State of Wisconsin RESPONSES TO VENDOR QUESTIONS Date: 5/11/2017

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 1 of 15

1. Regarding: General (ref. 001)

Q: The Level II indicates: “The determination regarding the possible masking symptoms or mimicking mental illness in this person must be completed by a psychiatrist.” Is this still required?

A: Yes. 42 CFR 483.134 (c) (1) states, “If the history and physical examination are not performed by a physician, then a physician must review and concur with the conclusions.” Wisconsin’s PASRR Level II Screen process requires a psychiatrist to fulfill this function.

2. Regarding: General (ref. 002)

Q: Reviewing an individual’s PASRR history is important when determining the need for a review.

If the contract is awarded to a new Vendor (not the incumbent), how will the new Vendor access past

PASRR data?

A: The Level II Screen determinations are to be based on the assessment of the individual’s current status and needs. Therefore, access to prior Level II Screens generally should not be necessary. Upon request, DHS will provide the Supplier with the records necessary to fulfill contract obligations, including a listing of all PASRR Level II Screens completed since January 1, 1996, and access to the electronic copies of all PASRR Level II Screens completed since August 1, 2014.

3. Regarding: General (ref. 003)

Q: a. Does the Department require the PASRR Vendor to provide documentation for and/or participate in appeal hearings?

A: To date, no additional documentation beyond the Level II Screen with the accompanying documentation has been required for any administrative hearing. DHS staff review the Level II

Screen and accompanying documentation and represent the Supplier and DHS during all hearings.

DHS staff work with nursing facility staff and the appealant to determine if additional information is available that would warrant a change in a Level II Screen determination or warrant a new Level II

Screen based on a change of status. If such information is available, DHS staff will share the information with the Supplier and plan possible next steps.

b. If so, please provide the following volume information for each of the past three years:

i. Number of hearing packets requested and submitted by the vendor

ii. Number of times testimony was required and permitted to be conducted by phone

iii. Number of times testimony was required and was required to be given in person

A: The answer to each of the above three questions is “none”.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 2 of 15

4. Regarding: General (ref. 004)

Q: Do you want the Level I Screens to be submitted to the Vendor electronically?

A: In the future, the submission of the Level I Screen may be automated. Currently and for purposes of this contract, nursing homes and hospitals can submit the PASRR Level I Screen to the PASRR

Contractor via fax, US mail, or encrypted email.

5. Regarding: General (ref. 005)

Q: Do you want the Level II Screens to be completed electronicly?

A: The Level II Screens are not required to be completed electronically. If handwritten, the contents must be legible. All completed Level II Screens must be scanned and electronically uploaded to the DHS

PASRR data warehouse.

6. Regarding: General (ref. 006)

Q: Are you going to verify the origin and past history of any LLCs or corporations of vendors?

A: Per Section 7.3 Method of Award, the award will be made to the lowest bid by a responsive and responsible Vendor. DHS will use the information provided under 7.4 Vendor Refrences, 8.3

Financial Statements, and any other resources DHS deems necessary to assure the contract award is in the best interests of the State.

7. Regarding: General (ref. 007)

Q: Will you verify the financial stability of companies/vendors who have had a PASRR contract and have lost the contract?

A: Per Section 7.3 Method of Award, the award will be made to the lowest bid by a responsive and responsible Vendor. DHS will use the information provided under 7.4 Vendor Refrences, 8.3

Financial Statements, and any other resources DHS deems necessary to assure the contract award is in the best interests of the State.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 3 of 15

8. Regarding: 1.1 (ref. 008)

Q: The RFB states that: The screening process will include a physical exam, medical history, a functional status evaluation, and other required elements.(pg.8),

a. If the Level I submitter (Level II referrer) has not completed the physical exam, is the vendor responsible to complete this exam?

