IFB_No._S22942531_Optical_Billing___Website_Maint.pdf

State of California Department of Corrections and Rehabilitation

October 8, 2025

INVITATION FOR BID (IFB)

IFB No. S22942531

OPTICAL BILLING AND WEBSITE MAINTENANCE SERVICES

Notice to Prospective Contractors

The California Prison Industry Authority (CALPIA) invites you to review and respond to this Invitation for Bid (IFB), entitled OPTICAL BILLING AND WEBSITE AND WEBSITE MAINTENANCE SERVICES, IFB NO. S34652224. In submitting your bid, you must comply with the instructions found herein and the Bidders Instructions REV-524 located on the CALPIA website (www.calpia.ca.gov, select About tab and then Doing Business with CALPIA).

In the opinion of CALPIA, this IFB is complete and without need of explanation. However, should you have questions, or need clarifying information, please contact the Contract Analyst indicated below.

Due Date/Time: October 22, 2025, by 3:00 PM CALPIA Contact SUBMIT BID TO:

Quica Teames, Contract Analyst Phone: (916) 358-2756

Email: Quica.Teames@calpia.ca.gov

California Prison Industry Authority Attention: Quica Teames, Contract Analyst

560 East Natoma Street Folsom, CA 95630

Please note that no verbal information given will be binding upon the CALPIA unless such information is issued in writing as an official addendum to this IFB.

Term: The CALPIA anticipates that the proposed contract term will be for a period of three (3) years with the option to extend for an additional one (1) year.

The contract award will be made on the basis of BEST VALUE as determined by CALPIA alone, under statutory authority (Penal Code 2808) considering the following criteria:

1. Cost: Fair, reasonable, and competitive price, and customer service commitments for goods and or services.

2. Performance: Past performance, including but not limited to, quality and/or reliability for the product or service as well as efficient billing practices; certification by the International Organization for Standardization (ISO).

3. Experience: Length of time and/or number of instances the bidder has offered or produced the requested type of product and/or service.

California Prison Industry Authority (CALPIA) IFB No. S22942531 Optical Billing and Website Maintenance Services

CALPIA may consider other factors deemed necessary to ensure that best value is achieved.

In the interest of achieving best value, CALPIA does not grant Small Business, Disabled Veteran Business Enterprise (DVBE), Target Area Contract Preference Act (TACPA), Local Agency Military Base Recovery Act (LAMBRA), or Enterprise Zone Act (EZA) preferences in evaluating bids.

Employment of ex-offenders by the bidder is encouraged by CALPIA as part of our ongoing mission to change lives through opportunities.

Any agreement resulting from this solicitation shall be of no force or effect until it is signed by both parties and approved by CALPIA. The Contractor is not to begin work until a contract has been made, all approvals have been obtained, and the contract has been fully executed. Should work begin before all approvals are obtained, services shall be considered voluntary.

California Prison Industry Authority (CALPIA) IFB No. S22942531

TABLE OF CONTENTS

SECTION PAGE

A. Purpose and Description of Service 4

B. Bid Information 4

C. Bidder’s Submittal Requirements 5

D. Bid Evaluation 6

E. Licenses and Permits 6

F. Standard Language 6

G. Bid Attachments 6 Attachment 1: Bid Document Submittal Check List 7 Attachment 2: Sample Standard Agreement (STD 213), Statement of

Work and Payment Provisions

Attachment 3: Cost Sheet 25 Attachment 4A: Payee Data Record (STD 204) 27 Attachment 4B: Payee Data Record Supplement (STD 205) 29 Attachment 5: Darfur Certification 31 Attachment 6: Appropriate Attire Policy 32 Attachment 7: Experience/Past Performance (References) 34 Attachment 8: Contractor Certification Clauses (CCC’s) 35 Attachment 9: PREA Volunteer/Contractor Information Sheet 39 Attachment 10: Economic Sanctions Certification 42 Attachment 11: California Civil Rights Laws Certification 43

Bid Submittal Documents:

Attachment 1: Bid Document Submittal Check List 1 page Attachment 3: Cost Sheet 1 page Attachment 4A: Payee Data Record (STD 204) 2 pages Attachment 4B: Payee Data Record Supplement (STD 205) 2 pages Attachment 5: Darfur Certification 1 page Attachment 7: Experience/Past Performance (References) 1 page Attachment 8: Contractor Certification Clauses (CCC’s) 4 pages Attachment 9: PREA Volunteer/Contractor Information Sheet 3 pages Attachment 10: Economic Sanctions Certification 1 page Attachment 11: California Civil Rights Laws Certification 1 page

Bidder Instructions and Contract Provisions:

Bidders Instructions REV-524* 10 pages General Provisions REV-0524* 21 pages Security Provisions REV-0325* 5 pages Travel Provisions REV-1024* 2 pages

NOTE: Items shown with an Asterisk (*), are hereby incorporated by reference and are located on our website at the following link http://www.calpia.ca.gov select About tab, then select Doing Business with CALPIA.

A. Purpose and Description of Service

The California Prison Industry Authority (CALPIA) requires electronic billing services for Medi- Cal claims and annual website maintenance services for its optical online ordering system.

