Purchase of Service Forms 1 3 4.pdf

OPERATIONAL SERVICES DIVISION

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PURCHASE OF SERVICE ATTACHMENT INSTRUCTIONS

FOR HUMAN AND SOCIAL SERVICES

Refresh Date: March 21, 2014

SUMMARY OF ATTACHMENTS

• Attachment 1: Program Cover Page. Designed to provide general contractor and program information and create an historical “starting point” for all future contract amendments. This form is required for all human and social services contracts and may also be attached to the Standard Contract Form when amending a contract to document changes to the original contract.

• Attachment 2: Performance Measures. Designed to document negotiated performance measures. This form should be used for all human and social services contracts and should also be attached to the Standard Contract Form when amending a contract to document changes to the original contract.

• Attachment 3: Fiscal Year Program Budget. Designed to reflect the total annual program costs associated with the fiscal year operation of a program. This form is required for all human and social service contracts where payment is based on the submission of a summary or complete program budget and may also be attached to the Standard Contract Form when amending a contract to document changes to an existing budget.

• Attachment 4: Rate Calculation/Maximum Obligation Calculation Page. Designed to calculate a unit rate, document program and invoice offsets, calculate the number of billable and purchased units and develop a maximum obligation. This form is required for all human and social service contracts where the rate is based on the submission of a summary or complete program budget and may also be attached to the Standard Contract Form when amending a contract to document changes to the original contract.

• Attachment 5: Non-Reimbursable Cost Program Offset Schedule. Designed to provide information on non-reimbursable costs, the source of private funds used to offset those costs and identify if the non-reimbursable costs are a result of related party transactions. This form is required for all human and social service contracts if non-reimbursable costs appear in the budget. If subsequent amendments result in new non-reimbursable costs or a change to the original Attachment 5, an amended version of the attachment should be attached to the Standard Contract Form when amending a contract.

• Attachment 6: Capital Budget. Designed to identify capital expenditures necessary to provide contracted services. This form is required for all human and social services contracts with capital expenses and may also be attached to the Standard Contract Form when amending a contract to document changes.

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ATTACHMENT 1: PROGRAM COVER PAGE

Program Information

Requests general information on the contractor, department, program type (day, residential, etc.) and name, complete program address and contact persons. Much of the information requested is self-explanatory.

Document ID # Twenty digit MMARS contract identification number.

UFR Program # Unique identifier (digits or letters) that the contractor and department agree to use to track this program. Please note: The same identifier must be used on all contracts procuring the program and on the Uniform Financial Statements and Independent Auditor’s Report (UFR) for the same period.

Other Reference Information

Departments may wish to include additional information in this field, such as object code, baseline annualization information for renewals or program specific ready-payment information.

RFR Information Check the appropriate box. Attach the Request for Response (including all applicable attachments) or copies of the COMMBUYS Solicitation (referred to as a “Bid” in COMMBUYS) Header Information and the Contract (referred to as a “Master Blanket Purchase Order” in COMMBUYS) Header Information screen prints containing the titles and Bid and Purchase Order document numbers.

Scope of Services The bidder’s response is part of and must be filed with the contract. If, as a result of the negotiation process, there have been changes to the original bidder’s response, departments may document those changes on the original bidder’s response or may document those changes as a separate attachment filed with the contract. Departments should attach a separately drafted scope of services when there is no RFR response, as in the case of a competitive procurement exception.

Total Anticipated Contract Duration

Anticipated Contract Duration includes the initial contract period and any anticipated options to renew. This is the longest possible period that the contract may run given the limits specified in the RFR. You may customize this entry to accommodate duration language options included in the associated guidance (in the Procurement Information Center) entitled Request for Response/Contract Duration.

Initial Duration Duration of the contract executed. Examples include one year or more than one year (multi-year contract).

Options to Renew Options to renew the contract beyond the initial duration. Departments should enter both the number of options to renew and the duration of each option. (For example, three options to renew for one year each).

Fiscal Terms Departments have the flexibility to develop and negotiate a pricing and payment structure most appropriate to the services being procured. Specific expectations regarding compliance with the pricing limitations, including, but not limited to, restrictions on commercial fees for for-profit contractors, should be described in the RFR and documented in the contract. The standardized budget forms are applicable to the three budget options indicated below that are available to departments to accommodate a variety of pricing approaches. These attachments are required for all new human and social services contracts where payment is based on the submission of a summary or complete program budget. Use of the attachments is optional in the RFR; however, if a department chooses to require the attachments as part of the RFR response, it should indicate which pricing option is required and identify any back-up documentation requirements.

Pricing Options Option 1: This option is available to departments when a detailed or summary budget is unnecessary to establish a price or if the price is already established by another authority. It may be considered by departments under the following

Sensitivity level - low circumstances:

• Rates have already been established pursuant to another independent rate setting authority, such as the Division of Health Care Finance and Policy or OSD Special Education Pricing.

• A full budget is not required. (Note: The federal government requires a budget. Consequently, this option is not available for programs receiving federal funds. Departments requiring additional information on any federal funding requirements may contact OSD.)

• Federal dollars are not available to support the purchase of the service.

• Reasonableness of the proposed price can be evaluated by the purchasing department based on market rates and a review of historical expenses.

• Department has pre-determined the price.

