REQUEST FOR PROPOSAL

DHA RFP 2027-005

MEDI-CAL NAVIGATION SERVICES

County of Sacramento

9660 Ecology Lane

Sacramento, CA 95827

RELEASE DATE: October 13, 2026

DEADLINE FOR QUESTIONS: October 20, 2026

RESPONSE DEADLINE: November 3, 2026, 3:00 pm

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://secure.procurenow.com/portal/saccounty https://secure.procurenow.com/portal/%7bproject.government.code%7d

County of Sacramento

REQUEST FOR PROPOSAL

Medi-Cal Navigation Services

1. Introduction

2. General Rules

3. Scope of Work

4. Evaluation and Selection

5. Proposal Format and Content

6. Vendor Submissions

Attachments:

A - RFP_ATT_Proprietary_Agreement

B - RFP_ATT_ DHA Contract & Exhibits Template

Request for Proposal #DHA RFP 2027-005 Title: Medi-Cal Navigation Services

1. Introduction

1.1. Summary

The County of Sacramento (County), Department of Human Assistance (DHA), is soliciting proposals from qualified entities to provide Medi-Cal navigation support services in response to federal requirements enacted under House Resolution 1 (H.R. 1), which mandate semi-annual Medi-Cal renewals for adults aged 19-64 in the New Adult Group beginning January 1, 2027. These changes substantially increase customer assistance needs, requiring DHA to contract with an organization capable of delivering reliable, timely, and high-volume navigation support.

Adults in the New Adult Group will be subject to new Medi-Cal work requirements beginning January 1, 2027, under H.R. 1. Navigators must be prepared to help applicants and recipients understand these requirements and provide the information or documentation requested by the County. Work requirements include completing 80 hours per month of qualifying activities such as work, community service, volunteering, half-time enrollment in an educational program, or participation in a work program. Individuals must meet these requirements at application and renewal, with up to 30 days allowed to demonstrate compliance or provide an allowable exception. Qualifying activities may also include earning at least 580 dollars per month.

The proposed contract term will be one year, with the option of two (2) one-year renewals, contingent on federal and state funding.

1.2. Background

In preparation for Medi-Cal policy and operational changes associated with H.R. 1, including new work or community engagement requirements and more frequent renewals for affected members beginning in 2027, DHA seeks to strengthen timely application and renewal processing by expanding access to pre-application assistance, document support, renewal navigation, enhancing participant understanding of required actions, and follow-up services.

Medi-Cal Navigation Services are designed to promote complete and timely submissions, reduce preventable processing barriers, and support efficient County administration during implementation of new federal Medi-Cal requirements.

1.3. Contact Information

Any inquiries or requests regarding this solicitation must be submitted via OpenGov. Contact with unauthorized County personnel during the selection process may result in disqualification.

Anna Bilik

Administrative Services Officer II

Email: bilika@saccounty.gov

Phone: (916) 876-5238

Department:

Human Assistance mailto:bilika@saccounty.gov tel:(916)876-5238

Department Head:

Ethan E. Dye

Director

1.4. Timeline

Release Project Date October 13, 2026

RSVP to Proposers' Conference Deadline

(Mandatory)

October 19, 2026, 2:00pm

MS Teams Meeting Invitation will be sent directly to those who RSVP

Proposers Conference (Mandatory) October 20, 2026, 9:30am

MS Teams Meeting Invitation will be sent directly to those who RSVP

Question Submission Deadline October 20, 2026, 12:00pm

Question Response Deadline October 21, 2026, 4:00pm

Proposal Submission Deadline November 3, 2026, 3:00pm

Notice of Awards Posted on OpenGov and

DHA Website

November 23, 2026

Final Date To Submit Written Protest of

Awards

December 2, 2026

Recommend Award to Board of Supervisors January 26, 2027

Contract Begins February 1, 2027

2. General Rules

2.1. Important Instructions for Electronic Submittal

The County is accepting electronic proposal submissions. Proposers shall create a FREE account with

OpenGov Procurement by signing up at Sign Up (opengov.com). Once you have completed account registration, browse back to this page, click on "Draft Response", and follow the instructions to submit your electronic proposal.

2.2. General Rules

2.2.1 Overview

This Request for Proposals (RFP) is an invitation for proposers to submit a proposal to the County. This

RFP does not commit the County to award a contract to any proposer. Submission of a proposal shall neither obligate nor entitle a proposer to enter into a contract with the County.

2.2.2 Proposal format and content

When submitting a proposal, proposers must follow the format and content detailed in section 5, Proposal Format and Content. Failure to do so will likely prolong the evaluation process and could result in a proposal not being considered.

2.2.3 Proposal submission

Proposals must be received BEFORE 3:00 pm on Tuesday, November 3, 2026 electronically via OpenGov.

Failure to submit a proposal on time may be grounds for rejection of the proposal; however, the County reserves the right, in its sole and absolute discretion, to accept proposals after the proposal due date.

