RFA 5304 updated Feb 15 2022.pdf

RFA 5304 jmb Page 1 of 35 OregonBuys #S-44300-00001160

In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audio recordings, Web-based communications and other electronic formats.

To request an alternate format, please send an e-mail to dhs-oha.publicationrequest@state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to arrange for the alternative format.

REQUEST FOR APPLICATION (RFA) 5304

Volunteer Organization Enrollment Assistance and System Navigation

OregonBuys #S-44300-00001160

The Oregon Health Authority (OHA) requests applications from qualified individuals or organizations hereinafter “Applicants,” to provide volunteer enrollment assistance and system navigation to Oregon families and individuals applying for health coverage through OHA or HealthCare.gov.

Date of Issuance: November 9, 2021

Applications accepted through: November 9, 2026

Issuing Office: Oregon Health Authority Office of Contracts and Procurement 635 Capitol Street NE, Suite 350 Salem, Oregon 97301

Sole Point of Contact: Jewelee Bell, Procurement and Contract Specialist Work Cell: 971-208-4144 Email: jewelee.m.bell@dhsoha.state.or.us

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1. Background

The Oregon Health Plan (OHP) serves over 1,100,000 Oregonians. It is guided by the vision for better health, better care and lower costs for all Oregonians.

The Affordable Care Act (ACA) has realized the largest increase in health coverage enrollment in US history. Under the ACA’s provision allowing states to expand Medicaid to serve more citizens, OHP has enrolled over 700,000 new members since January 2014. However, there continues to be more individuals who need health coverage, need to re-enroll in health coverage, or “churn” between Medicaid and private plans, challenging both continuity and quality of care.

Since its inception, Oregon Health Insurance Market (OHIM) has worked with OHA to capitalize on OHA’s statewide network of community partners and broaden that network, offering localized, in-person assistance services for Oregonians enrolling in health coverage.

OHA continues to work towards supporting a statewide outreach, enrollment, and system navigation network of application assisters to provide Oregonians of all income levels access to public and private health insurance. OHA continues to work towards building upon the successful community partner program and to leverage existing networks to achieve this goal.

This network, known as the Community Partner Program, meets all ACA standards for Navigators and Certified Application Counselors. Outreach and services by community partners will continue to be critical to reach many working families that may have incomes above Medicaid eligibility levels but would still find affording health insurance impossible without the tax credits and cost share reduction.

2. Authority

OHA issues this RFA under the authority of Oregon Revised Statute (ORS) 413.033, and Special Procurement 826-16.

3. Minimum Qualifications

Applicants must meet the following minimum qualifications prior to submitting an Application (Attachment 1 to this RFA) to OHA to provide enrollment assistance as specified in Attachment 2, Form Contract.

Applicants must meet the “Responsible Proposer” requirements, identified in Oregon Revised Statutes (ORS 279B.110) and Oregon Administrative Rules (OAR 137-047-0500), which includes the requirement to be registered as a business with the Oregon Secretary of State. For information about and assistance with the Secretary of State’s Business Registration process, click on the following link: http://sos.oregon.gov/business/Pages/register.aspx.

4. Scope of Work

All services provided under any Contract awarded as a result of this RFA shall adhere to and comply with the provisions set forth in Attachment 2, Form Contract.

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5. Sole Point of Contact (SPC) and Issuing Office

Oregon Health Authority Office of Contracts and Procurement Jewelee Bell, Procurement and Contract Specialist 635 Capitol Street NE, Suite 350 Salem, Oregon 97301 Telephone: 971-208-4144 E-mail: jewelee.m.bell@dhsoha.state.or.us

All communications concerning this RFA document and the application process must be directed to the Office of Contracts and Procurement (OC&P) addressed to the SPC named above. Any oral communications will be considered unofficial and non-binding. Information received in writing from the SPC is considered official.

When appropriate, OC&P will issue revisions, substitutions, or clarifications as addenda to this RFA. Changes/modifications to the RFA shall be recognized only if in the form of written addenda issued by OC&P. OC&P will not automatically mail copies of any information related to this RFA but will publish any additional information or changes to the RFA in OregonBuys.

The OregonBuys system will be used to distribute all information regarding this RFA. To review complete RFA documentation please go to OregonBuys: https://oregonbuys.gov/bso/

By submitting an Application in response to this RFA, Applicant certifies that the following statements are true:

a. Applicant does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, sex, disability, sexual orientation or national origin, nor has Applicant nor will Applicant discriminate against a subcontractor in the awarding of a subcontract because the subcontractor is a minority, women or emerging small business enterprise certified under ORS 200.055 or a Disabled Veteran or a subcontractor that employs a Disabled Veteran, and

b. Information included in the Application shall remain valid for 90 days after the Application is submitted or until a Contract is executed, whichever comes first, and

c. The information contained in the Application is true and complete to the best of the Applicant’s knowledge and Applicant accepts as a condition of the Contract, the obligation to comply with applicable state and federal requirements, policies, standards, and regulations. The Applicant recognizes that this is a public document and open to public inspection, and

d. The Applicant acknowledges receipt of any Addenda to the RFA, and

e. If the Applicant is awarded a Contract as a result of this RFA, they will be required to complete, and will be bound by, a Personal Services Contract (Form Contract - Attachment 2) or an Intergovernmental Agreement (sample available upon request).

