NYS RMS RFA ACCESSIBLE.pdf

Request for Applications

New York State Refugee Medical Screening & Immunization Program

Release Date: 8/24/2026

Submission Deadline: 10/1/2029

Designated Contact:

Name: Justin Hymes Agency: Office of Temporary & Disability Assistance Title: Program Manager Address: 40 N. Pearl St., Suite 10C Albany, NY 12243-0001 Phone/Email: 518-474-5764 / BRS.RFP@otda.ny.gov mailto:BRS.RFP@otda.ny.gov

Contents

Part A - Summary Information

I. Introduction

II. Registration and Prequalification Requirement

III. Procurement Schedule/Submission Guidelines

IV. Federal Authority

V. Eligible Grant Applicants

VI. Program Description

VII. Service Strategy

VIII. Eligible Participants

IX. Funding Limitations And Provisions

X. Program Information

XI. Selection Process

XII. Award Procedures

XIII. Reports And Record Keeping

XIV. General Terms and Conditions

XV. Participation Opportunities For New York State Certified Service-Disabled Veteran-Owned Businesses

XVI. Executive Order Number 190: Incorporating Health Across All Policies Into State Agency Activities

XVII. Contractor Requirements and Procedures for Business Participation Opportunities for New York State Certified Minority- and Women-Owned Business Enterprises and Equal Employment Opportunities for Minority Group Members and Women

Part B Application Packet

Section A - Applicant Documentation

Section B – Program Narrative (No Page Limit)

Section C – Required Forms

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Part A - Summary Information

I. Introduction

The Bureau of Refugee Services (BRS) of the New York State Office of Temporary and Disability Assistance (OTDA) issues this Request for Applications (RFA) to solicit applications from qualified applicants to administer the New York State Medical Screening and Immunization Program.

Note: For the purpose of this RFA, eligible persons as defined in Part A, Section VIII Eligible Participants will hereafter be referred to as “refugees” unless special circumstances apply.

OTDA anticipates distributing approximately $6,000,000 in Refugee Medical Assistance (RMA) funds under this procurement. All funds allocated for the administration of this program are received from the federal Office of Refugee Resettlement (ORR), an Office of the Administration for Children and Families (ACF) within the United States Department of Health and Human Services (HHS). All program funds are subject to continued availability and State appropriation thereof.

If selected, the proposal and all parts submitted in response to this RFA may become part of a contract with OTDA, subject to approval by the New York State Attorney General (AG) and the Office of the New York State Comptroller (OSC). At the time of contract development, awardees may be required to submit additional program information and any revised forms and documents for the final contract. Successful applicants will be required to submit all final contract documents, narratives, and budgets via mail or email.

II. Registration and Prequalification Requirement

Pursuant to the New York State Division of Budget Bulletin H-1032 (revised), dated January 19, 2025, not-for-profits are required to register in SFS and complete the Vendor Prequalification process in order for proposals to be evaluated. Information on these initiatives can be found at the NYS Grants Management website.

Below is a summary of the steps that must be completed to meet registration and prequalification requirements.

Registration for the Statewide Financial System

Applicants must be registered in SFS to compete for New York State grants and are strongly encouraged to initiate this process as soon as possible to participate in this opportunity. Complete instructions on how to register in SFS are available here.

In addition to the support resources available to SFS users on the SFS website in the SFS Coach Training section (such as manuals, videos, webinars and FAQs), SFS provides live help desk support for SFS users.

• Hours: Monday – Friday 8:00 a.m. to 5:00 p.m.

• Phone: (518) 457-7737 or (877) 737-4185

• Email: helpdesk@sfs.ny.gov https://www.budget.ny.gov/guide/bprm/h/h-1032.html https://grantsmanagement.ny.gov/ https://grantsmanagement.ny.gov/ https://grantsmanagement.ny.gov/register-your-organization-sfs https://grantsmanagement.ny.gov/resources-grant-applicants mailto:helpdesk@sfs.ny.gov

Prequalification

Not-for-profit organizations must prequalify to do business with New York State agencies before they can compete for State grants. This process enables not-for-profit organizations to address questions and concerns before entering a competitive bid process. Not-for-profit organizations are strongly encouraged to begin the prequalification process as soon as possible.

To become prequalified, a not-for-profit organization must first register in SFS. Once registered, not-for-profit organizations complete an online prequalification application. This includes completing a series of forms by answering basic questions regarding the organization and uploading key organizational documents. Additional information on prequalification can be found at https://grantsmanagement.ny.gov/get-prequalified.

Grant proposals received from not-for-profit applicants that are not prequalified in SFS at the application due date and time will not be evaluated and will be disqualified from further consideration.

Specific questions about the prequalification process should be referred to the SFS help desk at helpdesk@sfs.ny.gov.

