OPD-2026-27_CASCANS_RFP.pdf

RFP# OPD-2026-27 CAS/CANS Functional Needs Assessment Services

Request for Proposal

RFP OPD-2026-27

CAS/CANS Functional Needs Assessment Services

Proposal Due Date: October 1, 2026

Contract Term: April 1, 2027-March 31, 2032

1. INTRODUCTION

1.1. Issuing Office

1.2. Purpose

1.3. Calendar of Events

1.4. Announcements and Amendments to the RFP

1.5. Term of Contract

1.6. Conflicts of Interest

1.7. Bidder Minimum Qualifications

1.8. Glossary and Definitions

2. SCOPE OF WORK

2.1. General Duties

2.2. CMS-Recognized QIO/QIO-like Entity Designation

2.3. Start-Up Time Period

2.4. One-Time Start Up Costs

2.5. Data Management System(s)

2.6. Staffing and Organization

2.7. Assessment

2.8. Quality Assurance and Reporting

2.9. Business Continuity

2.10. Requested Informatics

3. PROPOSAL REQUIREMENTS

3.1. Proposal Validity

3.2. Accuracy of Proposals

3.3. Extraneous Terms

4. ADMINISTRATIVE PROPOSAL

4.1. Document Submission Checklist and Attestation (Attachment 1)

4.2. Ownership of Work Product

4.3. Non-Collusive Bidding Certification (Attachment 5)

4.4. Vendor Responsibility Questionnaire (Attachment 7)

4.5. Procurement Lobbying Requirements (Attachment 10)

4.6. Diversity Requirements and Equal Employment Opportunities for Minorities and Women (Attachment 19)

4.7. NYS Service-Disabled Veteran-Owned Businesses

4.8. Encouraging the Use of New York Subcontractors and Suppliers (Attachment 4) and New York State Business Usage Form (Attachment 4A)

4.9. Consultant Disclosure Legislation

4.10. Conflicts of Interest (Attachment 9)

4.11. Executive Order 177 Anti-Discrimination Certification (Attachment 15)

4.12. Sexual Harassment Prevention Policy Certification (Attachment 14)

4.13. Tax Law Section 5-A

4.14. Executive Order No. 16 Prohibiting State Agencies and Authorities from Contracting with Businesses Conducting Business in Russia (Attachment 16)

4.16. Vendor Identification Number

4.17. Subcontractors

5. TECHNICAL PROPOSAL— 70 POINTS

5.1. Functional Operational Plans 35 points

5.2. Requested Informatics 4 points

5.3. Quality Assurance and Reporting 12 points

5.4. Experience Years in Business 4.5 points

5.5. Statewide Availability and Regional Presence 6 points

5.6. CMS-Recognized QIO/QIO-like Entity Qualifications 5 points

5.7. Diversity Practices 3.5 points

6. COST PROPOSAL — 30 POINTS

6.1. Proposal Requirements

7. INSURANCE REQUIREMENTS

7.1. Proof of Workers’ Compensation Coverage

7.2. Proof of Disability Benefits Coverage

7.3. Additional Insurance Requirements

8. PROPOSAL SUBMISSION REQUIREMENTS

8.1. Specific Requirements

8.2. Required Submission Documents

8.3. Late Submissions

8.4. Proposal Redactions - Freedom of Information Law / Trade Secrets

8.5. Packaging of Proposal

8.6. Building Access Procedures for Hand Deliveries

9. AWARD

9.1. Method of Award

9.2. Administrative Evaluation (Pass/Fail)

9.3. Technical Evaluation (70 points)

9.4. Cost Evaluation (30 points)

9.5. Final Composite Score

9.6. Notification of Award

9.7. Form of Contractual Agreement

9.8. Debriefing

9.9. Bid Protest Policy

10. OPWDD RESERVED RIGHTS

11. Payment

12. Service Level Agreement Standards and Consequences

12.1. Ramp up and One Time Startup Costs

12.2. Assessments

1. INTRODUCTION

1.1. Issuing Office

The New York State Office for People With Developmental Disabilities (OPWDD) is the New York State (NYS) executive agency responsible for the provision, regulation, and oversight of services to NYS people with developmental disabilities. Per Mental Hygiene Law § 1.03 (22), people served by OPWDD have a documented history of diagnoses that may include, but are not limited to, intellectual disabilities, cerebral palsy, epilepsy, neurological impairments, and autism spectrum disorders. (https://opwdd.ny.gov/eligibility).

OPWDD provides services and supports directly and through a network of approximately 500 nonprofit service-providing agencies, with about 80% of services provided by the private nonprofits and 20% provided by state-run services. OPWDD also provides residential support and services for approximately 43,000 people with developmental disabilities throughout New York State. People receiving OPWDD services reside in residential homes, group homes, and supported apartments, as well as secure facilities. OPWDD operates approximately 1,500 residential and institutional sites statewide.

1.2. Purpose

OPWDD issues this Request for Proposal (RFP) for CAS/CANS Functional Needs Assessment Services to administer NYS approved functional needs assessments for enrollees eligible for OPWDD services, with the intent to award one contract for these services.

NYS OPWDD oversees the Home and Community Based Services (HCBS) 1915(c) Medicaid waiver program.