A: Yes, unless a recent physical exam that appears to be valid, reliable and reflects current funtioning has been made available to the PASRR vendor.

b. If so, please indicate both:

i. Which practitioners are permitted by the Department to conduct these exams for PASRR purposes (e.g., RNs, APRNs, or Physicians Assistants)?

ii. The volume of physical exams required to be conducted by the vendor each year over the past 3 years.

A: Federal PASRR regulations require a History and Physical along with a mental status exam. It would be unnecessary to send out multiple professionals when a psychiatrist can do all three. Also, Wisconsin’s PASRR policies and procedures permit the use of utilizing data that appears to be valid, reliable and reflects current functioning, i.e., if a recent History and Physical has been completed, then the psychiatrist may not need to complete a new one.

The PASRR contract has not required the Supplier to report such information to the Contract

Administrator, so the volume of assessments requiring completion of a medical history and physical is unknown. However, DHS believes that the volume is very small.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 4 of 15

9. Regarding: 1.2 (ref. 009)

Q: The RFB states (pg. 9) “The PASRR Supplier must be reasonably sure that facts and conclusions in the

Level I Screen are accurate prior to completing a Level II Screen. The Supplier will not be reimbursed for

Level II Screens for which they failed to verify the accuracy of the Level I Screen.”

Please indicate, for each year of the last 3 years, the volume of:

a. Submitted Level I screens that were found to be inaccurate and not to require a Level II evaluation after review.

b. Submitted Level I screens that were found to be inaccurate and were not considered a Partial Level II evaluation.

A: The average number of Level I Screens submitted for review that did not result in the completion of a

Level II Screen has averaged 2,754 Screens annually for the past three calendar years. DHS does not know how many of these Level I Screen submissions were inaccurately completed and did not need to be submitted versus accurately completed and submitted for review by the Supplier to verify that a

Level II Screen was not warranted.

10. Regarding: 1.2 (ref. 010)

Q: Level I screen submission: Please describe any documentation or supporting documents that Level I screeners:

a. Typically submit with the Level I screen.

b. Are required to submit with the Level I screen.

A: The only document that is required as part of a Level II referral is the four-page completed Level I

Screen. Other information is provided to substantiate the diagnosis of a mental illness or an intellectual disability. The following are normally included:

A Facesheet

Diagnosis

List of Medications

Physician’s orders

History and Physical, if available

Nursing notes

Consults

Social History

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 5 of 15

11. Regarding: 1.2, D.2.f (ref. 011)

Q: a. Are both biennial Resident Reviews (page 15) and “change in status reviews” (page 10) considered

Full Level II Screens and therefore must be face-to-face?

A: Wisconsin’s PASRR policies and procedures permit the use of existing data that appears to be valid, reliable and reflects current functioning. If the data elements required by 42 CFR 483.132 – 483.136 can be gathered from available information and collateral sources, then a face-to-face review is not required. If circumstances are such that all the required data elements are not addressed from existing data and other available sources (e.g., interviewing the individual, family, social worker, and other collateral sources, such as the individual’s physician or psychiatrist via phone), then a face-to-face encounter is required.

b. Are the total volume of “change in status” reviews and biennial resident reviews are included in the volume data provided in Attachment C? If not, please clarify.

A: Yes. Attachment C includes the total volume of reviews.

12. Regarding: 1.5 (ref. 012)

Q: This section includes, “…the Procurement Manager may authorize in writing contact or communication with another State employee or officer as circumstances dictate”. If a Vendor would like to request that a

Wisconsin DHS employee serve as a Vendor reference for this solicitation, how should the Vendor proceed with this request?

A: Vendors may make reference contacts to current State staff only within the following constraints:

The purpose of the contact must be only to ask permission to be listed as a reference for purposes of this RFB and to confirm contact information. There shall be no discussion of Vendor’s planned RFB submittal, future contract ideas, or any other discussion that may call into question the integrity of this solicitation process.

Vendors shall pose the request directly to the State staff person via email with a copy to DHSProcurement@dhs.wisconsin.gov.