Under this option, departments may request that a prospective bidder or contractor submit price and capacity information and check this box. Indicate pricing methodology and any additional price specification information at the bottom of the page. For Chapter 71B approved schools, if there are SSI or other program offsets, the net amount including offsets should be reflected on the Option 1 price line and an explanation included in the box at the bottom of the page or in a separate attachment.

Option 2: OSD encourages departments to use this approach that summarizes major categories of expenses (Direct Care Staff Wages, Fringe Benefits & Payroll Taxes; Occupancy; Other Direct Care/Program; Direct Administrative Expenses, Agency Administrative Support Allocation; Commercial Fees;

Program Offsets) under the following circumstances:

• A budget is required due to federal dollars available to support the program.

• Categorical information is sufficient to evaluate the comprehensiveness of the services and adequacy of resources to achieve performance measures.

• Departments can request additional information (required staffing pattern, staff qualifications, housing requirements, etc.) as needed.

Using this method, departments would request that a prospective bidder submit a summary budget when they respond to the RFR.

Under Option 2, only the summary budget lines with a “T’ must be completed.

Commercial Fees and program offsets for other revenue or non-reimbursable costs, if any, must also be noted. Check the appropriate methodology and reference any additional price specification information at the bottom of the page.

Option 3: Departments should require complete budgets only when deemed necessary. Some situations which might benefit from a complete budget submission include:

• Program is a new or reconfigured service and detailed cost information is necessary to determine future price.

• Departments have a documented need to closely monitor expenditures.

• Categorical information is insufficient to evaluate the comprehensiveness of the services and adequacy of resources to achieve performance measures.

• Special circumstances exist that make Option 1 or Option 2 impossible.

Under Option 3, a complete budget must be submitted. Check the appropriate

Sensitivity level - low methodology and reference any additional price specification information at the bottom of the page.

Current Max Obligation

Enter the current year maximum obligation for this program. (If Attachment 4:

Rate Calculation/Maximum Obligation Calculation Page was used, see Line 15;

if Option 1 used, this figure will be maximum obligation). This may be left blank if the contract does not have a maximum obligation (rate contract).

Unit Rate The unit rate negotiated between the department and the contractor. Enter the figure from line 8 from Attachment 4: Rate Calculation/Maximum Obligation Calculation Page or the negotiated rate agreed to under Option 1, if applicable.

Not applicable to cost reimbursement contracts.

Billable Units The number of units to be paid for under the contract. Line 9 from the Attachment 4: Rate Calculation/Maximum Obligation Calculation Page.

Funding Prior Years. List past year(s) funding history (if any). Taken together with the next two lines, this section is intended to show the funding for the program over the life of the contract.

Current Year. List the current year maximum obligation (same as above).

Future Years. List projected funding for each year of a multi-year contract.

Additional Payment or Price Specifications

This section should include any addition payment or price information, such as historical information, price methodology or performance reimbursement that may be relevant.

ATTACHMENT 3: FISCAL YEAR PROGRAM BUDGET

General Instructions

The budget form is designed to reflect the annual fiscal year operating cost of a total program, not just the portions of a program purchased by the Commonwealth. It has been designed to be used for both new contracts and any subsequent amendments. A budget must be completed for contracts executed under either Option 2 or Option 3. If Option 2 is selected, complete only the "Τ" lines of the budget and the Attachment 4: Rate Calculation/Maximum Obligation Calculation Page. If Option 3 is selected, all relevant budget lines must be completed as well as Attachment 4, Rate Calculation/Maximum Obligation Calculation Page.

Note: Non-reimbursable costs, as defined in 808 CMR 1.05 (state) and OMB Circular A-122 or A- 21 (federal), should be listed in the budget, but will be deducted from the total program expenses under program offsets - Line 2b of Attachment 4: Rate Calculation/Maximum Obligation Calculation Page or as described later for cost reimbursement contracts.

Commercial Fees for For-Profit Contractors: The amount of fee that a contractor may retain must be noted, for informational purposes only (even if the amount is zero), on POS Attachment 3, Fiscal Year Program Budget. A commercial fee may not be added into the price (rate) paid by the Commonwealth. Commercial fees may not be negotiated or noted on Cost Reimbursement budgets.

For new contracts: Complete the “current” column only.

For amendments within fiscal years: Complete all three columns, the “current”, the “amended change” and the “new”.

For one year options to renew: Departments have two options for completing this form:

1. Complete all three columns: the “current” (final amounts for current FY), the “amended change” (negotiated increases or decreases for next FY) and the “new” (revised amounts for new FY).

2. Complete just the “new” column only to reflect next FY costs. Under either scenario, the “new” column must be completed.

Please use only position numbers and titles as they appear in the Uniform Financial Statements and Independent Auditor’s Report (UFR) Audit and Preparation Manual. The recommended font size for completion of the program budget attachment is 8.

Completion of the budget form:

Step 1: List all resources specified in the contract that are needed to operate the program. In the first two columns, list the UFR title # and the UFR position title in the order that they appear in the UFR using the exact number and position title.

Step 2: FTE: For each Direct Care/Program Support Staff position listed, enter the required full-time equivalents in the FTE column. Combine all FTEs of the same title on one line.

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Step 3: Amount: For each line listed in the budget, enter the total cost in the amount column. Calculate the subtotals category and the Program Total box at the bottom of the page. For unit rate contacts, proceed to Attachment 4: Rate Calculation/Maximum Obligation Calculation Page.