Since 1992, OPWDD has operated an HCBS 1915(c) waiver that provides HCBS for people (both children and adults) with developmental disabilities, also known as, the Home and Community Based Services Waiver | Office for People With Developmental Disabilities.) State and federal regulations require that a conflict free assessment chosen by OPWDD must be used to review and record a person’s strengths and needs, as a condition of receiving OPWDD services (NY Soc. Serv. §366(7)(f); 14 NYCRR §636-1.6). This conflict-free functional needs assessment provides a framework towards person-centered planning and the development of a written service plan. The Comprehensive Waiver allows adults and children access to an aligned array of HCBS to address their needs, goals, and preferences as detailed in their Person-Centered Plan of Care (POC). Participation in the Comprehensive Waiver requires members to receive Care Management services via choice of Care Coordination Organization-Health Home (CCO- HH) care management service providers. CCO-HH Care Managers conduct person-centered care planning to develop a comprehensive POC and ensure the POC supports the person’s functional development within the community. A functional needs assessment, that outlines a person’s strengths and needs, is a required part of this person-centered care planning process.

OPWDD assesses people ages 17 and younger with the Child and Adolescent Needs and Strengths (CANS-NY) assessment. People ages 18 and older are assessed with the Coordinated Assessment System (CAS).

On April 22, 2024, the Centers for Medicaid and Medicare Services (CMS) issued the Ensuring Access to Medicaid Services (“Access Rule”) final rule which aims to improve access to Medicaid services, particularly HCBS. Key aspects of the Access Rule include the establishment of detailed quality measures that provide data and information which can be used for quality improvement purposes. The OPWDD functional needs assessments, CAS and CANS, will support OPWDD’s work to meet the Access Rule quality standard requirements. However, OPWDD’s method of assessment, frequency of assessment, and/or content of assessment may vary during this 5-https://opwdd.ny.gov/eligibility https://opwdd.ny.gov/providers/home-and-community-based-services-waiver https://opwdd.ny.gov/providers/home-and-community-based-services-waiver https://opwdd.ny.gov/data/care-coordination-organization-profile https://opwdd.ny.gov/data/care-coordination-organization-profile https://www.cms.gov/newsroom/fact-sheets/ensuring-access-medicaid-services-final-rule-cms-2442-f https://www.cms.gov/newsroom/fact-sheets/ensuring-access-medicaid-services-final-rule-cms-2442-f year award, at OPWDD’s discretion, to match the deliverables of the Access Rule as well as the federal Medicaid funding to support these goals. Details regarding the CMS Medicaid Waiver Services are referenced here: eCFR :: 42 CFR 441.301 -- Contents of request for a waiver.

This RFP will be posted on both the NYS OPWDD Procurement Opportunities webpage at https://opwdd.ny.gov/procurement-opportunities, and on the NYS Contract Reporter (NYSCR) website at https://www.nyscr.ny.gov/, as required by Economic Development Law 4-C, titled “The Procurement Opportunities Newsletter.”

1.3. Calendar of Events

RFP Release Date ……………………………………… … ….Wednesday, August 26, 2026 Mandatory Pre-Bid Conference………………via TEAMS Monday, August 31, 2026, at 1:00PM Mandatory Pre-Bid Conference………… via ZOOM Thursday, September 3, 2026, at 11:00AM Deadline for Submission of Questions ……………………..Thursday, September 10, 11:00 2026 Issuance of Responses to Questions …………………… … Thursday, September 17, 2026 Proposal Due Date …………………………………………… … Thursday , October 1, 2026 Anticipated Notification of Tentative Award ……………………… …….…. TBD Anticipated Contract Start Date ………………… ……….. ... April 1, 2027

NOTE: The above dates are tentative and subject to change at OPWDD’s sole discretion.

Vendors must attend one (1) out of the two (2) mandatory pre-bid conferences listed above in order to be eligible to submit a proposal. Please see Microsoft TEAMS and ZOOM links below for respective mandatory pre-bid conferences:

https://teams.microsoft.com/meet/235868850989535?p=R0R5pJpo61fEDkBkvC https://us04web.zoom.us/j/71683384279?pwd=UmuKaowm0Sh3yzMRKaZOTyY7rdoO7i.1

Restricted Period

1.3.1. Prohibitions on Procurement Lobbying

Pursuant to State Finance Law (SFL) §§ 139-j and 139-k, this Solicitation includes and imposes certain restrictions on communications between OPWDD and a Bidder during the procurement process. The restricted period begins at the moment of the earliest posting, on a governmental entity’s website, in a newspaper of general circulation, or in the procurement opportunities newsletter, of intent to solicit offers or bids, and it ends only after final award and approval of the Contract by OPWDD and, if applicable, the Office of the State Comptroller (OSC). Throughout this restricted period, a Bidder is restricted from making contacts to staff other than those so designated, unless it is a contact that is included among certain statutory exceptions set forth in SFL § 139-j(3)(a). Designated staff, as of the date hereof, are identified below. OPWDD employees are required to obtain certain information when contacted during the restricted period and to make a determination of the responsibility of the Bidder pursuant to SFL §§ 139-j and 139-k. Certain findings of non-responsibility can result in rejection for Contract award. In the event of two such findings within a four-year period, the Bidder is debarred from obtaining governmental procurement contracts for four years. Further information about these requirements can be found on the Office of General Services website at https://ogs.ny.gov/acpl/.

1.3.2. Designated Contacts

Pursuant to SFL § 139-j(3)(a), OPWDD identifies the following allowable contacts for communications related to the submission of questions, letters of intent to bid, proposals, and requests for debriefings.

