County of Orange

Health Care Agency

Request for Applications

RFA No.: 042-3068503-KL

Rapid Antiretroviral Therapy (ART)

Protocol

Released Tuesday, May 26, 2026

Request for Applications 2 of 23 Rapid Antiretroviral Therapy (ART) Protocol

TABLE OF CONTENTS

SECTION 1. INTRODUCTION AND GENERAL INFORMATION

SECTION 2. MINIMUM SUBMISSION REQUIREMENTS

SECTION 3. APPLICATION PREPARATION AND EVALUATION

SECTION 4. PROTEST PROCEDURES

SECTION 5. INDEMNIFICATION AND INSURANCE PROVISIONS

SECTION 6. DESCRIPTION OF SERVICES

SECTION 7. APPLICANT RESPONSES

Request for Applications 3 of 23 Rapid Antiretroviral Therapy (ART) Protocol

1 INTRODUCTION AND GENERAL INFORMATION

1.1 APPLICATION FOCUS AND BACKGROUND

The County of Orange (County) Health Care Agency is seeking applications from qualified organizations that are licensed emergency departments, to provide Rapid Antiretroviral Therapy (ART) Protocol.

Rapid ART Protocol is intended to support the development of practical, evidence-based protocols that improve linkage to care for individuals newly diagnosed with HIV and people living with HIV (PLWH) who are re-engaging in care. Respondents are expected to create evidence-based, streamlined, and practical protocols that integrate Rapid ART into existing emergency department setting workflows, minimize handoffs, and treat initiation of ART as a standard component of care.

This RFA solicits protocol development and implementation planning, not direct clinical service delivery.

The goal of this opportunity is to increase and streamline linkage to HIV care in emergency settings by developing a feasible workflow and protocols for providing ART within seven (7) calendar days of diagnosis, disclosure, or re-engagement. Selected applicants will collaborate with County to design patient-centered procedures that can be integrated into existing clinical operations, reduce delays to treatment, and improve patient outcomes.

As of 2024, there were 6,955 PLWH in Orange County who are aware of their HIV status and an estimated 1,706 individuals who remain unaware of their infection. In 2024, 230 individuals in Orange County were newly diagnosed with HIV, and 56 (24%) were concurrently diagnosed with AIDS, indicating prolonged undiagnosed infection prior to testing. Among all PLWH aware of their status, 72.1% achieved viral suppression which is crucial for maintaining health and preventing the transmission of HIV. Additionally, 78.2% received HIV care, and 57.0% were retained in care. For additional local surveillance data, please visit: OChealthinfo.com. OC Health Care Agency | Orange County California - Health Care Agency.

Rapid ART is the immediate initiation of HIV therapy at the time of diagnosis or immediately upon reengaging in care for PLWH. Early treatment improves health outcomes and reduces HIV transmission. While best practice is to initiate ART within 72 hours, for the purposes of this RFA, “Rapid ART” is defined as initiating ART within seven (7) calendar days of an HIV diagnosis or disclosure of results.

1.2 CONTRACT TERM AND FUNDING AVAILABILITY

County plans to contract with applicants who meet the requirements of this solicitation to provide the subject services. At the discretion of County, the initial term of the contract(s) resulting from this solicitation may be renewed for an additional term or terms. Any renewal is contingent upon available funding, contractor performance, need for services, and County policies.

Successful applicants are expected to accept all of the terms and conditions of the attached Model Contract, which contains the contract requirements between County and the applicant regarding the provision of services solicited under this Request for Applicants (RFA). Any exceptions to the Contract Template must be indicated in the Vendor Responses. The selected application will be retained and incorporated into the contract by reference and made part thereof, except for assurances and promises that are unlawful.

https://www.ochealthinfo.com/ https://www.ochealthinfo.com/

Request for Applications 4 of 23 Rapid Antiretroviral Therapy (ART) Protocol

Contract(s) resulting from this solicitation shall be a cooperative contract and may be utilized by all County of Orange departments.

The provisions and pricing of any contract resulting from this solicitation will be extended to other governmental entities. Governmental entities wishing to use this Contract will be responsible for issuing their own purchase documents, providing for their own acceptance, and making any subsequent payments. Contractor shall be required to include in any subordinate contract entered into with another governmental entities pursuant to this contract, a contract clause that will hold harmless the County of Orange from all claims, demands, actions or cause of actions of every kind resulting directly or indirectly, arising out of, or in any way connected with, the use of this contract. Failure to do so will be considered a material breach of this contract and grounds for immediate contract termination. Governmental entities are responsible for obtaining all certifications of insurance, endorsements, and bonds required. The Parties agree that any other governmental entity utilizing this contract shall not be deemed to be an agency or employee of County for any purpose whatsoever. Contractor is responsible for providing each governmental entity a copy of this contract upon request. County makes no guarantee of usage by other users of this contract.

Contractor shall maintain a list of the County of Orange departments and governmental entities using this contract. The list shall report dollar volumes spent annually and shall be provided on an annual basis to County, at County’s request.

Subordinate contracts must be executed prior to the expiration or earlier termination of this contract and may survive the expiration of this contract up to a maximum of one year; however, in no case shall a subordinate contract exceed five (5) years in duration.