Please Note: The following total lines on the budget form contain category total codes:

100 - Total Direct Care/Program Staff 200 - Total Other Direct Care/Program 300 - Total Occupancy 500 - Total Direct Administrative Exp.

510 is a specific code for the expenses within the 410 & 390 - Other Direct Administrative Expenses line.

These codes are for use by the Executive Office of Health and Human Services’ Enterprise Invoice Management (EIM) system.

Step 4: For Cost Reimbursement contracts only: Fill in all columns as described above. Then enter:

• Offsets: Fill in the dollar amount (or 0 if there is none) to be offset from each line in the “offset” column on the budget page. The offset may be a distribution of a grant or other source of funding for general program support or it may be specific to a particular position or component (for example, third party payments or food stamps offsetting the cost of meals). The offset should also include other payers’ program support if this contract is buying only a portion of the available capacity. If the contract is partially or entirely federally funded, the program income provisions of OMB Circular A-110 require certain income received in the program to be used to offset allowable costs on which the federal share of the program costs are based. Identify the source(s) and the amount(s) of any anticipated program income used to offset the federal share of allowable costs as defined by OMB Circular A-110. Interest earned on advances of federal funds (ready payments) is not program income.

• Carefully review the budget to determine if any costs are non-reimbursable under state regulation (808 CMR 1.05). If a program is partially or entirely federally funded, federal OMB Circular A-122 or A-21 (if the contractor is a college or university) must be reviewed as well. Any non-reimbursable portion of any line must be offset with private (non-Commonwealth) funds. The subtotal of offsets specifically for all non-reimbursable expenses must be entered in Line A at the bottom of the budget page. Any such non-reimbursable costs must be itemized on a separate schedule and the contractor must identify private (non-Commonwealth) sources of revenue to pay for such expenses. Departments must use Attachment 5: Non- Reimbursable Cost Program Offset Schedule or may develop a comparable separate form if needed. Please consult with OSD prior to issuance of an alternate attachment.

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• Source: Cite the source of offset for each line. Non-reimbursable costs must be offset with funds from non-Commonwealth sources only.

• Reimbursable Costs: Subtract each offset from the corresponding number in the “Amount” column and enter the result in the “Reimbursable Cost” column. Enter subtotals and totals where required. The reimbursable cost amounts become the cost reimbursement line item budget against which monthly expenditure reports and any required amendments will be filed.

Note: Commercial fees may not be negotiated or noted on Cost Reimbursement budgets.

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ATTACHMENT 4:

RATE CALCULATION/MAXIMUM OBLIGATION CALCULATION PAGE

General Instructions

Attachment 4: Rate Calculation/Maximum Obligation Calculation Page is designed to calculate a unit rate, to document program and invoice offsets, to document the number of billable and purchased units of service and to develop a yearly maximum obligation. Often the annual program maximum obligation is less than the total program cost. In these cases, the total annual budget will be adjusted through the use of offsets or though other sources of revenue (from other purchasers of the program’s capacity, fundraising, etc.). Certain departments may require a modified version of this page for certain contracts. Please check and verify that you are using the correct format.

Calculate a Unit Rate

Line 1: Enter the program total from the bottom of the budget page.

Line 2: 2a: Program Offsets: Identify the source(s) and the amount(s) of any anticipated program offsets to cover reimbursable program costs only. Program offsets are supports which benefit the entire program and are available to the program regardless of which clients are in the program and who is purchasing the program.

Examples of program offsets include, but are not limited to, client resources, third party payments, United Way funding, utilization of public facilities or state employees, donated commodities and services if identified in the budget, voluntary unrestricted contractor contribution and commercial income. If the contract is partially or entirely federally funded, program income provisions of OMB Circular A-110 require certain income received in the program to be used to offset allowable costs. Identify the source(s) and amount(s) of any anticipated program income used to offset the federal share of allowable costs. Interest earned on federal funds (ready payments) is not program income.

The amount of offset to cover all non-reimbursable expenses in the budget must be listed separately on Line 2b. Also, be sure to consider whether an offset is more appropriately classified as an invoice offset (see below).

Note: For programs which serve a stable client population, the department may permit client-specific revenues (such as SSI and food stamps) to be treated as program offsets rather than invoice offsets. Check with the department.

2b: Offsets for Non-Reimbursable Costs: Carefully review the budget to determine if any listed costs are not reimbursable under state regulation 808 CMR

1.05. If the contract is partially or entirely federally funded, OMB Circular A-122 (or A-21 if the contractor is a college or university) must also be reviewed to determine if there are any additional federal non-reimbursable costs. The total amount of non-reimbursable costs contained in the program budget and corresponding offset from private sources must be entered on Line 2b. In addition, Attachment 5: Non-Reimbursable Cost Program Offset Schedule or a comparable form developed by departments must be completed and attached. Please consult with OSD prior to issuance of an alternate form. If there are no non-reimbursable costs, enter $0 on Line 2b. Complete the Attachment 5: Non-Reimbursable Cost Program Offset Schedule only if there are non-reimbursable program costs and attach to the budget.

Subtotal: Enter the sum of Lines 2a and 2b.

Line 3: Net Adjusted Program Costs: Subtract the total of Line 2 from Line 1.

