOR QUESTIONS

Eddie Mui Management Analyst III (302)255-9293

All other terms and conditions remain the same.

If you have any questions, please contact me at ricky.williamson@delaware.gov.

mailto:ricky.williamson@delaware.gov

HSS-26-061 - Medical School Partnership Public Q&A

1. Inquiry Regarding Inclusion of Rural Advanced Practice Provider Postgraduate Training

Programs in HSS-26-061 RFP Vendor, Feb 16, 2026 12:38 PM EST, Not Public - Pending

To Whom it May Concern, My name is Kerry Bamrick, and I serve as the Executive Director for the Consortium for Advanced Practice Providers. The Consortium for Advanced Practice Providers is a membership, education, advocacy and programmatic accrediting agency for postgraduate nurse practitioner (NP) and Physician assistant/physician associate (PA) training programs. The organization was created to advance the model and rigor of postgraduate NA/PA residency and fellowship training programs and to serve as a programmatic accreditor for these programs.

I am writing on behalf of the Consortium for Advanced Practice Providers regarding Delaware’s request for proposals for professional services medical school partnership issued by the Department of Health and Social services, a Division of Public Health Contract Number HSS-26-061. Congratulations on the development of Delaware’s first medical school. We greatly appreciate supporting rural health care access through the development of new medical school for physicians however given the ongoing and critical need for advanced practice providers (APPs), particularly nurse practitioners, in rural communities, we would like to inquire whether you would consider expanding the RFP to include rural APP postgraduate training programs?

Such programs have demonstrated strong outcomes in preparing highly qualified clinicians to practice in rural and underserved areas, complementing physician residency efforts and further addressing workforce shortages. Programs accredited by the Consortium for Advanced Practice Providers demonstrate consistently strong outcomes, with an average completion rate of 88% and 87% of graduates continuing employment with their sponsoring organizations, reflecting both program effectiveness and sustained workforce retention.

While developing a medical school typically requires an extended planning period, APP postgraduate training programs can be designed and launched in less than 12 months. Given this expedited timeline and the high interest among new APPs seeking a rural postgraduate training program, organizations may find APP postgraduate training programs to be a timely and effective option for expanding rural workforce capacity.

Thank you very much for your time and consideration. We greatly value your commitment to strengthening rural health care and look forward to exploring ways we might collaborate to enhance the reach and impact of the HSS-26-061 program.

Kerry Bamrick, MBA

Executive Director

Consortium for Advanced Practice Providers

19 Grand Street

Middletown, CT 06457

Kerry.Bamrick@APPpostgradtraining.com

PROGRAM response:

The scope of this RFP is limited to the establishment of an undergraduate medical school as described in the Scope of Work (Appendix B). Advanced Practice Provider postgraduate training programs are addressed separately under RHTP Initiative #12.

Interested parties are encouraged to monitor future procurement opportunities related to that initiative.

2. COCA Accreditation

Vendor, Feb 18, 2026 3:56 PM EST, Not Public - Pending

On page 45 of the RFP it states "Recruit, credential, and retain highly qualified teaching faculty and administrative staff necessary to meet LCME accreditation standards and the State of Delaware’s specific training needs.

LCME is for Allopathic Medial Schools, are Osteopathic Medical Schools which have COCA Accreditation Standards eligible for this RFP?

PROGRAM response:

Yes. The State will consider proposals from institutions accredited by either the Liaison Committee on Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA). Both allopathic (MD) and osteopathic (DO) medical school programs are eligible to respond to this RFP.

mailto:Kerry.Bamrick@APPpostgradtraining.com

3. Building Ownership of the Medical School

Vendor, Feb 18, 2026 3:57 PM EST, Not Public - Pending

Does the medical school building have to be part of an university in the state of Delaware or can it be an independent entity?

PROGRAM response:

No. The medical school is not required to be part of an existing university in the State of Delaware. Please refer to the Scope of Work in Appendix B for the requirements applicable to the selected partner.

4. Medical School Campus Building

Vendor, Feb 18, 2026 3:58 PM EST, Not Public - Pending

Does the building have to be owned by the state of Delaware?

PROGRAM response:

No. The building does not have to be owned by the State of Delaware.

5. Accreditation

Vendor, Feb 20, 2026 4:59 PM EST, Not Public - Pending

Good afternoon, Mr. Williamson and Mr. Mui, Ref RFP Appendix B, p 45, bullets 4 and 5.

The Liaison Committee on Medical Education (LCME) is a Federally recognized accrediting body for allopathic medical education programs leading to the MD degree. (https://lcme.org/about/)

The Commission on Osteopathic College Accreditation (COCA) is a Federally recognized accrediting body for osteopathic medical education programs leading to the DO degree. (https://osteopathic.org/accreditation/)

It seems to me that "COCA" should be inserted in bullet 5. I hope that you agree.

Please advise.

Thank you, George Beckerman

The State will consider proposals from institutions accredited by either the Liaison Committee on Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA). Both allopathic (MD) and osteopathic (DO) medical school programs are eligible to respond to this RFP.

6. re RFP Appendix E

Vendor, Feb 26, 2026 2:56 PM EST, Not Public - Pending

Please advise whether any ”shall, will and/or must” requirements in Appendix E of the RFP are mandatory and must be addressed.