Refer to the Sample STD 213, Statement of Work and Payment Provisions, attached to this IFB as Attachment 2.

CALPIA reserves the right, before the conclusion of the contract term to extend the contract for an additional one-year period. A written and approved amendment will be required to extend the contract prior to contract expiration.

B. Bid Information

1. Time Schedule

It is recognized that time is of the essence. All bidders are hereby advised of the following schedule and will be expected to adhere to the required dates and times. All times are Pacific Standard Time (PST)/Pacific Daylight Time (PDT).

*estimated timeframes

2. Bid Submittal

Bids must be received via U.S. Mail, common carrier, or hand delivered; no other method of response will be accepted. Bids not submitted under sealed cover may be rejected. Submit one (1) copy of the bid to the address and Contract Analyst on page 1 of this document. The interior sealed envelope must be plainly marked with the IFB number and title, must show your firm name and address, and must be marked with “DO NOT OPEN”, as shown in the following example:

EVENT DATE

TIME

(Pacific STD /Daylight Time)

IFB available to prospective bidders October 8, 2025 Final Date for Bid Submission/Bid Opening 10/22/2025 By 3:00 PM Successful Bidder Letter and Posting of Intent to Award* 10/23/2025 5:00 PM Last Day to Appeal Intent to Award* 10/29/2025 5:00 PM Proposed Start Date of Agreement* November 1, 2025

Company Name Company Address

IFB Number: S22942531 IFB Name: Optical Billing and Website Maintenance Services Attention: Quica Teames

BID SUBMITTAL – DO NOT OPEN

California Prison Industry Authority (CALPIA) IFB No. S22942531

C. Bidder’s Submittal Requirements

Experience: Contractor must provide proof of four (4) years of experience with services similar in nature to the services identified in the attached Scope of Work. Experience will be determined by documentation submitted by the Contractor and further information provided by the references submitted under the Past Performance requirement below. Experience is defined as the kind and amount of work a Contractor has done relevant to the work contemplated by this procurement.

Past Performance: Contractor will be evaluated on prior performance through Contractor’s references (Attachment 7), on three (3) projects similar in nature within the last three (3) years.

Past performance is defined as the Contractor’s record of conforming to standards of good workmanship; Contractor’s record of forecasting and controlling costs; Contractor’s adherence to contract schedules, including the administrative aspects of performance; Contractor’s history of reasonable and cooperative behavior and commitment to customer satisfaction; and the Contractor’s business-like concern for the interest of the customer.

Licenses/Permits: The Contractor shall provide copies of all required license(s) and permit(s) as required by the city, county, or both as determined by bidder’s place of business.

Department of Health Care Services (DHCS) Approved Submitter: Contractor must provide documentation showing they are on the DHCS Approved Submitter list.

Executive Order N-6-22 – Russia Sanctions:

CALPIA requires Bidders to include a completed Economic Sanctions Certification form (BSS- F069) as required by Executive Order N-6-22 in order to be eligible to conduct business with the State of California.

Executive Order N-12-23 – Generative Artificial Intelligence (GenAI):

The State of California seeks to realize the potential benefits of GenAI, through the development and deployment of GenAI tools, while balancing the risks of these new technologies.

Bidder / Offeror must notify the State in writing if it: (1) intends to provide GenAI as a deliverable to the State; or (2), intends to utilize GenAI, including GenAI from third parties, to complete all or a portion of any deliverable that materially impacts: (i) functionality of a State system, (ii) risk to the State, or (iii) Contract performance. For avoidance of doubt, the term “materially impacts” shall have the meaning set forth in State Administrative Manual (SAM) §

4986.2 Definitions for GenAI.

Failure to report GenAI to the State may result in disqualification. The State reserves the right to seek any and all relief to which it may be entitled to as a result of such non-disclosure.

Upon notification by a Bidder / Offeror of GenAI as required, the State reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the State.

California Prison Industry Authority (CALPIA) IFB No. S22942531

Government Code 11549.64 defines “Generative Artificial Intelligence (GenAI)” as an artificial intelligence system that can generate derived synthetic content, including text, images, video, and audio that emulates the structure and characteristics of the system’s training data.

D. Bid Evaluation

Award of a contract resulting from this IFB will be based on the contractor providing the best value. The Contractor must meet or exceed the minimum requirements of the following criteria:

Category – Description Cost Past Performance Experience

E. Licenses and Permits

During the term of the contract, the Contractor must maintain all required licenses and/or permits in full force and effect. If and when the State learns that the Contractor has failed to do so, the State may, in addition to any other remedy it may have, immediately terminate this contract without any cost or liability to the State. If, after bid submission, the Contractor replaces or renews a required license or permit or obtains a newly-applicable license or permit, the Contractor shall provide the State with a copy of the renewed or replaced or newly-obtained license or permit within 20 days following the Contractor's receipt of same.

F. Standard Language

CALPIA does not accept alternate contract language from a prospective contractor. A bid with such language will be considered a counter proposal and will be rejected. CALPIA’s General Provisions (GP’s) are not negotiable.

G. Bid Attachments

Refer to the following pages for additional required attachments that are a part of this IFB.

ATTACHMENT 1

BID DOCUMENT SUBMITTAL CHECK LIST

A complete bid or bid package will consist of the items identified below.