Line 4: Total Program Capacity: Enter the operating capacity of the entire program.

Line 5: Share of Total Capacity Purchased by Contract: Identify the number of units and the percentage (before adjustment for utilization) of the program operating capacity stated on Line 4 to be purchased by this contract. For example, if the department will be purchasing 5 beds of a 10 bed program for the entire year, the number of units would be calculated: 5 beds x 365 days = 1825 bed-days) and the percentage would be 1825/3650 = 50%.

Line 6: Negotiated Utilization Factor, if any: Based on historical and anticipated utilization, departments may identify a utilization factor.

Line 7: Adjusted Capacity Used to Establish Price: Multiply the number on Line 4 (program capacity) times the percentage on Line 6 (utilization factor) and enter.

Line 8: Unit Rate: Divide Line 3 (adjusted program costs) by Line 7 (adjusted capacity) and enter here with the type of unit (hour, bed-day, etc.).

Line 9: Maximum # of Billable Units: Multiply Line 5 (Share of Total Capacity Purchased by Contract) by Line 6 (Utilization Factor). Departments may also include additional language that specifies a contractor’s responsibility to continue providing services should the utilization factor result in a situation where the maximum obligation is reached before the end of the contract period.

Line 10: Other Price Calculation Method: Reference additional information here.

Maximum Obligation Calculation:

Line 11: Unit Rate Contracts: Line 8 (Unit Rate) times Line 9 (Maximum Billable Units).

Other Price Calculation Methods: Enter Line 10 amount.

Cost Reimbursement: Enter reimbursable cost total from program budget.

Line 12: Invoice Offset: Enter the source and amount of revenues from other payers for clients being served under this contract that serve as an offset via the invoicing process. Client specific revenues, such as client SSI or food stamp contributions, sliding fee collections and third party partial payments are treated as invoice offsets because they reduce the amount of the Commonwealth’s financial obligation for services to those specific clients. Do not re-enter any amount included in Line 2 (program offsets).

Subtotal: Add the amounts in Line 12 and enter here.

Line 13: Program Maximum Obligation: Line 11 minus Line 12.

Line 14: Capital Budget: Enter the total from POS Attachment 6: Capital Budget, if applicable.

Line 15: Total Maximum Obligation for Program: Sum of Line 13 and Line 14.

For Information Only:

Other Revenue Sources: If this contract is not purchasing the total program capacity (as identified in Line 5), enter the source(s) and amount of revenues that will be derived from other purchasers of the program capacity.

FY: Amendment #, if Applicable: If Federal Funds, CFDA #:

PURCHASE OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE

PROGRAM INFORMATION

Contractor Name:

Department Name:

Program Type:

Document ID #:

Program Name:

UFR Program #:

Program Address:

MMARS Activity Code:

City/State/Zip:

Other Reference Information (Information Purposes Only):

Contact Person:

Telephone:

Contact Person:

Telephone:

RFR INFORMATION: � Attached � RFR Reference # __________ � legislative exemption � emergency � collective purchase � interim � amendment

SCOPE OF SERVICES: � Bidder's Response Attached � Description of Services Attached

TOTAL ANTICIPATED CONTRACT DURATION: __________________________ to ________________________

INITIAL DURATION: _________________________ to ______________________________

OPTIONS TO RENEW: ____________options to renew for ______ years each option

FISCAL TERMS

FUNDING SUMMARY

Prior Years Current Year Future Years FY Amount FY Amount FY Amount

PRICE IS ESTABLISHED THROUGH: (CHECK 1, 2, OR 3)

� OPTION 1: PRICE AGREEMENT (list price) rate regulation (if any)___________________

� OPTION 2: SUMMARY BUDGET ("T" lines only) � unit rate � cost reimbursement � other _____________________________

� OPTION 3: COMPLETE BUDGET

� cost reimbursement

� unit rate Total: $ Total: $ Total: $ � other ______________________________ Multi-Year Total: $

CURRENT

MAX OBLIGATION: $________________ UNIT RATE: $__________per __________ # BILLABLE UNITS: ____________

ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS:

Updated 11/1/05

FY: Contractor Name: Amendment #,if Applicable: If Federal Funds, CFDA #:

PURCHASE OF SERVICE - ATTACHMENT 3: FISCAL YEAR PROGRAM BUDGET

Document ID#: MMARS Activity Code:

Program Type: UFR Prog. #:

Current Amend. Change New FTE Amount FTE Amount FTE Amount COST REIMBURSEMENT ONLY Program Component Offset Source Reimbursable

Cost

UFR

Title

Direct Care/Program Support Staff/Overtime/ Shift Differential & Relief (Titles 101-141)

SUBTOTAL STAFF

150 Payroll Taxes 151 Fringe Benefits T 100 Total Direct

Care/Program Staff

Title Occupancy 301 Program Facilities

* 390 Fac. Oper/Main/Furn T 300 Total Occupancy

UFR

Title Other Direct Care/Program Support

201 Direct Care Consultant 202 Temporary Help 203 Clients/Caregivers.

Reimb/Stipends

206 Subcontract Dir.Care 204 Staff Training 205 Staff Mileage/Travel 207 Meals 208 Contracted Client Trans.

* 208 Vehicle Expenses

* 208 Vehicle Depreciation 209 Incid. Health/Med Care 211 Client Per. Allowances 212 Prov. of Material Good 214 Direct Client Wages 214 Other Commercial Prod. &

Svs.