The contract(s) awarded through this solicitation is anticipated to be Professional Services. The funding source for these services is HRSA Ending the HIV Epidemic (EHE) funds. Any contract resulting from this solicitation is contingent upon sufficient funds being made available by federal, state, and/or county governments for the term of the contract. County reserves the right to revise the contract term stated in this solicitation. Start-up funds may be available for these services, with proper justification, and may be negotiable.

1.3 TIME APPLICATIONS WILL REMAIN VALID

Applications will remain valid for 365 days from the solicitation due date.

1.4 TIMELINE

Timeline dates are approximations only and do not constitute any commitment or guarantee by County.

RFA Released: May 26, 2026

RFA Q&A Deadline: July 24, 2026, 4:00pm

Applications Due: July 31, 2026, 4:00pm

Services Commence: August 10, 2026

1.5 WITHDRAWAL OF APPLICATIONS(S)

An application may be withdrawn by the applicant or an authorized representative, provided his or her identity is made known, and he or she provides a receipt for the application, but only if the withdrawal is made prior to the application due date.

Request for Applications 5 of 23 Rapid Antiretroviral Therapy (ART) Protocol

1.6 QUESTIONS REGARDING THE RFA PROCESS AND REQUIREMENTS

All questions regarding this RFA are to be posted online via The County’s online bidding system Question and Answer (Q&A) Section and will only be accepted and answered during the Q&A period that lasts until approximately one (1) week prior to the RFA closing date.

All applicants are expected to thoroughly read through the entire RFA package before posting questions. All participating applicants will simultaneously receive a notification via The County’s online bidding system that a question has been posted related to this RFA and will be available for view by all participating applicants. County’s responses to the questions asked will be posted as promptly as possible to The County’s online bidding system and will be available for view by all participating applicants.

The Q&A Section will close on Friday, June 26, 2026 at 4:00 pm Pacific Time. All applicants are encouraged to post any questions regarding the RFA by this deadline. After the close of the Q&A period, applicants may only contact the Procurement Administrator with questions related to uploading applications to the County’s online bidding system. No other specific solicitation-related questions will be answered.

It is up to each individual applicant to determine if their organization meets the eligibility criteria stated in the RFA prior to submitting an application. County does not provide any assistance to that effect.

Applicants are to strictly follow the directions above for questions regarding this RFA. During the entire RFA process, no County representative may be contacted for questions or information regarding this RFA with the exception of the assigned Procurement Administrator, Karen Leland

1.7 GENERAL INSTRUCTIONS FOR SUBMITTAL

A. Use the Application Preparation Checklist to plan and monitor solicitation application preparation as well as to verify completion of all materials before submission.

B. Applicant’s application must clearly meet all of the requirements of this solicitation.

C. Applicants should review all requirements and instructions to ensure that each requirement is met. County shall not be responsible for any oral instructions given by any employees of County in regard to the application instructions, specifications, or application documents as described in this solicitation.

D. Applications and requested documents must be electronically uploaded in PDF format, via County’s online bidding system. Hard copy applications will not be accepted.

E. Allow sufficient time to upload all required files. After the application deadline, County’s online bidding system will not allow any uploads. If all files are not uploaded successfully by the application deadline, Applicant’s application will not be accepted.

F. Provide accurate and honest information. Information that is deliberately inaccurate may prompt an investigative review and will affect the evaluation of the application.

G. Provide documentation where necessary, including items such as forms, licenses, etc.

H. If Applicant intentionally omits any required information or data, explain why.

I. Do not include home addresses, home phone numbers, and/or personal email addresses for any employee, volunteer, Board member, etc. in the application.

Request for Applications 6 of 23 Rapid Antiretroviral Therapy (ART) Protocol

NOTE: Electronic Applications cannot be viewed by County until after the solicitation deadline.

If you encounter any problems with your registration, system, bid/proposal submission, or other system issues, please contact OpenGov’s support staff via the live chat option or via email at procurement-support@opengov.com.

1.8 COUNTY RESERVES THE RIGHT TO:

A. Modify this RFA prior to the time applications are due, provided applicants are granted such extensions as necessary to allow sufficient time for submission of applications in response to the modified RFA.

B. Cancel this RFA at any time, but prior to award of a contract by the Board of Supervisors, in whole or in part, when it is determined that cancellation is in the best interest of County.

C. Reject any or all applications.

D. Reject an application at any time during the RFA process for reasons stated in this RFA or for false information submitted in response to the RFA.

E. Enter into a contract for all or some of the stated services.

F. Award single or multiple contracts.

G. Based on County’s needs and availability of funds, modify the scope of service described herein, provided applicants are allowed to re-submit modified applications within a reasonable time.

H. Ask applicants for additional information or documentation.

1.9 USE OF LOBBYISTS

County does not require, and neither encourages nor discourages, the use of lobbyists or other consultants for the purpose of securing business.

1.10 CHANGE OF OWNERSHIP/NAME AND LITIGATION STATUS

Applicant agrees that if there is a change or transfer in ownership of applicant’s organization prior to the completion of the contract, and County agrees to an assignment of the contract, the new owners shall be required under the terms of sale or other instruments of transfer to assume the duties and obligations contained in the contract and complete them to the satisfaction of County.