Complete this checklist to confirm the items listed below have been included in your bid. Place a check mark or “X” next to each item that you are submitting. For your bid to be responsive, all required attachments must be returned. This checklist should be returned with your bid package.

NAME OF BIDDER:

COMPANY NAME:

Attachment Name/Description

_____ Attachment 1: Bid Document Submittal Check List

_____ Attachment 3: Cost Sheet

_____ Attachment 4A: Payee Data Record (STD 204) NOTE: If company is incorporated, Payee’s Legal business name on the STD 204 must match the name registered with the Secretary of State of California.

_____ Attachment 4B: Payee Data Record Supplement (STD 205) NOTE: For use if additional remittance addresses are needed or if additional authorized representatives need to be identified.

_____ Attachment 5: Darfur Certification

_____ Attachment 7: Experience/Past Performance (References)

_____ Attachment 8: Contractor’s Certification Clauses

_____ Attachment 9: PREA Volunteer/Contractor Information Sheet

_____ Attachment 10: Economic Sanctions Certification

_____ Attachment 11: California Civil Rights Laws Certification

Additional Items Description (If Applicable)

_____ DHCS Approved Submitter documentation (Outlined on Page 5, Section C of this IFB)

STATE OF CALIFORNIA

STANDARD AGREEMENT ATTACHMENT 2

STD 213 (Rev 6/21/06) AGREEMENT NUMBER

IFB NO. S22942531

REGISTRATION NUMBER

OPTICAL BILLING & WEBSITE MAINTENANCE SERVICES

1. This Agreement is entered into between the State Agency and the Contractor named below:

STATE AGENCY'S NAME

CALIFORNIA PRISON INDUSTRY AUTHORITY

CONTRACTOR'S NAME

TBD

2. The term of this Month Day, 2025 or upon approval, whichever is the later, through Month Day, 2028Agreement is:

3. The maximum amount $ of this Agreement is: Dollars and No Cents

4. The parties agree to comply with the terms and conditions of the following exhibits that by this reference made a part of the Agreement.

Attachment 2 - Statement of Work and Payment Provisions 16 pages

Attachment 3 - Cost Sheet 2 pages

General Provisions REV-0524* 21 pages

Security Provisions REV-0325* 5 pages

Travel Provisions REV-1024* 2 pages

NOTE: Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached These documents can be viewed at http://www.calpia.ca.gov, (select About tab, then select Doing Business with CALPIA).

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

CONTRACTOR

CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.)

BY (Authorized Signature) DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

STATE OF CALIFORNIA

AGENCY NAME

California Prison Industry Authority BY (Authorized Signature) DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

560 East Natoma Street Folsom, CA 95630

STATE OF CALIFORNIASTATE OF CALIFORNIA

or upon approval, whichever is the later, throughor upon approval, whichever is the later, through Month DayMonth Day, 2028

4. The parties agree to comply with the terms and conditions of the following exhibits that by this reference made a part 4. The parties agree to comply with the terms and conditions of the following exhibits that by this reference made a part

Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached http://www.calpia.ca.govhttp://www.calpia.ca.gov,http://www.calpia.ca.gov (select (select About About tab, then select Doing Business with CALPIA).

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

CONTRACTORCONTRACTOR

(if other than an individual, state whether a corporation, partnership, etc.)(if other than an individual, state whether a corporation, partnership, etc.)

PRINTED NAME AND TITLE OF PERSON SIGNINGPRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

AGENCY NAMEAGENCY NAME

California Prison Industry AuthorityCalifornia Prison Industry Authority (Authorized Signature)

PRINTED NAME AND TITLE OF PERSON SIGNINGPRINTED NAME AND TITLE OF PERSON SIGNING

ATTACHMENT 2

STATEMENT OF WORK AND PAYMENT PROVISIONS

I. STATEMENT OF WORK

1. Contractor agrees to provide the California Prison Industry Authority (CALPIA) with Optical Program with electronic billing services for Medi-Cal claims and annual website maintenance services for its optical online ordering system.

There is a close relationship between the electronic billing function services for Medi-Cal claims and the information technology behind CALPIA’s optical ordering website known as POOLS (PIA Optical On-Line Systems). To maintain audit compliance and ensure electronic Medi-Cal billing integrity, the Contractor must have thorough understanding of Medi-Cal billing requirements and possess the information technology (IT) knowledge of the POOLS website to be able to make adjustments.

A. The Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies, parking fees and bridge tolls, insurance, transportation, equipment and every other item of expense necessary to perform services.

2. The Optical Laboratories are located at:

A. California State prison Solano (CSP), Vacaville

B. Central California Women’s Facility, Chowchilla

C. Valley State prison (VSP), Chowchilla

3. The services shall be provided during regular business hours, Monday through Friday, except State holidays, or as directed by the CALPIA Project Representative, or designee.

4. Service shall be available not later than the express date set by CALPIA and the Contractor, after all approvals have been obtained, the agreement is fully executed, and a Sage X3 Tracking Number is issued. Should the Contractor fail to commence work at the agreed upon time, the CALPIA, upon five (5) days’ written notice to the Contractor, reserves the right to terminate the agreement effective immediately. In addition, the Contractor shall be liable to the CALPIA for the difference between Contractor's bid price and the actual cost of performing work by another best value contractor.