* 215 Program Supplies/Mat T 200 Total Other Direct

Care/Program

Title Direct Admin Expenses 216 Program Support

* 510 (410 &

390)

Other Direct Administrative Expenses

T 500 Total Direct Administrative Exp.

T SUBTOTAL PROGRAM

COSTS

* 410

Agency Admin. Support Allocation

T PROGRAM TOTAL

Commercial Fee, if applicable, for for-profit contractors only (for informational purposes only; not to be included in the price paid by the Commonwealth): %___$___: N/A for Cost Reimbursement

A. $ ___________ Subtotal of offsets which are for non-reimbursable costs.

Non-reimbursable costs must be shown in detail on Attachment 5 when the program is subject to the provisions of Federal OMB Circular A-122 and/or 808 CMR 1.00.

* Contractor’s Board approved capitalization level relative to any negotiated expense costs in lines 208, 215, 390 or 410 is $___________

Updated 6/19/07 Sensitivity level - low

FY: Contractor Name: Amendment #, if Applicable: If Federal Funds, CFDA #:

PURCHASE OF SERVICE

ATTACHMENT 4: RATE CALCULATION/MAXIMUM OBLIGATION

CALCULATION PAGE

Document ID#: MMARS Activity Code:

Program Type: UFR Prog. #:

UNIT RATE CALCULATION

1. Program Total Costs $_________________

2a. Program Offsets: Source Amount

2b. Offsets for Non-Reimbursable Costs: ______________ _________________ Note: Total non-reimbursable costs listed in line 2b must be detailed on Attachment 5.

2. Subtotal Offsets (Line 2a + Line 2b) ($_________________)

3. Net Adjusted Program Costs (LINE 1 minus LINE 2) $__________________

4. Total Program Capacity ______ (# of units) ______ (Type of unit)

5. Share of Total Capacity Purchased by Contract_______ (# of units) ______ % (% of line 4)

6. Negotiated Utilization Factor, if any ________%

7. Adjusted Capacity Used to Establish Price (LINE 4 x LINE 6) ______ (# of units)

8. Unit Rate (LINE 3 DIVIDED BY LINE 7) ____________

9. Maximum # of Billable Units (LINE 5 x LINE 6) ____________

OTHER PRICE CALCULATION METHOD

10. Enter relevant information: ______________________________________________________________________________

MAXIMUM OBLIGATION CALCULATION

11. For Unit Rate: Line 8 X Line 9 For Other Price Calculation Method, Enter Obligation From Line 10 For Cost Reimbursement: Enter Reimbursable Cost Total From Program Budget $________________

12. Invoice Offset SOURCE AMOUNT

12. Subtotal ($_______________)

13. Maximum Obligation for the Program (LINE 11 minus LINE 12) $_________________

14. Capital Budget (from Attachment 6: Capital Budget), if applicable $_________________

15. Total Maximum Obligation for Program (LINE 13 + LINE 14) $_________________

FOR INFORMATION ONLY: Other Revenue Sources (Only if % in LINE 5 is less than 100%)

SOURCE AMOUNT

Updated 11/1/05

PURCHASE OF SERVICE - UFR TITLES

Refresh Date: July 27, 2006

UFR

Title #

UFR Titles (for a more complete title description, please refer to the UFR Audit & Preparation Manual)

101 Program Manager - An individual who has overall responsibility for the management, oversight and coordination of a programmatic functional area within or across programs as in the case of “Medical Director”, “Residence Director”, “Clinical Director”, “Education Director”, etc.

102 Program Director - An individual who has overall responsibility for the daily operation of one or more individual programs.

103 Assistant Program Director - An individual who reports directly to the Program Director, acts for the Program Director in his/her absence and functions as an adviser/assistant to the Program Director.

104 Supervising Professional - A credentialed professional (physician, psychiatrist, social worker, nurse, etc) whose primary responsibility is the supervision of fellow credentialed professionals in the daily performance of their programmatic functions.

105 Physician - A Board of Registration in Medicine-licensed or Board eligible physician (including all medical specialties, e.g.

dentist, podiatrist except psychiatrist # 121) with either an MD or DO degree whose primary responsibility is delivery or supervision of health/medical care to program participants.

106 Physician’s Assistant - An individual registered with the Department of Public Health and functioning in that capacity.

107 Registered Nurse-Master’s, Nurse Psychiatric Mental Health Specialist, Nurse Practitioner- An individual who possesses a

Master’s degree in nursing and/or is registered with the Board of Registration in Nursing and is functioning in any of the above capacities.

108 Registered Nurse - An individual who is licensed as a registered nurse by the Board of Registration Nursing (both BSNs and others) and is engaged in nursing duties.

109 Licensed Practical Nurse - An individual licensed as a practical nurse by the Board of Registration in Nursing and is engaged in nursing duties.

110 Pharmacist - An individual licensed by the Board of Registration in Pharmacy and functioning as a pharmacist.

111 Occupational Therapist - An individual registered as an occupational therapist by the Board of Registration in Allied Health

Professionals and who provides occupational therapy.

112 Physical Therapist - An individual registered as a physical therapist by the Board of Registration in Allied Health Professionals and who provides physical therapy.

