RFP#: 26-08RHT-010 Page 1 of 22

STATE OF SOUTH DAKOTA

RURAL HEALTH TRANSFORMATION

DEPARTMENT OF HEALTH

600 EAST CAPITOL AVENUE

PIERRE, SD 57501

DSS Rural Health Transformation Project Management

Questions and Responses

PROPOSALS ARE DUE NO LATER THAN MARCH 27th, 2026, BY 5:00 PM CDT

RFP#: 26-08RHT-010

POC: Kirsten Blachford Kirsten.Blachford@state.sd.us

Is DSS seeking the vendor to manage the overall RHT program across the initiatives, or primarily to provide a project management resource under DSS direction?

The vendor would be providing project management under DSS direction for the DSS initiatives.

The 3 DSS initiatives will require different levels of support due to varying resources within areas of work. There would be expected coordination with DOH project management when it comes to RHT reporting.

Can DSS confirm the expected initial priorities across the three initiatives (PACT, Rural Health Access and Quality Grants, Behavioral Health), and which initiative is anticipated to consume the majority of effort?

PACT and the Rural Health Access and Quality Grants are expected to have significant project management needs. Behavioral Health has project management support for day-to-day activities. The contract awardee would be responsible for coordinating with that person for reporting activities and overall DSS RHT oversight.

Does DSS prefer a single dedicated resource, or may offerors propose a small team (e.g., PM plus supporting roles)? If multiple staffing models are proposed, how will DSS evaluate them?

Offerors may propose a team approach. The staffing models will be assessed primarily for fit/coverage of needed tasks/responsibilities as detailed in the RFP.

May offerors propose multiple named candidates (for example, a primary and an alternate, or a small bench) to ensure coverage and continuity? If yes, how will DSS evaluate this (as a proposed team vs selection of one individual)?

Yes, this would be an appropriate response. Given the wide range of activities/responsibilities, it is expected that both options could be submitted and will be assessed against the criteria in the RFP.

The scope includes both program management and grant-related activities. Should offerors assume responsibility for hands-on grant administration execution, or primarily PM oversight/coordination with DSS staff and grantees?

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Please refer to the RFP for anticipated grant activities. Activities will include coordinating DSS staff and working directly with grant awardees as directed by DSS staff.

Can DSS provide an estimated level of effort (hours per week) and confirm whether the engagement is expected to be full-time or part-time? May offerors propose either model?

Could the State please provide an estimated number of hours per week or month anticipated for the project management services under this contract to assist Offerors in preparing accurate cost proposals?

The level of effort may vary depending on the timelines of the initiative but is expected to be between 40-80 hours a week. We expect at least the equivalent of 1.0 FTE. The model could involve a combination of part-time staff to accomplish this.

If an offeror believes additional roles would improve delivery (for example, grant management/administration support, business analyst, reporting coordinator), will DSS accept those roles in the proposed approach and cost proposal even if not explicitly identified in the

RFP?

Yes.

For tasks spanning program management and grant-related activities, does DSS prefer a single individual to perform all responsibilities, or may responsibilities be distributed across multiple proposed resources (with clear role delineation) under one contract?

Does the State anticipate this role being fulfilled by a single project manager or a project management team supporting the Rural Health Transformation initiatives?

Can the State clarify whether firms are eligible to respond with a team of individuals or whether the State is seeking a single person/consultant to deliver services?

The Scope of Work indicates that DSS is seeking qualified individual(s) to provide project management support for the Rural Health Transformation initiatives. Could the State please confirm whether Offerors are expected to propose a single Project Manager role or may propose multiple personnel with different roles or labor categories to support the project?

Section 3.0 references "individual(s)" in describing the contractor. Can the Department confirm whether respondents may propose a team of consultants rather than a single individual, and if so, whether there are any constraints on team size or structure?

Offerors may propose a team approach. The staffing models will be assessed primarily for fit/coverage of needed tasks/responsibilities as detailed in the RFP.

If the expectation is program management oversight, can DSS confirm the performance measures and reporting outcomes it will use to evaluate vendor performance (for example, reporting cadence/packages, milestone completion, compliance reporting)?

Performance measures are expected to include internal and CMS reports (timeliness and content), internal and external stakeholder satisfaction, and schedule variance.

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Does DSS have a budget cap or not-to-exceed (NTE) amount for this engagement? If yes, please share the target range (annual and/or total contract). If not, will an NTE be established during negotiations after selection?

Does the State have an anticipated budget ceiling or a not-to-exceed value for the project management services under this contract?

Budget Ceiling: Has the state established a maximum contract value or budget ceiling for this engagement, or is the contract amount fully determined by vendor proposals? Can you share the budget for this contract?

Are there any anticipated budget constraints, maximum hourly rate caps, or not-to-exceed funding limits that Offerors should consider when preparing their cost proposals?