THANK YOU.

PROGRAM response:

No. Appendix E contains the state's full RHTP application and is provided for context and reference only, so that vendors can understand the broader Rural Health Transformation Program and the medical school initiative. All mandatory requirements for this RFP are contained in Appendix A and Appendix B.

7. re MoU

Vendor, Feb 26, 2026 2:57 PM EST, Not Public - Pending

On October 30, 2025, the State signed a non-binding non-exclusive Memorandum of Understanding (MoU) with Thomas Jefferson University in Philadelphia.

The MOU includes an actionable work plan and a material financial commitment. It became effective immediately upon the Governor’s signature.

Purpose, the MoU’s first provision, states in part that “The goal of this Collaboration [between the State of Delaware and Thomas Jefferson University] is to establish a phased approach leading to the creation of a four-year medical school in Delaware.”

It appears that this competitive RFP to select a Medical School Partner published on Feb 6, 2026, is in direct operational and procedural conflict with the previously executed MoU. The MoU includes a simple non-punitive provision for terminating it.

Perhaps the parties have already done this. Will the State provide Respondents with all working papers developed by the Collaboration? Please comment and advise.

THANK YOU.

PROGRAM response:

The referenced Memorandum of Understanding (MoU) with Thomas Jefferson University is a non-binding, non-exclusive agreement. It does not preclude or predetermine the outcome of this competitive procurement. No additional working papers have been developed under the MoU.

8. re DIMER

Vendor, Feb 26, 2026 2:58 PM EST, Not Public - Pending

The RFP is virtually silent about the well-established Delaware Institute of Medical Education and Research (DIMER), a unit of Delaware’s Health Care Commission, itself a unit of the Delaware Division of Public Health.

(https://dhss.delaware.gov/dhcc/dimer/ )

DIMER supports college students who are Delaware residents seeking to matriculate into a high quality and close-by medical school, the first step into the State’s “Train Here, Stay Here” medical education pipeline. It manages the State’s long-standing financial and operational relationships with two highly regarded medical schools located in Philadelphia, one granting MD degrees and one granting DO degrees.

What is the State’s plan for DIMER’s relationship with the new Medical School Partnership? Please advise.

THANK YOU.

PROGRAM response:

The State intends to continue the DIMER program. DIMER supports Delaware residents by increasing the opportunity to attend medical school. The new medical school established under this initiative will serve both Delaware residents and residents of other states. The two programs are complementary, and the State anticipates that DIMER will continue to operate alongside the new medical school partnership.

9. re Governance

Vendor, Feb 26, 2026 2:58 PM EST, Not Public - Pending

What is the formal type of negotiated agreement that the State prefers to have with the selected MD or DO Medical School Partner and its private nonprofit Delaware-based school? Please advise.

Options include a contractual (buyer-vendor) relationship, a grantor-grantee relationship, and a cooperative agreement /Public Private Partnership (PPP) relationship. Many provisions in the RFP suggest that the State may prefer a contractual relationship. This option does not seem appropriate for the Initiative.

Since the solicitation is focused on establishing a solid Medical School Partnership, the cooperative agreement / PPP model seems the right choice. Please comment and, if yes, provide Respondents with related Terms and Conditions or an agreement template. Please comment.

In a related matter, what are the CMS provisions placed on the State that must flow down in the Agreement to the selected Partner? Please advise.

THANK YOU.

PROGRAM response:

As stated in the RFP, the State intends to enter into a contract with the successful vendor. Existing State contracts can be found via Euna Procurement. Specific contract terms will be negotiated following selection.

10. re Geographic Information, Planning, and Budgeting

Vendor, Feb 26, 2026 2:59 PM EST, Not Public - Pending

Understanding Delaware: The medical school will be geographically located in one of Delaware’s three counties, two rural – Kent and Sussex, one nonrural – New Castle. Each county and its attributes should get its due. In making its selection of a Partner for mission success, the State should consider - in the context of Evaluation Criteria 2- Respondents’ understanding of each county, their views about the challenges they will face and navigate, and the benefits and impacts that the medical school would have. Their perspectives on the range of locations will translate into a range of cost drivers that enable responsive and responsible budgeting. Comments please.

State of Delaware Facilities: The RFP stipulates that the Partner’s Delaware -based medical school will be housed in State of Delaware facilities. Please provide a list of those facilities, highlighting the facilities that the State assesses as being suitable for the medical school. The more details about each site, the more responsive and responsible their proposals will be.. Please advise.

Ownership Obligations To Be Stipulated In The Negotiated Agreement: What obligations, including provision of budgeted services will the State have as the owner of the facilities in which the Partner’s medical school will be housed? Please advise.

THANK YOU.

PROGRAM response:

The State has not identified specific buildings for the medical school at this time. The reference to "State of Delaware facilities" in the RFP does not require facilities to be State-owned; it refers to any existing facility within the State of Delaware that could be converted or renovated for medical education purposes. New construction is not an allowable use of RHTP funds. The selected vendor will be responsible for identifying and contracting with appropriate facilities. A list of eligible State-owned buildings may be provided to the successful vendor following award.