113 Speech/Language Pathologist, Audiologist - An individual registered as a Speech/Language Pathologist or as an Audiologist by the Board of Registration in Speech/Language Pathology and Audiology and provides speech and hearing therapy.

114 Dietitian/Nutritionist - An individual registered as a dietitian by the Commission on Dietetic Registration of the American

Dietetic Association or an individual with a Bachelor’s or Master’s degree in nutrition, who provides nutritional counseling, education, supervision of meal/menu preparation.

115 Special Education Teacher - An individual certified in special education by the Massachusetts Department of Education and working in that capacity.

116 Teacher - an individual certified by the Massachusetts Department of Education, other than special education and working in that capacity.

117 Day Care Director - An individual certified by the Office for Children as a Day Care Director and functioning in that capacity.

118 Day Care Lead Teacher - An individual certified by the Office of Children as a Day Care Lead Teacher and functioning in that capacity.

119 Day Care Teacher - An individual certified by the Office of children as a Day Care Teacher and functioning in that capacity.

120 Day Care Assistant Teacher/Aide - An individual certified by the Office of Children as a Day Care Assistant Teacher/Aide and functioning in that capacity.

121 Psychiatrist - An individual licensed to practice medicine, certified or eligible for certification by the American Board of

Psychiatry and primarily involved in rendering or direction psychiatric care.

122 Psychologist - Doctorate- An individual holding a doctoral degree in psychology (including behavioral psychologist and neuropsychologist) or a closely related field, registered by the Board of Registration of Psychologist and primarily engaged in providing diagnostic evaluations, psychological counseling/therapy or development and implementation of behavioral treatment plans.

123 Clinician (formerly Psychologist - Master's) - An individual holding a Master’s degree in psychology (including behavioral psychologist) or a closely related field and primarily engaged in providing diagnostic evaluations, psychological counseling/therapy or development and implementation of behavioral treatment plans.

124 Social Worker -LICSW - An individual registered as a Licensed Independent Clinical Social Worker by the Board of Registration of Social Workers and primarily engaged in providing diagnostic evaluations, psychological counseling/therapy or development and implementation of behavioral treatment plans.

125 Social Worker-LCSW- An individual registered as a Licensed Certified Social Worker by the Board of Registration of Social Workers and providing social work services.

126 Social Worker - LSW- An individual registered as a Licensed Social Worker by the Board of Registration of Social Workers and providing social work services (including casework/counseling).

127 Licensed Counselor - An individual with at least a Master’s degree in counseling or a related field who is licensed by the appropriate Board of Registration and provides counseling services.

128 Certified Vocational Rehabilitation Counselor - An individual certified by the Committee on Accreditation of Rehabilitation Facilities and provides vocational rehabilitation counseling.

129 Certified Alcoholism Counselor, Certified Drug Abuse Counselor, Certified Alcoholism/Drug Abuse Counselor- An individual registered as either an Alcoholism Counselor, Drug Abuse Counselor or both by the Massachusetts Board of Substance Abuse Counselor Certification and who provides counseling services for substance abusers.

130 Counselor - An individual who provides therapeutic or instructive counseling to program clients/service recipients.

131 Case Worker/Manager - Master’s - An individual possessing at least a Master’s degree in counseling, or a closely related discipline, providing casework/case management services including service eligibility determination, service plan development, service coordination, resource development advocacy, etc.

132 Case Worker/Manager - An individual , providing casework/case management services including service eligibility determination, service plan development service coordination, resource development advocacy, etc.

133 Direct Care/Program Staff Supervisor - A staff member whose primary responsibility is the supervision of nonprofessional or paraprofessional direct care/program staff in the performance of their programmatic functions or whose duties involve significant responsibility for program operations or logistics. A supervisor in this component may also perform direct client care.

134 Direct Care/Program Staff III - Staff, other than those described above, requiring a doctoral or Master’s degree, specific credentials or licensure, significant experience, or specialized skills, who are responsible for the general daily care of program clients/service recipients or for primary program service delivery.

135 Direct Care/Program Staff II - Staff, other than those described above, requiring a Bachelor’s degree, experience or specific skills who are responsible for the general daily care of program clients/service recipients or for primary program service delivery.

136 Direct Care/Program Staff I - Staff, other than those defined above, who are responsible for the general daily care of program clients/service recipients or for primary program service. This includes relief employees on payroll.

137 Program Secretarial, Clerical Staff - Individuals required to carry on direct program clerical activities such as program or client record keeping.

138 Program Support, Housekeeping, Maintenance, Janitorial, Groundskeeper, Drive, Cook - Individuals who carry our direct program activities for client health and safety.

150 Payroll Taxes - Employer’s share of FICA, MUCIA, Worker’s Compensation Insurance, FUTA (in the case of for-profit providers) and other payroll taxes paid by the employer on the direct care/program staff listed in category 1 on the budget.

151 Fringe Benefits - Life, health and medical insurance, pension and annuity plan contributions, day care, tuition benefits and all other non-salary/wage benefits received by direct care/program staff listed in category 1 on the budget.

Sensitivity level - low

RFR - REQUIRED SPECIFICATIONS FOR PURCHASE OF SERVICE (POS)

Published Date: September 1, 2019

The following RFR provisions must appear in all Commonwealth competitive procurements conducted under 801 CMR 21.00. In general, most of the required contractual stipulations are referenced in the Standard Contract Form and Instructions and the Commonwealth Terms and Conditions for Human and Social Services (also referred to as Purchase of Service).