2.2.4 Questions and communication

Questions concerning this RFP must be submitted in the project Q&A module in OpenGov Procurement by 12:00 pm on Tuesday, October 20, 2026.

Questions received via phone or e-mail to direct points of contact for this RFP will not be considered nor responded to. The County shall respond to questions properly submitted as described above.

2.2.5 Addenda

The County reserves the right to modify this RFP at any time prior to the proposal due date. The County will modify the RFP only by written addenda. Proposal should be based on this RFP document and any formal written addenda. Proposers should not rely on oral statements. Addenda will be posted in

OpenGov Procurement. It is the responsibility of each prospective proposer to assure receipt of all addenda.

2.2.6 County's right to withdraw, cancel, suspend and/or modify RFP

The County reserves the right to withdraw, cancel, suspend, and/or modify this RFP for any reason and at any time with no liability to any prospective proposer for any costs or expenses incurred in connection with the RFP or otherwise.

2.2.7 Proposer's right to edit or cancel proposal

Proposers may edit or cancel their proposal in OpenGov Procurement prior to the due date.

https://procurement.opengov.com/signup

2.2.8 Proposals will not be returned

Upon submission, proposals will not be returned.

2.2.9 Public disclosure of proposal documents

The County will treat all information submitted in a proposal as available for public inspection once negotiations with the selected party have been completed. If copies of proposals are included with

Board materials, the County will make proposals available for public inspection once staff has made a recommendation for award.

If a proposer believes protected data is included in its proposal, the proposer shall clearly identify the data and provide the legal basis in support of the asserted classification. Proposer must present such information separately as part of its proposal OR type in bold red letters the term "CONFIDENTIAL" on that specific part or page of the proposal which proposer believes to be confidential. Classification of data as trade secret data will be determined pursuant to applicable law, and, accordingly, merely labeling data as "trade secret" does not necessarily make the data protected under any applicable law.

In order for the County to assert the confidentiality of any such information in the event a California

Public Record Act request is received, the proposer must request, execute and submit a County-prepared written agreement to defend and indemnify the County for liability, costs and expenses incurred in asserting such confidentiality as part of the proposal. A copy of that written agreement is included in Attachments module.

The final determination of whether the County will assert a proposer's claim of confidentiality shall be at the sole discretion of the County. Any information determined to be non-confidential shall be considered public record. If the County determines that your information does not meet the criteria for confidentiality, you will be notified of the County's intent to release the public record pursuant to any

California Public Records Act request.

The proposer agrees, as a condition of submitting its proposal, that the County will not, as between the parties, be liable or accountable for any loss or damage, which may result from a breach of confidentiality related to the proposal. The proposer agrees to indemnity and hold the County, its officials, agents, and employees harmless from all claims arising out of, resulting from, or in any manner attributable to any violation of any provision of the California Public Records Act, including legal fees and disbursements paid or incurred to enforce this provision.

2.2.10 Proposer's costs

The County shall not be responsible for any costs incurred by proposer in connection with this RFP.

Proposer shall bear all costs associated with proposal preparation, submission, and attendance at interviews, or any other activity associated with this RFP or otherwise.

2.2.11 Proposer's ideas

To the extent permitted by law, the County reserves the right to use any or all ideas, concepts, or other information provided in any proposals. Selection or rejection of the proposal does not affect this right.

2.2.12 Collusion

If the County determines that collusion has occurred among proposers, none of the proposals of the participants involved in the collusion shall be considered. The County's determination shall be final.

2.2.13 Conflict of interest

The proposer affirms that to the best of its knowledge the submission of its proposal, or any resulting contract, does not present an actual or perceived conflict of interest. The proposer agrees that should any actual or perceived conflict of interest become known, it will immediately notify the County and will advise whether it will or will not avoid, mitigate, or neutralize the conflict of interest.

The County may make reasonable efforts to avoid, mitigate, or neutralize a conflict of interest by a proposer. To avoid a conflict of interest by a proposer, the County may utilize methods including disqualifying a proposer from eligibility for a contract award or cancelling the contract if the conflict is discovered after a contract has been issued. The County may, at its sole and absolute discretion, waive any conflict of interest.

2.2.14 Funding cycle and anticipated amount of funds

The term of the agreement(s) resulting from this solicitation is February 1, 2027, through June 30, 2027, with the possibility of two (2) one-year extensions. The expected budget for the agreement(s) is/are currently unknown and will be contingent on funding availability.

2.2.15 Qualified proposers

We encourage proposals from agencies that are able to demonstrate the following:

• Are a Community Based Organization (CBO)

• Operate within the geographic boundaries of Sacramento County;

• Provide services that are accessible to all Sacramento County residents;

• Hold current 501(c)(3) nonprofit status;

• Maintain facilities in Sacramento County that meet Medi-Cal confidentiality requirements and support in-person assistance;

• Possess the capacity to provide customer support by phone and/or in-person;

• Create and maintain an active Assistor account in BenefitsCal to assist customers with Medi-Cal applications and renewals;

• Demonstrate prior experience delivering Medi-Cal navigation services.