11. re Risk Management

Vendor, Feb 26, 2026 3:00 PM EST, Not Public - Pending

The RFP includes these provisions in Appendix B, p. 46::

Specific to the planning and implementation of school launch, following selection, the Partner will:

• Develop, in collaboration with DHSS and the State, a budget framework covering key cost drivers, incorporating start-up costs, facilities, personnel, program delivery, and operational infrastructure. This budget will align with RHTP funding levels.

• Design a sustainable financial plan for ongoing operations post-RHTP funding.

The school must have a long-term financial and operating model which ensures program continuity and financial independence from State funding.

(a) What are the “RHTP funding levels?”

(b) What options are available to the parties if they cannot come to agreement on these matters?

THANK YOU.

As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period to launch the State's first medical school. Respondents should submit their proposed costs using the Project Cost Template (Appendix F). The detailed budget framework will be developed collaboratively between the State and the selected partner following contract execution, as described in Appendix B.

12. re Clarity Sought on Matters of Cost, Price, Budget

Vendor, Feb 26, 2026 3:01 PM EST, Not Public - Pending

a. Please define “Budget Framework.” It seems that the term is substantively used once, in Appendix B, p. 46, only as a post-award deliverable to be developed by Respondent and the State. Please advise.

b. The RFP includes this sentence fragment of a minimum mandatory submission requirement (Appendix A) : “Pricing as identified in the solicitation.” Please cite the pertinent pricing provisions as soon as possible. Cost, Price and Budget data are essential for responsive and responsible proposals.

c. Is pricing - other than for the substantial but as yet unaddressable costs of preparing State-owned facilities for occupancy - to be addressed in some fashion by Respondents in their proposals? Please advise.

d. It is not clear if the State considers “Price” as an element of Budget Framework, weighted evaluation criterion 5. Please advise.

e. Please provide instructions for completing Appendix F? Please advise.

THANK YOU.

PROGRAM response:

As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period to launch the State's first medical school. Respondents should submit their proposed costs using the Project Cost Template (Appendix F). The proposed costs will be considered as part of Evaluation Criterion #5: Budget Framework and Sustainability. The detailed budget framework referenced in Appendix B – beyond the detail provided in Appendix F - will be developed collaboratively between the State and the selected partner following contract execution.

13. Delaware Medical School Location - Sussex County

Vendor, Feb 26, 2026 5:00 PM EST, Not Public - Pending

In the Request for Proposal HSS 26‑061, Appendix E (State RHTP to CMS), Section 9: Delaware Medical School, the State identifies only Sussex County and Kent County as ‘Impacted Counties.’

Does this designation indicate that the State intends to locate the ‘Primary Care – Rural Health’ track medical school program in either Kent or Sussex County?

If so, does the State plan to collaborate with the economic development stakeholders in each county as part of the location‑selection process?

PROGRAM response:

Not necessarily. Appendix E contains the State's full RHTP application and is provided for context and reference only, so that vendors can understand the broader Rural Health Transformation Program and the medical school initiative. All mandatory requirements for this RFP are contained in Appendix A and Appendix B.

The RFP requires that the medical school serve Delaware's rural communities. In the development of the RHTP application, the State conducted extensive stakeholder conversations across disciplines.

Respondents should demonstrate how their proposed approach will address the State's rural healthcare needs.

14. "State of Delaware’s specific training needs"

Vendor, Feb 26, 2026 9:05 PM EST, Not Public - Pending re RFP pager 45, 5th bullet: please direct me to the document in which I will find "State of Delaware’s specific training needs" that are pertinent to this solicitation and provision. Thank you.

PROGRAM response:

The RFP itself and Appendix E (State RHTP to CMS) describe Delaware's healthcare workforce training needs. Appendix B (p.45) also lists curriculum areas including community medicine, preventive care, SUD treatment, behavioral health, and care integration. There is no separate standalone training needs document referenced.

15. "State of Delaware facilities"

Vendor, Feb 26, 2026 9:21 PM EST, Not Public - Pending

Please define / describe "State of Delaware facilities," including whether they are State-owned.

Thank you.

PROGRAM response:

The reference to "State of Delaware facilities" in the RFP does not require facilities to be State-owned.

It refers to any existing facility within the State of Delaware that could be converted or renovated for use as medical education space. New construction is not an allowable use of RHTP funds. The selected vendor will be responsible for identifying and contracting with appropriate facilities. A list of eligible State-owned buildings may be provided to the successful vendor following award.

16. Following Selection

Vendor, Feb 26, 2026 9:31 PM EST, Not Public - Pending

Re this sentence fragment: "Specific to the planning and implementation of school launch, following selection, the partner will:" Please clarify the phrase "following selection?" For example, does it mean following the winning Respondent's execution of the awarded contractual agreement?

PROGRAM response:

In this context, "following selection" refers to the activities that will take place once a contract has been signed with the selected vendor.

17. Six teaching hospitals

Vendor, Feb 26, 2026 9:50 PM EST, Not Public - Pending

Please confirm that these systems are the six alluded to in Goal 5:

ChristianaCare

Bayhealth

Beebe Healthcare

Nemours Children's Health

Saint Francis Hospital

TidalHealth

The six major health systems referenced in Goal 5 of the RFP are: ChristianaCare, Bayhealth, Beebe Healthcare, Nemours Children's Health, Saint Francis Hospital, and TidalHealth.