County reserves the right to immediately terminate the contract in the event County determines that the assignee is not qualified or is otherwise unacceptable to County for the provision of services under the contract.

1.11 CONFLICT OF INTEREST

Applicant shall exercise reasonable care and diligence to prevent any actions or conditions that could result in a conflict with County interests. In addition to the applicant, this obligation shall apply to the applicant’s employees, agents, and subcontractors associated with the provision of goods and services provided under the contract. The applicant’s efforts shall include, but not be limited to, establishing rules and procedures preventing its employees, agents, and subcontractors from providing or offering gifts, entertainment, payments, loans or other considerations which could be deemed to influence or appear to influence County staff or elected officers in the performance of their duties.

mailto:procurement-support@opengov.com

Request for Applications 7 of 23 Rapid Antiretroviral Therapy (ART) Protocol

County reserves the right to disqualify any applicant on the basis of any real or apparent conflict of interest that is disclosed by the application submitted or any other information available to County. This disqualification is at the sole discretion of County. Any applicant submitting an application herein waives any right to object to County’s exercise of this right, now or at any future time, before anybody or agency including, but not limited to, the County Board of Supervisors or any court of competent jurisdiction.

1.12 CONFIDENTIALITY

California Public Records Act

Pursuant to California law, all information contained in an application may be public record, subject to disclosure to any member of the public who requests it through the California Public Records Act (CPRA).

1.13 MODIFICATIONS OF THE RFA

County reserves the sole right to interpret or change any provision of the solicitation at any time prior to the application submission date. Any and all interpretations or changes will be in the form of a written addendum, which will be furnished to all applicants through County’s online bidding system. All addendums issued will become part of the solicitation and resultant contract.

Applicants hereby acknowledge their receipt of any addendum by being registered in County’s online bidding system and acknowledge it is the applicant’s responsibility to check for, and read all addendums posted in County’s online bidding system.

Should such addendum require information not previously requested, County at its sole discretion, may determine that a time extension is required for the submission of applications, in which case an addendum will indicate the new application submission date.

2 MINIMUM SUBMISSION REQUIREMENTS

The following are the submission requirements for an applicant to be considered as an eligible candidate to be considered for the requested services described in this RFA. Should any of this information be missing, the applicant may be deemed non-responsive.

Provide the information requested below in one (1) file labeled [Solicitation Name]-[Applicant

Name] per the instructions in Section I. G. “General Instructions for Submittal”. Failure to provide and/or disclose requested information and/or documents may result in disqualification of your application.

A. Cover Page/Executive Summary. All Applications must be accompanied by a cover letter of introduction and executive summary of the application. The cover letter must be signed by person(s) with authority to bind the applicant together with the main office address, and telephone number (including area code). If the applicant is a corporation, two (2) signatures are required: one (1) signature by the Chairman of the Board, the President or any Vice President; and one (1) signature by the Secretary, any Assistant Secretary, the Chief Financial Officer or any Assistant Treasurer. The signature of one (1) person alone is sufficient to bind a corporation, if he or she holds corporate offices in each of the two (2) categories described above. For County purposes, proof of such dual office holding will be satisfied by having the individual sign the instrument twice, each time indicating his or her office that qualifies under the above-described provision. In the alternative, a single corporate signature is acceptable when accompanied by a corporate resolution demonstrating the legal authority of the signatory to bind the corporation. An unsigned or

Request for Applications 8 of 23 Rapid Antiretroviral Therapy (ART) Protocol improperly signed application submission is grounds for rejection of the application and disqualification from further participation in this RFA process.

B. Complete the Agency Description Form (Form B – Attachment II). Ensure Form B and Applicant’s Certification (Form C – Attachment II) are signed prior to submission.

C. Complete the Applicant Certification Form (Form C – Attachment II)

D. Complete the Board of Directors Form (Form D – Attachment II)

E. Complete the Campaign Contribution Disclosure Form. LEVINE ACT – COUNTY OF ORANGE CAMPAIGN CONTRIBUTION DISCLOSURE: Effective January 1, 2025, Senate Bill No. 1243 and Senate Bill No. 1181 amends § 84308 of the California Government Code, commonly referred to as the “Levine Act.” The Levine Act precludes an Officer of a local government agency from participating in the award of a contract if he or she receives any political contributions totaling more than $500 in the 12 months preceding the pendency of the contract award, and for three months following the final decision, from the person or company awarded the contract. This prohibition applies to contributions to the Officer or received by the Officer on behalf of any other Officer, or on behalf of any candidate for office or on behalf of any committee. The Levine Act also requires disclosure of such contributions by a party to be awarded a specified contract.

Proposers/bidders are responsible for reviewing and completing the attached County of Orange Campaign Contribution Disclosure Form as a minimum submittal requirement for all County solicitations.

F. Applicant must demonstrate prior or current services to the HIV population in the public sector and must provide a minimum of three (3) references. Please include the following information for each of the three references:

• Company Name

• Contact Name

• Email Address

• Telephone

• Address

G. Provide copies of the documents below. Include an index of all the documents included, and an explanation for any document requested but not provided.