Include the following statement in the body of the email message: In compliance with the instructions for using State of Wisconsin staff as a reference for this RFB, the DHS Procurement Manager Greg Smith is copied on this message to properly disclose this contact. Please reply all to this message to document your response. This is necessary even if you elect not to be listed as a reference.

At their option, Vendors may submit a reference request template to the Procurement Manager for review and comment.

This information will remain confidential during the solicitation process.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 6 of 15

13. Regarding: 4.A.1 Supplier Responsibilities (ref. 013)

Q: The RFB states: “The Supplier is responsible to: Hire staff with special translation or sign language skills…”

Please indicate the volume of assessments in each of the current contract years that required special translation or sign language skills.

A: The PASRR contract has not required the Supplier to report such information to the Contract

Administrator, so the volume of assessments requiring services of a translator or sign language interpreter is unknown. However, DHS believes that the volume is very small.

14. Regarding: 4.D (ref. 014)

Q: Is intellectual testing required as a part of the evaluations conducted on individuals with IDD? If so:

a. Under what circumstances are they required?

b. For the past 3 contract years, how many times was intellectual testing administered?

A: If an individual has been served by a county department of human services in the county’s intellectual/developmentally disabled system or now is enrolled in Family Care, a state hybrid home and community-based waiver/managed care program, due to an intellectual/developmental disability, then intellectual testing is unnecessary. Also, if social history information clearly indicates that the individual did not have three or more areas of major life activities that were substantially limited prior to age 22, then intellectual testing is unnecessary.

The PASRR contract has not required the Supplier to report the number of times that intellectual testings were administered, so the number is unknown. However, DHS believes the number is very small.

15. Regarding: 4E (ref. 015)

Q: What is the current/preferred method for contacting the county liaison or Contract Administrator when necessary?

A: Communication with the county liaisons are usually done through the US mail or fax .

Communication with the Contract Administrator can take place through phone, fax, encrypted email, or the U.S. Mail.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 7 of 15

16. Regarding: 4.F (ref. 016)

Q: The RFB states: The Department’s policies and procedures permit the use of existing data that is accurate and reflects current functioning, which may obviate the requirement of a direct observation for some screens.

a. Please indicate the volume over the last 3 contract years of Level II assessments that have not had sufficient existing data and therefore required direct observation.

b. Please describe the type of existing data that may obviate the requirement of a direct observation for some screens.

c. Please describe how the Vendor receives such data and verifies that direct observation is not required.

A: During CY 2013, 292 Level II Screens required a face-to-face evaluation from a psychiatrist (out of a total of 9,743 Level II Screens) and for CY 2014, 293 Screens (out of a total of 9,977 Level II Screens).

This information was not included in the CY 2015 audit. Such a face-to-face evaluation by a psychiatrist could be for a Partial Level II Screen (e.g., the psychiatrist’s process for a differential diagnosis determines that the individual’s behaviors are attributable to dementia rather than a major mental illness), for an Abbreviated Level II Screen (e.g., the psychiatrist determines that the individual’s cognitive losses are so significant that he/she cannot participate in or benefit from specialized services or specialized psychiatric rehabilitative services), or for a Full Level II Screen.

However, DHS believes that the vast majority of the face-to-face evaluations from a psychiatrist are for Full Level II Screens.

Wisconsin’s PASRR policies and procedures permit the use of existing data that appears to be valid, reliable and reflects current functioning. The type of existing data may include a medical history and physical from a recent/current hospitalization or from the nursing facility; psychiatric evaluation report or progress notes; hospital or nursing home medication administration records; minimum data set, resident assessment information, and care plans from the nursing facility; hospital or nursing facility progress notes;and similar written documentation. In addition, this listing of written documents may be supplemented with verbal information from the individual, the individual’s caregiver/family, the individual’s primary care physician and other sources with direct knowledge of the individual. This information may be requested by the Supplier’s staff or may be sent independently by a staff person in a hospital or nursing facility if he/she has been working with the

Supplier and understands what information likely will be useful to complete the Level II Screen.