18. Location Preference

Vendor, Feb 27, 2026 7:02 AM EST, Not Public - Pending

Page 5, Section II, Item B, Bullet 3:

A preference for sites in Kent and Sussex counties is noted. How will site location be scored with respect to the evaluation criteria on page 17? Given the entirety of Sussex County is defined as rural by both USDA and OMB, will a Sussex site location receive a higher score than Kent or New Castle sites?

PROGRAM response:

Site selection will be evaluated holistically as part of the overall proposal. Both preclinical and clinical locations will need to meet the educational needs of the program. Proposals should demonstrate how the selected site(s) will support the goals of the initiative, including service to Delaware's rural communities.

19. Accreditation

Vendor, Feb 27, 2026 7:03 AM EST, Not Public - Pending

Page 45, Appendix B, Scope of Work & Technical Requirements, Bullet 5 (beneath "The selected partner will:"

There is a reference to LCME Accreditation. Is it the State's intent to seek partnership only with MD programs, with LCME accreditation? Given evidence that DO graduates are statistically more likely to practice Family Medicine, and more likely to practice in rural areas, preference should be given to partners experienced in rural medical education, regardless of accrediting body. Will partners accredited under COCA, Commission on Osteopathic College Accreditation be eligible for award?

PROGRAM response:

Yes. The State will consider proposals from institutions accredited by either the Liaison Committee on Medical Education (LCME) or the Commission on Osteopathic

College Accreditation (COCA). Both allopathic (MD) and osteopathic (DO) medical school programs are eligible to respond to this RFP.

20. Launch & Ongoing Operations

Vendor, Feb 27, 2026 7:05 AM EST, Not Public - Pending

Page 46, "Specific to the planning and implementation of school launch, following selection, the partner will:..."

The Evaluation Criteria on page 17 shows the most heavily weighted criteria being "Launch and Ongoing Operations", at 16%, yet page 46 states launch will be planned in concert with DHSS, after award.

Would you please clarify the State's expectations regarding the proposers Launch and Ongoing Operations plan?

PROGRAM response:

Respondents should propose a launch and operations plan based on the timelines set forth in the Project Goals of the RFP (pages 5-6). Following selection, the State will work with the selected vendor to refine the approach as needed, consistent with the collaborative planning process described in Appendix B (p. 46).

21. Accreditation Requirements (RFP p. 45):

Vendor, Feb 27, 2026 10:18 AM EST, Not Public - Pending

The RFP requires the ability to “recruit, credential, and retain highly qualified teaching faculty and administrative staff necessary to meet LCME accreditation standards and the State of Delaware’s specific training needs.”

Is it correct to assume that the specific reference to Liaison on Committee Medical Education (LCME) accreditation means that the State will NOT consider any proposal contemplating accreditation by the Commission on Osteopathic College Accreditation (COCA) as an alternative accreditation model to LCME?

Will the State consider osteopathic medical schools accredited by the Commission on Osteopathic College Accreditation (COCA), in addition to LCME-accredited institutions, in alignment with the initiative’s emphasis on primary care?

The State will consider proposals from institutions accredited by either the Liaison Committee on Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA). Both allopathic (MD) and osteopathic (DO) medical school programs are eligible to respond to this RFP.

22. DIMER Integration and Governance Expectations

Vendor, Feb 27, 2026 10:20 AM EST, Not Public - Pending

1. While the RFP mentions "leveraging, as much as possible and practical, the State of Delaware’s existing healthcare and academic infrastructure (p. 4), it does not specifically mention the existing governance structure of the Delaware Institute of Medical Education and Research (DIMER), which is currently recognized under Delaware law as an “alternative to a state sponsored medical school” that “is sound and should be continued and strengthened.” 16 Del. C. § 9905(a).

2. Will the State pursue changes to synthesize the new medical school with the current governance structure of DIMER and, if so, what will this look like in terms of potential changes to governance and oversight authority?

3. Will the successful applicant have an opportunity to serve on the DIMER board and/or any new or modified governance and oversight bodies that the State may establish over this program?

Are there expectations for formal integration with the Governor’s Office, DHSS, the Delaware Healthcare Commission, DIMER or other State regulatory bodies beyond what is described?

PROGRAM response:

There are no expectations beyond what is described in the RFP. The State will consider inclusion of the partner institution on the DIMER board.

23. “Train Here, Stay Here” outcomes (RFP p. 45; Appendix E):

Vendor, Feb 27, 2026 10:23 AM EST, Not Public - Pending

Are there specific retention benchmarks (e.g., % of graduates practicing in Delaware after residency) the State intends to track beyond those stated in Appendix E of the

RFP?

No. Appendix E contains the State's full RHTP application and is provided for context and reference only. Specific performance metrics and benchmarks will be developed collaboratively with the selected partner as part of the contract and in alignment with CMS reporting requirements. All mandatory requirements for this RFP are contained in Appendix A and Appendix B.