Section 7.0 states that funding for this RFP is subject to spending approval of Rural Health Transformation grant funds. Could the State provide the anticipated budget or funding range for this contract?

Section 2.4 of the RFP does not specify an anticipated contract ceiling or not-to-exceed amount. To develop a responsive and realistic cost proposal, can the Department provide the anticipated budget range or maximum contract value for this engagement?

Will the Department please indicate the anticipated budget allocation for this contract?

Expected NTE amount is $250,000 per year (or $500,000 for the 2-year term of the initial contract).

Does responding to, or being awarded under, this RFP have any impact on eligibility or participation in future RHT-related solicitations, or are future procurements independent?

At this time it is expected that all future procurements are independent of this RFP award.

The RFP requests submission of hourly rates and references a not to exceed total contract amount subject to the availability of Rural Health Transformation grant funds and legislative expenditure authority. Many elements of the Scope of Work appear capable of being clearly defined with agreed deliverables and measurable outcomes. Would the State consider allowing offerors to propose a total fixed price based on the submitted hourly rates, or alternatively a fixed price per deliverable basis, in order to better align the cost proposal to defined outcomes and provide greater budget certainty towards these objectives?

A fixed budget amount could be submitted but payment based on specific deliverables would not be an acceptable proposal type.

Multiple RHTPs have been released that cover different aspects of South Dakota’s RHTP Program. While the DSS Rural Health Transformation Project Management Support RFP focuses on 3 initiatives (Medicaid Primary Accountable Care Transformation (PACT), Medicaid Rural Health Access and Quality Grants, and Behavioral Health), should we consider critical program wide tasks (e.g., writing of Year 1 project report, submission of Year 2 budget) in the project management scope of this RFP? Should developing a governance

RFP#: 26-08RHT-010 Page 4 of 22 structure for how different agencies / vendors involved across different RFPs and initiatives (e.g., Chronic Disease Project Management and DSS Project Management) will collaborate be included in the scope of this RFP?

Collaboration between DSS and DOH initiative is expected, but the ultimate responsibility for reporting/deliverables to CMS belongs to DOH as the lead agency. For example, the program-wide tasks of the Year 1 project report are not in the scope of this RFP. However, assistance with the 3 DSS initiative specific portions that gets submitted to the Year 1 project report would be.

Can you please confirm whether resumes may be included as an appendix that sits outside of the 50-page submission limit, or whether they must be incorporated within the 50-page maximum?

Section 6.3 states that the qualifications of proposed personnel will be evaluated. Please confirm whether Offerors are required to submit resumes for proposed personnel, and if so, whether there is a limit on the number of resumes that may be included in the proposal.

Additionally, please clarify whether Offerors should submit resumes of currently available personnel or if sample resumes would be acceptable.

Would the State like us to submit resumes of the proposed resource(s) as part of our response?

Resumes would be accepted and would be part of the 50-page limit.

Under the Scope of Work references "Experience in large-scale healthcare transformation projects." Could the State provide additional details and/or examples of the types of initiatives that would qualify as large-scale healthcare transformation for the purposes of this requirement?

Examples of similar work could include monitoring and managing multi-million dollar grant awards, or working with government or non-government payers to create new models of payment for care. Large-scale healthcare transformation can also include healthcare provider work including creating or implementing new lines of business or new models of care delivery. Work in population health or healthcare quality initiatives would also be pertinent.

This list is not exhaustive, and intent is to prioritize those with experience in larger healthcare projects that involve change management. Size can be defined by populations, financial impact, or reach.

What percentage of time does the State expect the Program Manager to be onsite in Pierre, SD?

Would the state be open to a Program Manager who works remotely most of the time and travels to Pierre for key meetings?

Does the State anticipate travel requirements across South Dakota for meetings or stakeholder engagement?

On-Site Presence: What are the expectations for on-site presence in Pierre, SD, is regular in-person attendance required for meetings, stakeholder sessions, or state agency visits, and if so, approximately how frequently?

Can the State please provide an estimated, not to exceed number of in-person/onsite meetings that vendors may be required to attend under this scope of work?

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Can DSS clarify the expected level and frequency of onsite presence for this engagement (e.g., periodic meetings in Pierre or other locations), or whether services are anticipated to be performed primarily remotely?

Do you anticipate this project will require onsite work or meeting attendance? If so, could you describe for staffing and budgeting purposes?

One of the evaluation criteria is the availability to the project locale. Is there an expected number of onsite meetings each contract year?

Evaluation criteria include availability and familiarity with the project locale. Could the State clarify whether the project management services are expected to be performed onsite in South Dakota, or if remote services with periodic onsite visits would be acceptable?

What amount of time do you expect the vendor to work onsite?

Does the State have an expected minimum or typical level of on-site presence in South Dakota (e.g., number of in-person meetings or workshops per year), versus work that may be performed remotely?