5. The Project Representatives during the term of this agreement will be:

State Agency: CALPIA Contractor:

Section/Unit: Operations Division - Optical Section/Unit:

Attention: Attention:

Address: 560 East Natoma Street

Folsom, CA 95630 Address:

Phone: Phone:

Email: Email:

Note: No formal amendment of this agreement is needed to change the contact information. Changes will be made by written or electronic notification.

6. The Contractor’s Project Representative will be a person to whom all project communications may be addressed with the authority to act on all aspects of the services. The person will review the scope of work and associated documents with CALPIA to ensure understanding of the responsibilities of both parties.

7. Contractor shall furnish to the CALPIA a certificate of insurance, stating that there is Commercial General Liability, Worker’s Compensation, and Automotive Liability. The certificate of insurance shall include the following three (3) provisions in their entirety:

A. The insurer will not cancel the insured’s coverage without 30 days prior written notice to the State and will provide the State with a written 10-day notice for Contractor’s non-payment of premiums.

B. Under Contractor’s General Liability and Automobile Liability insurance CALPIA and the State of California, its officers, agents, employees, and servants are included as additional insured, but only insofar as the operations under this contract are concerned.

C. The State will not be responsible for any premiums or assessment of the policy.

8. Licenses and Permits:

During the term of the contract, the Contractor must maintain all required licenses and/or permits in full force and effect. If and when the State learns that the Contractor has failed to do so, the State may, in addition to any other remedy it may have, immediately terminate this contract without any cost or liability to the State. If, after proposal submission, the Contractor replaces or renews a required license or permit or obtains a newly applicable license or permit, the Contractor shall provide the State with a copy of the renewed or replaced or newly obtained license or permit within 20 days following the Contractor’s receipt of same.

9. Security Requirements:

Per the State Administrative Manual (SAM) Section 4983.1, the physical location of the data center where data is stored must reside within the continental United States. Remote access to data from outside the continental United States is prohibited unless approved in advance by CALPIA’s Chief Information Officer. All confidential, sensitive or personal information must be encrypted in accordance with SAM 5350.1 and the Statewide Information Management Manual (SIMM) 5305-A, and at the necessary level of encryption for the data classification pursuant to SAM 5305.5. The commercial and/or government cloud service provider’s Standards for Attestation Engagements No. 16 Service Organization Control (SOC) 2 Type II report and the cloud service provider’s plan to correct any negative findings must be available to CALPIA upon request.

10. Electronic Billing Services

CALPIA operates its Optical Program under an agreement with the California Department of Health Care Services (DHCS). Medi-Cal eyewear benefits for adults were restored in January 2002, which is estimated to increase the electronic billing scope significantly from 550,000 RX’s annually (benefits for children) to an estimated 1.3 million Rx’s annually and potentially higher. The Contractor must be able to meet this anticipated demand.

Billing services include, but are not limited to, electronic claims transmissions; claims tracking and follow up; review and appeal of denied or underpaid claims; detailed claim status reporting; production and distribution of customized, industry standard, and specifically requested reports to CALPIA Management.

The Contractor shall respond to any DHCS Audit Department request, or any other State Department’s request as identified by the CALPIA Contract Manager concerning Medi-Cal claims that have been billed. The Contractor shall attend any designated meetings as scheduled by the CALPIA Contract Manager.

A. The Contractor agrees to provide the following Electronic Billing services:

i. Electronic File

The Contractor shall receive an XML formatted electronic file daily that is uploaded from our POOLs website (CALPIA’s Online Ordering System). The file will contain orders created by our Medi-Cal providers and contain manufacturing information for Rx’s needing to be processed. In addition, the Contractor will receive electronic information known as the Shp.scn file created by Digital Vision Incorporated, our laboratory manufacturing software vendor. This electronic file will contain information of all completed Rx’s shipped from CALPIA to the optical provider. The Rx information will contain patient’s name, Medi-Cal identification number, sex, birth date, control number, provider account number, ship date, country code, aide code, and all other production information that will allow Contractor to process billing of each other. Only Medi-Cal prescription information will be processed.

The Contractor shall convert electronic prescription data received from CALPIA to Health Care Financing Administration Common Procedure Coding System (HCPCS) billing codes. Prescription data coding has over 100 possible codes describing different aspects of eyeglass fabrication and requires knowledge to translate data and produce codes for billing procedures. Coding considers dioptric power identification for spheres and cylinders, material used, tints, applicable lens coatings, prisms and lens types including slab off, myodisc and lenticular lenses in addition to single vision, bifocals, trifocals and balanced lenses. CALPIA estimates that the Contractor will have to process electronic claims for approximately 1,300,000 Rx’s electronic claims annually by Computer Media Claims (CMC) submission via ANSI 837 at current format that Department of Health Care Services (DHCS) accepts.