24. RE HSS 26 011 Medical School Partnership Clarify Prohibition and or Request

Approval for Contacting State of Delaware educational institutions Vendor, Feb 27, 2026 10:25 AM EST, Not Public - Pending

The Request for Proposal establishes that “direct contact with State of Delaware employees other than the State of Delaware designated contact regarding this RFP is expressly prohibited without prior consent.” (Request for Proposal for Professional Services, Page 8 Clause 6) Does this prohibition extend to State of Delaware employees working in state-sponsored educational institutions such as Delaware State University, Delaware Technical Community College, and other state agencies involved in medical education, or in the support of Graduate Medical Education and health care workforce development. If such a prohibition applies to the above listed educational institutions, Tiber Health Public Benefit Corporation as a potential vendor responding to this RFP, would like to expressly request authorization from the State of Delaware to make such contacts as part of the RFP planning and development process.

PROGRAM response

Please refer to RFP Section IV.A.4 (RFP Designated Contact) and Section IV.A.6 (Contact with State Employees). All requests, questions, or other communications about this RFP shall be made through Euna Procurement (formerly Bonfire) at https://dhss.bonfirehub.com. Communications made to other State of Delaware personnel or attempting to ask questions by phone or in person will not be allowed or recognized as valid and may disqualify the vendor. The prohibition on direct contact applies to all State of Delaware employees regarding matters related to this RFP.

Exceptions exist only for organizations currently doing business in the State who require contact in the normal course of doing that business.

25. RHTP Funding Flow

Vendor, Feb 27, 2026 10:25 AM EST, Not Public - Pending

1. Will RHTP funds be passed through directly to the selected partner, or managed by the State with reimbursement to the partner?

2. Are there anticipated CMS-driven reporting or audit requirements that vendors should explicitly account for in staffing and costs?

3. Please confirm the total funding amount available under the Rural Health Transformation Fund (RHTF) for the initial five-year period. Additionally, describe the funding disbursement mechanism and any applicable timing requirements or constraints (e.g., annual appropriations, milestone-based payments, reimbursements, or advance payments).

4. Are there restrictions or guidelines on allowable uses of RHTF funds (e.g., infrastructure, personnel, curriculum development, or other eligible activities)?

5. Beyond the RHTF allocation, will additional State funding be available to support the development and ongoing operations of the proposed medical school initiative?

PROGRAM response

1. Funding is anticipated to be managed on a reimbursement basis.

2. Yes, there will be CMS reporting and audit requirements. Reports will be submitted to the State. Respondents should account for the staffing and costs associated with compliance and reporting in their proposals.

3. As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period. Specific disbursement mechanisms and timing will be addressed in the contract with the selected vendor.

4. Eligible expenses under the contract include those consistent with the Scope of Work outlined in Appendix B. Faculty salaries and marketing expenses are eligible costs. Respondents should use the Project Cost Template (Appendix F) to detail their proposed budget and identify all anticipated cost categories. Any cost not clearly addressed in the RFP should be identified and justified in the proposal for consideration. New construction is not an allowable use of RHTP funds. New construction is not an allowable use of RHTP funds.

5. Ongoing allocations will be subject to the terms of the RHTP program and the contract between the State and the selected vendor.

26. Conversion or Renovation of Existing State Facilities (RFP p.45):

Vendor, Feb 27, 2026 10:26 AM EST, Not Public - Pending

Will the State facilitate regulatory flexibility (potentially including expedited permitting, contracting, land use processes etc.) to effectuate any necessary conversions or renovations of existing State of Delaware facilities, as contemplated in the RFP?

PROGRAM response

The State will abide by all required current practices and applicable regulations.

27. HSS 26 011 Medical School Partnership - Identification of State Facilities which could be

Remodeled for Medical School Campus as part of RFP Response Vendor, Feb 27, 2026 10:28 AM EST, Not Public - Pending

The RFP Documents indicate that “RHTP funding will support program infrastructure and facility development including building conversion and renovation.” The funds will further support “transforming an existing building in Delaware into purpose-built medical education space including the creation of simulation labs, anatomy labs, clinical skills training areas, lecture halls, small group learning rooms and study spaces.” (RFP, “Rural Health Needs and Target Populations”, Page 41)

a. Has the State of Delaware identified specific buildings which could be considered for conversion into medical school space?

b. If such potential buildings have been identified, could potential vendors visit them in order to establish realistic cost estimates for their conversion and renovation into the planned rural track medical school academic campus?

c. If such state facilities were to be selected for remodeling into a medical school campus, will there be an associated cost of rent or use of facilities which vendor would need to consider and build into the budget of its proposal?

PROGRAM response

The State has not selected specific buildings for the medical school at this time.

Respondents should propose their approach to identifying and securing appropriate facilities within the State of Delaware, consistent with the Scope of Work in Appendix B. New construction is not an allowable use of RHTP funds.

28. Rural Healthcare Facility (Project Narrative p. 3)

Vendor, Feb 27, 2026 10:32 AM EST, Not Public - Pending

For the purposes of this RFP, are there any additional parameters of how the State defines a “rural healthcare facility” above and beyond the description of Kent/Sussex County residents as set forth in the State’s Application (Project Narrative p. 3)?

PROGRAM response

For purposes of this RFP, any healthcare facility that serves rural residents may be considered eligible. This includes, but is not limited to, Federally Qualified Health Centers (FQHCs) and other providers serving rural populations across the State.