• Demonstrate organizational capacity to provide adequate staffing, supervision, reporting, and quality assurance.

• Maintain infrastructure capable of supporting online system navigation and document-submission guidance (e.g., Truv, BenefitsCal).

• Provide assistance to individuals in understanding how to meet work and community engagement requirements and support reporting reasons for exception or a short-term hardship.

• Demonstrate the ability to provide culturally competent and multilingual services, including but not limited to English, Spanish, and Russian, to Sacramento County’s diverse households.

• Demonstrate the ability to work with variety of stakeholders including but not limited to customers, state/local governments, and providers of Medi-Cal services.

2.2.16 Proposers' conference

Refer to Section 1, Introduction, Timeline for further details. The purpose of the proposers' conference will be to discuss the requirements and objectives of the RFP, and to answer general questions. It is recommended that detailed and technical questions regarding this RFP be submitted via OpenGov procurement in the Question & Answer module.

All members of your organization who plan to attend the proposers' conference must RSVP via

OpenGov. This is essential for County staff to prepare and send out the Microsoft Teams meeting invitation. Please ensure your RSVP is submitted before the deadline.

2.2.17 News releases

News releases pertaining to this RFP and any award(s) shall not be made without prior approval from the County of Sacramento.

2.2.18 False or misleading statements

Proposals which contain false or misleading statements, or which provide references which do not support an attribute or condition contended by the vendor, may be rejected. If, in the opinion of the

County, such information was intended to mislead the County in its evaluation of the proposal and the attribute, condition, or capability is a requirement of the RFP, the bid shall be rejected.

2.2.19 Reference checks

Submittal of a proposal authorizes DHA to investigate without limitation the background and current performance of your agency. Input of references regarding your capacity to perform in relation to all aspects of this RFP will be used.

2.3. DHA Additional Information and Provisions

The proposer shall read and comply with all of the following provisions (see also Vendor Submissions section and confirm your acceptance of these terms and conditions). These provisions may be included or incorporated in any resulting contract(s).

2.3.1 Confidentiality

A. Personally Identifiable Information (PII), is information directly obtained in the course of performing an administrative function on behalf of a welfare program, such as determining eligibility, that can be used alone, or in conjunction with any other information, to identify a specific individual. PII includes any information that can be used to search for or identify individuals, or can be used to access their files, such as name, address, social security number, date of birth, driver’s license number or identification number. PII may be electronic or on paper.

B. As required by State and Federal laws and regulations, including California Welfare and

Institutions Code Section 10850 and Division 19-000 of the State Department of Social Services manual of Policies and Procedures, proposer is required to safeguard PII and not publish or disclose, use or permit, or cause to be published, disclosed, or used, any PII pertaining to an applicant or recipient for any purpose not directly connected with the administration of public social services. Access to this PII is restricted to staff members who require it to perform their official duties, as will be specified in the forthcoming contract.

C. Proposer must use all reasonable measures to prevent non-authorized personnel and visitors from accessing, controlling, or viewing this PII.

D. Proposer staff is not to access their own public assistance records, or the records of friends, family, acquaintances, co-workers, or tenants for any reason.

E. Proposer agrees to inform all of its employees, agents, subcontractors and partners of the above provisions and that knowing and intentional violation of the provisions of said state law is a misdemeanor. Proposer will have each person who will have access to PII read and sign the

Sacramento County, Department of Human Assistance Staff Statement of Confidentiality for

Outside Agency Staff (SC63 Outside Agency). The completed form is to be returned to

Sacramento County. In addition the form will need to be completed annually for multi-year contracts.

2.3.2 Security

A. Proposer staff for whom CalSAWS accounts or other DHA accounts are requested must be 18 years or older and must first comply with the following: pass a California State Department of

Justice security clearance, complete the DHA security training, sign the DHA Staff Statement of

Confidentiality (DHA form SC63), and sign the DHA security agreement (DHA form SC1170).

B. Proposer shall ensure that data containing PII is used and stored in an area that is physically safe from access by unauthorized persons during working hours and non-working hours. PII in paper form shall not be left unattended at any time, unless it is locked in a file cabinet, file room, desk, or office. Unattended means that information is not being observed by a person authorized to access the information. Such data must not be removed from the premises except for routine business purposes. Such data shall not be left unattended at any time in vehicles or airplanes and in checked baggage on commercial airplanes.

C. Proposer shall dispose of paper documents containing PII through confidential means, such as crosscut shredding and pulverizing.

D. Proposer shall ensure that faxes containing PII shall not be left unattended and fax machines shall be in secure areas. Faxes shall contain a confidentiality statement notifying persons receiving faxes in error to destroy them. Fax numbers shall be verified with the intended recipient before sending the fax.

E. Proposer shall ensure that mailings containing PII shall be sealed and secured from damage or inappropriate viewing of PII to the extent possible. Mailings that include 500 or more individually identifiable records containing PII in a single package shall be sent using a tracked mailing method that includes verification of delivery and receipt.