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17. Regarding: 4.F (ref. 017)

Q: The RFB states: “Except for Partial and Abbreviated Level II Screens (defined in Appendix A – PASRR-

Related Definitions), each Level II Screen must include at least one direct observation of or interview with the person who is being evaluated.”

Please confirm that only Full PASRR Level II Screens require direct, face-to-face observation or interview.

A: Please see the answer to question 16.

18. Regarding: 4.F (ref. 018)

Q: The RFB states: “…each Level II Screen must include at least one direct observation of or interview with the person who is being evaluated.”

a. Is the one direct observation required for each time the individual was referred?

b. If an individual has been previously evaluated face-to-face (Full PASRR Level II screen), but is re-submitted for a Status Change, is an additional direct observation required?

A: Wisconsin’s PASRR policies and procedures permit the use of existing data that appears to be valid, reliable and reflects current functioning. If the data elements required by 42 CFR 483.132 –

483.136 can be gathered from available information and collateral sources, then a face-to-face review is not required. If circumstances are such that all the required data elements are not addressed from existing data and other available sources (interviewing the individual, family, social worker, and other sources with direct knowledge of the individual via phone), then a face-to-face encounter is required. The decision as to the need for a face-to-face evaluation must be based on the availability of existing data that appears to be valid, reliable, and reflects current functioning each time the individual is referred for a Level II Screen.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 9 of 15

19. Regarding: 4.F (ref. 019)

Q: The RFB states, “For completion of a Full Level II Screen for persons who have a serious mental illness, a face-to-face psychiatric evaluation must be completed by a Board-certified psychiatrist, a physician who has satisfactorily completed the Board’s specialized training requirements in psychiatry, or a physician who is participating in a psychiatric residency program and whose work is reviewed and countersigned by a Board-certified psychiatrist.”

The PASRR Technical Assistance Center (PTAC), whose function is to promulgate guidance on behalf of, and with approval of CMS, has clarified and affirmed that a Level II for individuals with mental illness must include “an assessment of psychiatric history (for PASRR/MI) performed by a qualified assessor

(e.g., a psychiatrist, a psychiatric social worker, or a nurse with substantial psychiatric experience)”

[available here].

PTAC has also stated that “requiring psychiatrists to perform the psychosocial evaluation for PASRR/MI is generally impractical, especially in rural areas, where the density of such professionals is generally low. It is better for the state -- and for the individuals whom PASRR is meant to serve -- if a range of professionals can perform the evaluation” [available here].

Requirements for psychiatrists to conduct face-to-face Level II assessments were eliminated by CMS in

1992 for many reasons, including significant nationwide accessibility issues. CMS determined in the Final

Federal Rules for PASRR that qualified mental health professionals could more accessibly meet the needs of persons affected by PASRR.

a. Would the Department consider a model in which face-to-face evaluations are completed by qualified, experienced professionals (e.g., psychiatric social workers or nurses)?

b. Alternatively, if the Department prefers continued involvement of psychiatrists, would the

Department consider a model where the evaluation completed by a Qualified Mental Health

Professional is remotely reviewed and by a psychiatrist?

A: From 1994 to present, there have been sufficient psychiatrists available to meet contract requirements. The requirements in RFB section 4.F assure Wisconsin’s PASRR process will continue to use the most highly-qualified resources. Wisconsin’s process, which permits the use of existing data that appears to be valid, reliable and reflects current functioning by a QMRP with a psychiatrist review of the individual’s medication regiment, also provides added flexibility.

20. Regarding: 4 F (ref. 021)

Q: Would it be possible to eliminate the use of a psychiatrist?