III. Procurement Schedule/Submission Guidelines

Anticipated Earliest Contract Start Date

OTDA reserves the right to modify the following dates in this RFA:

• Original Request for Applications Release Date: 12/6/2024

• Release Date of the Revised Request for Applications: 8/24/2026

• Due Date for Application Submission: Open Application Period Through October 1, 2029

• Anticipated Earliest Notification of Awards: 8/1/2026

• Anticipated Earliest Contract Start Date: 9/1/2026

Questions and Answers Regarding this RFA

Prospective applicants may submit questions via email correspondence to Justin Hymes (justin.hymes@otda.ny.gov) or BRS.RFA@otda.ny.gov. Be sure to reference NYSRMSI RFA in the subject.

https://grantsmanagement.ny.gov/get-prequalified mailto:helpdesk@sfs.ny.gov mailto:justin.hymes@otda.ny.gov mailto:BRS.RFP@otda.ny.gov

OTDA will respond in writing to questions within two weeks of receipt via email.

OTDA reserves the right to respond to questions submitted throughout the continuous recruitment application period.

Application Submittal

One original and three copies or one original and a flash drive containing a copy of the entire application submission package (not stapled, bound or paper clipped) must be sent to the Bureau of Contract Management at the address below. OTDA will not accept faxed applications, or applications sent via electronic mail.

NYS OTDA

Bureau of Contract Management 40 North Pearl Street 12th Floor, Section D Albany, New York 12243-0001 ATTN: NFP Refugee Medical Screening Phone: (518) 486-6352 (For Delivery Questions Only)

IV. Federal Authority

ORR is authorized to grant funds to states that request to use RMA funds to provide medical screening as part of its refugee medical assistance program pursuant to Title 45 of the Code of Federal Regulations, Section 400.107 and under the authority of Section 412(b)(5) of the Immigration and Nationality Act (INA) (8 U.S.C. § 1522(b)(5)), as amended (Public Law 96-212) and further amended by the Refugee Assistance Amendments of 1982 (Public Law 97-363).

More information can be found at the following websites:

https://www.acf.hhs.gov/orr/programs/cma https://www.gpo.gov/fdsys/pkg/CFR-2013-title45-vol2/pdf/CFR-2013-title45-vol2-sec400-107.pdf

V. Eligible Grant Applicants

Eligible applicants include:

• Not-for-profit and for-profit public and private health care providers/agencies;

• Clinics and hospitals; local health departments, or any subdivision thereof;

• Faith-based organizations.

Eligible applicants must also:

• Be located in and do business in New York State;

• Be able to offer primary care services subsequent to the initial refugee medical screening; New York State county departments of health are exempt from this requirement and are welcome to apply

Not-for-profit corporations include charitable organizations incorporated, registered and in good standing with the Charities Bureau of the Attorney General in the State of New York.

https://www.acf.hhs.gov/orr/programs/cma https://www.gpo.gov/fdsys/pkg/CFR-2013-title45-vol2/pdf/CFR-2013-title45-vol2-sec400-107.pdf https://www.charitiesnys.com/

Eligible applicants are required to have a State of New York, Department of Health (NYSDOH), Office of Health Systems Management operating certificate or proof of designation as a Federally Qualified Health Center (FQHC).

Prospective applicants who want to verify their status as a charitable organization should contact the Office of New York State Attorney General, Charities Bureau at (800) 771-7755 or on the internet at Charities Bureau of the Attorney General in the State of New York.

VI. Program Description

The purpose of the New York State Refugee Medical Screening and Immunization Program is to provide initial medical screenings and immunizations to newly arriving refugees and other eligible persons within 90 days of their date of arrival or date of immigration status granted and to be able to offer primary care services subsequent to the initial refugee medical screening.

The New York State Refugee Medical Screening and Immunization Program has the following key objectives:

➢ Collaborate with refugee resettlement agencies to receive referrals of newly arriving refugees for the initial medical screening and necessary immunizations;

➢ Ensure follow-up with medical issues identified in an overseas medical examination;

➢ Identify refugees and other eligible persons with communicable diseases of potential public health importance;

➢ Enable a refugee to successfully resettle by identifying personal health conditions that, if left unidentified, could adversely affect his/her ability to effectively resettle; and

➢ Provide primary care to refugees or refer refugees to primary care providers.

Under the authority of the INA and the Public Health Service Act, the Secretary of HHS promulgates regulations outlining the requirements for the medical examination of non-citizens seeking admission into the United States (U.S.). The Centers for Disease Control and Prevention’s (CDC), Division of Global Migration and Quarantine (DGMQ) provides the Department of State (DOS) and the U.S.

Citizenship and Immigration Services (USCIS) within the Department of Homeland Security (DHS) with medical screening guidelines for all examining physicians, which outline in detail the scope of the overseas medical examination. The purpose of the medical examination is to identify, for the DOS and USCIS, non-citizens with inadmissible health-related conditions.

Additionally, a domestic medical examination is mandatory for all refugees coming to the U.S. and all applicants outside the U.S. applying for an immigrant visa.