29. Financial Support Vendor, Feb 27, 2026 10:36 AM EST, Not Public - Pending

Will the State provide financial support for the development or expansion of graduate medical education (GME) programs associated with the new medical school, given the critical role of residency and fellowship programs in influencing physician practice location?

PROGRAM response

The State recognizes the critical importance of GME programs to the long-term success of this initiative and to physician retention in Delaware. The State looks forward to partnering with the selected vendor and existing health systems to consider options for supporting and expanding GME opportunities. No specific financial commitment for GME expansion is made as part of this RFP.

30. Tuition

Vendor, Feb 27, 2026 10:37 AM EST, Not Public - Pending

Is the State anticipating discounted tuition for all Delaware residents, or specifically for residents of rural areas within Delaware?

PROGRAM response

The State does not expect discounted tuition as part of this RFP. However, the State encourages respondents to describe how philanthropic support and other strategies may be leveraged to provide Delaware residents with favorable tuition rates.

Respondents should also note that students enrolled in the medical school may be eligible for education awards available under separate RHTP initiatives (Initiatives #10 and #11).

31. Scope of Work

Vendor, Feb 27, 2026 10:42 AM EST, Not Public - Pending

Recognizing that certain elements of the initiative (e.g., facilities conversion or specialized infrastructure development) may involve additional contractual relationships, would the State clarify whether respondents must propose across the full Scope of Work, or whether the State anticipates awarding distinct components separately?

PROGRAM response

All components listed in Appendix B are mandatory and must be addressed in each proposal. The State does not anticipate awarding distinct components separately.

32. School of Medicine

Vendor, Feb 27, 2026 10:45 AM EST, Not Public - Pending

Is the State seeking the establishment of a new, independent LCME-accredited medical school entity in Delaware, a branch campus of an existing LCME-accredited institution, or is the structure to be established during the project? If an existing medical school, what level of interaction will be expected between the vendor and the school of medicine?

PROGRAM response

The State is seeking proposals for a full branch campus of an existing accredited allopathic or osteopathic medical school to be established in Delaware. Respondents should demonstrate how their proposed approach meets the requirements set forth in Appendix B.

33. Award Structure

Will the State structure this award as a five-year agreement aligned with the RHTP funding period, or does the State anticipate a shorter term with potential extensions?

As stated on page 19 of the RFP (Section V.C.1), the term of the contract shall be for one (1) year with four (4) extensions for a period of one (1) year for each extension.

34. Sustainability

How will the evaluation committee define and score “sustainability” beyond the RHTP funding period? Is sustainability evaluated primarily on financial independence, diversified revenue sources, institutional commitments, or demonstrated state alignment?

PROGRAM response

As stated in Goal 7 of the RFP (pages 5-6), "By the conclusion of the initial five-year RHTP-funded period, tuition revenue and philanthropic support/endowment should provide primary operating support for the medical school". Respondents are encouraged to present comprehensive strategies for achieving long-term financial sustainability. The Evaluation Committee will assess proposals holistically based on the criteria outlined on page 17 of the RFP.

35. Bond Requirement

Vendor, Feb 27, 2026 10:46 AM EST, Not Public - Pending

Will a Performance Bond or Surety Bond be required for the professional services scope of this work?

PROGRAM response

There is no requirement for a Performance Bond or Surety Bond.

Please refer to RFP Section.V.G.10 and RFP Section.V.G.11.

36. Liability

Vendor, Feb 27, 2026 10:46 AM EST, Not Public - Pending

Is the State willing to negotiate a market limitation of liability in favor of the service provider?

Once a vendor is selected, the State will enter into a negotiation period during which specific contract terms, including liability provisions, may be discussed. Any proposed exceptions to the RFP terms should be recorded on Attachment 4.

37. Indemnity

Vendor, Feb 27, 2026 10:47 AM EST, Not Public - Pending

Is the State willing to narrow the broad indemnity included in the contract terms?

PROGRAM response

Once a vendor is selected, the State will enter into a negotiation period during which specific contract terms, including indemnification provisions, may be discussed. Any proposed exceptions to the RFP terms should be recorded on Attachment 4.

38. Requirements

Vendor, Feb 27, 2026 10:48 AM EST, Not Public - Pending

Will the State waive drug testing requirements depending on the scope of work awarded?

PROGRAM response

The applicability of drug testing requirements will be determined based on the scope of work and applicable law. Please refer to Section V.G.26 of the RFP. Any proposed exceptions should be recorded on Attachment 4.

39. DTI

Will the State waive the requirement for DTI based on the scope of work awarded?

The DTI T&Cs will be needed as you will be using state data.

40. BAA Requirement

Will the State waive the requirement for a BAA if the scope of work awarded does not require the service provider to have access to PHI?

PROGRAM response

If it is specifically stated that PHI is not to be collected or transferred or used in any way, the BAA is not needed.

41. State Funding

Vendor, Feb 27, 2026 12:08 PM EST, Not Public - Pending

Please share the agreed-upon amount the State and CMS have budgeted for the medical school annually over the 5-year funding horizon (if updated since original budget was submitted to the state, including details on budgeted renovations)

PROGRAM response

As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period to launch the State's first medical school. Respondents should submit their proposed costs using the Project Cost Template (Appendix F).