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-441/subpart-G/section-441.301 https://opwdd.ny.gov/procurement-opportunities https://www.nyscr.ny.gov/ https://teams.microsoft.com/meet/235868850989535?p=R0R5pJpo61fEDkBkvC https://us04web.zoom.us/j/71683384279?pwd=UmuKaowm0Sh3yzMRKaZOTyY7rdoO7i.1 https://ogs.ny.gov/acpl/

Primary Contacts Amanda Talavera / Jennifer DeDonatis Contract Management Unit NYS Office for People With Developmental Disabilities 44 Holland Ave, 5th Floor Albany, NY 12229 Procurement@opwdd.ny.gov

Secondary Contacts Shannon Plasencia / Marc Kleinhenz Contract Management Unit NYS Office for People With Developmental Disabilities 44 Holland Ave, 5th Floor Albany, NY 12229 Procurement@opwdd.ny.gov

1.3.3. Questions and Answers

Questions from Bidders regarding this RFP must be received by OPWDD in accordance with the Deadline for Submission of Questions included in the Calendar of Events, Section 1.3. of this RFP. All questions must be submitted via electronic mail to the designated contact(s) at Procurement@opwdd.ny.gov as stipulated in Section 1.4.2. of this RFP.

1.3.3.1. Each question must, to the degree possible, cite the specific RFP Section to which it refers.

OPWDD reserves the right not to answer questions that are not directly related to this RFP.

1.3.3.2. Bidders are cautioned that any question or inquiry regarding the RFP must be written in generic terms and must not contain pricing information. The inclusion of specific information about a Bidder’s Cost Proposal in an inquiry may result in the Bidder’s disqualification.

1.3.3.3. Bidders must identify, during the question-and-answer period, any terms and conditions in the RFP that would prohibit a Bidder from submitting a proposal. This process may not be used to negotiate material changes to the terms and conditions set forth in the RFP; any such changes will not be accepted by OPWDD. If a Bidder discovers any ambiguity, conflict, discrepancy, omission, or other error in the RFP, the Bidder shall immediately notify OPWDD of such error(s) in writing to the designated contact(s) identified in Section 1.4.2. of this RFP.

If, prior to the proposal due date as specified in Section 1.3. of this RFP, a Bidder fails to notify OPWDD of a known error or an error that reasonably should have been known, the Bidder shall assume the risk of proposing. If awarded the contract, the Bidder shall not be entitled to additional compensation by reason of the error or its correction. Prior to the proposal due date, any clarifications or modifications deemed necessary by OPWDD will be posted to the OPWDD website and the NYSCR website provided in Section 1.2. of this RFP.

1.3.3.4. Any change to language, terms, or requirements within the RFP, including all associated attachments, appendices, and exhibits, that is proposed by a Bidder after the question-and-answer period has ended will not be considered by OPWDD, as any such change would not have been offered to all potential Bidders.

1.4. Announcements and Amendments to the RFP

OPWDD will utilize its procurement opportunities webpage and the NYSCR for the purpose of disseminating information relating to this procurement. OPWDD will post its official answers to Bidder questions and any changes to the RFP resulting from such questions on these sites on or before the Issuance of Response to Questions date as indicated in the Calendar of Events.

Bidders are encouraged to monitor these sites: https://opwdd.ny.gov/procurement-opportunities and https://www.nyscr.ny.gov/.

OPWDD’s responses to questions and notification of amendments to the RFP, if any, will be in the form of a formal addendum that will be annexed to and become part of this RFP and any ensuing contract.

mailto:Procurement@opwdd.ny.gov mailto:Procurement@opwdd.ny.gov mailto:Procurement@opwdd.ny.gov https://opwdd.ny.gov/procurement-opportunities https://www.nyscr.ny.gov/

1.5. Term of Contract

OPWDD intends to award one contract for the CAS/CANS Functional Needs Assessment Services to one responsive and responsible Bidder as a result of this RFP. The term of the Contract is anticipated to be five years with an anticipated start date of April 1, 2027. In accordance with SFL § 41, the State shall have no liability under this contract to the Bidder or to anyone else beyond funds appropriated and available for this contract. Continued contract approval beyond five years, will be at the sole discretion of OPWDD and the OSC, until such time as a replacement contract can be put in place. If this contract is extended, all original terms and conditions will remain the same.

1.6. Conflicts of Interest

Bidders must disclose actual and potential conflicts of interest in the Administrative Proposal (see Section 4.10. below for additional information).

If an organization or person is presently performing consulting services for OPWDD, or has provided consulting services for OPWDD, it may still submit a proposal in response to this RFP but must also satisfy these conflict-of-interest provisions.

A Care Coordination Organization (CCO) or any syndicate of a CCO who are engaged in active care management are unable to bid and are considered having a direct conflict of interest for this

RFP.

After the RFP is awarded, if the awarded Bidder utilizes people or entities that violate these conflict-of-interest provisions, the Bidder is subject to termination and reimbursement of contract funding to OPWDD.

1.7. Bidder Minimum Qualifications

Any Bidder submitting a proposal in response to this RFP must meet the minimum qualifications listed below. Information demonstrating these qualifications must be incorporated into the Bidder’s Administrative Proposal response.

1.7.1. A minimum of five years’ experience in all of the following:

• Maintaining and supporting through managerial oversight (either directly or through a subcontracted vendor) of a workforce equaling at least 300 people with geographic distribution and ability to perform in person assessments across all of NYS, including New York City (NYC).