In 1995, ORR issued the Medical Screening Protocol for Newly Arriving Refugees. Since then, the CDC issued a series of 12 subject-based guidelines to assist clinicians, health professionals and public health partners in conducting medical screenings. These guidelines are formally referred to as Guidelines for the U.S. Domestic Medical Examination for Newly Arriving Refugees, Refugee Health Domestic Guidance | Immigrant and Refugee Health | CDC. ORR endorsed the CDC guidelines and revised the 1995 Medical Screening Protocol for Newly Arriving Refugees accordingly by issuing State Letter #12-09, Revised Medical Screening Guidelines for Newly Arriving Refugees.

https://www.charitiesnys.com/ https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/index.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/index.html https://acf.gov/orr/policy-guidance/revised-medical-screening-guidelines-newly-arriving-refugees

VII. Service Strategy

The New York State Refugee Medical Screening and Immunization Program requires the following:

• Medical screening exam

• Immunizations

• Ability to provide primary care except for local departments of health who refer to outside clinics for primary care

Medical screening exam

The medical screening must be performed by a qualified and licensed health care professional. A medical interpreter must be used if the refugee does not speak English or is Limited English Proficient (LEP). The medical screening exam should ideally take place within 30 days of a refugee’s arrival to coincide with Program of Initial Resettlement services and, at minimum, include two visits. However, the medical screening can be administered as late as 90 days from the date of arrival to the U.S. or date of status granted.

Following the Refugee Health Domestic Guidance, the health care professional will use the Refugee Medical Screening Form (Attachment B) to record the exam results. OTDA reserves the right to make revisions to medical screening guidelines based on CDC and/or NYSDOH screening recommendations.

For awareness, the Minnesota Center of Excellence in Newcomer Health, in partnership with CDC, developed an interactive tool for U.S. clinicians, which customizes screening guidance for individual refugees based on age, sex, and country of origin.

The refugee medical screening exam protocol must include the following:

❖ Collect Refugee Identifying Information o Name o Alien Identification Number o Referring Refugee Resettlement Agency o Address o Date of Arrival o Country of Origin o Primary Language o Date of Birth o Sex

❖ Overseas Medical Information

Review Overseas Medical Information Packet, including:

o “Medical Examination for Immigrant or Refugee” (Form DS-2053 or DS-2054), also called the overseas medical exam.

o Chest X-ray film(s) and “Chest X-Ray and Classification Worksheet” (Form DS-3024 or DS-3030).

o Immunization records, including “Vaccination Documentation” (Form DS-3025).

https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/index.html https://careref.web.health.state.mn.us/ https://careref.web.health.state.mn.us/ https://careref.web.health.state.mn.us/ o “Medical History and Physical Examination Worksheet” (Form DS-3026) and any other available medical records.

Note any Class A or Class B Tuberculosis identified.

Note any Class B Other conditions identified.

Note Overseas Chest X-ray results where available.

❖ Medical History

Interview and Note:

o Personal and family medical history, medications, allergies.

o Recent fever, cough, weight loss, night sweats, hemoptysis, diarrhea.

o Other recent illnesses or conditions in self or family.

o History of drug use, including alcohol and tobacco.

o Cultural mores and health practices which might impact diagnostic and treatment needs.

o Social history (including refugee camp and migration experiences, etc.)

❖ General Laboratory Screening

Conduct laboratory screening according to criteria indicated below, and note any abnormal findings. If not done, a reason must be specified.

o Complete Blood Count (CBC) with Differential – All refugees. Include elevated eosinophil count, as well as any anemia with description, in abnormal findings.

o Serum Chemistries – A basic panel, including blood urea nitrogen and creatinine, if indicated by signs, symptoms, or comorbidities.

o Cholesterol – In accordance with US Preventive Services Task Force Guidelines Recommendation: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults:

Preventive Medication | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org) (testing should include, at a minimum, total cholesterol and

HDL).

o Urinalysis - All refugees able to provide a clean-catch specimen.

o Newborn Screening – Follow NYSDOH Newborn Screening Guidelines which can be found at

Newborn Screening Program | (NYSDOH), Wadsworth Center. Tests are optimized for newborns (<28 days old). Initial specimens will be accepted for a child up to one year of age at the discretion of the provider.

o Population-specific Testing – To be determined by examining clinician.

o Pregnancy Test – Women of child-bearing age, using opt-out approach. Girls of child-bearing age, using opt-out approach or with consent of guardian.

❖ Physical Examination

Conduct each element of the physical exam for all refugees, unless otherwise indicated below, and note any abnormal findings. If not done, a reason must be specified.

o Nutritional Status – height, weight, head circumference (less than 3 years old), BMI (greater than 2 years old).