F. Proposer shall ensure that only the minimum amount of PII is downloaded onto systems, electronic equipment, and media, such as computers, laptops, notebooks, hard drives, flash drives, CDs/DVDs, when absolutely necessary for current business purposes.

G. Proposer shall ensure that when data containing PII is no longer legally needed, it must be wiped using the Gutmann or U.S. Department of Defense (DoD) 5220.22-M (7 Pass) standard or by degaussing. Media may also be physically destroyed in accordance with NIST Special

Publication 800-88.

H. Proposer shall ensure that if PII is stored in a system under proposer's control, the system must provide an automatic timeout, requiring re-authentication of the user session after no more than 20 minutes of inactivity.

I. Proposer shall ensure that if PII is stored in a system under proposer 's control, the system must display a warning banner stating that data is confidential, systems are logged, and system use is for business purposes only by authorized users. User must be directed to log off the system if they do not agree with these requirements.

J. Proposer shall ensure that all data transmissions of PII outside its secure internal network must be encrypted using a FIPS 140-2 certified algorithm that is 128bit or higher, such as AES.

Encryption can be end to end at the network level, or the data files containing PII can be encrypted. This requirement pertains to any type of PII in motion such as website access, file transfer, and E-Mail.

K. Proposer shall ensure that all e-mails that include PII that are sent outside of its e-mail environment must be encrypted using a FIPS 140-2 certified algorithm 128bit or higher, such as

AES.

L. Proposer shall ensure that any data centers with servers, data storage devices, and critical network infrastructure involved in the use or storage of PII must include sufficient environmental protection such as cooling, power, and fire prevention, detection, and suppression.

M. Proposer shall ensure that all workstations, laptops and other systems that process and/or store

PII must have critical security patches applied, with system reboot if necessary. There must be a documented patch management process that determines installation timeframe based on risk assessment and vendor recommendations. At a maximum, all applicable patches deemed as high risk must be installed within 30 days of vendor release. Applications and systems that cannot be patched within this time frame, due to significant operational reasons, must have compensatory controls implemented to minimize risk

N. Proposer shall ensure that all computers, laptops, notebooks, and other systems that process and/or store PII have commercial third-party anti-virus software installed and that such software is updated when new anti-virus definitions or software releases are available.

O. Proposer shall ensure that all electronic equipment and media, such as computers, laptops, notebooks, hard drives, flash drives, CDs/DVDs, that contain PII are encrypted using a FIPS 140-2 certified algorithm 128bit or higher, such as AES.

P. Proposer shall ensure that if PII is stored in a system under proposer's control, the system must have User IDs and password controls. All users must be issued a unique user name for accessing

PII. Each username must be promptly disabled, deleted, or the password changed upon the transfer or termination of an employee with knowledge of the password, at maximum within 24 hours. Passwords are not to be shared. Passwords must be at least eight characters and must be a non-dictionary word. Passwords must not be stored in readable format on the computer. Passwords must be changed every 90 days, preferably every 60 days. Passwords must be changed if revealed or compromised.

2.3.3 In the event of PII incidents

A. Incidents include actual or suspected intrusion, loss or unauthorized use or disclosure of PII.

B. In the event of an incident, Proposer shall immediately, no later than within 24 hours, notify the

County by telephone call or e-mail. Telephone 916-875-3768 or e-mail DHA-

ISO@saccounty.gov. Proposer shall provide a description of the incident, including date, time, and location; numbers of documents, files, and records; names of all clients affected;

description of the PII and its source; type of system, equipment, or media affected; description of how the data was physically stored, contained, or packaged; names of persons involved;

probable causes; corrective actions taken or planned; if the incident was reported to law enforcement, the law enforcement report number; and any other details about the incident as requested by County.

C. In the event of an incident, if requested by County, proposer shall immediately, for the purpose of reviewing compromised PII:

D. Allow County to access and review the content of proposer's systems, equipment, and media affected by the incident.

E. Provide to the County copies of electronic documents and records containing PII that resided on proposer's systems, equipment, or media at the time of the incident.

mailto:DHA-ISO@saccounty.gov mailto:DHA-ISO@saccounty.gov

F. If a breach of security has occurred in the proposer's use of PII provided by the County, the proposer is responsible for any and all breach notifications and associated costs to the extent the breach of security was caused in whole or part by the negligence, recklessness or intentional error or omission of proposer . The means and contents of any breach notifications must first be approved by the County.

2.3.4 Reporting requirements

The Proposer will be required to complete monthly reporting documents to capture required DHA and

DHCS information. Information required by State and Federal governments changes rapidly, thus requiring changes in reporting during the contract period. Proposer must have in place a comprehensive management information system and system unit to comply with the changing fiscal and performance reports required.

2.3.5 Information system communication needed by proposer

Both DHA and proposer will be exchanging information. Proposers must ensure computer access allows for sharing of case information while protecting participant confidentiality.