42. State Funding

Vendor, Feb 27, 2026 12:11 PM EST, Not Public - Pending

Can faculty and staff salaries and wages, financial aid support, marketing expenses, and housing & transportation costs be covered under Contractor Cost Category:

“Contract: Lead Partner Institution” even though not explicitly listed (e.g., “faculty recruitment is listed but faculty salaries are not)?

PROGRAM response

Eligible expenses under the contract include those consistent with the Scope of Work outlined in Appendix B. Faculty salaries and marketing expenses are eligible costs.

Respondents should use the Project Cost Template (Appendix F) to detail their proposed budget and identify all anticipated cost categories. Any cost not clearly addressed in the RFP should be identified and justified in the proposal for consideration.

43. Financial Sustainability Vendor, Feb 27, 2026 12:12 PM EST, Not Public - Pending

Please clarify if providing “primary operational support” means no state funding can be provided? Can state support be provided in any degree after 5 years?

PROGRAM response

As stated in Goal 7 of the RFP (pages 5-6), by the conclusion of the initial five-year RHTP-funded period, tuition revenue and philanthropic support/endowment should provide primary operating support for the medical school. No State funding should be expected beyond the five-year RHTP-funded period. The State will assist the selected partner in developing relationships with local philanthropic organizations to support long-term sustainability.

44. Program Launch Timeline

Vendor, Feb 27, 2026 12:12 PM EST, Not Public - Pending

Please elaborate on the expectations associated with “full institutional launch” in Spring 2031 given the first matriculating class begins in fall of 2028? (i.e., Does this coincide with when all four graduating classes are expected to enroll?)

PROGRAM response

Please refer to the Project Goals outlined on pages 5-6 of the RFP. Goal 6 states that full institutional launch, including curriculum delivery, faculty engagement, and student instruction, must be completed by Spring 2031, and that the program's operations through Spring 2031 should remain within the funding provided under RHTP. Respondents should demonstrate in their proposals how they will achieve these milestones within the identified timeframe.

45. Complementary DE Initiatives

Vendor, Feb 27, 2026 12:13 PM EST, Not Public - Pending

What is the connectivity between the selected bidder for initiative #9 and how the funds are distributed for initiatives #10 and 11, i.e., will the operator of the medical school be involved in the distribution of the recruitment / retention funds in initiatives 10/11?

Students enrolled in the medical school established under this initiative (Initiative #9) will be eligible for education awards available under RHTP Initiatives #10 and #11.

The medical school will also be eligible to participate in other RHTP training programs (Initiative #12). The distribution of funds under Initiatives #10, #11, and #12 will be managed separately from this procurement.

46. Health System Requirements

Vendor, Feb 27, 2026 12:15 PM EST, Not Public - Pending

Per the RFP, the new medical school is expected to work with Delaware’s “six major health systems”. Please confirm which entities these are (between Bayhealth, Beebe Healthcare, ChristianaCare, Nemours, TidalHealth, Trinity Health, and the Wilmington VA Medical Center).

PROGRAM response

The six major health systems referenced in Goal 5 of the RFP are: ChristianaCare, Bayhealth, Beebe Healthcare, Nemours Children's Health, Saint Francis Hospital, and TidalHealth.

47. RFP Requirement - Primary Contractor

Vendor, Feb 27, 2026 12:16 PM EST, Not Public - Pending

Please confirm the definition of primary contractor? Does this mean only one legal entity? Are there any other requirements this legal entity meet (e.g., be a currently accredited medical school)?

PROGRAM response

Please refer to RFP Section IV.B.12 and RFP Section IV.B.12.13 relating to Prime contractor and Subcontractor.

48. RFP Requirement - Evaluation Criteria

Vendor, Feb 27, 2026 12:17 PM EST, Not Public - Pending

Are there accompanying descriptions to the evaluation criteria?

No. The evaluation criteria and their associated point values are as stated on page 17 of the RFP.

49. RFP Requirement - Vendor Pricing

Vendor, Feb 27, 2026 12:18 PM EST, Not Public - Pending

Please clarify the requirement on vendor "pricing" mentioned in item #2 under Appendix A, i.e., is this the expected operating and capital costs for the medical school for the 5 years?

PROGRAM response

As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period to launch the State's first medical school. Respondents should submit their proposed costs using the Project Cost Template (Appendix F). Proposals should identify anticipated funding needs for the full five-year RHTP-funded period.

50. RFP Requirement - Subcontractors

Vendor, Feb 27, 2026 12:19 PM EST, Not Public - Pending

Please confirm what type of subcontractors can be specified under Attachment 7 (Is this meant to include both partner academic institutions in Delaware as well as health systems in Delaware)?

PROGRAM response

Please refer to RFP Section IV.B.12 (Multi-Vendor Solutions) and Section IV.B.13 (Sub-Contracting). Subcontractors may include academic institutions, health systems, and other entities as appropriate to the scope of the proposal. All subcontractors must be identified by name and are subject to approval by the State.

51. RFP Requirement - Business References

Vendor, Feb 27, 2026 12:20 PM EST, Not Public - Pending

Please confirm what type of business references (e.g. health systems, universities) are permitted under Attachment 6.

PROGRAM response

The only references that are not accepted are State of Delaware employees. Please refer to RFP Section IV.B.23 for additional details.