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication https://www.wadsworth.org/programs/newborn/screening https://www.wadsworth.org/programs/newborn/screening o Physical findings – note any abnormal findings such as physical disabilities, injuries, structural or orthopedic impairment, etc.

o Vital signs, including blood pressure (5 years and older), heart rate, and respiratory rate.

o Gross evaluation of vision and hearing.

o Careful oral examination.

o General physical examination - review of systems, including heart, lungs, lymph nodes, abdomen, ENT, neurological, genital and skin evaluation.

o External genital exam for all refugees - A pelvic exam and/or Pap smear should be deferred until a trusting relationship is developed with a primary care physician, unless, in the provider’s clinical judgment, it is deemed necessary to perform at the health screening.

o Prescreening is advised to determine if there are signs/symptoms of female genital mutilation/ cutting (FGM/C). Direct examination is generally not recommended until a trusting relationship is developed. Providers may choose to begin discussion of cultural practices which may indicate FGM/C. Defer further assessment for primary care or gynecology specialist. Sexual and Reproductive Health Screening during the Domestic Medical Examination for Newly Arrived Refugees | Immigrant and Refugee Health | CDC o General assessment of Mental Status/Developmental Level using Refugee Health Screener-15

(RHS-15), Attachment A, or other suitable screening tool for mental health assessment.

o Indicate any physical or mental conditions likely to limit employability or school attendance.

o Multivitamins are to be given to all children ages 6-59 months, and all children > 5 years of age and adults with poor nutritional status.

❖ Disease Specific Screening

Conduct disease-specific screening as indicated below. If a required screening test is not done, a reason must be specified.

Tuberculosis:

o Review overseas records. Overseas exam includes interferon gamma release assay (IGRA) testing of most children 2-14 years old; refugees ≥15 years old receive a chest x-ray only.

Overseas IGRAs and chest x-rays are considered reliable and do not need to be repeated.

o Evaluate for signs or symptoms of disease, history of contacts and physical examination.

o Conduct an IGRA for all eligible refugees not receiving the test overseas, beginning at 2 years old and including refugees who received only a chest x-ray. Note Results.

o For a positive IGRA, perform a chest x-ray (when not done overseas) and make a referral to the county health department where the refugee resides.

Lead:

o Screen all infants and children ≤16 years of age. Older adolescents (>16 years old) should be screened if there is a high index of suspicion (sibling with elevated level, suspected environmental exposure, etc.)

o Please note for future primary care referral, all children ≤ 6 years of age should receive an additional lead test 3-6 months after the initial test, regardless of the results of the initial screening result. Repeat testing is also recommended for children 7-16 years of age with an elevated level on initial screening.

o Document blood lead level and indicate normal/abnormal. The CDC has established a blood lead level of ≥ 5 mcg/dL as the reference value for childhood lead exposure, while NYS Public Health Law has a longstanding definition of an elevated blood lead level in children as ≥ 10 mcg/dL. For https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/sexual-and-reproductive-health.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/index.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/sexual-and-reproductive-health.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/index.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/sexual-and-reproductive-health.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/index.html the purpose of the medical screening, providers are asked to document results of ≥ 5 mcg/dL as abnormal. Please note all lead screening results are reported to NYSDOH and the appropriate county health department via electronic laboratory reporting, which will initiate action in cases where indicated.

Malaria:

o Sub-Saharan African (SSA) refugees that did not receive presumptive treatment prior to departure, such as pregnant or lactating women or children weighing less than 5 kg. at the time of departure, will require post-arrival presumptive treatment or testing. All other SSA refugees receive treatment overseas with artemisinin-based combination therapy (ACT). Documentation of the pre-departure treatment may be found in the Overseas Medical Information Packet. If documentation is lacking, clinicians can reasonably assume pre-departure treatment was provided to SSA refugees per the Treatment Schedules for Presumptive Parasitic Infections for U.S.-Bound Refugees (Malaria | Immigrant and Refugee Health | CDC).

o If considering testing, polyamerase chain reaction (PCR) is the most sensitive test for persons with sub-clinical malaria.

o CDC does not recommend testing or treatment for refugees from malaria-endemic countries outside SSA, unless there are signs or symptoms of infection.

Intestinal and Tissue Invasive Parasites:

Note: Per CDC guidelines, “In cases when the documentation is not available it is reasonable to assume presumptive treatment has been received by the individual refugee if the refugee is from a population where the program is currently implemented per the Treatment Schedules for Presumptive Parasitic Infections for U.S.-Bound Refugees (Intestinal Parasites | Immigrant and Refugee Health | CDC) and as long as they had no contraindications at the time of departure.”

o For refugees who received pre-departure treatment, either documented in the Overseas Medical Packet or per the CDC Treatment Schedule (link above), check the “Yes” box. No further treatment or testing is required.

o For refugees who did not receive pre-departure treatment:

• As a general rule, it is recommended clinicians consider presumptive treatment in lieu of testing for eligible refugees while taking precautions to avoid duplicating overseas treatment.

• For all refugees, provide presumptive treatment for soil-transmitted helminths (STH) for refugees ≥ 6 months of age. For infants less than six months, testing should be performed if the infant has symptoms or signs of infection (including elevated eosinophil count).

• For all refugees, provide presumptive treatment for Strongyloides. Exclusions include refugees from Loa loa-endemic areas who may have contraindications to presumptive treatment with Ivermectin and European refugees who are not likely to be exposed to Strongyloides (per the CDC). If presumptive treatment is not provided, conduct diagnostics for Strongyloides (serology and/ or blood smear). For more details, especially regarding refugees with potential exposure to Loa loa, see Intestinal Parasites | Immigrant and Refugee Health | CDC.