2.3.6 Equipment ownership

If applicable, County shall have and retain ownership and title to all equipment purchased by proposer under this Agreement. Proposer shall furnish, and amend as necessary, a list of all equipment purchased under this Agreement together with bills of sale and any other documents as may be necessary to show clear title and reasonableness of the purchase price. The equipment list shall specify the quantity, name, description, purchase price, and date of purchase of all equipment. County shall inventory tag all equipment and shall conduct or require proposer to conduct an annual physical inventory of the equipment. Proposer shall make all equipment available to County during normal business hours for tagging and inventory. Proposer shall deliver the equipment to County upon termination of the Agreement, unless County instructs otherwise or the Agreement is renewed or extended.

2.3.7 Children's education rights

Proposer shall ensure parents are informed of their children’s educational rights. Upon admission to the program, parents shall be provided a brochure approved by Project Teach providing school district liaison contact information. Provision of this brochure will be documented in the case record. Proposer shall post in public view Project Teach approved posters detailing the educational rights of homeless children. Proposer shall participate at least quarterly in the Sacramento County Taskforce for the

Education of Homeless Children to ensure collaboration with educational providers and assure consideration of the educational needs of children served in the program.

2.3.8 Good Neighbor policy

A. Proposer shall comply with County’s Good Neighbor Policy. Proposer shall establish good neighbor practices for its facilities that include, but are not limited to, the following:

1. Provision of parking adequate for the needs of its employees and service population;

2. Provision of adequate waiting and visiting areas;

3. Provision of adequate restroom facilities located inside the facility;

4. Implementation of litter control services;

5. Removal of graffiti within seventy-two hours;

6. Provision for control of loitering and management of crowds;

7. Maintenance of facility grounds, including landscaping, in a manner that is consistent with the neighborhood in which the facility is located;

8. Participation in area crime prevention and nuisance abatement efforts; and

9. Undertake such other good neighbor practices as determined appropriate by County, based on County’s individualized assessment of proposer's facility, services and actual impacts on the neighborhood in which such facility is located.

B. Proposer shall identify, either by sign or other method as approved by the Director, a named representative who shall be responsible for responding to any complaints relating to proposer's compliance with the required good neighbor practices specified in this section. Proposer shall post the name and telephone number of such contact person on the outside of the facility, unless otherwise advised by Director.

C. Proposer shall comply with all applicable public nuisance ordinances.

D. Proposer shall establish an ongoing relationship with the surrounding businesses, law enforcement and neighborhood groups and shall be an active member of the neighborhood in which proposer's site is located.

E. If County finds that proposer has failed to comply with the Good Neighbor Policy, County shall notify proposer in writing that corrective action must be taken by proposer within the specified time frame. If proposer fails to take such corrective action, County shall take such actions as are necessary to implement the necessary corrective action. County shall deduct any actual costs incurred by COUNTY when implementing such corrective action from any amounts payable to proposer under the Agreement.

F. Proposer's continued non-compliance with the Good Neighbor Policy shall be grounds for termination of the Agreement and may also result in ineligibility for additional or future contracts with County.

2.3.9 Charitable choice

If the proposer certifies that it identifies as a faith-based religious organization, and receives direct funding from one of the following funding sources, then the following apply:

A. Substance abuse prevention and treatment services under the Substance Abuse Prevention and

Treatment Block Grant (SAPT);

B. The Projects for Assistance in Transition from Homelessness (PATH) formula grant program;

C. Substance Abuse and Mental Health Services Administration (SAMSHA) discretionary grants; or

D. General Temporary Assistance for Needy Families (TANF), that:

1. Proposer shall adhere to the requirements contained in Title 42, Code of Federal

Regulations (CFR) Part 54; or Title 45, Code of Federal Regulations (CFR) Part 260, whichever applies to this Agreement.

2. Proposer's services shall be provided in a manner consistent with the Establishment Clause and the Free Exercise Clause of the First Amendment of the United States Constitution.

3. If Proposer offers inherently religious activities, they shall be provided separately, in time or location, from the programs or services for which the organization receives funds from

Federal, State or local government sources. Participation in religious activities must be voluntary for program beneficiaries (42 CFR Part 54.4) and (45 CFR Part 260(b)(2).

4. Proposer shall not expend any Federal, State or local government funds to support any inherently religious activities such as worship, religious instruction, or proselytization (42

CFR Part 54.5) and (45 CFR Part 260(c).

5. Proposer shall not, in providing program services or engaging in outreach activities under applicable programs, discriminate against a program beneficiary or prospective program beneficiary on the basis of religion, a religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice (42CFR Part 54.7) and (45 CFR Part

260(f).

6. Proposer shall inform program beneficiaries that they may refuse to participate in any religious activities offered by proposer.

7. Proposer shall inform program beneficiaries that, if they object to the religious character of the program, they have the right to a referral to an alternate service provider to which they have no objections (42 CFR Part 54.8) and (45 CFR Part 260(g)(1).