6. Application Review

Applications must be complete at the time of submission. OHA will review Applications as they are received, to determine whether an Applicant meets the minimum qualifications.

During the review process, OHA reserves the right to obtain clarification from Applicants regarding their Application information. Only Applicants determined by OHA to be qualified to provide services pursuant to this RFA will be offered a Contract.

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Applicants shall be notified of the status of their Application and, for successful Applicants, the timeline to be issued a Contract.

7. Public Information

All Applications are public information after the Application has been received by OHA. Any person may request copies of public information. However, copies of Applications will not be released until the review process has been completed. Requests for copies of public information must be submitted in writing. Requestors will be charged according to the current OHA policies and rates for public records requests in effect at the time OHA receives the written request for public information. Fees, if applicable, must be received by OHA before the records will be delivered to the requestor.

8. Cost of Applications

All costs incurred in preparing and submitting an Application in response to this RFA are the responsibility of the Applicant and will not be reimbursed by OHA.

9. Closing Date for Submittal of Applications

Applications will be received on an open and ongoing basis through November 9, 2026. When OHA has determined that sufficient Applications have been received, or for any other reason that OHA determines, OHA will issue notice through OregonBuys specifying a date after which Applications will no longer be received. Applications received after the date and time specified in the OregonBuys notice will not be accepted.

APPLICATIONS MAY BE EVALUATED BY OHA AT ANY TIME AFTER RECEIPT.

Applicants are encouraged to submit Applications as soon as possible. Contracts may be issued at any time throughout the open application period.

10. Contract Document Terms and Conditions

Contracts will be based on the Form Contract (Attachment 2) and will include all exhibits and attachments identified in the Contract. The terms and conditions included in the Contract are not subject to negotiation.

11. Reservation of OC&P Rights

OC&P reserves all rights regarding this procurement, including, without limitation, the right to:

a. Amend or cancel this procurement without liability if it is in the best interest of the State to do so;

b. Reject any and all Applications received by reason of this request upon finding that it is in the best interest of the State to do so;

c. Waive any minor informality with the provisions or procedures of this procurement, and to seek clarification from the Applicant, if required;

d. Reject any Application that fails to substantially comply with all prescribed procurement procedures and requirements;

e. Extend, amend or negotiate any Contracts that are a result of this procurement, in accordance with the terms and conditions of the Form Contract document; and

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f. Engage Contractor by selection or procurement for different or additional services independent of this RFA process or any Contracts or Agreements established as a result of this RFA.

12. Contractual Obligation

All Applicants who submit an Application in response to this RFA understand and agree that OHA is not obligated thereby to enter into a Contract or an Agreement with any Applicant and further, has absolutely no financial obligation to any Applicant.

13. Application Requirements

Applicants must submit a completed Application form (Attachment 1 to this RFA) through OregonBuys: https://oregonbuys.gov/bso/

Applicant must submit a separate application for each site that has a different Employer Identification Number (EIN).

Applicants must be registered with the Oregon Secretary of State as a business or note on the application that Applicant is a Government Entity.

Applicant must meet the minimum insurance requirements as outlined in Exhibit C of the Form Contract (Attachment 2) or Applicant will meet those requirements prior to Contract execution.

Government Entities will meet the insurance requirements contained in the state’s Intergovernmental Agreement. A sample Intergovernmental Agreement is available from the SPC upon request.

Applications will only be accepted through the OregonBuys system.

14. Compliance with Executive Order 21-29

“EO 21-29” means Governor of the State of Oregon’s Executive Order 21-29 as may be amended, https://www.oregon.gov/gov/Documents/executive_orders/eo_21-29.pdf.

‘FAQ” means the Executive Order 21-29 Vaccination Requirements for State Contractors Frequently Asked Questions as may be amended.

ExecutiveOrder21-29_ContractorFAQ.pdf (oregon.gov)

For interpretation of provisions relating to EO 21-19:

a. The terms "Executive Branch," "COVID-19," "Fully Vaccinated," "Proof of Vaccination," "Employee," and "Worker" have the meanings defined in EO 21-19.

b. The term “Worksite” has the meaning defined in the FAQ.

15. Training

Applicants are encouraged to register for Certified Assister Training if they have not already done so.

For a list of upcoming trainings, directions on registering, or other questions, please contact:

cp.business@dhsoha.state.or.us

Attachment 1 – APPLICATION FORM

Applicants must meet the Minimum Qualifications, as described in Request for Application (RFA) 5304.

Applicants must submit this completed Application Form through OregonBuys to be considered for a Contract/Agreement.