• Maintaining and supporting a data management system that can capture person-level data elements for at least 200,000 people and meets relevant state Office of Information Technology Services (ITS) and/or federal requirements for both CMS) Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant data security and privacy standards.

• Operating a telephony and scheduling system that can receive assignments, call people needing assessment, and provide appointment level confirmations (both digitally and in writing) 24/7 and 365 days a year.

• Receiving and processing a minimum of 135,000 assessment assignments annually and completing assessments for conducting standardized functional needs assessment tools for people with developmental disabilities and other special needs.

Experience acquired concurrently is considered acceptable. Failure to meet these Minimum Qualifications will result in a proposal being found non-responsive and eliminated from consideration.

1.8. Glossary and Definitions

Abbreviated Adult Assessment

The CAS assessment will be completed for people 18 years or older on an annual basis. However, OPWDD may request that an abbreviated functional needs assessment (i.e., ‘Abbreviated Adult Assessment’) may need to be conducted on a frequency that is to be determined, and in substitution of the CAS assessment, at the discretion of the agency.

Assessment Assignment

The request of an assessment and/or engagement with the OPWDD waiver and/or state-based services.

Assessment Completion

The process by which the vendor conducts and completes the assessment interviewing process required for and the OPWDD waiver and/or state-based services. The methods used for conducting and completing the assessment are defined in Section 2.7.3.

Assessment Finalized

The process by which the vendor signs and finalizes and submits all findings of the assessment required for the OPWDD waiver and/or state-based services in the UAS system. A finalized assessment, following all protocols, will result in full payment for this deliverable. The methods used for final reporting of the assessment findings are defined in Section 2.7 and will be reported monthly and accompany the monthly invoice.

Assessment Scheduling and Outreach

The process by which the vendor begins engaging a person to schedule an assessment (e.g., CAS or CANS-NY) is required for OPWDD waiver and/or state-based services. The methods used for outreach are defined in Section 2.7.2.

Bid Response to the RFP submitted by a Bidder to provide products or services to this scope of work.

Bidder Any person, business, vendor or other legal entity, or any employee, agent, consultant, or person acting on behalf thereof, submits a bid in response to this RFP.

Child and Adolescent Needs and Strengths

(CANS-NY)

Assessment/ Reassessment

The CANS-NY assessment is the OPWDD approved comprehensive functional needs assessment tool used with people 17 years old and younger.

The administration process includes interviewing the person and/or their primary support(s), custodian(s) and Legal Guardian(s), as well as a review of all available supporting documentation. The assessment is completed within the Uniform Assessment System for New York (UAS-NY) online or offline client. Initial assessments must be completed following an OPWDD programmatic eligibility determination of provisional eligibility determination.

Initial assessments must be completed for service provision, and reassessments are administered within a 12-month period.

Conflict of Interest A real or seeming incompatibility between one’s private interests and one’s public or fiduciary duties. When the same entity is both assisting a person to gain access to services and providing services to that person, the role of the entity staff has potential to be conflicted. This is a higher threshold than the requirements of conflict-free; and to avoid a conflict of interest, the same entity would not be allowed to serve in both capacities.

Contractor Any person, business, vendor, or other legal entity awarded a contract with OPWDD to furnish services for an agreed upon price.

Coordinated Assessment System (CAS) Assessment/ Reassessment

The CAS assessment is the OPWDD approved comprehensive functional needs assessment tool used with people 18 years old and older. The administration process includes interviewing the person and/or their primary support(s), custodian(s) and Legal Guardian(s), as well as a review of all available supporting documentation. The CAS assessment is completed within the UAS-NY online or offline client. Initial assessments must be completed following an OPWDD programmatic eligibility determination and compliant with federal regulation Title 42, Chapter IV, Subchapter C, Part 441, Subpart G, § 441.301 (3i). Reassessments are administered within a 12-month period or at a frequency outlined by OPWDD. OPWDD’s method of assessment, frequency of assessment, and/or content of assessment may vary during this 5-year contract, at OPWDD’s discretion, to match the deliverables of the Access Rule as well as the federal Medicaid funding to support these goals.

Incomplete Assessment

CAS and CANS not completed; however, substantial administrative effort following assignment or assignment worked but unable to be completed. This will result in a partial payment for this assessment deliverable, upon review and approval of OPWDD. The methods used for final reporting of the assessment findings are defined in Section 2.7 and will be reported monthly and accompany the monthly invoice.

Newly eligible A person found “Newly eligible” for OPWDD services and is receiving their first assessment. Assignments are to be completed, or closed with the appropriate disposition, within 30 days of the assignment.

OPWDD The New York State Office for People With Developmental Disabilities

OPWDD Medicaid Eligibility

Any person in New York State who is eligible for OPWDD services and Medicaid, whether eligible via income consideration, medically needy definitions, or categorical eligibility (e.g., foster care) as described in the 1915c Comprehensive Waiver.

Priority Assessment Assignment

OPWDD may request that the vendor reprioritize their assessment assignments for a ‘Priority Assignment’. Priority assignments for assessment are to be completed, or closed with the appropriate disposition, within 45 days of the assignment.

Staffing and Organization Plan

Detailed description of the total number of staff proposed for the project, and how the staff is organized, including an organizational chart of key staff and staffing titles, with the proposed number of supporting staff and units identified.

The staffing and organization plan should also identify staff that support the project but are not full time employees dedicated and include their role and percentage of time dedicated to the project. The plan should also outline where the staff are located and how communication is handled between remote sites, the main project site, and OPWDD.