1. If incorporated:

a. Articles of Incorporation executed by the Secretary of State, including all amendments.

b. By-laws, including all amendments.

c. Board of Directors resolution empowering a Corporate Officer either by title or individual name, to act on behalf of the organization by his/her signature alone.

2. If not incorporated, documentation empowering an Authorized Representative to act on behalf of the organization by his/her signature alone.

3. Fictitious Business Name statement filed with the County Clerk and proof of publication.

Request for Applications 9 of 23 Rapid Antiretroviral Therapy (ART) Protocol

4. Partnership papers and/or joint venture contracts.

5. Evidence of federal/state tax status.

6. IRS W-9 Form: Request for Taxpayer Identification Number and Certification.

7. Business License/Certifications/Conditional Use Permit (CUP).

8. Table of contents from the organization’s policies and procedures manual covering daily operations and emergency procedures (medical, fire, etc.). If a policies and procedures manual does not exist, provide a plan and time frame for development.

9. Corporate organizational chart that includes all programs, identifies the relationship of the proposed program to the overall organization, and identifies the reporting relationship of each proposed staff position.

10. Unique Entity Identifier (UEI): A unique twelve-character identification number required by the federal government as part of their financial request and reporting process, which can be obtained free of charge from the SAM.GOV website (https://sam.gov/content/entity-registration). Every applicant must provide a UEI number regardless of the funding source of this solicitation.

H. Recent financial statement prepared by an independent Certified Public Accounting (CPA) firm.

I. Any audits, reviews, or inspection reports completed by a CPA firm, regulatory agency (e.g., Occupational Safety and Health Administration), or other government agency within the last 12 months.

J. Provide a description of any active litigation and resolution, performance issues and/or audit or review of any contractual documents (e.g., invoices, units of service reports, etc.)

within the last five (5) years that resulted in a corrective action plan, reimbursement of money to funder, investigation, and/or termination of any agreements or contracts between your organization and the County of Orange, other government entity, and/or private organization. Provide a copy of a letter from your attorney and/or in-house legal counsel concerning the status of lawsuits and pending litigation for the most recent year. IF THERE ARE NONE, PLEASE STATE SUCH IN THE SUBMITTAL RESPONSE. For each litigation and or performance issue include:

1. The type of contracts, contract term (dates), funding amount and services provided.

2. The issues and circumstances.

3. How and when the issues were resolved.

4. Your plans to ensure that the issues will not re-occur in future contracts.

K. Attach detailed information regarding past, current, or threatened litigation, liens, or claims (including claims filed or pending with Financial Industry Regulatory Authority and/or with the Security Exchange Commission) within the past five (5) years involving your company, or any company your company holds a controlling interest in, or any company that holds an interest in your company, or any of the principal officers of your company that has also involved the County of Orange or any of its officers or agencies.

L. Complete the Applicant Responses.

https://sam.gov/content/entity-registration)

Request for Applications 10 of 23 Rapid Antiretroviral Therapy (ART) Protocol

3 APPLICATION PREPARATION AND EVALUATION

Applicants should review all requirements and instructions to ensure that each requirement is clearly addressed in the application.

3.1 ELIGIBILITY TO SUBMIT APPLICATIONS

To be eligible to submit an application for these services, the applicant must be a licensed Emergency Department (ED). Eligible organizations need to serve Orange County residents and have a location in Orange County, California.

In order to be eligible to contract with County, an individual or entity must not be listed on the current Cumulative Sanction List of the Office of the Inspector General (U.S. Department of Health and Human Services), the General Services Administration’s list of parties excluded from federal programs, or the California Medi-Cal Suspended and Ineligible Provider List.

Accordingly, County will not review any application submitted by an individual or entity found to be on any of these lists and the application will automatically be rejected. County will notify the applicant of this determination in writing.

County plans to use the following databases to identify individuals and entities that are not eligible to contract with County:

• https://exclusions.oig.hhs.gov/

• https://sam.gov/search/

• Medi-Cal Suspension Search Database

It is the sole responsibility of all applicants to verify that they are not on any of these lists prior to preparing and submitting an application in response to this RFA. Correction of any errors found on any of the lists, above, is the sole responsibility of the applicant and must be made prior to submission of the application.

In addition, in order to be eligible to enter into a contract with County, an individual or entity must not have any pending charge(s) or conviction(s) for violation of criminal law(s) and/or any sanction(s) or disciplinary action(s) imposed or taken against them by any federal or state law enforcement, regulatory or licensing agency or body, including exclusion from Medicare and Medicaid programs. Accordingly, all applicants must self-disclose with explanation, or deny the existence of this information pertaining to their principals, executives, and managers directly involved with the performance of the services solicited herein in Attachment II. Form C “Applicant Certifications”.

3.2 REJECTION OF APPLICATION(S)

County reserves the right to reject any application at any time during the RFA process on the basis of any substantiated actual and/or apparent conflict of interest regarding the performance of the proposed services solicited under this RFA. All applicants must self-disclose any potential and/or actual conflict of interest(s) in Attachment II. Form C “Applicant’s Certifications”. Any applicant submitting an application herein waives any right to object to County’s exercise of this right, now or at any future time, before anybody or agency including, but not limited to, the County Board of Supervisors or any court of competent jurisdiction.