A: No. See also response to question 19.

http://www.pasrrassist.org/resources/federal-regulations/pasrr-plain-english http://www.pasrrassist.org/resources/level-ii-personnel/who-can-complete-level-ii-evaluation-and-determination

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 10 of 15

21. Regarding: 4.G (ref. 020)

Q: The RFB states, “The Supplier must ensure that an evaluation summary and notice of appeal rights document or other Department approved document is written for each completed Level II Screen and that a team member presents, in person, a copy of the evaluation summary and an interpretation of the evaluation results and recommendations to the person who was evaluated (or his/her legal representative, if he/she has one).”

a. Is the “Level II Preadmission Screening and Resident Review Evaluation Summary and Notice of

Appeal Rights” (Schedules 6/7 in the RFB), the information that is provided to the individual and legal representative?

A: Yes.

b. Is this information currently presented to the evaluated person/legal representative by the assessor at the conclusion of the interview/evaluation? In other words, does the assessor complete this document and present it to the individual/guardian before departing from the interview or, alternatively, is this typically presented/interpreted on a later date?

A. If the individual or his/herlegal representative is present for the evaluation, the information could be presented at the end of the meeting. Otherwise, the completed form may be mailed to the individual or his/her legal representative through the U.S. Mail as soon as the Level II Screen is completed. If an adverse determination is made, then the Evaluation Summary and Notice of Appeal

Rights must be mailed using certified mail.

22. Regarding: 4I. (ref. 022)

Q: Federal PASRR requirements mandate that the Primary Care Physician (PCP) also receive a copy of the applicable portions of the Level II Screen.

Please confirm the Department would also like vendors to provide this information to PCPs.

A: While 42 CFR 483.128 (l) (4) requires the Evaluation Report to be sent to the individual’s attending physician, Wisconsin’s PASRR process does not require the Supplier to do so because:

1. A substantial number of individuals who receive a Level II Screen do not have an identified attending/primary care physician or know the mailing address of their attending/primary care physician; and

2. Wisconsin Statutes § 51.30 related to confidential treatment information, which is more stringent than HIPAA regulations, require a written consent to release the confidential treatment information to the attending physician.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 11 of 15

23. Regarding: Section 5 (ref. 023)

Q: “Vendor must accept all terms and conditions or submit point-by-point exceptions along with proposed alternative or additional language for each point.” This is very broad language, could you be more specific? Can you identify any portions of the RFB that these exceptions or alternatives apply to?

A: The introductory text to 5.0 provides the process by which Vendors may submit exceptions and modifications to sections 5.1 through 5.16.

24. Regarding: 5.0 (ref. 024)

Q: The 3 introductory paragraphs in Section 5 are very ambiguous, could you be more specific? Please identify any portions of the RFB that these exceptions or alternatives apply to or will be allowed?

A: The introductory text to Section 5.0 Contract Terms and Conditions provides the process by which

Vendors may optionally submit exceptions and modifications to sections 5.1 through 5.16.

25. Regarding: 5.2 (ref. 025)

Q: Can a Vendor make modifications to the Contract after the bid is awarded? If so, what specific areas can be modified?

A: The Supplier can request modifications to the resulting contract. Such changes will be subject to negotiation with DHS and must be confirmed in writing.

26. Regarding: 5.3 (ref. 026)

Q: Will changes to these documents (DOA-3054 & DOA-3681) be permitted?

A: As with the other provisions in section 5.0, Vendors may submit point-by-point exceptions to

DOA-3054 and DOA-3681.

27. Regarding: 5.4 (ref. 027)

Q: Is the DHS data warehouse web-based? How will the vendor connect to the database?

A: Yes. The connection will be made through a secure network.

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 12 of 15

28. Regarding: 5.6 (ref. 028)

Q: (a) If a bidder contracts with independent contractors (single individuals with no associated legal or business entities) to deliver the services as set forth in the RFB, is the bidder required to submit all required information for these individuals as required for subcontractors, including financial information? For purposes of this RFB will these types of independent contractors be considered

“subcontractors”? Bidder notes that most of these individuals do not maintain levels and types of insurance typically in place for business entities. We take exception to the insurance obligations as applied to subcontractors and request that the insurance obligations not be required for these subcontractors.