The Contractor shall also receive optical orders that are presented on paper. These orders shall be key data entered to the CALPIA website to create the equivalent web order. Frames received with such orders are to be enclosed with a printout equivalent to the one a provider would use had the provider created the order on the web. All orders so processed shall be sent via courier to the CALPIA Optical Laboratory at CSP Solano once each day. The Contractor shall bear the cost of any shipping expenses associated with the return if these orders. All paper Rx orders will be scanned, and the electronic versions shall be retained for seven (7) years by the Contractor.

ii. Reports

Reports that contain meaningful and timely information will allow CALPIA to evaluate and assure proper compensation. Listed below are diagnostic tools that will allow CALPIA to examine each Optical Lab and optimize revenue. These reports shall provide CALPIA with the ability to look at the overall picture, strategic trend data, and to pinpoint problem areas.

The Contractor shall make available any report currently considered useful that would assist CALPIA in the management of the Optical Enterprise. However, CALPIA at times may need customized reports. Based on CALPIA specifications, the Contractor is expected to build a query, extract and format the data, and generate an ad hoc report (see below).

Note: All reports, except ad hoc reports, shall be accessible on a website maintained and controlled by the Contractor and available to CALPIA management staff on demand.

The Contractor shall provide, but not limited to, any report needed for management of administration of optical programs.

Reports available to CALPIA shall include the following:

REPORT DESCRIPTION FREQUENCY

a. Resubmitted claims and reason for additional submittal(s) Web

b. Financial summary of charges, payments, and adjustments Web

c. Timely aged Accounts Receivable totals (unpaid claims & procedure codes used) Web

d. Productivity Report (procedure codes, charges, reimbursement payments and adjustments)

Web

e. Current Accounts Receivable (reconciliation report of billing & status of disputed claims)

Web

f. Account volume by provider Web

g. Denial Report: As seen in EDS Remittance Advice Detail

(RAD) report Web

h. End of Month Statement that reflects orders (claims) received, claims submitted by vendor for payment, and paid claims

Web

i. Ad-Hoc report as needed (via standard queries from vendor database with CALPIA data).

As Requested

Reports provided on the web include the following formats:

Microsoft Office format, including processing documents, spreadsheets, presentations, and databases, unless specified. The media of delivery will be compatible with the CALPIA document storage devices, i.e. Microsoft programs, Excel, Word, PowerPoint, and Access.

iii. Additional Criteria

The Contractor will provide the independent IT services needed to support this scope of work, subject to the following:

a. Expenses

All costs associated with the execution of the electronic billing services must be included in the rate per Rx listed on the Cost Sheet (Attachment 3). The CALPIA will not reimburse for any expenses incurred by the Contractor in the execution of the electronic billing services as described by the Scope of Work, except as specifically preauthorized in writing by the CALPIA.

b. Confidentiality

In addition to the terms and conditions pertaining to confidentiality, the Contractor will sign all confidentiality/privacy/security/conflict of interest agreements, and other necessary agreements if applicable and as required by the CALPIA, to successfully provide the services described in this Scope of Work.

c. Federal Health Insurance Portability and Accountability Act (HIPAA)

For purposes of the Federal Health Insurance Portability and Accountability Act (HIPAA), the Contractor will be a Business Associate of CALPIA and the Contractor will agree and sign CALPIA’s Business Associate Agreement (see Exhibit A). The Contractor shall abide by all applicable HIPAA rules and regulations, as well as all applicable California State laws.

d. Destruction of Protected Health Information (PHI)

For purposes of this Agreement, PHI is defined as individually identifiable health information that is being or has been transmitted by electronic means. The Contractor shall extend the protections of this Agreement to such PHI and limit further use and disclosures of such PHI for so long as the Contractor, or any of its agents or subcontractors, retains or otherwise possesses such PHI. Upon termination of this Agreement for any reason, the Contractor shall:

1. Return to CALPIA all PHI received from CALPIA, or created or received by the Contractor on behalf of CALPIA, that is required to be retained by the Privacy Rule; or

2. Return or destroy all PHI received from CALPIA, or created or received by the Contractor on behalf of the CALPIA that is not required to be retained by the Privacy Rule.

The Contractor shall retain copies per the PHI pursuant to Federal law.

B. Minimum Qualifications for Electronic Billing Services

The Contractor and their personnel must possess the following experience, knowledge, skills and abilities in the following areas:

i. The Contractor must have a minimum of four (4) years experience in electronic Medi-

Cal professional claims billing submissions and be able to provide to the CALPIA the quantity of orders submitted to DHCS for processing.

ii. The Contractor and associates must be certified as a Medi-Cal Telecommunications Provider and Biller and have in place the California Department of Health Care Services Application/Agreement (DHS 6153) showing that they successfully tested their Computer Media Claims (CMS) submission ability.

iii. The Contractor must currently be approved for the CMC submission process by

Electronic Data Systems (EDS) and the Department of Health Care Services (DHCS). The Contractor will provide in writing the length of time that they have been submitting claims and if there has been any interruption in service.