As soon as County has determined that an applicant has a conflict of interest as stated herein, County will provide written notification of such conflict and rejection of the application.

County also reserves the right to reject any application at any time during the RFA process on the basis of any one or more of the following substantiated grounds:

https://exclusions.oig.hhs.gov/ https://sam.gov/search/

Request for Applications 11 of 23 Rapid Antiretroviral Therapy (ART) Protocol

A. Evidence of collusion amongst applicants;

B. Lack of such business skills and/or financial resources necessary and appropriate to successfully operate the services solicited in this RFA, as revealed by either the financial statement or experience statement;

C. Default on, or unpaid, County debt;

D. Default on any obligation to County;

E. Current or past failure to perform to County standards any obligation of a contract with County, as determined by County; and

F. Ineligible to enter into a contract with County, as set forth in Section “Applicants’ Eligibility to Contract with County”.

All applications that are irregular, incomplete, conditional, ambiguous and/or obscure and not minor irregularities and/or immaterial or inconsequential variations from the RFA requirements will be rejected. County will provide a written notification of the grounds upon which an application is rejected.

3.3 MINOR IRREGULARITIES AND DEFICIENCIES IN APPLICATION(S)

County reserves the right at its sole discretion, to accept an application containing a minor irregularity or when a defect or variation is immaterial or inconsequential.

County reserves the right to waive any and all minor irregularities in lieu of seeking corrections thereof. All requests for correction of minor irregularities or notification of waiver thereof will be given to applicants in writing.

3.4 NON-RESPONSIVE APPLICATION(S)

Any application which fails to conform to the essential requirements of this RFA, such as specifications, may be rejected as non-responsive.

County will provide a written notification of rejecting non-responsive applications, which will state the specific grounds for the rejection. Therefore, it is the sole responsibility of the applicants to ensure their applications are conforming and responsive to all requirements of this RFA.

3.5 EVALUATION OF APPLICATIONS AND SELECTION OF PROVIDERS

County plans to review all applications received and enter into contract negotiations with applicants that meet all requirements.

County has the right to conduct a compensation plan analysis to review and audit all business records and related documents of any any/all applicants (including an affiliated or parent company), determine the adequacy, fairness, and reasonableness of the application, and to contact any and all client references.

County’s determination as to whether an applicant is qualified and responsive will be based on the information furnished by the applicant in this solicitation, interview(s) with the applicant (if applicable), as well as from other sources determined to be valid by County. Award will not be made until after such investigations, as are deemed necessary, are made by County regarding the experience and financial responsibility of applicant, which each applicant agrees to permit by submitting its application.

4 PROTEST PROCEDURES

Request for Applications 12 of 23 Rapid Antiretroviral Therapy (ART) Protocol

Any actual or prospective bidder or respondent who alleges an error or impropriety in the solicitation or award of a contract may submit a grievance or protest to Karen Leland at kleland@ochca.com, as set forth herein.

Protest of Solicitation Specifications:

All protests related to solicitation specifications must be submitted to HCA Procurement and Contract Services no later than five (5) business days prior to the close of the solicitation period.

Protests received after the five (5) business day deadline will not be considered by County. In the event the protest of specifications is denied, and the protester wishes to continue in the solicitation process, it must still submit an application prior to the closing of the solicitation in accordance with the application submittal procedures provided in the solicitation.

Protest of Award of Contract:

A. Protests related to the award of a contract must be submitted to the Deputy Procurement Agent (DPA), no later than five (5) business days after the Notice of Solicitation Ranking Results is provided by the DPA.

B. Protests relating to a proposed contract award received after the five (5) business day deadline will not be considered by County.

C. If the five (5) business day period expires without the receipt of a protest, the department may move forward with the contract award or if necessary, file the item for approval by the Board of Supervisors.

Protest Process

All protests shall be typed under the protestor’s letterhead and submitted in accordance with the provisions stated herein. All protests shall include at a minimum the following information:

o The name, address, and telephone number of the protestor;

o The signature of the protestor or the protestor’s representative;

o The solicitation or contract number;

o A detailed statement of the legal and/or factual grounds for the protest; and, o The form of relief requested.

o Written protests must be sent to:

▪ County of Orange/Health Care Agency Procurement and Contract Services, 405 West 5th Street, Suite 600Attn: Karen Leland at Kleland@ochca.com

APPEALS PROCESS

A. If the protestor wishes to appeal the protest decision of the Deputy Procurement Agent, the protestor must submit, within three (3) business days from receipt of the Deputy Procurement Agent’s decision, a written appeal to the Office of the County Procurement Officer.

Written appeals must be sent by mail to the address below with a courtesy copy by email;

County of Orange/County Executive Office County Procurement Office

Request for Applications 13 of 23 Rapid Antiretroviral Therapy (ART) Protocol

400 W. Civic Center Drive, 5th Floor Santa Ana, CA 92701 Attn: County Procurement Officer CPOAppeals@ceo.oc.gov

B. Within fifteen (15) business days, the County Procurement Officer will review all materials in connection with the appeal, assess the merits of the protest and provide a written determination that shall contain his or her decision on whether the appeal shall be forwarded to the Procurement Appeals Board.