Primary Contractor The one who holds the contract with the owner of a project or job and has full responsibility for its completion. A prime contractor undertakes to perform a complete contract and may employ and manage one or more subcontractors to carry out specific parts of the contract.

Subcontractor Any person or legal entity (including but not limited to sole proprietor, partnership, limited liability company, firm, or corporation) who has entered into a contract, express or implied, for the performance of a portion of a Contract with a Contractor.

2. SCOPE OF WORK

2.1. General Duties

Upon award, the vendor must be able to perform the following tasks and will be held to the Service Level Agreement (SLA) terms as detailed in Section 12. The vendor must maintain the necessary data in appropriate electronic formats to measure its performance and report on all SLAs illustrating monthly, quarterly, and/or annual metrics against the SLAs defined in this RFP and attachments.

The qualified and awarded vendor will conduct CAS/CANS Functional Needs Assessments as outlined in the following:

2.1.1. Schedule, conduct, and submit results of the assessments of people seeking OPWDD Medicaid HCBS waiver or state-based services in accordance with state regulations for OPWDD (10 NYCRR § (NY Soc. Serv. §366(7)(f);14 NYCRR §636-1.6) accordingly and by utilizing OPWDD state-approved assessment tools and standard operating procedures (SOPs), as further detailed in this RFP.

2.1.2. The general operating hours for the vendor will be Monday through Friday, and may include weekend hours, as agreed upon with OPWDD. The operating hours will be publicly listed on the vendor’s website(s) and consumer materials to reflect the hours referenced in this requirement.

2.1.3. Assessments will occur Monday through Friday, and may include weekend and evening hours, as agreed upon with OPWDD. These hours must be maximized to ensure convenience for the person and their primary support/knowledgeable person’s schedule.

2.1.4. Change to any hours of operation or assessments must be submitted in writing to OPWDD 30 days in advance of change and agreed upon by both parties.

2.1.5. Eligible vendors must have current and ongoing data and workforce management infrastructure to successfully meet the deliverables outlined in this RFP. Bidder must clearly describe in the Technical Proposal submission how they can and/or will meet the deliverables .

2.2. CMS-Recognized QIO/QIO-like Entity Designation

OPWDD prefers that the Contractor be a CMS-recognized Quality Improvement Organization (QIO) or a CMS-recognized QIO-like entity with demonstrated experience performing independent medical and utilization review services for Medicaid-funded programs.

Contractors that are not CMS-recognized QIOs or QIO-like entities must clearly demonstrate equivalent qualifications, expertise, organizational capacity, and experience providing utilization review and quality improvement services that meet applicable federal and State Medicaid requirements.

The Bidder must demonstrate the ability to:

• Conduct independent medical and utilization reviews to evaluate the medical necessity, quality, and efficiency of servicers provided to Medicaid beneficiaries.

• Analyze patterns and trends identified through the reviews and recommend opportunities to improve quality of care, patient safety, and program outcomes.

• Provide findings, reports, and recommendations to OPWDD in a timely manner and in accordance with contract requirements.

• Maintain all qualifications and certifications necessary to meet the definition of a CMS-recognized QIO or QIO-like entity throughout the term of the contract

• Perform all review activities in a manner that supports compliance with federal Medicaid requirements and enables OPWDD to receive applicable federal financial participation.

2.3. Start-Up Time Period

2.3.1. A time lag of no more than 180-calendar days to meet 100% of all contract deliverables and

100% of requested monthly assessment volume is called the ‘Start-Up Time Period’.

2.3.2. The Technical Proposal will outline the vendor’s existing ability at the time of RFP bid to meet all technical requirements, as well as detailed plans and requirements for enhancing or expanding existing infrastructure to fully meet the requirements of this RFP within 180 calendar day ‘Start-Up Time Period’ from the effectuated contract date.

2.3.3. This ‘Start-up Time Period’ must not exceed the timeframes and deliverables noted above.

2.4. One-Time Start Up Costs

2.4.1. The ‘Start-up Time Period’ will begin following contract execution on April 1, 2027, and can be associated with the proposed ‘One-Time Start Up Cost’ in the Cost Proposal Attachment 2.

‘One-Time Start Up Cost’ may not exceed the proposed monthly budget of performing 100% requested monthly volume of assessments under full working capacity and may not exceed 180 calendar days from the time of contract award. This One Time Start Up Cost is intended to support the Contractor with any recruitment or infrastructure needs to successfully meet the timeline requirements outlined in this RFP.

2.4.2. Because every vendor must train, certify, and successfully provide access to both staff and data systems in accordance with requirements from the Department of Health (DOH), OPWDD, and NYS ITS, OPWDD will accept no more than a 90-calendar day lag from contract award until when assessments begin at least 50% of the requested monthly assessment volume.

2.4.3. OPWDD will accept no more than a 180-calednar day lag from contract award and when the vendor has fully recruited additional positions if required, completed system modifications/ enhancements as needed, programed the creation of all required reporting functions, developed all required policies and procedures needed to support RFP functions, refine existing staff training program(s), and enhance existing quality assurance oversight to meet 100% of all contract deliverables and 100% of requested monthly assessment volume. Because OPWDD expects the vendor to support 100% requested monthly assessment volume within 180 calendar days of contract execution, the ‘One-Time Start Up Costs’ will not be permitted beyond 180 calendar days.