(b) Relatedly, Section 5.6 requests a list of potential subcontractors. If a Vendor intends to use individuals as discussed above, it is unlikely that Vendor will have the names of all potential subcontractors at the time of proposal submission due to ongoing recruitment efforts. Will the Department instead consider an overview of this type of subcontractor and the services they will provide, instead of actual named subcontractors in evaluating this section? Further, will the Department consider a process that allows

Vendors to easily add and remove certain types of subcontractors, where there is large number of these types of subcontractors and the group of subcontractors is prone to a moderate turnover rate?

A: (a) Staff performing this work will only be either employees or subcontractors. Examples of subcontractors include corporations, partnerships, and sole proprietors. Subcontractors, no matter their classification, must comply with all RFB requirements including insurance. See also RFB

Section 5.0, and include suggested revisions to the Contract Terms and Conditions, if any, at the end of Tab G.

(b) DHS will confirm Vendor’s submitted plan and timetable for obtaining sufficient qualified staff reasonably assures Vendor will be able to perform the required volume and scope of work. The awarded Supplier will be held to this plan and will be responsible to meet all contract requirements for the price bid. Supplier failure to meet contract terms may result in contract cancellation. The

DHS Contract Administrator will establish an ongoing process for reviewing and approving Supplier staff qualifications.

29. Regarding: 7.1 (ref. 029)

Q: Will you announce the price per screen and the Vendor’s name for each bid submitted?

A: Bidding company name and price per screen will be announced at the public bid opening described in section 7.1 Bid Opening

Dept. of Health Services Request for Bid S-0627 DCTS-17 Page 13 of 15

30. Regarding: Appendix C (ref. 030)

Q: a. Please describe in more detail how the evaluation and documentation of Partial and Abbreviated

Level II Screens differs from a Full Level II.

A: The primary distinction between the Partial and Abbreviated Level II Screens compared to the Full

Level II Screens is that the Partial and Abbreviated Level II Screens do not need to have information for all the required data elements in 42 CFR 483.132 – 483.136. For example, a Partial Level II Screen may be completed as soon as it is apparent that one or more of the three criteria in the Federal definition of a serious mental illness or the four criteria in the Federal definition of intellectual disabilities is not met. Generally, existing data (with or without supplementary information via interviews) is readily obtainable, so it is possible to conclude that the Screen may be completed as a

Partial or Abbreviated Screen quickly/early in the Level II Screen process.

b. Is the Level II Facesheet completed for all Level II screen types?

A: Yes, the Level II Facesheet is completed for all Level II Screens.

31. Regarding: Appendix C (ref. 031)

Q: a. Please confirm, for the purposes of Vendors creating comparable cost estimates, that the Department is assuming that the ratio between partial, abbreviated, and Full Level II screens are likely to remain steady over the next contract term.

A: In general, persons seeking admission to a nursing facility or are nursing facility residents now are older and have a higher acuity of medical needs and/or significant cognitive losses compared to twenty years ago. DHS believes that some individuals who received an Abbreviated Level II Screen perhaps could appropriately have received a Partial Level II Screen instead. The following table includes the number of completed Level II Screens for CY 2016:

# of screens % of total

Partial 1,124 10.14%

Abbreviated 9,387 84.66%

Full 577 5.20%

Total 11,088 100.00%

b. Should Federal policy changes or guidance lead to changes in these ratios in the future, please confirm the Department would be willing to renegotiate the rate.

A: DHS would consider but would not guaranatee to renegotiate the per screen rate. DHS may also elect to rebid the contract. DHS does not anticipate a change in Federal policy or guidance that would impact these ratios in the foreseeable future.