The terms of 801 CMR 21.00: Procurement of Commodities and Services and 808 CMR 1.00: Compliance, Reporting and Auditing for Human and Social Services, are incorporated by reference into this RFR. Words used in this RFR shall have the meanings defined in 801 CMR 21.00 and 808 CMR 1.00. Additional definitions may also be identified in this RFR. Other terms not defined elsewhere in this document may be defined in OSD’s Glossary of Terms. Unless otherwise specified in this RFR, all communications, responses, and documentation must be in English, and all cost proposals or figures in U.S. currency. All responses must be submitted in accordance with the specific terms of this RFR.

COMMBUYS Market Center. COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at www.commbuys.com. Information contained in this document and in COMMBUYS, including file attachments and information contained in the related Bid Questions and Answers (Q&A), are all components of the Bid, as referenced in COMMBUYS, and are incorporated into the Bid and any resulting contract.

Bidders are solely responsible for obtaining all information distributed for this Bid via COMMBUYS. Bid Q&A supports Bidder submission of written questions associated with a Bid and publication of official answers.

It is each Bidder’s responsibility to check COMMBUYS for:

• Any amendments, addenda, or modifications to this Bid, and

• Any Bid Q&A records related to this Bid.

The Commonwealth accepts no responsibility and will provide no accommodation to Bidders who submit a Quote based on an out-of-date Bid or on information received from a source other than COMMBUYS.

COMMBUYS Registration. To respond to a Bid, Bidders must register and maintain an active COMMBUYS Seller account. Bidders may elect to obtain a free COMMBUYS Seller registration which provides value-added features, including automated email notification associated with postings and modifications to COMMBUYS records.

All Bidders submitting a Quote (previously referred to as Response) in response to this Bid (previously referred to as Solicitation) agree that, if awarded a contract: (1) they will maintain an active seller account in COMMBUYS; and (2) in the event the Commonwealth adopts an alternate market center system, successful Bidders will be required to utilize such system, as directed by the procuring entity. Commonwealth Commodity Codes are based on the United Nations Standard Products and Services Code (UNSPSC).

COMMBUYS introduces new terminology, with which bidders must be familiar to conduct business with the Commonwealth. To view this terminology and to learn more about COMMBUYS, please visit the Learn about COMMBUYS page on www.mass.gov.

Multiple Quotes. Bidders may not submit Multiple Quotes in response to a Bid unless the RFR authorizes them to do so. If a Bidder submits multiple quotes in response to an RFR that does not authorize multiple responses, only the latest dated quote submitted prior to the bid opening date will be evaluated.

Quote Content. Bid specifications will prevail over any proposed Bidder terms entered as part of the Quote, unless otherwise specified in the Bid.

Supplier Diversity Program (SDP). Massachusetts Executive Order 565 reaffirmed and expanded the Commonwealth’s policy to promote the award of state contracts in a manner that develops and strengthens certified Minority Business Enterprises (MBEs), Women Business Enterprises (WBEs), Minority and Women http://www.mass.gov/anf/budget-taxes-and-procurement/oversight-agencies/osd/glossary-of-terms.html http://www.commbuys.com/ http://www.mass.gov/anf/budget-taxes-and-procurement/procurement-info-and-res/conduct-a-procurement/commbuys/quick-click-resource-center.html http://www.mass.gov/anf/budget-taxes-and-procurement/procurement-info-and-res/conduct-a-procurement/commbuys/quick-click-resource-center.html http://www.mass.gov/governor/legislationexecorder/execorders/executive-order-no-565.html

Sensitivity level - low

Nonprofit Organizations (M/WNPOs), Veteran Business Enterprises (VBEs), Service-Disabled Veteran- Owned Business Enterprises (SDVOBEs), Disability-Owned Business Enterprises (DOBEs), and Lesbian, Gay, Bisexual and Transgender Business Enterprises (LGBTBEs).

In support of this Executive Order, the Commonwealth tracks SDP spending through POS contracts. As a result, providers that are issued a contract from this procurement (Bid) will be required to submit a “Supplier Diversity Program (SDP) Plan Form for Purchase of Service (POS)” with their Uniform Financial Report (UFR) through the Operational Services Division’s (OSD) eFiling site. Providers that file a UFR exemption request are to submit the SDP Plan Form for POS with their exemption request. The plan will be evaluated yearly by the Commonwealth Department with the most Purchase of Service funding to a provider during the previous fiscal year. This Department commonly is referred to as the Principal Purchasing Agency (PPA).

Bidders are to submit a copy of their most recently submitted “SDP Plan Form for POS” with their proposal (Quote) for procurements (Bids) in excess of $150,000 to signify to the Procurement Management Team that a form has been submitted. Bidders that do not currently hold POS contracts with Commonwealth Departments are to complete the Form and include it with their proposal. The “SDP Plan Form for POS” may be found at the COMMBUYS Bid Solicitation; File Attachments Section. While the Plan will not be assigned any points in the evaluation process, a Department will not be able to issue a contract to an organization that has not submitted a Plan that demonstrates a strong commitment to working with MBEs, WBEs, M/WNPOs, VBEs, SDVOBEs, DOBEs, and/or LGBTBEs.