Volunteer Organization Information Organization Name:

Mailing Address:

City: State: County: Zip Code:

Physical Address:

Phone:

Tax ID (EIN):

What region(s) or area(s) of the state does your organization intend to serve?

Please be as specific as possible.

Type of Organization Advocacy Group Other service organization Governmental Food bank Faith-based organization Education Service District (ESD) Tribal organization Financial service organization Head Start Minority organization Fraternal/service organization School Medical care provider Day Care Provider (licensed or registered) Other Governmental:

Insurance Organization

Conflict of Interest Applicants must not be an individual or entity that has a conflict of interest and may not be an individual or entity that has the appearance of a conflict of interest. If a conflict of interest exists, or may exist, you will be contacted to provide an explanation. Insurance Organizations shall disclose all relationships with insurers, their subsidiaries or other potential conflicts of interest.

Conflict of interest exists for:

Insurers and their subsidiaries Issuers of Stop Loss Insurance Members of, or individuals who lobby on behalf of, the insurance industry Individuals or entities receiving direct or indirect consideration from insurers in connection with enrollment of individuals in a health insurance plan

Insurance Commercial General Liability Insurance Yes, Applicant currently meets the CGL insurance requirement.

Do not currently meet CGL insurance requirements, and will meet requirement prior to Contract execution.

Automobile Insurance Requirements Yes, Applicant currently meets the Auto insurance requirement, or will meet requirement prior to Contract execution.

No, do not meet Auto insurance requirement and will not travel to assist applicants and consumers with enrollment. Applicant assumes full responsibility should OHA agree to waive this requirement.

Organization’s Contract Administrator

Name and Title:

Phone:

Email:

Applicant, by signing this Application, certifies that they have read, understands and agrees to comply with RFA 5304.

Signature:

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Attachment 2 – Form Contract

SAMPLE ONLY

Contract Number 000000

STATE OF OREGON

PERSONAL/PROFESSIONAL SERVICES CONTRACT

In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audio recordings, Web-based communications and other electronic formats.

To request an alternate format, please send an e-mail to dhs-oha.publicationrequest@state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to arrange for the alternative format.

This Contract is between the State of Oregon, acting by and through its Oregon Health Authority, hereinafter referred to as “OHA ,” and

Contractor Name Address

City, state, zip Attention: (required) Telephone: (required)

Fax: (optional) E-mail address: (required) hereinafter referred to as “Contractor .”

Work to be performed under this Contract relates principally to OHA’s

Office / Program Address

City, state, zip Contract Administrator: Name or delegate

Telephone:

E-mail address:

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1. Effective Date and Duration.

This Contract shall become effective on the date this Contract has been fully executed by every party and, when required, approved by Department of Justice or on [start date], whichever date is later. Unless extended or terminated earlier in accordance with its terms, this Contract shall expire on [end date]. Contract termination shall not extinguish or prejudice OHA’s right to enforce this Contract with respect to any default by Contractor that has not been cured.

2. Contract Documents.

a. This Contract consists of this document and includes the following listed exhibits which are incorporated into this Contract:

(1) Exhibit A, Part 1: Definitions and Standards

(2) Exhibit A, Part 2: Statement of Work

(3) Exhibit A, Part 3: Special Provisions

(4) Exhibit B: Standard Terms and Conditions

(5) Exhibit C: Insurance Requirements

There are no other contract documents unless specifically referenced and incorporated in this Contract.

b. This Contract and the documents listed in Section 2. Contract Documents, Subsection a.

above, shall be in the following descending order of precedence: this Contract less all exhibits, Exhibits B, A, and C.

3. Consideration.

Contractor is considered a Volunteer Organization under this Contract. OHA will not compensate the Contractor for Work performed under this Contract. For purposes of this Contract, “Work” means the tasks or services and deliverables accepted by OHA, and which are described in Exhibit A, Part 2, Statement of Work.

4. Contractor or Subrecipient Determination. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.104, OHA’s determination is that:

Contractor is a subrecipient Contractor is a contractor Not applicable

Catalog of Federal Domestic Assistance (CFDA) #(s) of federal funds to be paid through this Contract: Not Applicable

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5. Contractor Data and Certification.

a. Contractor Information. This information is requested pursuant to ORS 305.385.

PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION

Contractor Name (exactly as filed with the IRS):

Street address:

City, state, zip code:

Email address:

Telephone: ( ) Fax: ( )

Is Contractor a nonresident alien, as defined in 26 U.S.C. § 7701(b)(1)?

(Check one box): YES NO

Business Designation: (Check one box):

Professional Corporation Nonprofit Corporation Limited Partnership Limited Liability Company Limited Liability Partnership Sole Proprietorship Corporation Partnership Other

Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C must be in effect prior to Contract execution.

If Contractor is self-insured for any of the Insurance Requirements specified in Exhibit C of this Contract, Contractor may so indicate by: (i) writing “Self-Insured” on the appropriate line(s); and (ii) submitting a certificate of insurance as required in Exhibit C.