8. Proposer shall, within a reasonable time of learning of a beneficiary’s objection to the religious character of the program, refer the program beneficiary to an alternate service provider (42 CFR Part 54.8) and (45 CFR Part 260(g)(3).

9. If 42 U.S.C. 2000 e-1 regarding employment practices is applicable to this Agreement, it shall supersede 42 CFR Part 54.7 to the extent that 42 CFR Part 54.7 conflicts with 42 U.S.C. 2000 e-1.

3. Scope of Work

DHA is seeking one or more qualified nonprofit agencies with current 501(c)(3) status to provide Medi-

Cal program navigation, outreach, application, and renewal assistance services to Sacramento County residents. Selected agencies must demonstrate the capacity to deliver accurate, accessible, and culturally responsive support to individuals and families who need help understanding or completing

Medi-Cal application and renewal processes.

Outreach services will focus on educating community members on Medi-Cal benefits and assisting individuals with Medi-Cal applications and renewals through BenefitsCal and other designated platforms. Agencies must be prepared to help customers understand notices, provide the items or information requested by the County, and report exceptions or short-term hardships when applicable.

These services are intended to support applicants and recipients in supplying the documentation needed for the County to make an eligibility determination, without performing eligibility work themselves.

The purpose of these services is to increase and maintain Medi-Cal participation among individuals who are now subject to Work Requirement and Community Engagement rules, subject to 6-month renewals, and face structural barriers such as housing instability, transportation challenges, difficulty accessing care, and elevated risks due to environmental exposures or chronic illness. The goal is to ensure those that are eligible to Medi-Cal become and remain eligible, by strengthening collaborative efforts throughout the community, enhance residents’ understanding of the Medi-Cal program requirements, and reduce avoidable loss of coverage caused by incomplete applications, missed deadlines, or confusion about new federal requirements. Contractor(s) will provide additional community-based resources to help residents navigate these requirements, thereby improving the Department of Human

Assistance’s capacity to process applications and renewals more effectively and preventing denials and/or loss of coverage. These services aim to deliver timely, high-quality navigation assistance that supports continuous Medi-Cal coverage for all eligible residents.

3.1 Proposer Requirements

The contracted agency must:

• Must be a public agency, nonprofit, tribal organization, community-based organization, or other legal entity authorized to conduct business in California.

• Have at least two years of experience providing health-coverage enrollment, public benefits navigation, Medi-Cal/Medicaid eligibility support, case management, or comparable direct customer services.

• Have a fixed location (address) that is open, accessible and available to the public for a minimum of 20 hours per week. DHA reserves the right to verify operating hours via physical inspection for all awarded participants.

• Have infrastructure already in place to support a potentially high volume of telephone calls and in-person contacts during stated business hours.

• Have staff resources available to provide the additional level of service requested, by providing information on available staffing and functions to be used to meet the requirements of this RFP.

• Provide services to the diverse population of Sacramento County to persons of all age groups, languages and cultures.

• Must provide bilingual/bicultural staffing or qualified interpretation and translated materials sufficient for the County’s priority languages but not limited to English, Spanish and Russian.

• Demonstrate a working knowledge of the process to submit an electronic application for Medi-

Cal in BenefitsCal.

• Demonstrate working knowledge of Medi-Cal application, renewal, reporting, documentation, and County eligibility processes.

• Must identify adequate administrative and program staff to perform the required work.

• Must demonstrate secure handling of personally identifiable information and health-related information, including role-based access, staff training, secure document transfer, and incident-reporting procedures.

• Must be financially stable, able to manage reimbursement-based contracting, and must not have unresolved audit findings that would materially affect performance.

3.2 Outreach and education activities

The contractor shall:

• Conduct proactive outreach in community settings, including clinics, schools, libraries, shelters, food-distribution sites, faith-based organizations, and other trusted locations.

• Provide plain-language education on Medi-Cal application pathways, renewal obligations, reporting duties, and available sources of assistance.

• Explain, when applicable, the H.R. 1 work or community-engagement requirements and the importance of responding to County notices and request for information.

• Provide outreach in culturally responsive and linguistically appropriate formats.

• Offer assistance through in-person, telephone, virtual, and other accessible service modalities.

• Offer assistance on how to create an account and navigate Truv and BenefitsCal.

• Contracted agencies must coordinate with the other contracted agencies funded under this RFP as to which outreach events they plan to attend to avoid duplication efforts.

• Demonstrate the ability to work with variety of stakeholders including but not limited to customers, state/local governments, and providers of Medi-Cal services.

DHA will provide approved literature but will be the responsibility of the selected agencies to print the material. Agencies may not alter or use any other literature other than what has been provided by DHA or approved by DHA.

3.3 Application and enrollment assistance

The contractor shall assist individuals seeking to apply for Medi-Cal by:

• Explaining Medi-Cal application pathways and helping applicants identify the appropriate

County or approved submission channel.

• Assisting applicants with completing Medi-Cal applications online via BenefitsCal, by phone, on paper, or through approved in-person processes.

• Helping applicants gather, organize, and submit required information and verifications.