C. The decision of the County Procurement Officer on whether to allow the appeal to go forward will be final and there shall be no right to any administrative appeals of this decision.

5 INDEMNIFICATION AND INSURANCE PROVISIONS

5.1 Indemnification

Contractor agrees to indemnify, defend with counsel approved in writing by County, and hold County, its elected and appointed officials, officers, employees, agents and those special districts and agencies which County’s Board of Supervisors acts as the governing Board (“County Indemnitees”) harmless from any claims, demands or liability of any kind or nature, including but not limited to personal injury or property damage, arising from or related to the services, products or other performance provided by Contractor pursuant to this Contract. If judgment is entered against Contractor and County by a court of competent jurisdiction because of the concurrent active negligence of County or County Indemnitees, Contractor and County agree that liability will be apportioned as determined by the court. Neither Party shall request a jury apportionment.

Notwithstanding anything stated above, nothing contained herein shall relieve Contractor of any insurance requirements of obligations created elsewhere in this Contract.

5.2 General Insurance Requirements

Prior to the provision of services under this Contract, the Contractor agrees to carry all required insurance at Contractor’s expense, including all endorsements required herein. Contractor agrees to keep such insurance coverage current, provide Certificates of Insurance, and endorsements to the County during the entire term of this Contract.

The procuring of such required policy or policies of insurance shall not be construed to limit Contractor's liability hereunder nor to fulfill the indemnification provisions and requirements of this Contract, nor act in any way to reduce the policy coverage and limits available from the insurer. Any failure on the part of the County to monitor or enforce compliance with any of the insurance requirements shall not be construed as a waiver of any required insurance provisions herein.

Evidence of Insurance

Insurance certificates and all endorsements shall be forwarded to the County agency/department. The name of the Insured Party on the Certificate of Insurance shall match the name of the Contractor identified in the Contract.

If the Contractor fails to provide the insurance certificates and endorsements within seven (7) days of notification by CEO/Procurement or the agency/department procurement division, award may be made to the next qualified supplier.

mailto:CPOAppeals@ocgov.com

Request for Applications 14 of 23 Rapid Antiretroviral Therapy (ART) Protocol

Failure to maintain and/or provide evidence of insurance acceptable to the County for the full term of this Contract shall constitute a material breach, upon which the County may terminate this Contract.

Cancellation and Changes in Insurance

Contractor shall provide thirty (30) days prior written notice to the County of any policy cancellation or non-renewal and ten (10) days prior written notice where cancellation is due to non-payment of premium and provide a copy of the cancellation notice to County. Failure to provide written notice of cancellation may constitute a material breach of the Contract, upon which the County may suspend or terminate this Contract.

Insurance requirements are subject to periodic review by County. County retains the right to require additional types of insurance coverage or higher limits throughout the term of this Contract.

Any change will be deemed by County Risk Manager as appropriate to adequately protect County’s risk. County shall notify Contractor in writing of changes in the insurance requirements. If Contractor does not provide acceptable Certificates of Insurance and endorsements to County incorporating such changes within thirty (30) days of receipt of such notice, this Contract may be in breach without further notice to Contractor, and County shall be entitled to all legal remedies.

Subcontractor Insurance Requirements

All subcontractors performing work on behalf of Contractor pursuant to this Contract shall be included under Contractor’s insurance as an Additional Insured or shall maintain insurance subject to the same requirements as Contractor (unless specified below). Contractor shall not allow subcontractors to work if subcontractors have less than the level of coverage required by County from Contractor under this Contract. Contractor shall provide the insurance requirements to every subcontractor and shall be responsible for verifying each subcontractor complies with the required insurance prior to allowing any subcontractor to begin work. Evidence of subcontractor’s insurance must be maintained by Contractor through the entirety of this Contract for inspection by County at any reasonable time.

Self Insured Retention (SIR)

All SIR’s shall be clearly stated on the Certificate of Insurance. Any SIR above Fifty Thousand Dollars $50,000 shall specifically be approved by the County’s Risk Manager, or designee. The County reserves the right to require current audited financial reports from Contractor as evidence it can support the SIR.

Qualified Insurer

The policy or policies of insurance must be issued by an insurer with a minimum rating of A- (Secure A.M. Best's Rating) and VIII (Financial Size Category as determined by the most current edition of the Best's Key Rating Guide/Property-Casualty/United States or ambest.com).

Waiver of subrogation

All insurance policies required by this Contract shall waive all rights of subrogation against the County of Orange, its elected and appointed officials, officers, employees, and agents when acting within the scope of their appointment or employment.

Umbrella or Excess Insurance

If Contractor utilizes combination of umbrella or excess policies to satisfy the required insurance, these policies must “follow form” and afford

Request for Applications 15 of 23 Rapid Antiretroviral Therapy (ART) Protocol

5.3 Commercial General Liability

Minimum limits and coverage

Commercial General Liability $1,000,000 per occurrence

$2,000,000 aggregate

Required Coverage

The Commercial General Liability coverage shall be written on occurrence basis utilizing Insurance Services Office (ISO) form CG 00 01, or a substitute form providing liability coverage at least as broad.