Minimal travel is anticipated with occasional on-site work in Pierre or Sioux Falls (not to exceed 4 times in one year). While there will be meetings throughout the state, the contractor could satisfy the attendance component at those meetings virtually. Preference would be considered for regular on-site presence in Sioux Falls.

Is the Program Manager expected to start soon after the work is awarded in April? If not, please specify the expected start date.

Yes; work would start as quickly as possible once a contract is executed.

How many DSS personnel are involved in each of the three specific initiatives in the RHT grant? What are their roles in the program?

There are initiative leads for each of the three DSS RHT initiatives. There are also subject matter experts and content contributors related to policy, system, data/evaluation, and other aspects of advancing the initiatives. Internal workgroups of approximately 3-8 across various DSS teams are engaged with each initiative.

Will the selected contractor provide project management support across all three initiatives (PACT, Rural Health Access and Quality Grants, and Behavioral Health)?

Among the three RHT initiatives (PACT, Medicaid Rural Health Access and Quality Grants, and Behavioral Health), are there specific initiatives or workstreams the State anticipates will require the greatest level of support from the contractor during the first and second year of the contract?

The Scope of Work references three initiatives: Medicaid Primary Accountable Care Transformation (PACT), Medicaid Rural Health Access and Quality Grants, and Behavioral Health. Could the State please clarify the anticipated distribution of effort or percentage of time expected to be allocated across these three initiatives?

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Yes, the vendor will provide overall RHT project management support to all. However, the effort is not expected to be equally split amongst all 3 initiatives. Effort is expected to be PACT >Rural Health Access and Quality Grants > Behavioral Health. Behaviroal Health will only need high-level support since day-to-day project management staff is already in place.

Can the State clarify the expected reporting cadence and deliverables for the project management role?

Expectations are for reporting biweekly to internal senior state leaders starting shortly after work begins. Quarterly reporting for CMS starts in August 2026.

Will the contractor be expected to coordinate with external stakeholders such as rural hospitals, community health centers, or tribal health organizations?

Yes, though this coordination would not be expected to be proactive. All connections would be directed.

PACT Model Maturity: Can you share where the PACT initiative currently stands in its design and development lifecycle? For example, whether key model parameters (quality measures, payment structure, provider eligibility) have been finalized with CMS, or whether the selected consultant will be expected to support those design decisions as part of the scope?

How will the successful vendor for this RFP collaborate with the successful vendor for the Accountable Care Reimbursement Transformation Reimbursement Design RFP26-08RHT- 008?

One of the activities in Section 3.3 is “Support design, refinement, and implementation of Medicaid Primary Accountable Care Transformation (PACT) model.” Please clarify which design activities are in scope under the Project Management RFP #26-08RHT-010 as opposed to the PACT Reimbursement Design RFP #26-08RHT-008

PACT as an initiative has multiple components including the alternative payment model.

Support for the model design itself are within the scope of a separate RFP. At this point the design phase is expected to Jan 2026-Dec 2026. Jan 2027-Dec 2027 will be operationalizing the model and enrolling for go-live of Jan 2028.

It would be expected the awardees of these 2 RFPs would communicate, and ultimately this RFP awardee would be expected to monitor the progress of the model design especially with regards to reporting but not participate directly.

Multi-Vendor Coordination Authority: The scope references coordination across inter-departmental, inter-divisional, and cross-program dependencies. Can you speak to the current vendor landscape: 1) approximately how many external vendors or contractors are already engaged across the three RHT initiatives 2) will the selected project manager have formal authority to hold vendors accountable, or primarily an advisory and coordination role?

BH has project management, but there are no other external vendors/contractors at this time.

The project manager will coordinate but formal authority to hold vendors accountable will reside with the state/contract holder.

CMS Reporting Infrastructure: Are state-level CMS reporting templates and evaluation frameworks already established for the RHT grant, or will the selected consultant be expected to help develop the reporting infrastructure from the ground up alongside DSS staff?

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CMS has provided draft reporting templates awaiting final federal approval. It is not expected that the awardee would have to create/develop the CMS reporting format.

Tools and Systems Access: Will the consultant have access to existing state project management, reporting, and data systems, or will the consultant be expected to independently procure and operate their own project management infrastructure?

The state does not have standard project management infrastructure. DSS does have its own data systems.

Can the State please further differentiate the PACT scope of work expectations under each

RFP?

The PACT initiative includes an alternative payment model as well as other components (for example: creation of centralized case management). RFP # 26-08RHT-010 includes project management related to the creation of the payment model itself only and the associated stakeholder engagement meetings required for consensus. This RFP includes coordinating and obtaining updates/information with the awardee of that RFP but with an eye on the overall DSS RHT initiatives as a whole. Their role with stakeholders would be different and relevant stakeholder forums to be held would be more informational (as compared to decisional).

Are vendors prohibited from being awarded contracts under both RFPs?

No.