C. CALPIA Responsibilities for Electronic Billing Services

i. The CALPIA’s Project Representative shall be a person to whom all Contractor communications may be addressed with authority to act on all aspects of the services. This person will review the Scope of Work and associated documents with the Contractor to ensure understanding of the responsibilities of both parties.

ii. The CALPIA will provide information regarding the business structure of the CALPIA as required by the Contractor to provide the services under this Scope of Work. The CALPIA will provide any other information as required by the Contractor to perform its responsibilities and schedule the availability of the CALPIA personnel for interviews as required by the Contractor.

iii. The CALPIA will provide timely review and approval of the Contractor proposal and documentation provided by the Contractor and required by the Contractor to perform its obligations under this Scope of Work.

11. POOLS Website Maintenance Services

A. The Contractor will respond to all maintenance requests from CALPIA central office within one (1) business day, via email or phone, with confirmation that the request was received, and an estimated completion date for each item in the request. Maintenance requests received after 3:00pm PST may not be completed until the next business day unless prior arrangements have been made.

B. The Contractor will adhere to all quoted deadlines for the deliverables in the maintenance requests at all possible costs. In the event that the Contractor has any issues in delivering on a quoted deadline, CALPIA will be notified via email or telephone of the reasoning for any change.

C. All changes made to the software required by the above services will be tested by the Contractor staff, both on its own test servers and on the test server maintained by CALPIA prior to its production release. CALPIA staff will also have the opportunity, if they require, to test any change prior to its implementation. Any aspect that fails such quality assurance testing will be reviewed and corrected by the Contractor development team and redeployed for validation.

D. All costs associated with the execution of the website maintenance services must be included in the monthly rate listed on the Cost Sheet (Attachment 3). The CALPIA will not reimburse for any expenses incurred by the Contractor in the execution of the website maintenance as described by the scope of work, except as specifically preauthorized in writing by the CALPIA.

E. Consulting Services Responsibilities for Website Maintenance:

Combined with efforts of CALPIA staff, Contractor will provide consultative services as needed and when requested on site at 560 East Natoma Street, Folsom, California or virtually feasible, to effectively provide the following:

i. Project Management:

Lead complex projects with minimal oversight.

Determine project scopes, milestones, tasks, risk, objectives, and dependencies.

Ensure projects are delivered on time, within budget, and according to specifications.

Perform resource allocation and work assignments and monitor deliverable deadlines.

Create and revise scope of work (work plans, deliverables, and team resources).

Create timetable, including delivery dates (project plan) for business process analysis, system configuration, training, project meetings, data conversions/interfaces and other project deliverables or milestones.

Schedule and facilitate ongoing project status meetings with Contractor and project team.

Ensure effective and creative idea generation among the project team.

Act as contact for key client executives and management (business and/or technical).

Work with project staff to define and manage all contractual project requirements.

Prepare and maintain documentation of any programming changes.

ii. Application Development:

Determine Application change requirements working with CALPIA Operations staff.

Develop requirements and flow charts; schedule and facilitate Joint Application Development (JAD) session.

Finalize Application Development design and schedule start date for work.

Prioritize, schedule, and approve “new” Application Development work.

Monitor and manage Application Development efforts; ensure specifications and timelines are being met.

Perform User Acceptance and Testing.

Manage and coordinate requests for changes from original specifications.

Manage and perform quality assurance testing.

Track and report on quality assurance metrics.

iii. Systems Support:

Design and test systems backup strategy and recovery plans.

Monitor and manage system backups, database backups and system imaging.

Monitor and implement operating system and application release updates and patches.

Manage all support for the “Development Server”.

Take corrective action to resolve hardware, software, or application failures.

Manage SQL Database and make changes as required.

Troubleshoot issues and work with the customer and management to implement positive solutions, identifying the data necessary to prove test conditions.

iv. Operations Management:

Recommend appropriate process and procedure revisions where needed.

Provide technical support to Optical Annex, Medi-Cal Providers, and Labs.

Work closely with Department of Health Care Services (DHCS) to ensure the

Optical Program is in compliance with Medi-Cal regulations.

Provide information and support to CALPIA online Medi-Cal Provider community as requested.

v. Infrastructure Support:

Provide problem solving in SQL.

Have cursory knowledge of VB.net, JavaScript, HTML, and ASP.net.

vi. Consulting Services Deliverables:

a. System documentation as required including, but not limited to:

Analysis and design documents

Program specifications

Test plans and test scripts

Desk guides and technical reference manuals

File documentation (e.g., file layouts, data dictionaries)

Accurate and fully functional (working as designed) code

Script documentation (including location, procedures, etc.)

Complete system documentation and updates for improved processes and systems

Ongoing processes and procedures to Management Information Systems’

(MIS) standards

b. Presentations to customers and management, as requested.

vii. Consulting Services Reporting Requirements:

The Contractor shall provide to the CALPIA Contract Administrator weekly, or as requested, status reports with the following information:

Completed deliverables

Tasks in process

Projection of tasks/deliverables for the next week

F. POOLs Website Maintenance Service Responsibilities:

The Contractor report to the Operations POOL Manager, and/or the Management Information Systems (MIS) LAN/WAN Lead. The Contractor will work closely with other Operations/MIS staff or contractors. Functions include, but are not limited to, the following:

i. Planning

Establish data exchanges.

Attend meetings on POOL issues and/or requirements.

Work with other departments to identify data issues.

Provide problem solving in an SQL Server environment.

Provide problem definition.