Commercial General Liability Insurance Company: ___________________________________

Policy #: ______________________________________ Expiration Date: _______________

Automobile Liability Insurance Company: __________________________________________

Policy #: ______________________________________ Expiration Date: _______________

Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027?

(Check one box): YES NO If YES, provide the following information:

Workers’ Compensation Insurance Company: ________________________________________

Policy #: ______________________________________ Expiration Date: _______________

b. Certification . Without limiting the generality of the foregoing, by signature on this Contract, the undersigned hereby certifies under penalty of perjury that:

(1) Contractor is in compliance with all insurance requirements in Exhibit C of this Contract, and notwithstanding any provision to the contrary, Contractor shall deliver to the OHA Contract Administrator (see page 1 of this Contract) the required Certificate(s) of Insurance within 30 days of execution of this Contract.

By certifying compliance with all insurance as required by this Contract, Contractor acknowledges it may be found in breach of the Contract for failure to obtain required insurance. Contractor may also be in breach of the Contract for

RFA 5304 jmb Page 10 of 35 failure to provide Certificate(s) of Insurance as required and to maintain required coverage for the duration of the Contract;

(2) Contractor acknowledges that the Oregon False Claims Act, ORS 180.750 to 180.785, applies to any “claim” (as defined by ORS 180.750) that is made by (or caused by) the Contractor and that pertains to this Contract or to the project for which the Contract work is being performed. Contractor certifies that no claim described in the previous sentence is or will be a “false claim” (as defined by ORS 180.750) or an act prohibited by ORS 180.755. Contractor further acknowledges that in addition to the remedies under this Contract, if it makes (or causes to be made) a false claim or performs (or causes to be performed) an act prohibited under the Oregon False Claims Act, the Oregon Attorney General may enforce the liabilities and penalties provided by the Oregon False Claims Act against the Contractor;

(3) The undersigned is authorized to act on behalf of Contractor and represents and warrants that Contractor has complied with the tax laws of the State of Oregon and the applicable tax laws of any political subdivision of Oregon. Contractor shall, throughout the duration of this Contract and any extensions, comply with all tax laws of this state and all applicable tax laws of any political subdivision of Oregon. For the purposes of this Section, “tax laws” includes: (i) All tax laws of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of Oregon that applied to Contractor, to Contractor’s property, operations, receipts, or income, or to Contractor’s performance of or compensation for any work performed by Contractor; (iii) Any tax provisions imposed by a political subdivision of Oregon that applied to Contractor, or to goods, services, or property, whether tangible or intangible, provided by Contractor; and (iv) Any rules, regulations, charter provisions, or ordinances that implemented or enforced any of the foregoing tax laws or provisions.

Contractor acknowledges that the Oregon Department of Administrative Services will report this Contract to the Oregon Department of Revenue (DOR).

The DOR may take any and all actions permitted by law relative to the collection of taxes due to the State of Oregon or a political subdivision, including: (i) garnishing the Contractor’s compensation under this Contract; or

(ii) exercising a right of setoff against Contractor’s compensation under this Contract for any amounts that may be due and unpaid to the State of Oregon or its political subdivisions for which the DOR collects debts;

(4) The information shown in Section 5.a., “Contractor Information” above is Contractor’s true, accurate and correct information;

(5) To the best of the undersigned’s knowledge, Contractor has not discriminated against and will not discriminate against minority, women or emerging small business enterprises certified under ORS 200.055 in obtaining any required subcontracts;

(6) Contractor and Contractor’s employees and agents are not included on the list titled “Specially Designated Nationals” maintained by the Office of Foreign Assets Control of the United States Department of the Treasury and currently found at: https://www.treasury.gov/resource-center/sanctions/SDN- List/Pages/default.aspx;

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(7) Contractor is not listed on the non-procurement portion of the General Service Administration’s “List of Parties Excluded from Federal procurement or Non-procurement Programs” currently found at:

https://www.sam.gov/portal/public/SAM/;

(8) Contractor is not subject to backup withholding because:

(a) Contractor is exempt from backup withholding;

(b) Contractor has not been notified by the IRS that Contractor is subject to backup withholding as a result of a failure to report all interest or dividends; or

(c) The IRS has notified Contractor that Contractor is no longer subject to backup withholding; and

(9) Contractor Federal Identification Number (FEIN) or Social Security Number (SSN) provided is true and accurate. If this information changes, Contractor shall provide OHA with the new FEIN or SSN within 10 days.

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CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY A CKNOWLEDGES

THAT CONTRACTOR HAS READ THIS CONTRACT, UNDERSTANDS IT AND AGREES

TO BE BOUND BY ITS TERMS AND CONDITIONS.

6. Signatures. This Contract and any subsequent amendments may be executed in several counterparts, all of which when taken together shall constitute one agreement binding on all parties, notwithstanding that all parties are not signatories to the same counterpart. Each copy of the Contract and any amendments so executed shall constitute an original.