Section 3.3 requires that vendors “develop and implement systems for tracking grant applications, awards, disbursements, and reporting.” Can the State please provide additional details regarding the system required to track grant applications, as well as any required functionality. For example, is there an expectation that the system has the capability for application submission by potential grantees?

Does the State envision a role-based system to be used by multiple “user-types” (i.e., vendor, Agency staff, grantee staff).

Is the system envisioned to provide specific outputs to the State and/or publicly (e.g., grantee outcomes and/or reports, dashboards, etc.)?

Section 7.0 directs vendors to submit an hourly cost proposal. How should costs associated with the system referenced in Section 3.3 be reflected in the cost proposal?

The State would like to clarify that our use of the term “system” referred to the development of internal processes, procedures, and operational workflows. The expectation was not the development of a new software platform, but rather a structured operational framework to facilitate grant management. The Medicaid Provider Efficiency and Quality grants are anticipated to involve subawards to multiple entities who will be invoicing and submitting milestone updates that must be synthesized and summarized for broader understanding by various audiences of initiative status, risks, progress and success. If the offeror has specific preferred tools or systems that it uses, they may suggest or reference these tools, but development or implementation of a specific software tool is not expected.

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Section 2.4 indicates that contractor expenses will not be reimbursed separately. Please confirm that offerors should include any anticipated travel costs within their proposed hourly rates.

If onsite meetings or activities in South Dakota are required, please clarify whether travel expenses are expected to be included within the proposed hourly rate, or if travel costs may be reimbursed separately in accordance with State travel policies.

Yes, included in hourly rate for required on-site engagements. Additional optional travel would not be reimbursed.

Does DSS require use of a specific state-approved project management or collaboration tool (e.g., MS Project, Smartsheet, Jira, SharePoint) for integrated workplans, risk logs, and status reporting? If so, which tool should be used, will access be provided to the contractor, and are there required reporting templates?

For administration and monitoring of the Rural Health Access and Quality Grants, does DSS utilize a specific grants management system or platform that the contractor will be expected to use?

Does DSS currently use a grants management platform? Should bidders include a proposed grants management platform as part of their response

For the grant administration responsibilities described in the Scope of Work, please clarify whether the State will provide existing templates, systems, or tools for tracking grant applications, awards, disbursements, and reporting, or if the contractor will be expected to develop and implement these processes and systems.

See RFP 3.0 Scope of Work. Subsection 3.3 describes scope of work activities, including grant administration. Does DSS expect to use or modify existing monitoring and tracking tools to track grant administration? If yes, which tools? can DSS share examples or templates of these tools?

DSS does not currently use a grants management or project management tool and does not require the use of a specific tool. Contractors will not be expected to develop technology systems but will be expected to develop and implement processes for grant and project management.

Can DSS provide an approximate number of internal and external stakeholders (e.g., providers, partner agencies, vendors, and other participants) the contractor is expected to coordinate with across the Rural Health Transformation initiatives?

Could the Department provide information regarding the project team structure on the SD DSS side, including key roles and the anticipated allocation of full-time or part-time effort for each role?

Internally it is expected that the awardee would have frequent contact with 15-20 internal staff working on the 3 initiatives in smaller workgroups. There would be additional interactions with agency leadership for milestone reporting. The external stakeholder workgroup interactions are part of separate work, but this awardee would assist with arranging stakeholder meetings for updates (less than 5 in a year.) With the exception of Behavioral

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Health specific project management, all DSS staff are committing part-time effort to the RHT initiatives at varying FTE percentages.

Section 5.2.4 indicates that the cost proposal will be evaluated independently from the technical proposal. Should the cost proposal be submitted as a separate file within the SFTP submission, or included as a section within the same proposal document?

Is it acceptable to DSS for the cost proposal to be included as a subsection within the overall bidders’ proposal?

Offerors may submit as a separate file or include it with the general proposal.

Section 7.0 indicates that vendors should submit an hourly cost proposal. Should offerors provide hourly rates only, or should the proposal also include estimated hours by role and an estimated total cost for planning purposes?

For the cost proposal, does the State want offerors to provide estimated hours by position and by year?

Section 7.0 requests an hourly cost proposal, and Section 2.4 states that contractor expenses will not be paid as a separate item. To ensure our cost proposal is structured appropriately, can the Department confirm whether respondents should propose a single hourly rate or a rate structure by labor category?

Please provide hourly (by labor category if applicable) and estimated total.

Does DSS permit offerors to submit proposed contract exceptions or redlines with their proposal, or must offerors accept the RFP and attachments as written at the proposal stage?

Offerors may submit proposed redlined contract changes with their proposals. However, any RFP selection is not an indication of acceptance of proposed changes. All contract terms and conditions are negotiated as part of finalizing the contract.

Can DSS confirm whether services procured under this RFP are intended to be staff augmentation (i.e., Contractor personnel working under the direction of DSS staff) or project based consulting services with Contractor managed deliverables?