• For all SSA refugees, provide presumptive treatment for Schistosomiasis. If presumptive treatment is not provided, conduct serologies for Schistosomiasis.

o For refugees who received incomplete pre-departure presumptive treatment:

o Refer to CDC guidance on testing and/or presumptive treatment found at Intestinal Parasites |

Immigrant and Refugee Health | CDC. For refugees who received complete pre-departure presumptive treatment:

https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/malaria.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/malaria-guidelines-domestic.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/intestinal-parasites.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/intestinal-parasites-domestic.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/intestinal-parasites.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/intestinal-parasites-domestic.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/intestinal-parasites.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/intestinal-parasites-domestic.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/intestinal-parasites.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/intestinal-parasites-domestic.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/intestinal-parasites.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/intestinal-parasites-domestic.html

• Note: a persistently elevated absolute eosinophil count conducted as part of hematology testing indicates need for further investigation.

Sexually Transmitted Infections (STI):

Obtain history for signs and symptoms of STIs and conduct physical examination.

o Syphilis

Review Overseas Medical Information Packet for documentation of pre-departure syphilis screening; note results. If overseas screening is negative, no further screening is required. If documentation of overseas screening is not available:

Conduct venereal disease research laboratory (VDRL) or rapid plasma regain (RPR) for:

• All refugees ≥ 18 years of age,

• Refugees < 18 years of age if sexually active, history of sexual abuse, mother who tests positive, or exposure in a country endemic for other treponemal subspecies (e.g. yaws, bejal, pinta.)

• Conduct confirmation testing for positive treponemal tests o Chlamydia and Gonorrhea Conduct urine nucleic amplification test for:

• All refugees aged 18 to 24

• Any refugee with symptoms or risk factors o HIV All refugees should be screened unless they opt out.

• Children ≤ 12 years of age should be screened unless the mother’s HIV status is confirmed negative and the child is otherwise thought to be at low risk.

• Refugees should be clearly informed orally or in writing when/if they will be tested for HIV.

• Note for future referral, screening should be repeated 3-6 months following resettlement for refugees who had recent exposure or are at high risk.

• Provide culturally sensitive and appropriate counseling for HIV-infected refugees in their primary language.

• Refer refugees confirmed to be HIV-infected for care, treatment, and preventive services.

Hepatitis:

o Hepatitis B Review Overseas Medical Information Packet for documentation of pre-departure Hepatitis B screening; note results. If overseas screening is negative, vaccine series should be initiated or completed if there are missing doses according to the overseas vaccine record (DS3025). If documentation of overseas screening was not conducted or is not available:

• Conduct Hepatitis B serologic testing, including hepatitis B surface antigen (HBsAG), hepatitis B surface antibody (HBsAb), and hepatitis B core antibody (HBcAb) screening, for all refugees from endemic countries regardless of vaccination history.

• If HBsAG is negative, the refugee should be offered vaccination.

• If HBsAg is positive, testing for HDV infection is required. Hepatitis D testing can be conducted at primary care, or by a specialist. Document as a referral. Viral Hepatitis | Immigrant and Refugee Health | CDC

• It is not recommended to vaccinate in lieu of testing to ensure identification of those with active disease.

o Hepatitis C All adult arrivals (≥18 years of age) should be screened for Hepatitis C. Screen pregnant women ≤17 years old and children born to HCV+ mothers.

Immunizations

Most refugees, regardless of age, will have a New York State Immunization Information System (NYSIIS) record pre-populated with demographic and overseas vaccine information. Check NYSIIS before administering vaccines. Refugees that do not have an overseas vaccine record, will not have a NYSIIS record.

The health care professional will provide initial doses of all missing or undocumented age-appropriate vaccines per Advisory Committee on Immunization Practices (ACIP) guidelines for children and adults. Record dates of vaccines administered at health assessment.

Immunizations must be administered if any are indicated at the time of exam. OTDA will provide reimbursement for approved initial vaccines administered to adults, age 19 and older. Medical screening providers are encouraged to use the NYSDOH Vaccines for Children Program, New York State Vaccines for Children (VFC) Program, or the New York City Department of Health and Mental Hygiene (NYCDOHMH), Vaccines for Children Program or Vaccines for Children Program - NYC Health, to offset the cost of immunizations administered to children.

❖ Dates of Medical Screening o Record Visit #1 and Visit #2 dates. Note medical screening must be conducted within 90 days of the refugee’s arrival in the U.S.

Referrals

“Referral” means setting up a specified appointment with a designated provider. Referrals must be made for ongoing primary care and indicated on the Refugee Medical Screening Form (including a primary care referral to the same facility providing the health medical screening). Referrals must also be made for routine dental care and specialty care for any conditions noted on the medical screening requiring follow-up evaluation and/or treatment.