Contractor Name By:

Authorized Signature Printed Name

Title Date

State of Oregon, acting by and through its Oregon Health Authority By:

Authorized Signature Printed Name

Title Date

Approved for Legal Sufficiency Not required per OAR 137-045-0030(1)(a)

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EXHIBIT A

Part 1

Definitions and Standards

1. Definitions

a. Application Assisters: Employees or volunteers who will provide information about available public and private health insurance coverage options to potentially eligible consumers. Application Assisters are under no obligation to provide enrollment assistance to individuals other than those the organization seeks to serve; however, Application Assisters must provide informational materials regarding coverage options to potentially eligible consumers.

b. Applicants: Oregon residents who have applied or may apply to access health coverage through HealthCare.gov or OHA.

c. Application: An Application is the process followed by an Applicant to apply for health coverage and potential financial assistance either through HealthCare.gov or OHA.

d. Oregon ONE Eligibility: The system where applicants apply for Oregon Health Plan (OHP) coverage via ONE (Medicaid Eligibility Determination).

e. System Navigation: Application Assisters provide system navigation to assist kids and families in getting an OHP eligibility determination and enrolling in a CCO (when applicable). This also includes assisting kids and families in understanding their OHP coverage (example: providing an overview of covered benefits), how to use it (example:

helping them connect to their CCO or establish primary care) and how to keep it for as long as they qualify (example: help with renewals and assistance understanding notices). Lastly, this could also include provision of wrap around support services to ensure needs surrounding the social determinants of health are addressed (example referrals for energy assistance, housing support, etc.).

f. Volunteer Organization: An OHA contracted organization that is not compensated for work performed under Contract but is given access to technical assistance, ONE system, ongoing training, opportunities to collaborate with other organizations doing similar work, and outreach materials.

Contractors must adhere to the following Standards when providing services throughout the Contract period.

2. Conflicts of Interest Standards

Contractor must not be an individual or entity that has a conflict of interest and may not be an individual or entity that has the appearance of a conflict of interest.

These entities include:

a. Insurers and their subsidiaries or issuer of stop loss insurance.

b. Insurance companies.

c. Associations and their subsidiaries that include members of, or lobby on behalf of, the insurance industry.

d. Entities receiving direct or indirect consideration from insurers in connection with the enrollment of any individuals or employees in a health insurance.

e. Individuals or entities, including insurance agents, receiving commission may not receive

RFA 5304 jmb Page 14 of 35 direct or indirect compensation or other consideration from health insurers, issuers of stop loss insurance or their subsidiaries. Such consideration includes, but is not limited to, commissions for enrollment renewals, pension income, and other sources of income from health insurers.

A conflict of interest will be deemed to exist for Contractors who have an ownership stake or other investments in a health insurer or its subsidiaries. Contractor will provide a statement indicating that employees and volunteers providing outreach and enrollment services will adhere to the same conflict of interest standards described in the preceding paragraphs. Application Assisters shall disclose any relationships the Application Assister has with insurers, their subsidiaries, or other potential conflicts of interest.

Contractor should also indicate if their employees assigned to provide volunteer outreach and enrollment services have any immediate family members who are employed by the following entities:

a. Insurers or their subsidiaries or issuers of stop loss insurance.

b. Provider entities (including, but not limited to, hospitals, clinics, and physician practices) that are directly or indirectly owned by, or exclusively contract with, a single insurer or its subsidiaries.

c. Associations and their subsidiaries that include members of, or lobby on behalf of, the insurance industry.

d. Entities receiving direct or indirect consideration from insurers in connection with the enrollment of any individuals or employees in a particular health insurance.

3. Standards of Equitable Service

a. Contractor will provide equitable treatment to all who request assistance.

b. Contractor will employ materials and communications that are objective, informative and factually correct. All outreach and enrollment materials developed by the Contractor must be approved by OHA prior to distribution.

c. Contractors who cannot provide the service(s) requested by a consumer will refer the consumer to another resource, program, or organization.

4. Organization Standards

Contractor shall not:

a. Offer or provide any gift, favors or other inducement to potential Applicants without OHA approval.

b. Accept money or premium payments for outreach or enrollment activities.

c. Submit eligibility or enrollment information without obtaining permission to assist from the Applicant using the current OHA-provided consent form.

d. Divulge any information obtained while assisting an Applicant with the application for purposes other than conducting application or enrollment assistance for Qualified Health Plans (QHP) or Public Medical Programs.

e. Invite or influence an employee or their dependents to separate from an employer-based group insurance plan or arrange for this to occur.

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f. Allow any person who has not passed a criminal history check within the last two years to perform services under this Contract.

g. Provide inaccurate, misleading or coercive oral or written information or materials.

h. Encourage Applicants to include on the application any false or misleading information regarding income, residency, alienage and other eligibility information.