Resources available to assist providers in identifying SDP Certified Partners are located on the Supplier Diversity Program webpage at www.mass.gov/sdp. See “Which businesses are eligible to serve as SDP partners?” for resources to identify potential SDP partners.

Best Value Selection and Negotiation. The Procurement Management Team or PMT (also known as Strategic Sourcing Services Team or SSST) may select the response(s) which demonstrates the best value overall, including proposed alternatives that will achieve the procurement goals of the department. If services are not rate regulated, the PMT and a selected bidder, or a contractor, may negotiate a change in any element of contract performance or cost identified in the original RFR or the selected bidder’s or contractor’s response, which results in a more cost effective or better value.

Bidder Communication. Bidders are prohibited from communicating directly with any employee of the procuring department or any member of the PMT regarding this RFR except as specified in this RFR, and no other individual Commonwealth employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFR. Bidders may contact the contact person for this RFR in the event this RFR is incomplete or the bidder is having trouble obtaining any required attachments electronically through COMMBUYS.

Contract Expansion. If additional funds become available during the contract duration period, the department reserves the right to increase the maximum obligation or the number of units purchased to some or all contracts executed as a result of this RFR or to execute contracts with contractors not funded in the initial selection process, subject to available funding, satisfactory contract performance, and service need.

Costs. Costs which are not specifically identified in the bidder’s response, and accepted by a department as part of a contract, will not be compensated under any contract awarded pursuant to this RFR. The Commonwealth will not be responsible for any costs or expenses incurred by bidders responding to this RFR.

Debriefing. POS requirement only. Non-successful bidders may request a debriefing from the department that issued the RFR. Department debriefing procedures may be found in the RFR. Non-successful POS bidders aggrieved by the decision of a department must participate in a debriefing as a prerequisite to an administrative appeal.

Debriefing/Appeals: Administrative Appeals to Departments. POS requirement only. Non-successful bidders who participate in the debriefing process and remain aggrieved with the decision of the department may appeal that decision to the department head. Department appeal procedures may be found in the RFR.

Debriefing/Appeals: Administrative Appeals to OSD. POS requirement only. Non-successful bidders who participate in the department appeal process and remain aggrieved by the selection decision of the department http://www.mass.gov/sdp http://www.mass.gov/sdp http://www.mass.gov/sdp

Sensitivity level - low may appeal the department decision to the Operational Services Division. The basis for an appeal to OSD is limited to the following grounds:

1. The competitive procurement conducted by the department failed to comply with applicable regulations and guidelines. These would be limited to the requirements of 801 CMR 21.00 or any successor regulations, the policies in the OSD Procurement Information Center, subsequent policies and procedures issued by OSD, and the specifications of the RFR; or

2. There was a fundamental unfairness in the procurement process. The allegation of unfairness or bias is one that is easier to allege than prove, consequently, the burden of proof rests with the bidder to provide sufficient and specific evidence in support of its claim. OSD will presume that departments conducted a fair procurement absent documentation to the contrary.

Requests for an appeal must be sent to the attention of the Operational Services Division, Legal, Policy and Compliance Office, Room 1017, One Ashburton Place, Boston, MA 02108 and be received within fourteen

(14) calendar days of the postmark of the notice of the department head’s decision on appeal. Appeal requests must specify in sufficient detail the basis for the appeal. Sufficient detail requires a description of the published policy or procedure which was applied and forms the basis for the appeal and presentation of all information that supports the claim under paragraphs 1 or 2 above. OSD reserves the right to reject appeal requests based on grounds other than those stated above or those submitted without sufficient detail on the basis for the appeal.

The decision of the Operational Services Division shall be rendered, in writing, setting forth the grounds for the decision within sixty (60) calendar days of receipt of the appeal request. Pending appeals to the Operational Services Division shall not prohibit the department from proceeding with executing contracts.

Electronic Communication/Update of Bidder’s/Contractor’s Contact Information. It is the responsibility of the prospective bidder and awarded contractor to keep current on COMMBUYS the email address of the bidder’s contact person and prospective contract manager, if awarded a contract, and to monitor that email inbox for communications from the PMT, including requests for clarification. The PMT and the Commonwealth assume no responsibility if a prospective bidder’s/awarded contractor’s designated email address is not current, or if technical problems, including those with the prospective bidder’s/awarded contractor’s computer, network, or internet service provider (ISP) cause email communications sent to/from the prospective bidder/awarded contractor and the PMT to be lost or rejected by any means including email or spam filtering.

Electronic Funds Transfer (EFT). All Bidders must agree to participate in the Commonwealth Electronic Funds Transfer (EFT) program for receiving payments. Additional information about EFT is available on the Comptroller’s VendorWeb site located at: https://massfinance.state.ma.us/VendorWeb/vendor.asp.

Upon notification of award, Contractors are required to enroll in EFT by completing and submitting the “Authorization for Electronic Funds Payment Form” to the SSST for review, approval, and forwarding to the Office of the Comptroller, unless already enrolled in EFT. A copy of the form will be supplied to the successful bidder upon award. This form, and all information contained on this form, shall not be considered a public record and shall not be subject to public disclosure through a public records request.

Executive Order 509, Establishing Nutrition Standards for Food Purchased and Served by State Agencies.