Required Endorsements

The Commercial General Liability policy shall contain the following endorsements, which shall accompany the Certificate of Insurance:

A. The Commercial General Liability policy shall contain the following endorsements, which shall accompany the Certificate of Insurance:

1. An Additional Insured endorsement using ISO form CG 20 26 04 13, or a form at least as broad naming the County of Orange its elected and appointed officials, officers, employees, and agents as Additional Insureds, or provide blanket coverage, which will state As Required by Written Contract.

2. A primary non-contributory endorsement using ISO form CG 20 01 04 13, or a form at least as broad evidencing that the Subrecipient's insurance is primary, and any insurance or self-insurance maintained by the County shall be excess and non-contributing.

B. The Commercial General Liability policy shall contain a severability of interests clause also known as a “separation of insureds” clause (standard in the ISO CG 0001 policy).

5.4 Automobile Liability

Minimum limits and coverage

Automobile Liability including coverage $1,000,000 combined for owned, non-owned and hired vehicles single limit each accident

Required Coverage

The Business Auto Liability coverage shall be written on ISO form CA 00 01, CA 00 05, CA 0012, CA 00 20, or a substitute form providing coverage at least as broad.

5.5 Workers' Compensation

Minimum limits and coverage

Statutory

Coverage is required for all employees providing services pursuant to the Contract. Worker’s Compensation coverage shall meet all the requirements of the State of California Labor Code.

Required Endorsements

Request for Applications 16 of 23 Rapid Antiretroviral Therapy (ART) Protocol

The Workers’ Compensation policy shall contain a waiver of subrogation endorsement waiving all rights of subrogation against the County of Orange, its elected and appointed officials, officers, employees, and agents or provide blanket coverage, which will state As Required by Written Contract.

If Contractor has no employees, it may certify to County that it does not currently have any employees or individuals who are defined as “employees” under the Labor Code by signing a County waiver. The waiver shall be reviewed and will require approval from the County Risk Manager or designee.

5.6 Employers Liability Insurance

Minimum limits and coverage

Employers Liability Insurance $1,000,000 per occurrence

5.7 Network Security & Privacy Liability

Minimum limits and coverage

Network Security & Privacy Liability $1,000,000 per occurrence

Required Endorsements

The Network Security and Privacy Liability policy shall contain the following endorsements which shall accompany the Certificate of Insurance:

A. An Additional Insured endorsement naming the County of Orange, its elected and appointed officials, officers, agents, and employees as Additional Insureds for its vicarious liability.

B. A primary and non-contributory endorsement evidencing that the Subrecipient’s insurance is primary, and any insurance or self-insurance maintained by the County of Orange shall be excess and non-contributing.

If Subrecipient's Network Security & Privacy Liability is a "Claims-Made" policy, Subrecipient shall agree to the following:

A. The retroactive date must be shown and must be before the date of the contract or the beginning of the Contract services.

B. Insurance must be maintained, and evidence of insurance must be provided for at least three (3) years after expiration or earlier termination of Contract services.

C. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a retroactive date prior to the effective date of the contract services, Subrecipient must purchase an extended reporting period for a minimum of three (3) years after expiration of earlier termination of the Contract.

5.8 Professional Liability

Minimum limits and coverage

Professional Liability Insurance $1,000,000 per claims made Required Endorsements

Request for Applications 17 of 23 Rapid Antiretroviral Therapy (ART) Protocol

If Subrecipient's Professional Liability is a "Claims-Made" policy, Subrecipient shall agree to the following:

A. The retroactive date must be shown and must be before the date of the contract or the beginning of the Contract services.

B. Insurance must be maintained, and evidence of insurance must be provided for at least three (3) years after expiration or earlier termination of Contract services.

C. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a retroactive date prior to the effective date of the contract services, Subrecipient must purchase an extended reporting period for a minimum of three (3) years after expiration of earlier termination of the Contract.

6 DESCRIPTION OF SERVICES

6.1 TARGET POPULATION

Rapid Antiretroviral Therapy (ART) Protocol Development shall be provided to individuals newly diagnosed with HIV, or people living with HIV (PLWH).

6.2 SERVICES TO BE PROVIDED

Successful applicants will develop Rapid ART protocols designed for emergency department workflows that enable HIV antiretroviral therapy initiation within seven (7) calendar days of diagnosis or disclosure and minimizes patient handoffs.

A. Protocols must include the following elements:

1. Staffing & Roles

• Identify all staff involved in Rapid ART.

• Define each staff member’s role, responsibilities, and availability.

• Establish a streamlined workflow to reduce handoffs with the patient.

2. Required Training

• List required training topics, who must complete them, and frequency.

Training must cover: Rapid ART process, HIV disease basics, medication options, counseling components, psychosocial and cultural considerations, prevention and harm-reduction strategies.

B. Identification & Engagement of Patients

1. Define how newly diagnosed individuals will be identified (on-site, in other health system settings, or from outside providers).