5. Application Assister Standards

a. All Application Assisters will be trained and certified by OHA. Training and certification must be renewed as required.

b. Application Assisters will provide information about possible public and private health insurance coverage options to potentially eligible consumers in a fair, accurate, and impartial manner. Information shall be provided in a culturally and linguistically appropriate manner, including to persons of limited English proficiency, and shall ensure accessibility and usability of enrollment tools for persons with disabilities. Application Assisters are under no obligation to provide enrollment assistance to individuals other than those the organization seeks to serve; however, Application Assisters must provide informational materials about coverage options to eligible consumers.

c. The Application Assister shall encourage Applicants to provide accurate and truthful information, and shall not attempt to pre-determine consumer eligibility, or make any assurances regarding the eligibility of the consumer for any health coverage option. In addition, Application Assisters shall not promise or quote benefits, or advise applicants on the legal provisions of a Qualified Health Plan.

d. All Application Assisters working under the Contractor’s organization will utilize HealthCare.gov, OregonHealthCare.gov, and the ONE system to provide enrollment assistance. If circumstances require using a paper application, the Application Assister will write the date the application was started and the assigned Assister Identification number in the appropriate space on the application. The Contractor’s organization agrees to follow the policies and guidelines provided by OHA in establishing a date of request for applications when assisting consumers with a paper or PDF OHA application, and will follow the policy and guidelines for consent forms when assisting with all application formats.

e. The Application Assister shall maintain copies of all eligibility verification documents and all records related to enrollment assistance, including the required, current OHA-provided Consent Form for six years, whether in paper, electronic or other form in a secure and locked location; this includes paper applications submitted on a consumer’s behalf. Access to these records shall be limited to authorized personnel only, including OHA.

f. The Application Assister shall provide unbiased health coverage choice counseling. If an applicant requests assistance for recommending a Qualified Health Plan, the Application Assister should refer the applicant to an agent listed at Oregon HealthCare.gov

g. The Application Assister shall disclose any relationships the Application Assister or organization has with insurers, their subsidiaries, or other potential conflict of interest.

h. The Application Assister shall obtain appropriate permissions from the Applicant prior to helping the Applicant submit an application. These permissions are defined on the current OHA-provided Consent Form.

i. When appropriate, the Application Assister shall provide referrals for consumers with questions, complaints or grievances to the Federal Marketplace Service Center, OHP

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Customer Service and the Oregon Insurance Division as requested by the consumer.

j. Background checks must be completed prior to Application Assisters providing any Application Assistance.

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EXHIBIT A

Part 2

Statement of Work

1. Services

The Contractor agrees to provide Application assistance to Applicants as follows:

a. Contractor Responsibilities (the Work):

(1) Contractor shall provide enrollment assistance, or provide an appropriate referral for enrollment assistance, for anyone who requests assistance accessing health coverage through OHA or HealthCare.gov.

(2) Contractor shall ensure that all individuals performing work under this Contract receive training from OHA on procedures for providing assistance to Applicants.

(3) Contractor will require all Application Assisters to use and fill out the current OHA-provided Consent Form with an Applicant, before any personal information is shared with an Application Assister. Either a paper or electronic copy of the document must be shared with the Applicant. The Contractor is responsible for securely storing all consent forms for six years.

(4) Contractor will provide information to potential Applicants. Information provided will explain Public Medical Programs and Qualified Heath Plan options. Contractor will give the potential Applicant enough information to make informed choices. The information shall, at a minimum, include an explanation of the role of an Application Assister. The Contractor shall use information materials produced by OHA , or receive approval prior to using any other materials.

(5) The Contractor will employ or engage Application Assisters to provide enrollment assistance to potential eligible applicants through HealthCare.gov and OHA.

(6) Potential Application Assisters must attend initial training and all required additional training to become and maintain status as a certified Application Assister.

(7) Application Assisters will provide information about accessing health coverage and potential financial assistance through HealthCare.gov and OHA to potentially eligible consumers.

2. Eligibility and Continued Participation

a. Contractor shall notify OHA of any changes to the information contained in the Contractor’s application to RFA #5304, reports and supporting documentation within 30 days of the date of the change.

b. Contractor shall inform OHA of any changes to its status or the status of any individual performing under this Contract affecting eligibility or ability to perform services under the Contract.

c. Any deliberate omission, misrepresentation or falsification of any information contained in the Contractor’s application to RFA #5304, reports, or contained in any communication supplying information to OHA may be punishable by law.

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3. OHA Responsibilities

a. OHA will provide training to Contractor and its staff on HealthCare.gov and OHA application procedures and documentation requirements and provide additional training as needed following changes in policy or procedure. Training dates and times will be set by

OHA.

b. OHA will make outreach and public education materials available to Contractor, (in English, Spanish, Russian, Korean, Traditional Chinese, and Vietnamese). Additional outreach tools and resources may be made available and shared online.

c. OHA will provide Contractor with a business contact and an outreach contact for program support including technical assistance, ongoing training, and opportunities to collaborate with other organizations doing similar work.