• Assisting applicants with BenefitsCal account access, document uploads, and follow-up responses to County requests.

• Providing status follow-up, as permitted, and helping applicants understand next steps.

• Providing warm handoffs to managed care plan resources, or other partners when needed.

• Informing applicants that the contractor does not determine Medi-Cal eligibility and cannot guarantee approval.

• Provide confidential computer access to Medi-Cal applicants if needed to access BenefitsCal.

3.4 Renewal and retention assistance

The contractor shall assist current Medi-Cal members with maintaining active coverage by:

• Helping members understand and complete Medi-Cal renewals.

• Helping members update address, household, and other information through BenefitsCal.

• Assisting members with understanding notices, gathering documents, and responding to requests for information before deadlines.

• Establishing reminder systems and follow-up contacts for upcoming renewal due dates.

• Helping members retain proof of submission and monitor whether additional action is needed.

• Assisting members who experience discontinuance or adverse action to restore benefits, to re-apply, provide fair-hearing information or refer to qualified legal-services providers.

3.5 H.R. 1 Work community engagement support

For affected populations, the contractor shall:

• Provide plain-language information about H.R. 1 work or community-engagement requirements effective January 1, 2027.

• Conduct a non-determinative screening to identify whether a participant may be in an affected eligibility group, may already meet the requirement, or may need additional support.

• Assist participants in identifying qualifying activities, including work, school, training, or volunteer/community-service activities.

• Help participants gather and organize verification related to qualifying activities.

• Help participants respond to County requests for information related to work or community engagement.

• Explain that final determinations about applicability, sufficiency of documentation, and ongoing eligibility are made by the County.

3.6 Exempt-related assistance

The contractor shall:

• Help participants identify possible exemptions and obtain supporting documentation or referrals, where appropriate.

• Assist participants with the Medical Frailty Screener Tool (when it becomes available and is released by the State).

• Assist participants with collecting medical, caregiving, treatment, veteran-status, educational, or other records that may be relevant to an exemption, when allowed and appropriate.

• Refer participants with complex eligibility, legal, or appeals issues to the County or qualified legal services organizations.

3.7 Workforce, education and supportive-service referrals

The contractor shall maintain referral relationships and warm handoff protocols with:

• Workforce development and employment-service providers.

• Adult education, community college, GED, ESL, and job-training programs.

• Volunteer and community-service organizations able to document participation.

• Health, behavioral health, substance use disorder, and disability-support providers.

• Legal services and benefits-advocacy organizations.

• The contractor shall document referrals made, follow-up conducted, and outcomes known.

3.8 Individualized navigation and follow-up

For participants receiving direct services, the contractor shall:

• Conduct a needs screening and establish a service plan or next-step action plan.

• Provide warm handoffs rather than solely distributing written resource lists when active coordination is needed.

• Follow up with participants to determine whether applications, renewals, verifications, or referrals were completed.

• Prioritize urgent cases involving imminent loss of Medi-Cal coverage, unresolved renewals, or missing verifications.

• Obtain participant consent before sharing information with County staff or partner organizations, except as otherwise required by law.

3.9 Staffing requirements

The proposer shall identify staffing adequate to serve the target population and geographic area. At minimum, the proposal shall include staff:

• Responsible for contract compliance, supervision, quality assurance, training, and County coordination.

• Responsible for outreach, application assistance, renewal assistance, document support, referrals, and participant follow-up.

• Responsible for maintaining current knowledge of Medi-Cal policy and procedures and supporting staff with escalated non-determinative guidance.

• Responsible for reporting, quality monitoring, confidentiality, and performance management.

Staff shall receive initial and ongoing training on Medi-Cal application and renewal processes, H.R. 1 work or community-engagement requirements, possible exemptions, language access, disability access, trauma-informed engagement, confidentiality, document handling, and escalation protocols.

3.10 Performance measures

The contractor shall collect and report, at minimum, the following measures:

• Outreach: Number of residents reached; events held; priority communities served

• Application assistance: Number of individuals assisted with Medi-Cal applications

• Application completion: Number and percentage of assisted applications submitted

• Verification support: Number assisted with application-related or renewal-related document requests

• Renewal assistance: Number of members assisted with renewals or mid-cycle eligibility actions

• H.R. 1 support: Number screened for possible applicability; number assisted with activity verification or possible exemption support

• Referrals: Number of warm referrals; percentage with known connection outcomes

• Participant experience: Percentage reporting they understood their next action and how to obtain additional help

3.11 Population and geographic area to be served

The Department of Human Assistance serves a low-income, multi-lingual, multi-cultural population. The

Department desires proposals that will include services to residents in the entire Sacramento County area who are in need of Medi-Cal benefits or other services provided by DHA.

The target population includes low-income individuals and families who receive or may be eligible for

Medi-Cal, with particular focus on adults aged 19-64 in the New Adult Group who will be subject to more frequent eligibility redeterminations. Many customers will require assistance interpreting renewal requirements, responding to notices, completing forms, submitting documentation, and navigating online platforms such as BenefitsCal and other designated systems. Additional support may also be required to understand and comply with new work and community engagement requirements or to report applicable exceptions or short-term hardships.