The intention is that this RFP would procure staff augmentation.

In the event of a conflict between the terms and conditions of the umbrella contract and the terms of an individual Work Order, which document will prevail?

There will not be an umbrella contract with work orders from this RFP.

Will resulting Work Orders contain terms and conditions (ie. scope of work, acceptance criteria, etc.)

Work orders are not being used for the Rural Health Transformation program. RHT RFPs are being issued separately and would contain the terms and conditions of this engagement.

The following is a correct to the line in the RFP:

Creating a monthly status report associated with any work accomplished timelines related to this work order RFP.

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In section 5.2.3.2, it is noted that the contractor must "provide a specific point-by-point response for each requirement in the RFP." Can DSS identify the specific requirements in the RFP that must be addressed?

Section 5.2.3.2 states: "A specific point-by-point response, in the order listed, to each requirement in the RFP. The response should identify each requirement being addressed as enumerated in the RFP." Could you please clarify which specific requirements should be addressed point by point in our response? We seek confirmation on whether this refers to:

The activities listed in Section 3.3 (bulleted items under "Activities include but are not limited to")

The required skills and experience enumerated in Section 3.1

The evaluation criteria outlined in Section 6.1.1-6.1.8

All of the above

A different set of requirements

Additionally, if there is a preferred numbering or reference system the State would like offerors to use when identifying each requirement being addressed, please advise.

RFP Section 5.2.3.2 requests: “A specific point -by-point response, in the order listed, to each requirement in the RFP.” Will the State please clarify what constitutes a “requirement”? Are requirements considered everything in RFP Sections 1 – 6? Are requirements only Section 3 Scope of Work? If “requirements” only refers to Section 3 Scope of Work, will the State please clarify where we should respond to Section 4.3 (references) and Section 6.1.1 – 6.1.8 (evaluation criteria)? Should we include those as part of our response to 5.2.3.1 Assessment of Work, Ability, and Approach?

See RFP 5.0 Proposal Response Format. 5.3.3.2 indicates “A specific point-by-point response, in the order listed, to each requirement in the RFP. The response should identify each requirement being addressed as enumerated in the RFP.” Please clarify which specific requirements listed in the RFP should be addressed in the Detailed Response as enumerated in RFP? Does this refer to the requirements listed in 3.0 Scope of Work and those listed in 6.0 Proposal Evaluation Criteria 6.1.1– 6.1.8? Please confirm. Are there other RFP Sections containing requirements required to be addressed in the Detailed Response?

The point-by-point response refers to list found in Section 6.1 (items 1-8). These required response elements are informed by the description in the scope of work found in Section 3.

It is noted that the Contractor "will not use State equipment, supplies or facilities." In the event the Contractor needs to work on site (vs. remotely), can Contractor leverage space temporarily in a State facility to perform their work?

Yes.

It is noted in the Scope of Work that the contractor is responsible to "coordinate with data vendors as needed to be able to provide reporting on PACT's goals and deliverables." Is any technology implementation work anticipated as part of the scope for the Contractor?

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No.

In Section 3.3, one of the activities listed is "assisting DSS staff in the creation, evaluation, and award of RFps as well as contract renewals, amendments, and scope changes." Does this include requests for applications (RFAs) as well as RFPs?

No.

In Section 3.3, one of the activities listed is "assisting DSS staff in the creation, evaluation, and award of RFPs as well as contract renewals, amendments, and scope changes."

Approximately how many RFPs/RFAs does DSS envision the contractor supporting?

What are the vendor’s responsibilities with respect to assisting DSS staff in the creation, evaluation, and award of RFPs as well as contract renewals, amendments, and scope changes?

Anticipate less than 3 RFPs/RFAs in the next 2 years. The number of contract renewals or amendments will depend on the number of Medicaid Quality and Access provider grants that are awarded.

The DSS RHT Project Management vendor may provide logistic and administrative assistance with preparing documents, editing or review draft materials, facilitating review meetings, and tracking and following up on completion of contract documents.

In Section 3.3, one of the activities listed is "assisting DSS staff with monitoring and oversight of subrecipients of federal grant funding." Does this apply to all three initiatives managed by DSS as described in this RFP?

This is specific to the Medicaid Rural Health Access and Quality Grants initiative.

In Section 3.3, one of the activities listed is "developing and implementing systems for tracking grant applications, awards, disbursements, and reporting." Is DSS looking for the contractor to propose a technology system to support those tasks?

One activity is to “Develop and implement systems for tracking grant applications, awards, disbursements, and reporting”. Is the expectation that the vendor proposes and implements a technical system that DSS can utilize for grants management purposes?”.

No, DSS does not expect offerors to develop or propose technology systems for State use.

Can DSS share examples of what the contractor may be asked to support regarding risk management and internal control processes?

The State does not anticipate significant efforts by the contractor in this area, the contractor may be asked to make suggestions or enhance existing processes.