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EXHIBIT A

Part 3 Special Provisions

1. Confidentiality of Information.

a. Client Information:

(1) All information as to personal facts and circumstances obtained by the Contractor on the client (“Client Information”) shall be treated as privileged communications, shall be held confidential, and shall not be divulged without the written consent of the client, his or her guardian, or the responsible parent when the client is a minor child, or except as required by other terms of this Contract. Nothing prohibits the disclosure of information in summaries, statistical, or other forms which does not identify particular individuals.

(2) The use or disclosure of Client Information shall be limited to persons directly connected with the administration of this Contract. Confidentiality policies shall be applied to all requests from outside sources.

(3) If Contractor, or any of its officers, directors, employees, agents, or subcontractors receives or has access to confidential Social Security Administration (SSA), or Federal Tax Information (FTI) records in the performance of Work under this Contract, Contractor shall comply, and ensure that all of Contractor’s officers, directors, employees, agents and subcontractors comply, with the following provisions:

(a) With respect to SSA records:

i. Provide a current list of employees and employees of any agent or subcontractor with access to SSA records;

ii. Adhere to the same security requirements as employees of

OHA;

iii. Abide by all relevant Federal laws, restrictions on access, use, disclosure, and the security requirements contained within OHA’s agreement with SSA;

iv. Provide its employees and agents the same security awareness training as OHA’s employees; and

v. Include the provisions of this Section 1.a.(3)(a) in any subcontract.

(b) With respect to Federal Tax Information (FTI), as defined in IRS Publication 1075:

i. Contractor and its officers, directors and employees with access to, or who use FTI provided by OHA must meet the

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ii. Any FTI made available to Contractor shall be used only for the purpose of carrying out the provisions of this Contract.

Contractor shall treat all information contained in FTI as confidential and that information shall not be divulged or made known in any manner to any person except as may be necessary in the performance of this Contract. Inspection by or disclosure to anyone other than an officer or employee of the Contractor is prohibited;

iii. Contractor shall account for all FTI upon receipt and shall properly store all FTI before, during, and after processing.

In addition, all FTI related output and products will be given the same level of protection as required for the source material;

iv. No work involving FTI furnished under this Contract will be subcontracted without prior written approval of the IRS;

v. Maintain a list of employees who are authorized access to FTI. Such list will be provided to OHA and, upon request, to the IRS reviewing office; and

vi. Include the provisions of this Section 1.a.(3)(b) in any subcontract.

(c) Failure to abide by any of the requirements in this subsection could result in criminal or civil penalties and result in termination of this Contract.

(d) Contractor may be subject to periodic and ongoing security reviews to ensure compliance with the requirements of Section 1.a.(3).

(4) Except as prohibited by Section 1.a.(3) above, OHA, Contractor and any subcontractor will share information as necessary to effectively serve OHA clients.

b. Non-Client Information:

(1) Each Party acknowledges that it and any of its officers, directors, employees and agents may, in the course of performing its responsibilities under the Contract, be exposed to or acquire information that is confidential to the other Party. To the extent permitted by law, any and all information of any form provided to a Party or its officers, directors, employees and agents in the performance of the Contract that reasonably could at the time of its disclosure be understood to be confidential shall be deemed to be confidential information of the originating Party (“Confidential Non-Client Information”).

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(2) Confidential Non-Client Information shall be deemed not to include information that:

(a) Is or becomes (other than by disclosure by the Party acquiring such information) publicly known or is contained in a publicly available document except to the extent applicable law still restricts disclosure;

(b) Is furnished by the originating Party to others without restrictions similar to those imposed on the receiving Party under the Contract;

(c) Is rightfully in the receiving Party’s possession without the obligation of nondisclosure prior to the time of its disclosure by the originating Party under the Contract;

(d) Is obtained from a source other than the originating Party without the obligation of confidentiality;

(e) Is disclosed with the written consent of the originating Party; or

(f) Is independently developed by the receiving Party’s officers, directors, employees and agents who can be shown to have had no access to the Confidential Non-Client Information.

(3) Nondisclosure. The receiving Party shall hold all Confidential Non-Client Information in strict confidence, using at least the same degree of care that it uses in maintaining the confidentiality of its own confidential information; and shall not sell, assign, license, market, transfer or otherwise dispose of, give or disclose Confidential Non-Client Information to third parties; shall not use Confidential Non-Client Information for any purposes whatsoever other than as contemplated by this Contract or reasonably related thereto; and shall advise any of its officers, directors, employees and agents that receive or have access to the Confidential Non-Client Information of their obligations to keep Confidential Non-Client Information confidential. These confidentiality obligations do not restrict disclosure of information otherwise qualifying as Confidential Non-Client Information if the receiving Party can show that either of the following conditions exists: (i) the information was disclosed in response to a subpoena or court order duly issued in a judicial or legislative process, in which case the receiving Party shall notify the originating Party of the subpoena five days prior to the disclosure, unless such notice could not reasonably be given; or (ii) the disclosure was required to respond to a request for the information made under the Oregon Public Records Law, ORS 192.311 to 192.478. The receiving Party shall notify the originating Party of a public records request five days prior to the disclosure.

c. Upon request and pursuant to the instructions of OHA, Contractor shall return or destroy all copies of Confidential Information, and Contractor shall certify in writing the return or destruction of all Confidential Information.