2.4.4. The ‘Start-up Time Period’ and associated ‘One Time Start Up Costs’ will include the agreed upon rollout schedule of deliverables outlined in Section 2.4.6.6. Business Continuity Plan.

2.4.4.1. The Contractor must need to meet all deliverables, benchmarks, and OPWDD expectations that are set in the scope of work related to the One Time Start Up Cost. Upon Contractor successfully meeting deliverable expectations within the timelines required, payment of the One Time Start Up Cost will be interconnected as follows:

• Contractor will be paid 30% of the One Time Start Up Cost 30 days after the contract start date.

• Contractor will be paid another 30% of the One Time Start Up Cost 60 days after the contract start date.

• Contractor will be paid another 10% of the One Time Start Up Cost 90 days after the contract start date.

• Contractor will be paid another 10% of the One Time Start Up Cost 120 days after the contract start date.

• Contractor will be paid another 10% of the One Time Start Up Cost 150 days after the contract start date.

• Contractor will be paid the remaining 10% of the One Time Start Up Cost 180 days after the contract start date.

• The Contractor will only receive the full One Time Start Up Cost if they meet all expectations set in the contract timely. The Contractor must meet the requested monthly assessment volume percentage benchmarks set by OPWDD. If the Contractor does not meet the deliverables or requested monthly assessment volume percentage benchmarks within the timeframe set, the contractor may have invoices withheld as outlined in Section 12.

2.4.5. OPWDD will notify the contractor that consequences will be assessed because of nonconformance of Section 12. SLA Standards and Consequences, and the files are not maintained or are damaged in such a way that the contractor cannot substantiate its performance against an SLA standard, it will be construed and admitted to by implication that the contractor did not meet the SLA standard in question.

2.4.6. Functional Operational Plans as part of the Technical Proposal

Plans related to Data Management Systems, Staffing and Organization, Assessment, Quality Assurance and Reporting, and Business Continuity must be submitted as part of the vendor’s submission and Technical Proposal outlined in Section 5. Initial Plan details provided as part of the vendor application will be reviewed and scored based on each vendor’s ability to meet the full scope..

2.4.7. Proposed Revised Functional Operational Plans

As a part of the Bidder’s Technical Proposal, they must provide a detailed explanation on how they intend to bridge the gap between their provided Functional Operational Plans and any proposed Revised Functional Operational Plans. These must be submitted with Technical Proposal, as referenced in Section 5.1.2.

2.4.8. OPWDD Approved Functional Operational Plans Within First 30 days and Annually Thereafter If a vendor is awarded, and their Functional Operational Plans need additional enhancements and/or modifications to meet OPWDD’s needs, Revised Operational Plans must be submitted within 30 calendar days from contract execution and then functional operational plan annually thereafter.

If any Revised Operational Plan is accepted by OPWDD in writing and later is demonstrated to be deficient in its real-world ability to meet the full scope and intent of this contract, OPWDD will withhold funds as outlined in the Service Level Agreements (SLA) outlined in Section 12. Once plans are accepted by OPWDD, Contractor can submit annually.

Requirement Timing Consequence if Not

Met Functional Operational Plans Section 2.4.6.

Bidder submits versions of all five plans from Section

2.4.6. (Data Management System(s), Staffing and Organizational, Assessment, Quality Assurance and Reporting, Business Continuity) and must provide a detailed explanation on how they intend to bridge the gap between their submitted Functional Operational Plans and any Revised Operational Plans.

Must be submitted with Technical Proposal

Bid will be disqualified.

Proposed Revised Functional Operational Plans Section 2.4.7.

Contractor Determined a revision needs to be made to one or more plans to add or enhance to meet the full scope.

Within 30 calendar days of contract execution

OPWDD Approved Functional Operational Section 2.4.8.

Five accepted plans to kick off the Contract.

30 days and annually thereafter

Plans accepted, later found deficient Section 2.4.8.

OPWDD accepted a revised plan in writing, but it’s later shown not to meet full scope/intent

Ongoing OPWDD withholds funds per SLA terms (Section 12)-separate remedy from the Start-Up Cost withholding

2.4.8.1. Data Management System(s) Plan

The vendor must submit to OPWDD for review and approval a plan to operate and maintain data management system(s) that, at a minimum, support all herein requirements related to the informatics infrastructure, maintenance and operations of a Management Information System (MIS), Telephony System, Workforce Management (WFM) System as well as other systems and services deemed necessary by the state, with specifications outlined in Section

2.5. and metrics and reporting requirements described in Section 2.8. Quality Assurance and Reporting.

2.4.8.2. Staffing and Organizational Plan

The vendor must submit to OPWDD for review and approval a Staffing and Organization Plan, depicting each component of the respective project, all cross-cutting functional units of the organization/project, numbers, and types of staff for each component/function, and identified lines of authority governing the interaction of staff, and relationships with subcontractors. The names of management personnel must be shown on the organization chart which displays key staff and staffing titles, how the project staff will be organized, located across the state, and how communication will be handled between the main site and remote sites. The Plan must include the total number of each staff for each function, outline sufficient numbers of staff in each role needed to support the scope and requested monthly assessment volume of this RFP, ratio for supervision, quality assurance and case management, and the designated full time Key Staff with specifications outlined in Section 2.6., specifically staffing ramp up outlined in section 2.6.4.1. and metrics and reporting requirements described in Section 2.8. Quality Management and Reporting.