Is the successful vendor for this RFP prohibited from serving as the vendor for the Accountable Care Reimbursement Transformation Reimbursement Design RFP26-08RHT- 008?

No.

Will you conduct in-person oral evaluation of any finalists?

Will oral presentations be required for all responsive offerors, or only for shortlisted offerors, and when would those likely occur?

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The State has not determined if oral evaluations will be required. If additional evaluation is required, it would be reserved for shortlisted offerors or where specific clarifications are required for decisions on a proposal. These would occur if needed the week of March 30th Could you please provide a list of criteria and associated weights for how you will evaluate the submitted proposals?

Evaluators will use subjective judgement in conducting a comparative assessment of the proposal by considering the criteria in 6.1.1 - 6.1.8.

Can you provide an anticipated start date for this work?

The State would hope after award and contracting work is done that the awardee could start as soon as possible with precise start date open to discussion.

Would DSS consider extending the deadline to allow for at least seven business days between receipt of answers to questions and the proposal submission date?

At this time, the State intends to maintain the proposal submission deadline as published in the RFP in order to support the established procurement timeline.

If possible, please provide the comprehensive set of bidder questions and DSS’s answers for this solicitation.

Questions and responses will be published online on the OPM and DSS websites with the RFP.

Approximately how many awards does DSS anticipate under the Medicaid Rural Health and Access Grant initiative?

What is the anticipated number of grants DSS expects to award as part of this initiative?

For the Medicaid Rural Health and Access Grant, can the State provide guidance on the anticipated number of grant applications annually and in total?

Can DSS provide additional information related to the anticipated number of applicants and awards that will be administered given the number of primary care providers enrolled in Medicaid under the Medicaid Rural Health and Access Grant Initiative?

The State has not set a specified number of awards. The number of awards may vary based on the quality of proposals received.

Approximately how much funding does DSS plan to distribute to rural hospitals and clinics through the Health and Access Grant initiative? What is the anticipated average award size and range (min / max) under this program?

$31,750,000.00 is the current total funding. The number and amount of awards may vary based on the quality of awards.

Does DSS anticipate that the selected contractor will conduct site visits as part of the monitoring activities related to the Medicaid Rural Health and Access Grant?

The State does not anticipate a need for site visits as part of monitoring activities.

RFP Section 5.2 shows the required organization of the proposal. Please indicate where the bidder’s response to RFP Section 4.3 (Client References) should be placed in the bidder’s proposal.

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Is DSS expecting a narrative response to RFP Section 6.2 through 6.5 to be included in a bidder’s proposal? If yes, please clarify where in the organization of the bidder's proposal this content should be placed.

All items should be organized and tabbed in the order they are listed in the RFP per section 5.2.

Please confirm that the activities listed in Section 3.3 are limited to project management support for the three DSS initiatives only (i.e., PACT, Medicaid Rural Health Access and Quality Grants, and Behavioral Health).

Yes.

One of the activities in Section 3.3 is “Support development of policies, guidance, technical assistance, and operational workflows.” Does DSS envision that the contractor would provide technical assistance across each of the three DSS initiatives?

Would the following activities listed under Section 3.3 apply to all three DSS initiatives or would these activities be limited to the Medicaid Rural Health and Access Grant initiative?

“Assist DSS staff with monitoring and oversight of subrecipients of federal grant funding”, “Assist DSS staff with addressing and remedying issues of non-compliance or underperformance by subrecipients of federal grants”

It is anticipated the contractor will provide support across all three initiatives for activities listed under section 3.3.

Please clarify the scope of the technical assistance. For example, does DSS anticipate that the scope includes technical assistance to grant recipients on specific aspects of the RHTP initiatives they are implementing (e.g., service line expansion assessments, CCBHC standards, PACT workflows)?

Please provide examples of technical assistance that the vendor will be expected to provide to grantees on application processes, eligibility, and compliance requirements.

Please provide clarity on the extent of technical assistance required. Is the technical assistance focused solely on the grants administration, or does it also include technical assistance related to the programmatic aspects of the grants?

Does DSS anticipate that technical assistance would be provided at the subrecipient level or more broadly across subrecipients participating in a given initiative?

Technical assistance in the form of communicating instructions, answering questions, or providing targeted follow up and feedback to subrecipients related to overall RHT requirements is anticipated. The scope is not expected to include direct support and assistance to grant recipients in the implementation of their specific projects or workflows.

Please clarify who the users of the “population health and case management tools” would be, as referenced in Section 3.3.

State staff would be utilizing these tools. There may be a component of allowing healthcare providers access as well pending further discussions/capabilities.

Please confirm if the cost proposal should include the base period only, or if option years should be included.

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Base years (first 2) only at this point.

Please describe DSS’s expectations for the vendor to “assist DSS staff with federal evaluation grant evaluation activities as stated in section 3.3.