Provide program specifications, pseudo code, or logic diagrams.

ii. Analysis/Design

Review existing system for impacts.

Generate analysis documents for accepting new modules/programs and other changes.

Derive new edits or update existing edits.

Update new processes.

Review existing system for impact.

Create and support enhancements for various customizations.

Analyze systems design and programming specifications to identify the extent of change – including reading system flowcharts, Visio diagrams, specification documents, graphs, and spreadsheets.

Conduct and/or participate in design meetings and specification walkthroughs.

Communicate with users on planning, pending, and post changes.

Finalize requirements and produce analysis documents.

iii. Development

Provide Code and Code Walkthroughs

iv. Testing

Identify and create Test Plans.

Perform System test.

Perform Acceptance test.

Participate in structured walkthroughs to occur on test scenarios, conditions, and overall plan.

Coordinate and identify testing changes and enhancements.

Prepare and maintain documentation on test conditions and test plans.

v. Implementation

Develop and implement production processes and procedures.

Prepare and obtain approval for work plans for development, implementation, documentation, and knowledge transfer to staff.

vi. Improvements

Perform system analysis while working with program staff, other departments, and contractors in the process.

Determine the scope of required system changes.

Document the business requirements.

Assist in the overall planning activities.

Develop comprehensive all-inclusive work plans.

Analyze and document system requirements.

Monitor system reports.

Perform implementation activities.

Identify and develop solutions; resolve production issues.

Develop and maintain system and user documentation as directed by program policies, regulations, and statutes.

Transition program changes into production and notify users.

Document the proposed project assessment and approach for individual assignments.

Prepare and obtain approval of work plans for development, implementation, documentation, and knowledge transfer to staff.

G. CALPIA’s Responsibilities for Website Maintenance Services

CALPIA’s Project Representative will act as a single point of contact for all communications between Contractor staff and CALPIA. The Project Representative will oversee all aspects of the Scope of Work (SOW), including task direction for Contractor’s staff. The Project Representative will have full responsibility for the review and approval of invoices, work products, compliance of deliverables as outlined in the SOW, and the authority to resolve disputes. Additionally, CALPIA will provide the following:

Designated staff to attend project status meetings;

Assistance in resolving and/or escalating issues as needed;

Subject matter experts to assist in accomplishing tasks in a timely manner;

Workstation space, equipment, and necessary software at CALPIA’s central office location, if determined that it is needed;

Security clearance for facility access during normal business hours;

Facilities for meetings;

Timely submittal of approved invoices;

Remote access to CALPIA POOL server and backup server.

12. Executive Order N-6-22 – Russia Sanctions

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals.

“Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. The EO directs state agencies to terminate contracts with, and to refrain from entering into any new contracts with, individuals or entities that are determined to be a target of Economic Sanctions. Accordingly, should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for termination of this agreement. The State shall provide Contractor advance written notice of such termination, allowing Contractor at least 30 calendar days to provide a written response. Termination shall be at the sole discretion of the State.

13. Executive Order N-12-23 – Generative Artificial Intelligence (GenAI)

GenAI Technology Use & Reporting

During the term of the contract, Contractor must notify the State in writing if their services or any work under this contract includes, or makes available, any previously unreported GenAI

At the direction of the State, Contractor shall discontinue the use of any new or previously undisclosed GenAI technology that materially impacts functionality, risk or contract performance, until use of such GenAI technology has been approved by the State.

The State reserves the right to amend the contract, without additional cost, to incorporate GenAI Special Provisions into the contract at its sole discretion and/or terminate any contract that presents an unacceptable level of risk to the State.

14. CALPIA reserves the right to amend the agreement, prior to expiration, in writing on the STD 213A. CALPIA may adjust the terms of the agreement including but not limited to the following:

A. Term extension up to one (1) year.

B. Decreasing the amount of the contract’s original value.

C. Increasing the contract amount by up to 30% of the original value.

II. PAYMENT PROVISIONS

1. Invoicing and Payment

A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the CALPIA agrees to compensate the Contractor in accordance with the amount specified in the Cost Sheet , Attachment 3, which is attached hereto and made part of this agreement.

B. Travel shall be invoiced separately in accordance with the CALPIA approved Travel Provisions REV – 1024 which are incorporated by reference.

i. All travel for or on behalf of CALPIA shall require written approval by the CALPIA

Project Representative or designee in advance.

ii. Mileage reimbursement will not exceed the rate established by California Department of Human Resources (CalHR) at http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx.

C. Invoices shall be itemized and include the time period covered by the invoice, work completed for the period (detailed statement of services) and number of hours worked (if applicable). Invoices shall include the eight-digit Purchase Order (Sage X3) Number and the Agreement Number referenced in the executed contract cover letter. Invoices shall be submitted in triplicate not more frequently than once every 30 days in arrears to:

i. Medi-Cal electronic billing services invoices will be submitted to the appropriate

Optical Program for review and approval:

a. California Prison Industry Authority

ATTN: Optical Unit Superintendent California State Prison Solano 2100 Peabody Road Vacaville, CA 95687-6615

b. California Prison Industry Authority ATTN: Optical Unit Superintendent Central California Women’s Facility 23370 Road 22 Chowchilla, CA 93610

c. California Prison Industry Authority ATTN: Optical Unit Superintendent Valley State Prison 23370 Road 22 Chowchilla, CA 93610-4329

ii. Electronic website maintenance services invoices will be submitted via email to the Optical Enterprise Manager at the address listed below. The Contractor will be notified if there is a change in the contract name/email address.

a. Optical Enterprise Manager

Xxxxx.Xxxxx@calpia.ca.gov

D. All invoice packages must contain original documents and be legible. Failure to provide original, legible documents will delay payment at Contractor’s expense.