2. Include reporting frequency, system access, and point-of-contact information.

3. Describe process to engage patients within 72 hours of a reactive test when diagnosed externally.

4. Re-engagement of PWLH

• Explain how the site will identify and reconnect individuals who have fallen out of care.

Request for Applications 18 of 23 Rapid Antiretroviral Therapy (ART) Protocol

5. Rapid ART Counseling Components

• Key counseling skills must include disclosure support, medication adherence, medication options, and obtaining sexual and drug-use history.

• Counseling on the importance of daily medication adherence, potential side effects, the benefits of ART and that follow-up appointments should be scheduled within 1-2 weeks to reassess psychological needs, address challenges, and provide support services.

6. Partnerships

• Describe partnerships with HIV treatment providers and how collaboration will enable timely ART access.

7. Workflow/Diagram

• Provide a step-by-step visual from reactive test to evaluation, to medication start date.

• Must address consent, lab testing (including STI screening), insurance/payment enrollment, linkage to case management/partner services, and (where applicable) follow-up scheduling.

8. Barriers & Mitigation Strategies

• Identify anticipated challenges and how they will be addressed.

• Include referral resources for support services.

9. Clinical Support

• Describe access to clinical consultation.

• List the names and role of a designated Infectious Disease doctor or other appropriately credentialed clinician available to consult for any clinical questions that may arise when starting a patient on ART.

C. Contract Deliverables

Selected applicants shall be required to:

• Develop and submit Rapid ART protocol for HCA review and approval.

• Develop and submit an Implementation Plan detailing how Rapid ART protocols will be integrated into existing workflows, for HCA review and approval.

• Develop and submit an Evaluation Plan to monitor progress, barriers, and lessons learned, for HCA review and approval.

Preference will be given to applicants that demonstrate strong leadership commitment, cross-departmental collaboration, and a feasible plan to sustain Rapid ART activities after the conclusion of the contract/grant funding.

Deliverables and timelines are listed below. Applicants should submit a budget (Attachment III) with proposed costs per deliverable. The proposed payment schedule listed below represents estimates and will be negotiated with successfully awarded applicant(s).

Request for Applications 19 of 23 Rapid Antiretroviral Therapy (ART) Protocol

Deliverables Timelines Proposed Costs per

Deliverable

Start-Up Funds (If Applicable)* Negotiable $

Draft Rapid ART Protocol Within 90 days of contract execution

Implementation Plan Within 120 days of contract execution

Evaluation Plan Within 150 days of contract execution

Final Rapid ART Protocol Approved by HCA

Within 180 days of contract execution

Optional opportunity: Rapid ART medications**

After HCA approval of Rapid ART Protocol

Total “Proposed” Costs

*If requesting Start-up funds, please provide justification and narrative for proposed expenses/costs.

**Pending available funding, an optional opportunity will be considered for purchasing Rapid ART medications upon successful completion of all deliverables. The purchase of these Rapid ART medications is intended to serve as starter packs for clients to quickly engage in treatment. The amount available is subject to available funding. If requesting the optional opportunity to purchase Rapid ART medications, application must include the anticipated number of clients served and amount of medications to be dispersed.

D. Ability to initiate ART within seven (7) calendar days of HIV diagnosis or disclosure, either directly or through a formal partnership with an HIV treatment provider.

6.3 STAFFING REQUIREMENTS

REQUIRED:

ONE (1) HEALTHCARE PROFESSIONAL - A healthcare professional with experience in delivering HIV clinical services and counseling.

RECOMMENDED:

ONE (1) SOCIAL WORK/CASE MANAGEMENT PROFESSIONAL

COMPETENCY REQUIREMENTS TO BE INCLUDED IN PROTOCOLS

Rapid ART protocols should require all staff members to complete the following training, at minimum, prior to the implementation of protocols:

• ART medication choices and regimens.

• Cultural issues related to communities affected by HIV.

• HIV disease process.

• Rapid ART counseling.

• Psychosocial issues related to HIV

• Prevention and harm reduction strategies

Request for Applications 20 of 23 Rapid Antiretroviral Therapy (ART) Protocol

6.4 FACILITY REQUIREMENTS

The selected applicant shall maintain a facility that meets the following minimum requirements:

• Licensed hospital emergency department located in Orange County, California, with the ability to conduct HIV testing on-site.

Request for Applications 21 of 23 Rapid Antiretroviral Therapy (ART) Protocol

7 APPLICANT RESPONSES

1 Does your organization accept the terms and conditions of the attached Model

Contract?*

☐ Yes

☐ No

*Response required

2 Does your organization have the experience and ability to complete the proposed deliverables in Section II.B. of this solicitation?*

☐ Yes

☐ No

*Response required

3 Does your organization have the capacity to develop Rapid ART protocols as outlined in this RFA?

☐ Yes

☐ No

4 Does you organization meet, or plan to meet the minimum staffing requirement to develop the protocols?

☐ Yes

☐ No

5 Does your organization’s facility meet the requirements in Section 6.4 of this solicitation?

☐ Yes

☐ No

6 Is the applying organization a…