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d. “Client” means any individual, family or provider:

(1) For whom OHA must provide Services and incidental or specialized Goods, in any combination thereof (“Services and Incidental Supplies”), according to state, federal law, rule, and policy. Those Services and Incidental Supplies include but are not limited to treatment, care, protection, and support without regard to the proximity of the services being provided;

(2) Who in fact receives and utilizes services provided by OHA primarily for that individual's or family's benefit;

(3) Who is under the custody, care, or both of OHA; or

(4) Who provides direct care or Services and is a proxy or representative of the non-provider Client.

2. Amendments.

a. OHA reserves the right to amend or extend the Contract for additional periods of time. The determination for any extension for time may be based on OHA’s program requirements, review of the contracting document terms and conditions, and satisfaction with performance of the work or services provided by the Contractor under this Contract.

b. OHA further reserves the right to amend the Statement of Work based on the original scope of work of RFA #5304 for the following:

(1) Programmatic changes, additions or modifications deemed necessary to accurately reflect the original scope of work that may not have been expressed in the original Contract or previous amendments to the Contract;

(2) Implement additional phases of the Work; or

(3) As necessitated by changes in Code of Federal Regulations, Oregon Revised Statutes, or Oregon Administrative Rules, which, in part or in combination, govern the provision of services provided under this Contract.

c. Upon identification, by any party to this Contract, of any circumstance which may require an amendment to this Contract, the parties may enter into negotiations regarding the proposed modifications. Any resulting amendment must be in writing and be signed by all parties to the Contract before the modified or additional provisions are binding on either party. All amendments must comply with Exhibit B, “Standard Terms and Conditions”, Section 24. “Amendments;

Waiver; Consent.” of this Contract.

3. Contractor Requirements to Report Abuse of Certain Classes of Persons.

a. Contractor shall comply with, and cause its employees, agents and subcontractors to comply with, the applicable laws for mandatory reporting of abuse including but not limited to abuse of the following classes of persons in Oregon:

(1) Children (ORS 419B.005 through 419B.045);

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(2) Elderly Persons (ORS 124.055 through 124.065);

(3) Residents of Long Term Care Facilities (ORS 441.630 through 441.645);

(4) Adults with Mental Illness or Developmental Disabilities (ORS 430.735 through 430.743).

b. In addition to the requirements of Section 3.a. above, if law enforcement is notified regarding a report of child abuse, Contractor shall also notify the local Child Protective Services Office of the Department of Human Services within 24 hours. If law enforcement is notified regarding a report of abuse of elderly, long term care facility residents, adults with mental illness or developmental disabilities, the Contractor shall also notify the local Aging and People with Disabilities Office of the Department of Human Services within 24 hours.

c. If known, the abuse report should contain the following:

(1) The name and address of the abused person and any people responsible for that person’s care;

(2) The abused person’s age;

(3) The nature and the extent of the abuse, including any evidence of previous abuse;

(4) The explanation given for the abuse;

(5) The date of the incident; and

(6) Any other information that might be helpful in establishing the cause of the abuse and the identity of the abuser.

4. Background Checks. Any agent, applicant/employee or volunteer working with clients referred by OHA shall not been convicted of any of the following crimes: child or elderly abuse, offenses against persons, sexual offenses, child neglect, identity theft or any fraud related crime, or any other offense bearing a substantial relation to the qualifications, functions or duties of an employee or volunteer scheduled to work with OHA’s client.

As a condition of employment/engagement, Contractor shall require that the applicant/employee or volunteer apply for and receive a criminal history check from OHA’s designated Background Check Unit (BCU).

BCU will determine, after receiving the criminal history check, whether the applicant/employee or volunteer has listed convictions, and whether these convictions pose a risk to working safely with OHA clients.

5. Equal Access to Services. Contractor shall provide equal access to covered services for both males and females under 18 years of age, including access to appropriate facilities, services and treatment, to achieve the policy in ORS 417.270.

6. Media Disclosure. The Contractor will not provide information to the media regarding a recipient of services purchased under this Contract without first consulting the OHA office. The Contractor will make immediate contact with the OHA office when media contact occurs. The OHA office will assist the Contractor with an appropriate follow-up response for the media.

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7. Nondiscrimination.

a. The Contractor must provide services to OHA clients without regard to race, religion, national origin, sex, age, marital status, sexual orientation or disability (as defined under the Americans with Disabilities Act). Contracted services must reasonably accommodate the cultural, language, and other special needs of clients.

b. As required by ORS 279B.235, Contractor must comply with ORS 652.220 and shall not…