E. Accurate/correct invoice packages must be submitted for review and payment in a timely manner subject to the following:

i. All invoices, including revised/amended/corrected invoices, must be received by CALPIA within 60 days from the date services were rendered.

ii. Invoices received by CALPIA more than 60 days after the date services were rendered will be denied, deemed a forfeiture of payment by Contractor, and no payment will be issued.

a. It is Contractor’s responsibility to ensure invoices are received by CALPIA by the deadline. No exceptions will be allowed for invoice packages lost in transit unless supported by documentation that they should have arrived on time (i.e., proof of overnight delivery).

b. If a revision/amendment/correction of a timely submitted invoice is requested by

CALPIA, payment will not be forfeited if the requested invoice is received more than 60 days after the date services were rendered.

iii. All invoices received shall be deemed accurate/correct unless Contractor provides

CALPIA with written notice of any error(s) within 60 days from the date services were rendered. Written notice must include a written explanation of the change, a revised/amended/corrected invoice, and supporting documentation.

iv. Invoices received by CALPIA on the 60th day from the date services were rendered cannot be revised/amended/corrected by Contractor except at the request of CALPIA.

F. Contractors unable to provide accurate/correct invoice packages in a timely manner may receive a vendor performance report for failure to meet contract needs. Patterns related to failed vendor performance may result in termination of contract at any time.

G. Contractor is to provide a monthly report showing billed, paid, and outstanding invoices.

2. Availability of Funds

All financial obligations of CALPIA for the fiscal year(s) encompassed by the term of this agreement are subject to the availability and approval of funding by the Prison Industry Board and/or the presence of sufficient funds to cover those obligations in the fund from which those obligations are to be paid. If such obligations are, or become contingent, on funding by and/or through the CALPIA budget or on the availability of federal funds or on the action of any Legislative body, said obligations are contingent on the appropriation and availability of funds for the purpose of meeting those obligations. If insufficient funds are approved or appropriated or otherwise available in order to meet CALPIA’s obligations under this agreement, CALPIA may immediately terminate this agreement.

3. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927. Unless expressly exempted by statute, the Act requires State agencies to pay properly submitted, undisputed invoices not more than 45 days after (a) the date of acceptance of goods or performance of services or (b) receipt of an undisputed invoice, whichever is later.

4. Cash Discounts

CALPIA has a history of taking cash discounts and intends to take advantage of cash discounts offered when they are in the best interest of the CALPIA.

Optical Billing and Website Maintenance

ATTACHMENT 3

COST SHEET

The estimated quantities indicated below will be used solely for computing the cost to determine the best value bidder and is not binding upon the contracting agency. However, the actual costs quoted by the bidder shall be binding for the term of the Agreement. CALPIA is not obligated to purchase any quantity of services from the contractor.

Under no circumstances will the contractor be allowed to use a subcontractor for more than 50% of the contract dollar amount. For all services where a subcontractor is used, the contractor will be required to provide a minimum of 50% of the staffing for the project including project contact person.

The rates specified on the Service Agreement Cost Sheet must include all costs for services as described in this IFB for a three-year term. There can be no upfront costs to CALPIA.

It is unlawful for any person engaged in business within this state to sell or use any article or product as a “loss leader” as defined in Section 17030 of the Business and Professions Code.

Item No.

Description Rate Estimated

Annual Total

Estimated Rx Billing

1,300,000/Year

$____________ / RX

(A)

Estimated Annual Rx Billing Total

X three (3) years

(B)

3 Web Maintenance $____________ / Month

(C)

Estimated Web Maintenance

X three (3) years

(D)

Total 3-Year Contract Value $_____________ (B + D)

Billing cycle: Monthly

Any approved travel expenses will be billed separately per the Travel Provisions REV 1024

See Bidders Instructions Item 26 for complete instructions on offering Cash Discounts.

_____% Cash discount for payment within __________ days of receipt.

ATTACHMENT 3

COST SHEET (CONT.)

For accounting reporting purposes, please provide the following information: Are you certified with the California Department of General Services, Office of Small Business Certification and Resources (OSBCR) as:

a. California Small Business Micro Business Yes No Yes No

If yes, enter certification number: __________ Expiration Date: __________

b. Disabled Veteran Business Enterprise Yes No

If yes, enter your service code: __________

NAME OF

BIDDER:

COMPANY NAME

ADDRESS:

PHONE: FAX:

EMAIL:

AUTHORIZED

NAME:

PLEASE PRINT

AUTHORIZED

SIGNATURE DATE:

TITLE:

California Prison Industry Authority (CALPIA)

IFB. No. S22942531

IFB. No. S22942531

ATTACHMENT 5

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 - 10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States.