The vendor should assist in collecting and preparing draft material for submission to CMS for annual and quarterly reports.

What are the vendor’s responsibilities with respect to the support design, refinement, and implementation of Medicaid Primary Accountable Care Transformation (PACT) model?

There is a separate RFP (RFP # 26-08RHT-010) that is specific to the creation and design of the PACT model itself. The vendor selected for this DSS RHT Project Management would have responsibility related to overall RHT project management, and would work with the PACT model design vendor and initiative lead for updates and information needed to inform overall DSS Project Initiative status.

What are the vendor’s responsibilities with respect to creating a payer engagement framework including assistance in supporting the group with meetings and deliverables?

It is anticipated that the vendor would help with communication to payer stakeholders, organization of meeting materials, and managing the timeline to meet deliverable deadlines from this group.

What are the vendor’s responsibilities in creating case management framework including integration of population health and case management tools?

The vendor may assist in the overall project management of the internal case management framework but would not be expected to actually create the framework.

What is the vendor’s role with the planning and execution of annual Case Management, Social Worker, and Community Health Worker Medicaid Workshop in support of PACT and RHT goals?

Since this is part of the PACT initiative, the vendor would assist with holding DSS to timelines/conference deliverables. They would occasionally be asked to assist with specific tasks in support of this effort, but would anticipate it would be minimal.

Please provide clarity on the vendor’s responsibility for monitoring grantee performance and ensuring alignment with program goals and funding requirements.

The vendor would assist DSS staff with monitoring grantee performance (for providers getting grants from DSS), especially with regards to defined deliverables. The vendor would have significant responsibility with regards to ensuring alignment with goals and funding responsibilities for DSS with regards to CMS requirements.

Section 3.3 references coordination with the DOH Digital Health Modernization PM vendor and internal DSS program management staff. Can the Department describe the anticipated governance structure for this coordination — specifically, how decision authority, escalation paths, and reporting relationships will be defined across the multiple PM entities?

A joint DOH and DSS RHT Governance team made up of key initiative leads has been established for issues and communication that cut across agency initiatives. Decision making authority for DSS initiatives is with the DSS Executive team. Coordination with other project management staff within DSS (such as Behavioral Health) is expected to be collaborative but

RFP#: 26-08RHT-010 Page 15 of 22 this RFP would be providing staff responsible for RHT program related updates to DSS Executive leadership. This vendor would be working closely with DSS initiative leads, those leads would be responsible for those portions of RHT work. This vendor may interact with PM staff and/or vendors of DOH initiatives for purposes of collaborating or supporting joint subawardees but are not expected to have regular reporting relationships.

In section 3.3, DSS provides a breakdown of activities associated with PACT and with the Medicaid Rural Health and Access Grant initiative. Can a similar breakdown of activities be provided for the Behavioral Health activities?

Behavioral Health has already in place project management. This awardee would coordinate with that person for oversight and CMS reporting only.

Section 6.1 lists evaluation criteria without assigned weights. Will the Department provide scoring weights for each criterion prior to proposal submission?

Can the State provide additional detail on the relative weighting of the evaluation criteria in Section 6.1, particularly how cost will be weighed relative to technical approach and experience?

Evaluators will use subjective judgement in conducting a comparative assessment of the proposal by considering the criteria in 6.1.1 - 6.1.8.

Can the Department provide additional details on expected deliverable timelines, particularly for the PACT model design phase and the first Rural Health Access grant cycle?

Understanding key milestone dates would help respondents develop realistic project plans for the technical proposal.

The first annual report to CMS is due August 2026 and quarterly reports start fall 2026. The expectation is that the PACT model design portion will finish end of calendar year 2026 and 2027 will be work to operationalize and enroll as well as create the internal case management structure and the patient incentive program.

Does the State have budget estimates for each of the three DSS initiatives being funded under the RHT Grant: Medical Primary Accountable Care Transformation (PACT), Medicaid Rural Health Access and Quality Grants, and Behavioral Health?

The estimated 5-year budgets for the proposals are:

$62,735,000 for PACT $125,000,000 for Rural Health Access and Quality Grants $56,457,876 For Behavioral Health In the specific requirements/tasks in the Scope of Work (3.1-3.4), there are specific tasks called out for PACT and the Medicaid Rural Health Access and Quality Grants, but not for Behavioral Health. Are there SOW tasks related to the Behavioral Health initiative which should be addressed in our point-by-point response?

No.

To ensure we respond in the correct format per Section 3.3, should the below bullets be sub-bullets to the requirement to “Support design, refinement, and implementation of Medicaid Primary Accountable Care Transformation (PACT) model?”

Support development of policies, guidance, technical assistance, and operational workflows

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Assist in creation of communications including written documents and presentations as needed

Assist DSS staff in creation, evaluation, and award of RFPs as well as contract renewals, amendments, and scope changes

Assist DSS staff with monitoring and oversight of subrecipients of federal grant funding.