❖ Additional Information o Age-specific recommendations may need to be adjusted based on history, lab results, cultural knowledge and professional judgment.

o Reasons for not conducting screening procedures as indicated must be documented on the Refugee Medical Screening Form.

o Screening results must be discussed at a second office/clinic visit, and all appropriate referrals made.

https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/viral-hepatitis.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/hepatitis-screening-guidelines.html https://www.cdc.gov/immigrant-refugee-health/hcp/domestic-guidance/viral-hepatitis.html?CDC_AAref_Val=https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/hepatitis-screening-guidelines.html https://www.cdc.gov/acip/vaccine-recommendations/index.html https://www.health.ny.gov/prevention/immunization/vaccines_for_children/ https://www.health.ny.gov/prevention/immunization/vaccines_for_children/ https://www.nyc.gov/site/doh/providers/nyc-med-cir/vaccines-for-children-program.page

VIII. Eligible Participants

In the event of federal regulation changes that affect the program eligibility, New York State Refugee Medical Screening & Immunization (NYSRMSI) providers will be notified of the change and required to comply with the new criteria for participant eligibility.

NYSRMSI funds must be used for services to individuals who meet program eligibility based on their immigration status and eligibility date as described below. NYSRMSI providers are responsible for confirming each participant’s eligibility prior to screening and must maintain acceptable documentation in the patient’s case file that clearly demonstrates eligibility for the program.

Additional information can be found here: Eligible Populations | The Administration for Children and Families

Eligible Immigration Status

• Individuals paroled as refugees or asylees under § 212(d)(5) of the Immigration and Nationality Act (INA);

• Refugees admitted under § 207 of the INA;

• Asylees whose status was granted under § 208 of the INA;

• Cuban and Haitian entrants, in accordance with the requirements in 45 CFR § 401.2 o Any individual granted parole status as a Cuban/Haitian Entrant (Status Pending) or granted any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the status of the individual at the time assistance or services are provided;

o A national of Cuba or Haiti who was paroled into the United States and has not acquired any other status under the INA and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation or exclusion has not been entered;

o A national of Cuba or Haiti who is the subject of removal, deportation or exclusion proceedings under the INA and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation or exclusion has not been entered;

o A national of Cuba or Haiti who has an application for asylum pending with DHS/USCIS or Department of Justice (DOJ)/EOIR and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation or exclusion has not been entered;

• Victims of a severe form of trafficking in persons per the Victims of Trafficking and Violence Protection Act of 2000, Pub. L. No. 106-386, as amended, 22 U.S.C. § 7105(b) (1) (A) and (C);

• Lawful permanent residents provided the individuals previously held one of the statuses identified above (Note that this does not refer to Amerasians who are admitted as lawful permanent residents, or to Iraqi and Afghan Special Immigrants. See below.);

• Certain Amerasians from Vietnam who are admitted to the United States as immigrants pursuant to § 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988 (as contained in § 101(e) of Public Law 100-202), as amended (8 U.S.C. § 1101 note);

https://acf.gov/orr/programs/refugees/factsheets https://acf.gov/orr/programs/refugees/factsheets

• Iraqi and Afghan Special Immigrants per section 1244(g) of Div. A of Pub. L. 110-181, as amended (8 U.S.C. § 1157 note) and section 602(b)(8) of Div. F of Pub. L. 111-8, as amended (8 U.S.C. § 1101 note);

• Afghan individuals with SI/SQ Parole (aka Afghan Special Immigrant Parolee);

• Afghan individuals with Special Immigrant Conditional Permanent Residence (SI CPR);

• Citizens or nationals of Afghanistan paroled into the United States under section 212(d)(5) of the Immigration and Nationality Act between July 31, 2021, and September 30, 2023;

• A spouse, as defined in section 101(b) of the INA (8 U.S.C. 1101(b)), of any Afghan humanitarian parolee described above, who is paroled into the United States after September 30, 2023;

• Any other status deemed eligible by the ORR

Eligibility Period

Services may be provided to refugees who have been in the country up to 90 days from the date of arrival or from the date the eligible immigration status is granted. Eligibility for services will expire on the 91st day following the refugee’s date of arrival into the United States or date the eligible immigration status was granted. Eligibility is subject to change based on ORR policy.

IX. Funding Limitations And Provisions

Available Funds

Awards for the New York State Refugee Medical Screening and Immunization Program will be made from OTDA’s RMA funds, a suballocation of the Cash and Medical Assistance (CMA) award to OTDA. It is estimated that approximately $6,000,000 in RMA funding will be available for the multi-year program period. Only designated RMA funds for the New York State Refugee Medical Screening and Immunization Program are available through this RFA.

Distribution of Funds

The allocation for each grant award is based on the number of refugees each applicant will potentially serve. OTDA reserves the right to establish the award amount based on historical demographic data.

OTDA reserves the right to award funds based on emergent need, as well as on demographic data.

These decisions will be made in order to serve the greatest number of refugees in a given area.

Contract Term

This RFA governs the provision of funds for up to a 60-month contract term starting on or after October 1, 2025, and ending on September 30, 2030.

X. Program Information

Performance Based Contracts

The New York State Refugee Medical Screening and Immunization program contracts are performance-based, per capita reimbursement at established rates. Compensation is directly tied to the completion of medical screening components. Documentation of the completion of one visit or two visits and immunizations administered allows a contractor to claim the respective rates. The contractor is paid at the established rate, as defined in the contract.