3.12 Reporting

All reporting information must be submitted with the monthly invoice claim form for reimbursement by the 15th of each month. DHA reserves the right to change or increase reporting requirements at any point during the term of the contract period if it becomes necessary. Meet with DHA quarterly to provide updates, discuss progress, and address any concerns.

3.13 Confidentiality

Any proposer awarded a contract must comply with and require its employees and subcontractors to comply with the provisions of Section 10850 of the Welfare and Institutions code and Division 19-000 of the California Department of Social Services (CDSS) Manual of Policies and Procedures, to assure complete confidentiality.

The Contractor shall:

• Maintain secure, timely, and accurate participant records.

• Collect only information necessary to provide services and meet reporting requirements.

• Comply with all applicable privacy, confidentiality, security, and records-retention requirements.

• Obtain appropriate consent before releasing participant information, except where disclosure is legally required.

• Submit monthly service-data reports and quarterly narrative and fiscal reports.

• Track applications assisted, renewals assisted, document support, H.R. 1-related assistance, referrals, known outcomes, barriers encountered, and corrective actions.

• Participate in County quality-improvement and program and contract-monitoring activities.

3.14 Information system communication needed by contractor

Both DHA and proposer will be exchanging information. Proposals must include computer access to allow for sharing of case information while protecting participant confidentiality.

4. Evaluation and Selection

4.1 Proposal evaluation and recommendation for selection

The County reserves the following rights, to be exercised in the County’s sole and absolute discretion: 1) to determine whether any aspect of a proposal satisfactorily meets the criteria established in this RFP; 2) to seek clarification or additional information from any proposer; 3) to negotiate, sequentially or simultaneously, pricing and/or terms with any proposer or vendor; 4) to reject any or all proposals with or without cause; 5) to waive any irregularities or informalities in a proposal; 6) to cancel or amend by addenda this RFP, in part or entirely; 7) to award multiple contracts to proposers; and/or 8) award a contract to a vendor that did not submit a proposal.

Evaluation of proposals by a selection committee, evaluation panel, County staff, a technical advisory committee, or by another group, individual or entity is advisory only. The County of Sacramento Board of Supervisors or its designee may consider or reject such evaluation(s) for any or all proposals. Such evaluations are for the sole benefit of the County of Sacramento Board of Supervisors or its designee, and as such, they are not binding upon the County, nor may they be relied upon in any way by a proposer.

4.2 Evaluation of responsiveness

The County will consider all the material submitted by a proposer to determine whether the proposer’s offer is in compliance with the terms and conditions set forth in this RFP. Proposals that do not comply with the provisions in this RFP may be considered nonresponsive and may be rejected.

4.3 Evaluation of responsibility

To determine whether a proposer is responsible, the County will consider the proposer’s general qualifications to perform the requested services in a satisfactory manner; financial responsibility;

integrity; skill; past performance; and ability. Proposals from proposers considered non-responsible will be rejected.

4.4 Evaluation criteria

After review of each responsive proposal, the County may award a contract to a successful proposer based on the evaluation criteria, or it may establish a short list of proposers for further consideration.

The short list of proposers may be asked to provide additional information. The short list of proposers may also be asked to attend an in-person or telephone interview/presentation, as determined by the

County in its sole discretion.

Proposals will be evaluated based on the following criteria:

• Technical Review (10 points).

o This review ensures that all submitted documents have been completed and pertinent information included as specified in the RFP. Ensure Table of Contents is included with your

Proposal Narrative.

• Cover Letter (5 points).

o The cover letter is a required part of this RFP and must be fully completed. The signed cover letter must confirm your intent to comply with all requirements outlined in the RFP and to follow all applicable rules. If you are requesting any exceptions, they must be clearly identified. By signing the cover letter, you acknowledge and agree to meet the RFP requirements and abide by its terms.

• Proposal Narrative (45 points total). Not to exceed four (4) pages.

o Explain how the proposed services will meet or exceed the County’s requirements. (15 points) o Describe any unique resources, methods, or approaches that make your services especially beneficial to the County. (15 points) o Identify any known limitations or restrictions that may affect your ability to deliver the proposed services, so the County can consider them in its evaluation. (15 points)

• Deliverables (5 points).

o Describe your approach to ensuring all program deliverables are completed effectively and on time.

• Population/Geographic Target Area (5 points).

o Describe the population currently being served and the targeted geographic area within

Sacramento County.

• Qualifications, Experience and Knowledge (10 points).

o Briefly describe the qualifications, training, and relevant experience of your staff, including key job roles. Summarize your organization’s experience and ability to manage a program that aligns with the proposed scope of services, including the types of services provided and for how long. If you currently provide or have previously provided services to the County, include a brief description of those services.

• Proposer's Organizational Structure (5 points).

o This section should explain how the proposer will…