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32. Regarding: Schedule 2 (ref. 032)

Q: In previous RFBs for the Wisconsin PASRR Project the cost bid was required to tie to the budget. Why has the department decided that the cost per screen does not need to tie to the budget?

A: This solicitation will result in a contract for services. Since this is not a grant award, a budget tied to the cost per screen is not necessary. The Overview and General Instructions tab of Schedule 2

Budget Form describes how the information submitted on this form will be used for general contract administration purposes but not as the basis of award.

33. Regarding: Schedule 2 (ref. 033)

Q: How will you ensure that the cost bid permits the fulfillment of the terms of the contract?

A: This is a performance-based contract. The cost bid is determined by the bidding Vendor, and the awarded Supplier is responsible to meet all contract requirements for the price bid. Supplier failure to meet contract terms may result in contract cancellation.

34. Regarding: Schedule 2 (ref. 034)

Q: In Schedule 2 in the Overview and General Instructions item 4e, should this read Row 153?

A: Correct. In Schedule 2 in the Overview and General Instructions Item 4e, should read Row 153.

35. Regarding: Schedule 3 (ref. 035)

Q: Will you allow any changes in the way Level I’s are submitted to the vendor?

A: In the future, the submission of the Level I may be automated. Currently nursing homes and hospitals submit the PASRR Level 1 to the PASRR Contractor via fax, U.S. mail, or encrypted email.

36. Regarding: Schedule 4 (ref. 036)

Q: In Schedule 4, the Department requests that bidders “[d]etail in a logical progression how the program will be implemented and operated in stated timeframes. Include the day-to-day work plan, the staffing structure and task schedule, staff organization structure and the qualifications of key personnel.”

How should bidders distinguish between the proposed “staffing structure” and “staff organization structure” in their response?

A: “Staffing structure” should describe day-to-day operations. “Staff organization structure” should describe reporting relationships and general management structure.

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37. Regarding: Schedule 4, Schedule 5 (ref. 037)

Q: In Schedule 5, the Department requests that bidders list the qualifications of all proposed key staff in the table provided. In Schedule 4, the Department requests that bidders list “qualifications of key personnel.”

Can the Department confirm whether the qualifications and background of proposed key staff need to be listed in each Schedule, or whether a reference to Schedule 5 in Schedule 4 would suffice?

A: Cross-references between Schedules 4 and 5 are acceptable.

38. Regarding: Schedule 4, Schedule 5 (ref. 038)

Q: Schedule 4 requests a list of key staff, their qualifications, and responsibilities.

Unless a Vendor is already conducting the work, which excludes all other companies except the incumbent, it is likely it may not have names to list in Schedule 5. Will the Department instead consider the requirements for personnel (instead of actual named staff) in evaluating this section?

A: The RFB was issued on April 11 and is due on May 23, allowing six weeks for Vendors to secure key staff, e.g., an agreement to be employed or sign a contract if the Vendor is awarded the contract.

Vendors who are not able to identify all key staff should include with their bid submittal a viable plan for recruiting sufficient staff prior to July 1, 2017.

39. Regarding: Schedule 6, Schedule 7 (ref. 039)

Q: Does the State provide specialized services to residents in nursing facilities, or only in institutional settings such as inpatient psychiatric care?

A: No, the State does not directly provide specialized services or specialized psychiatric rehabilitative services. DHS staff do provide limited training and technical assistance to nursing facility staff regarding specialized services and specialized psychiatric rehabilitative services. A nursing facility that chooses to admit an individual whose PASRR Level II Screen indicates he/she needs specialized psychiatric rehabilitative services is responsible for meeting the individual’s needs, including the provision of services and interventions that are designed to address the individual’s disability needs.

Some of the needed services, such as an assessment from a licensed mental health professional or psychotherapy, are Medicaid direct billable services or billable to private insurance (i.e., the facility is not responsible for the payment of these services). The facility is eligible for supplemental reimbursement from the State for the provision of specialized services or specialized psychiatric rehabilitative services.