Reimbursement Rates

The following chart provides information regarding the reimbursement rates for the specific medical screening components. The rates have been established using the NYS Medicare Fee Schedule for the corresponding activities as indicated in the Current Procedural Terminology (CPT) codes:

Current Procedural Terminology Codes

Medical Screening Component Rates

First Visit Only $634.13

Completed Medical Screening (2 Visits) $753.66

Immunizations: Up to $463.14 per capita

Diphtheria, tetanus, pertussis (DTaP) $28.80

Haemophilus influenza type b4 (Hib) $12.80

Pneumococcal (PCV) $117.08

Inactivated poliovirus (IPV) $42.64

Influenza rate from 10/2009 MA update $19.73

Measles, mumps, rubella (MMR) $92.49

Varicella $174.32

Hepatitis A Adult dosage $78.97

Hepatitis B $65.50

Hep A/ Hep B Combo $126.19

Human Papillomavirus (HPV) $287.53

Meningococcal $166.98

Zoster $197.90

Rates will only change with authorized revisions to the Refugee Medical Screening Protocol and authorization from ORR.

Additional Rate Information:

• Visit #1 visit includes as many Disease Specific Screening and General Laboratory Screening tests as indicated with the refugee’s consent and cooperation.

• Interpreter costs are included in the exam reimbursement rates.

• Immunizations are reimbursed for adult refugees only at established rates with documentation of expenditures for a maximum reimbursement of $463.14 per adult refugee.

• Contractors are encouraged to seek reimbursement for immunizations administered to refugee children through the NYSDOH Vaccines for Children Program, New York State Vaccines for https://www.health.ny.gov/prevention/immunization/vaccines_for_children/

Children (VFC) Program or the NYCDOHMH, Vaccines for Children Program or Vaccines for Children Program - NYC Health

XI. Selection Process

Evaluation Process

Each application will be recommended for an award based on the submission of required documents, and work plan that meets the program intent while offering the required medical screening exam elements, preventive health interventions, and other screening activities including:

• The content of the applicant’s work plan that demonstrates the applicant’s ability to perform medical screenings and immunizations;

• The applicant’s ability to provide primary care services subsequent to the initial refugee medical screening;

• If applying as a local department of health, ability to make referrals for primary and follow up care;

• The applicant’s established relationships with other local agencies that provide services to refugees and other healthcare providers;

• The applicant’s experience with, and knowledge of, specific cultural and linguistic needs of the eligible service population and the quality of the work plan in addressing those needs;

• Sufficient project staff, in numbers and qualifications;

• The availability and frequency in which medical screening and immunization services can be provided;

• The accessibility of the applicant’s location for services; and

• Possession of a State of New York, Department of Health, Office of Health Systems Management operating certificate or proof of designation as a Federally Qualified Health Center (FQHC).

• The applicant’s description of how the above-referenced services improve community health and wellness and advance applicable New York State Prevention Agenda Priorities, consistent with Executive Order 190 (EO 190). Please see Section XVI of Part A (page 25) for additional information on EO 190.

Each application will be reviewed independently from other applications.

Award Methodology

OTDA reserves the right to award contract(s) to as many or as few applicants as it may select, to accept or reject any or all proposals, and to cancel, in part or in whole, this RFA, if OTDA deems it to be in its best interest to do so.

OTDA will select an array of applications that best establishes comprehensive medical screening and immunization services for eligible refugees within New York State. OTDA has not pre-determined the number of contracts to be awarded.

OTDA reserves the right to conduct site visits and solicit the opinion of applicants’ other funding sources prior to making a funding decision.

Continuous awards to new applicants will be made throughout the multi-year program period through September 30, 2029. OTDA will make continuous awards until all available funds are awarded or until such time the program needs are met. Upon award of all available funds or when the program needs https://www.health.ny.gov/prevention/immunization/vaccines_for_children/ are met, OTDA will suspend this procurement opportunity. If additional funding becomes available or the program needs increase, the procurement may be reopened at the discretion of OTDA.

Should an awarded applicant exceed the initial award amount at any point during the contract term, a supplemental award to continue operations will be considered, based on available funding, continuing need, satisfactory contractor performance, history of expenditures as evidenced by claims for payment and program monitoring, and subject to OSC and the State Office of the AG approval.

When making supplemental awards, OTDA reserves the right to do any of the following:

• Reallocate funding from contractor to contractor;

• Suspend a contract award to an underperforming contractor;

• Amend an award to an underperforming contractor; or

• Amend an award to an over-performing contractor, due to an increased need for services.

XII. Award Procedures

It is the policy of OTDA to provide all program applicants with an opportunity to resolve complaints or inquiries related to solicitations from this RFA or pending contract awards administratively. OTDA encourages all Applicants to seek resolution of complaints concerning the contract award process through consultation with OTDA. All such matters will be accorded impartial and timely consideration.

Detailed procedures are provided on OTDA website at Contracts & Grant Opportunities. OTDA continues to encourage all successful or unsuccessful applicants who desire a debriefing to contact OTDA directly.