52. RFP Requirement - Faculty and Administrators

Vendor, Feb 27, 2026 12:21 PM EST, Not Public - Pending

Can the requirement of at least 10 full-time core faculty and administrators stated under Project Goals be fulfilled by equivalent FTEs or must it be fulfilled by fully dedicated faculty? Medical school faculty typically retain a portion of their time for seeing patients in clinic.

Yes, the requirement may be met with full-time equivalent (FTE) positions.

53. RFP Requirement - Contract Requirements

Vendor, Feb 27, 2026 12:22 PM EST, Not Public - Pending

Please clarify the "contract requirements" stated in Appendix A Item #2 ("The proposal package shall identify how the vendor proposes meeting the contract requirements and shall include pricing"). Are these requirements related to the Scope of Work in Appendix B?

PROGRAM response

Yes. Item #2 in Appendix A refers to the proposal package that shall identify how the vendor proposes meeting the contract requirements and shall include pricing. This refers to the Scope of Work outlined in Appendix B.

54. RFP Requirement - Subcontractors

Vendor, Feb 27, 2026 12:23 PM EST, Not Public - Pending

May proposers identify "to be determined" subcontractors for certain functions, or must all subcontractors be named in the proposal?

Yes, proposers may identify subcontractors as "to be determined" for certain functions. Please highlight this in your proposal. Please also refer to RFP Section IV.B.12 and Section IV.B.13 relating to prime contractor and subcontractor requirements. All subcontractors are subject to approval by the State of Delaware.

55. RFP Requirement - Licensure

Vendor, Feb 27, 2026 12:24 PM EST, Not Public - Pending

Must submitters meet Delaware licensure requirements (i.e., Department of Education license) at the time of submission, at the time of award, or at the time the medical school is launched in Fall of 2028?

PROGRAM response

As stated on page 6 of the RFP, prior to the execution of an award document, the successful vendor shall either furnish the Agency with proof of State of Delaware Business Licensure or initiate the process of application where required. Licensure is not required at the time of submission but must be addressed prior to contract execution.

56. RFP Requirement - Oral Presentations

Vendor, Feb 27, 2026 12:24 PM EST, Not Public - Pending

Will oral presentations be scored separately or are these included in the overall evaluation criteria?

PROGRAM response

Please refer to RFP Section IV.C.5 (Oral Presentations) on page 18. The State reserves the right to invite selected vendors for oral presentations following initial scoring. The specific scoring methodology for oral presentations will be determined by the Evaluation Committee.

57. RFP Requirement - Other Considerations

Vendor, Feb 27, 2026 12:25 PM EST, Not Public - Pending

How will the "Other Considerations" category (2 points) be evaluated—what factors does the State anticipate considering?

PROGRAM response

The evaluation of "Other Considerations" will be determined at the discretion of the Evaluation Committee.

58. Delaware Medical School - Questions Related to RFP

Vendor, Feb 27, 2026 12:37 PM EST, Not Public - Pending

Hospitals and local practices will be needed to support the medical school as student do rotations through those various locations, requiring those entities to incur time and cost to support the students.

a. Should non-medical school entities submit a separate proposal to the state for expenses incurred to support the medical school (i.e., preceptors, administrative coordination, etc.)

or include funding request as a “sub-contractor” component of a proposer for the actual school itself (i.e., if there are 5 medical school proposers, the sub-contractor may have their funding request included with each of the 5 proposers)?

b. Are capital costs (i.e., meeting rooms, student lounges, etc.) an allowable cost under the grant or is the grant restricted to operational costs?

c. If capital costs are allowed, should the proposal include multi-year project costs (i.e., Year 1: Design and Permitting Costs: $xx,xxx, Year 2: Construction Costs: $xx,xxx, etc.), or just costs related to Year 1 of the project?

b. 4) If a hospital/practice is submitting its funding request as a sub-contractor to a medical school proposer, will the medical school proposer actually receive the funding and disseminate to sub-contractors, or will the funding be sent by the state directly to the sub-contractor?

PROGRAM response

All components listed in Appendix B are mandatory and must be addressed in each proposal. Responders are welcome to submit proposals which include a Primary Vendor and additional subcontractor(s), as appropriate.

Eligible expenses under the contract include those consistent with the Scope of Work outlined in Appendix B. New construction is not an allowable use of RHTP funds, but costs for renovations and new equipment and supplies, are. Respondents should use the Project Cost Template (Appendix F) to detail their proposed budget and identify all anticipated cost categories. Any cost not clearly addressed in the RFP should be identified and justified in the proposal for consideration.

Please refer to RFP Section IV.B.12 and RFP Section IV.B.12.13 for the definition and requirements relating to the prime contractor and subcontractors.

59. Funding projections

Vendor, Feb 27, 2026 1:30 PM EST, Not Public - Pending

Should a proposer identify the funding needs (capital and/or operating costs) for a 5-year period or just for the 1-year funding period for the grant?

PROGRAM response

As stated on page 5 of the RFP, the State of Delaware has requested nearly $100 million in RHTP funding over a five-year period. Respondents should identify anticipated funding needs for the full five-year RHTP-funded period using the Project Cost Template (Appendix F).