Assist DSS staff with addressing and remedying issues of non-compliance or underperformance by subrecipients of federal grants

Monitor budgets and expenditures in coordination with finance staff Track vendor deliverables Coordinate with other project management staff as needed including any internal or vendor support Consultation Process: coordinate provider outreach, education, and technical assistance related to PACT (and related sub-bulleted requirements) Ongoing/Post-Launch (and related sub-bulleted requirements)

No. For example, “Assist DSS staff with monitoring and oversight of subrecipients of federal grant funding” and “Assist DSS staff with addressing and remedying issues of non-compliance or underperformance by subrecipients of federal grants” are not part of PACT but are part of the Medicaid Rural Health Access and Quality Grants Initiative.

RFP Section 3.0 indicates that the scope includes “three specific initiatives in the RHT grant titled Medicaid Primary Accountable Care Transformation (PACT), Medicaid Rural Health Access and Quality Grants, and Behavioral Health.” Will the State please provide a brief description for each of the three initiatives with intended purpose of each?

Initiative summaries can be found here:

RHT Resources & FAQs | South Dakota Department of Health https://doh.sd.gov/healthcare-professionals/rural-health/rural-health-transformation-project/rht-resources-faqs/#Resources RFP Section 3.3 references activities for PACT and Medicaid Rural Health and Access Grant initiatives. Will the State please provide a comparable set of defined activities and key responsibilities for Behavioral Health, similar to how this RFP section specifies activities for PACT and the Medicaid Rural Health and Access Grant initiatives?

Behavioral Health has project management in-place for day-to-day activities. This vendor would coordinate with that person and help with reporting to leadership and CMS.

Could the State clarify if this a new contract, or is there an incumbent vendor? If there is an incumbent, could you share their name? Are there any specific challenges or "pain points" with the current service that you are hoping a new vendor will resolve?

Is there an incumbent for this work? If yes, are you satisfied with their past performance?

This is a new contract.

Please provide a list of all attachments and forms necessary to include with the proposal.

Please see section 5.2 in the RFP.

Do we need to submit the Certificate of Insurance and Business License with the proposal?

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Certificate of Insurances and Business Licenses will be submitted at time of award during contract negotiations.

Please confirm the required mode of proposal submission (e.g., SFTP upload, email, or other electronic submission method).

Offerors are required to submit proposals through an SFTP as outlined in the RFP.

Are there any anticipated changes to the Schedule of Activities (e.g., proposal due date, award decision date)?

The State does not anticipate changes at this time.

For the SFTP submission, is there a file size limit or naming convention you prefer?

There is not a file size limit. The naming convention should be based on section 5.2 in the

RFP.

Could the State clarify whether the contractor will be expected to support only project management activities, or if the contractor will also be responsible for strategic advisory, policy development, and program design activities related to the Rural Health Transformation initiatives?

Project management activities are the scope of this RFP. Strategic advisory tasks would be within the scope of creating the initiatives and the best practices for management, task completion, etc..

The RFP states subcontracting may require State approval. Please confirm whether Offerors may propose subcontractors or partner organizations to provide specialized expertise related to Medicaid, behavioral health, or CMS grant reporting.

Offerors may propose subcontracts or partner organizations, final approval of subcontractors and partner organizations is subject to DSS review upon contract award. DSS recommends offerors have a contingency plan to perform services should a subcontrator or partner not be approved.

The Scope of Work references CMS grant reporting requirements. Could the State provide additional details on the reporting structure, frequency, and specific CMS reporting tools or templates expected to be used?

CMS has shared a tentative template, but it has not been officially approved. The first annual report is due in August and quarterly reports start fall 2026.

Could the State clarify the expected timeline for the implementation phases of the Rural Health Transformation initiatives, including any major milestones for PACT, Rural Health Access Grants, and Behavioral Health projects?

Could the State clarify the expected key deliverables, such as reporting frequency, dashboards, or program documentation, for the project management services under this contract?

Implementation is expected to be staggered across the initiatives. Major milestones for PACT include model design by Dec 2026. Jan 2027-Dec 2027 will be operationalizing the model and provider enrollment and readiness for go-live of Jan 2028. The first Rural Health Access Grant applications are expected to be received late May, with awards in June of 2026.

Milestones associated with these grants will be dependent on the subrecipient proposals. The first provider budget period for the access grant award activity runs through September of

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2027. Behavioral Health initiatives include pilot launch by end of 2026, with outcome reporting by the end of 2027.

The project management services under this contract are expected to facilitate biweekly reporting to internal senior state leaders starting shortly after work begins, and collection and preparation of necessary information for quarterly reporting for CMS starting in August 2026.

Ad hoc preparation of summary reports for public audiences may also be requested.

Section 4.3 of the RFP requests information related to at least three previous or current services/contracts performed by the offeror’s organization.