2.4.8.3. Assessment Plan

In addition to the required features of the vendor’s MIS referenced in Section 2.5.4., the vendor will have an Assessment Plan that supports the documentation and track assessment assignments, assessment scheduling (including contact information and correspondences of all parties involved), and completion of assessment activities with specifications outlined in Section 2.7 and metrics and reporting requirements described in Section 2.8. Quality Management and Reporting.

2.4.8.4. Quality Assurance and Reporting Plan

The vendor must submit to OPWDD for review and approval a Quality Assurance and Reporting Plan which outlines all vendor policies and procedures, in addition to, quality measurements to track work assignments, improvements, executing quality improvement testing and activities, development of quality assurance standards and processes, verification of assessment processing and accuracy, documented corrective actions indented to fix errors and issues, and all reporting metrics with specifications and metrics and reporting requirements described in Section 2.8. Quality Management and Reporting.

2.4.8.5. Business Continuity Plan

The vendor must submit to OPWDD for review and approval a Business Continuity Plan that is based upon the vendor’s business continuity and disaster recovery methodology, in addition to, transition (e.g., turn over) planning with specifications. At a minimum, the Business Continuity Plan must provide for back-up processing capability at remote site(s) from the contractor's primary site(s), such that normal payment processing, as well as other systems and services deemed necessary by the state, can continue in the event of a disaster or major hardware problem at the primary site(s) with specifications outlined in Section 2.9. and metrics and reporting requirements described in Section 2.8. Quality Management and Reporting.

2.5. Data Management System(s)

2.5.1. The Contractor will operate and maintain data management system(s) that, at a minimum, support all herein requirements related to the informatics infrastructure, maintenance and operations of a Management Information System (MIS), Telephony System, Workforce Management (WFM) System with specifications outlined in this Section, including supporting timelines and metrics needed for required reporting described in Section 2.8. Quality Assurance and Reporting.

2.5.1.1. Infrastructure, including but not limited to, the application(s), all systems and/or components supporting it, including, but not limited to, any forms and databases that include Personal Health, Personal Identification or other New York State information, must comply with all NYS security policies and standards listed at http://its.ny.gov/tables/technologypolicyindex.htm.

2.5.2. Before developing or utilizing new Commercial Off the Shelf (COTS) application programs, systems programs, operating systems, websites and/or vendor-supplied web portals, that will http://its.ny.gov/tables/technologypolicyindex.htm affect this RFP, prior approval must be granted by OPWDD. The vendor must provide access to OPWDD, and any designed entities based on role and access policy approved by OPWDD.

Permissions and privileges to enable access to authorized users, using role-based access control to provide varying levels of access based on user roles and responsibilities must be set upon request from OPWDD.

2.5.3. The Contractor will obtain, use, and/or manage technology to support program implementation and ongoing operations, that includes, but is not limited to the following:

Contractor must

• have the ability to securely separate person-level data, eligibility, and workflows for

OPWDD-directed work;

• document imaging to accommodate the scope of work;

• have a secure portal accessible by people and/or families who are being assessed where they can submit any required documentation in a HIPAA compliant manner to the vendor that supports the assessment process;

• provide a Knowledge Management System, a searchable database that supports customer service infrastructure and gives staff quick access to call scripts, policies, template documents, and other key resources;

• have a public facing website that includes information about the vendor, and available services and options;

• provide capability to support secure file transfer system, to and from OPWDD as indicated by the agency. Vendor must support ability to send/receive secure information between OPWDD and DOH when people transfer between DOH and OPWDD waivers;

may be requested to also have access and data exchange with other agency-specific technology resources as needed (e.g., ‘Sterling’);

• must have access to the Health Commerce System (HCS) hosted by the DOH, to facilitate information sharing with DOH, OPWDD, and any subcontracted entities;

• have capability to access and utilize secure applications, including but not limited to: the HCS, UAS-NY, CHOICES, eMedNY; and

• must install ‘Off-Line Client’ onto staff computers. UAS-NY is a web-based application used to conduct assessments. In instances when an assessor may be required to perform an assessment in a location that does not have internet access or when the assessor does not have access to a trusted, secure internet connection (E.g., an organization provided, secure hotspot), the UAS-NY Offline Application must be installed on a secure laptop computer and be used to conduct the assessment. Use of the Offline Application comes with additional security responsibilities for the organization. This includes being responsible for the security of the data housed in the Offline Applications used by their users.

2.5.4. Management Information System (MIS)

The Contractor must maintain an MIS that can capture and track all requirements of this RFP on an individual-level basis, including but not limited to receive, document, and track assessment assignments; schedule appointments; conduct and track outreach activities;

conduct, manage, and report on quality assurance processes; and other activities outlined in this document.

2.5.4.1. The MIS must identify potential efficiencies related to people who may enroll and/or transfer between DOH and OPWDD waiver services. The MIS must also be able to track each step of the assignment, intake, outreach, scheduling, assessment, assessment completion, and reporting on an individual level and provide monthly metrics of the status of each person. Final MIS capability will be agreed to by OPWDD prior to the building of a new system, or modification of an existing MIS before implementation.

2.5.4.2. The MIS and all systems and components supporting it, including, but not limited to, any forms and databases that include Personal Health, Personal Identification or other New York State information, must comply with all NYS security policies and standards listed at Policies | Office of Information Technology Services

2.5.4.3. Support the procurement and/or access to technology by staff located across the state and in the field based on operational need, including but not limited to: laptops, cell phones, Wi-Fi connectivity, secure VPN access, and ability to access all state data systems and applications mentioned in this RFP.