An appeal may be requested by following the protest procedures established by the Office of the State Comptroller (OSC). These procedures can be found in the OSC Guide to Financial Operations here. Additional information is also available in OSC’s Guide to Financial Operations, Chapter XI Procurement and Contract Management, 17. Protest Procedures.

Contract Development Process

OTDA will initiate the contract development process with successful applicants following the announcement of awards. Successful applicants may be asked to provide updated work plans that specify the services to be delivered, project goals, deliverables, and the process for claiming funds.

The contract will include standard terms and conditions such as confidentiality of records, publications and contract termination. The contract will constitute a legally binding agreement between the selected applicant and OTDA and will be in effect for the full term of the contract.

The contracts will have a term of up to 60 months and will contain work plans reflecting goals for a 60-month period. Contracts awarded thereafter will be for the duration from the contract execution date through the end of the contract term, September, 2030.

Payment

The contractor will not be reimbursed for line-item expenses. Under performance-based contracts, the contractor will be reimbursed per capita at established rates. Payment will be made only for services that are documented and for which vouchers are submitted by the required due date.

No payments will be made until the contract is fully executed and signed by the State Comptroller and the State Attorney General. Once the contract has been fully executed by OTDA (signed and approved by OTDA, the State Attorney General and the Office of the State Comptroller), OTDA may, http://otda.ny.gov/contracts/ http://www.osc.state.ny.us/agencies/guide/MyWebHelp/ https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi17-protest-procedures https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi17-protest-procedures at its discretion, advance up to 25 percent of the first budget period amount, if requested and if deemed appropriate by OTDA. There will be no advances for subsequent budget periods.

Contractors will work at their own risk if they conduct program activities prior to the contract being executed.

XIII. Reports And Record Keeping

Record Keeping

The contractor must maintain current and accurate fiscal and accounting controls to support the claims for deliverables and/or outcomes claimed under the contract. Records must adequately identify revenue sources and expense items for all contract activities. Accounting records must be supported by clear documentation for all funds received and disbursed. Records must be retained and be accessible for a period of six years from the end of the contract, the last payment, or the last contract transaction.

However, if any claim, audit, litigation, or State/Federal investigation is commenced before the expiration of the aforementioned record retention period, the records must be retained by the contractor until all claims or findings regarding the records are finally resolved. OTDA or its designee shall have access to any records relevant to the project (including but not limited to books, documents, photographs, correspondence, and records), for audits, examinations, transcripts, and excerpts. If OTDA determines that such records possess long-term or historic value, they must be transferred, upon request, to OTDA.

If the Contractor expends $750,000 or more in Federal funds during any one fiscal year, the Contractor will be subject to the Audit Requirements and provisions of OMB Super Circular, found in Federal regulations at 2 CFR Part 200 (Subparts A – F) - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; and, all other audit requirements determined applicable by the OTDA. The audit shall be completed on an annual basis and the audit report submitted within the earlier of 30 days after receipt of the auditor's report(s), or nine months after the end of the audit period, unless a longer period is agreed to in advance by the OTDA. The audit shall be conducted in accordance with generally accepted government auditing standards by an independent auditor and submitted in a form determined by the OTDA. The OTDA will report its findings and any recommendations to the Contractor and may impose any sanctions as determined appropriate.

Reporting and Vouchering Requirements

Unless otherwise specified, requests for reimbursement must be submitted to the OTDA/BRS program manager by the contractor on a quarterly basis during the contract term. Payments will be based on vouchers and any necessary documents that support the services for which reimbursement is requested. Additional reporting, as may be determined by OTDA, may also be required.

Contractor must submit the NYS Claim for Payment, NYC Refugee Medical Screening Form (see Attachment B), and NYC Refugee Medical Screening Program Client Roster (See Attachment C), all of which must be submitted to OTDA on a quarterly basis. Contractors must also ensure that any e-mail sent to OTDA containing personally identifiable or protected health information (PII/PHI) is encrypted.

Final vouchers, known as “close-out” vouchers, are due within 60 days after the completion of, or termination of, the contract.

Case Records

The contractor must adhere to OTDA instructions and requirements regarding case records as stated in the contract and in related directives, forms of notification and OTDA manuals that may be found on OTDA’s website.

Monitoring

OTDA will monitor projects on a regular basis throughout the contract’s duration. Monitoring may include site visits, regular telephone contact and/or discussions of monthly progress reports. The goals of project monitoring are to determine whether the terms of the contract are being met and to provide technical assistance, where necessary, to help the contractor meet these terms. OTDA reserves the right to conduct site visits and make telephone contact with subcontractors as a means of monitoring the prime contractor’s performance.

Selected contractors are expected to provide services aligned with the goals of this program. As part of OTDA program oversight, the agency will monitor services provided to assess the extent to which those services are necessary and appropriate.

Amendments to the Contract

Amendments and modifications of executed contracts are sometimes necessary to accommodate the needs of both the contractor and OTDA. These changes, which must be by mutual written agreement, may include modification to reimbursement schedules, time and money amendments, or no-cost extensions as necessary.