2.5.5. Telephony System

2.5.5.1. The general operating hours are stated in Section 2.1.2. The operating hours will be publicly listed on the website and consumer material to reflect the hours referenced in this requirement.

Change to any hours of operation or assessments will be submitted in writing 30 days in advance of change and agreed upon by both parties.

2.5.5.2. OPWDD requires the vendor to maintain a toll-free line to provide language interpretation services for those not fluent in English, Telecommunication Device for the Deaf (TDD), and Teletypewriter (TTY) services for callers who are hearing impaired, as per the NYS Language Access Law listed at New York State Language Access Law | Office of General Services.

2.5.5.3. The vendor will operate a telephone system that will be used for user-friendly scheduling and assistance. This Automatic Call Distribution System must support the following features:

• Has a call routing and queuing system that guides consumers to direct call routing based on topics and/or appropriate skillsets;

• Provides real-time view of call center activity and calling patterns;

• Has outbound call software used to make outbound calls to consumers, family members, and providers;

• Has call recording and quality monitoring to record 100% of calls, providing an effective method to monitor calls for compliance and quality assurance;

• Integrated Voice Response System that allows consumers to direct call routing to appropriate skill sets;

• Computer Telephonic Integration (screen pop) – integration of telephony and desktop computer to provide call center agent with caller ID information for efficient handling;

• Has a dedicated toll-free number;

• Supports automated phone scheduling by people seeking OPWDD services;

• Provides a reminder via an automated and/or targeted text, or email for all appointments one business day prior to the scheduled assessment; and https://its.ny.gov/policies https://ogs.ny.gov/new-york-state-language-access-law

• Can support Language Access Services as required by the NYS Office of Language Access.

2.5.5.4. The vendor will track and report on call volume (approximately 2,000 calls/month)

2.5.6. Workforce Management (WFM) System

The vendor must have the ability to securely separate person-level data, eligibility, and workflows for OPWDD-directed work. In addition, the Contractor must

2.5.6.1. operate and maintain a workforce management system that schedules and forecasts appropriate staffing levels to handle incoming call volumes, as well as all OPWDD assessment assignments.

2.5.6.2. track and monitor on and off boarding staff, including background checks, and provisioning and deprovisioning to required systems.

2.5.6.2.1. track and monitor all staff training, results of field observations, certification, performance standards, and complaints.

2.5.6.2.2. report to OPWDD all changes (addition and removal) of users to the Uniform

Assessment System- New York (UAS-NY), CHOICES, and any other secure NYS system within 24 hours of the updates.

2.5.6.2.3. Provide quarterly, the vendor employee names list must be reviewed and confirmed as accurate for quarterly reporting. OPWDD will send the vendor the current list of users and the vendor will review and respond with any discrepancies within 24 hours.

2.5.6.2.4. provide routine reports regarding staffing volume and forecasted risks on, at a minimum, a monthly basis or when requested.

2.5.7. Data Security, Privacy, and Confidentiality

2.5.7.1. Comply with all privacy and security policies and procedures of NYS Policies | Office of

Information Technology Services and applicable Federal law and administrative guidance with respect to the performance of the Contract. The Vendor is required, if applicable, to execute a number of security and privacy agreements with OPWDD including a Business Associate Agreement and a Data Use Agreement (DUA) at contract signing.

2.5.7.2. Provide secure and confidential backup, storage and transmission for hard copy and electronically stored information and person-level documents per OPWDD policies and procedures. Under no circumstances will any records be released to any person, agency, or organization without specific written permission of OPWDD. The vendor is obligated to ensure any Subcontractor hired by the Vendor who stores, processes, analyzes or transmits Medicaid Confidential Data (MCD) on behalf of the Vendor has the appropriate security requirements in place. The Vendor is required to include in all subcontracts and Business Associate Agreements with their Subcontractors’ language surrounding the security and privacy requirements as well as the language contained in the Confidentiality Language for Third Parties section of the DUA. If any breach or suspected breach of the data or confidentiality occurs, whether the breach occurred with the vendor or Subcontractor, OPWDD must be notified immediately.

2.5.7.3. Maintain and provide to OPWDD upon request their data confidentiality plans and procedures for meeting security requirements as they relate to the deliverables and services within this RFP, including all plans as they relate to subcontractor work where applicable.

2.5.7.4. Develop and maintain adequate fully trained staff to respond to all stakeholder inquiries while protecting confidentiality and maintaining the security and integrity of all systems. Staff must be trained to understand and observe requirements related to confidentiality and operating guidelines for functions included in this RFP.

2.5.7.5. Comply fully with all current and future updates of the security procedures of OPWDD as well as with all applicable State and Federal requirements, in performance of the Contract.

2.6. Staffing and Organization

2.6.1. Staffing Portfolio

Details must be provided that outline the proposed titles and numbers of staff needed to respond to incoming calls, questions, requests for information, complaints, and any other customer service request or concern raised by the public and/or OPWDD.

2.6.1.1. Specifically required roles and qualifications for Field Assessors, Quality Assurance, Quality

Assurance Management Staff, and Key Staff are outlined in Sections 2.6.2. and 2.6.3., and OPWDD reserves the right to request a resume (including qualifying details) for any staff member (including subcontracted staff) assigned to the RFP deliverables.

2.6.1.2. The vendor must ensure all staff are trained in updates made to administrative requirements, program policies and procedures, technology…