RFA Evaluation Tool Worksheet Amended and Restated.docx

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Amended and Restated Respite Services - Master Agreement Request for Applications
Solicitation number
BD-21-1022-DMH08-8220A-53630
Issued by
Massachusetts

About this file

This document is an Amended and Restated Respite Services - Master Agreement Request for Applications issued by the Massachusetts Department of Mental Health (DMH). Through this RFA, DMH seeks to establish a pool of qualified providers from which DMH Areas can purchase Site-Based Respite and/or Mobile Respite Services on an as needed basis. The RFA outlines the service models, staffing requirements, service delivery, and site-based and mobile respite locations. Bidders must qualify for at least one site-based location or mobile respite site office and receive an overall rating of "Good" or higher to be selected for the master agreement. The RFA has specific requirements for bidder background, organizational structure, staff qualifications, service model, service delivery, scenarios, site locations, and quality management.

The RFA does not provide specific pricing terms, but indicates that services will be purchased on an as needed basis. It does not mention any set asides, incumbents, or funding sources. The master agreement will be valid until December 31, 2026, with the ability to add new qualified providers throughout the term.

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Text version

EVALUATION TOOL WORKSHEET AMENDED AND RESTATED

_________________________________________________ Applicant

_________________________________________________Date of Application

Service Model Information:

Service Model
Check Applicable Model
Site Based Location(s) for Site Only, Blended Capacity or Peer and Site Office(s) for Mobile Only
Proposed Capacity

Site Only

Site Based Location(s) by Town(s):

Proposed capacity per location:

Blended Capacity

Site Based Location(s) by Town(s):
Proposed rate model A or B and proposed site based capacity and mobile capacity per location:

Peer Respite

Site Based Location(s) by Town(s):
Proposed capacity per location**:

Mobile Only

Site Office(s):
Proposed capacity per Site Office:

*Blended Capacity: Model A is for a total capacity of 13 individuals 4-6, must be site based and the remainder 7-9 in mobile; Model B is for a total capacity of 20 individuals of which 7-9 must be site based and the remainder 13-11 in mobile.

**Peer Respite: the program must have 3-5 beds.

___ Re-application: Date of original Application__________ Cover Sheet includes summary of changes; ___ limits on re-applications met (Subsection 11.7).

___ Addition of a new site-based respite location for Site Only, Blended Capacity, Peer Respite or increase in capacity for existing location(s). Cover Sheet includes a summary of the proposed addition and, if needed, an update of the information included in the previous application.

___ Addition of a new Site Office to serve for Mobile Only or increase in capacity. Cover Sheet includes a summary of the proposed addition and, if needed, an update of the information included in the previous application.

For Additions – need only to review information that has changed from the bidder’s original application and the new information for the proposed addition as reflected in the following application categories submitted in response for the proposed addition: Category II, Staff Positions, Qualifications and Requirement; Category III Service Model and Category VI Site-Based Locations and Mobile Respite Site Office(s). A bidder must receive a rating of good or higher in each new category submitted to qualify for the addition.

MINIMUM SUBMISSION REQUIREMENTS CHECKLIST

Completed By:____________________________________________ Date Completed:___________________

Part 1 RFA Application Submission Format (RFA Subsections 11.1, 11.2 and 11.3):

___ Separate applications for different Service Models ___ Electronic Application was posted on COMMBUYS: _________ date and ____ time. (Needs to be submitted before 12/31/2026) ___ Naming conventions were used

Part 2 Application Format:

a. Application must be in the following format (Application Requirements):

___ type-written, 12 point Times New Roman font ___ 8 ½ x 11 inch paper ___ fully justified (print fully abuts both margins) ___ one-inch margins ___ single-spaced ___ page numbers at bottom of each page ___ Table of Contents

b. Page Limit and Attachments (RFA Subsection 11.6; Application Requirements) ___ Pages are within stated limit, OR ___ Page limits exceeded, excessive pages removed from the end of Application

___ Attachments limited to those on the List of Permitted Attachments, OR ___ Extra attachments included, but removed by DMH.

Part 3 Application Requirements (RFA Subsection 11.5 and Application Requirements) An Application must consist of the following parts:

___ Signed RFA Cover Sheet ___ Application ___ Executed Standard Contract Form (with the Commonwealth Human and Social Services Terms and Conditions being indicated as being applicable) ___ An executed original Massachusetts Form W-9 or DMH verified that an original is on file with the State Comptroller (If by verification, initial ____) ___ A Contractor Authorized Signatory Listing (1 original), includes both pages with the second page notarized.

___ An original Authorization for Electronic Funds Payment or verified by DMH that an original has be filed with the State Comptroller (If by verification, initial ____) Supplier Diversity Program Plan Submitted (Optional) ___ Supplier Diversity Program Plan Form for POS Used

PART 4 Qualification/Debarment

___ Bidder is EOHHS Qualified or has submitted to Greg Drouin a completed “Contracting Qualification Form and Supplement” on or before the date the Applications was filed. ___ Bidder is not EOHHS Qualified and has not submitted to Greg Drouin a completed “Contracting Qualification Form and Supplement” on or before the date the Applications was filed. A MA can only be awarded to an Applicant that has been qualified by EOHHS.

___ Bidder is subject to a Debarment order. ___Bidder is not subject to a debarment order.

Part 5 Minimum Submission Requirements Summary (See Subsection 12.1.2)

Meets__________________ Does Not Meet________________

Explanation:

The following actions (e.g., disqualifications, penalties, etc.) were taken because the Response failed to meet the Minimum Submission requirements: ____________________________________________________________________________________________________

ORGANIZATIONAL MINUTES

Review Committee Members:

Quorum:

Method for breaking ties:

Describe preliminary reviews, if any. Identify who conducted the preliminary review and the; and attach input:

Department of Mental Health Amended and Restated Respite Services – Master Agreement Request For Applications

DMH # 2017-DMH-3048-03

July, 2020

APPLICATION REVIEW

For the purpose of evaluating the Application, the Application has been clustered into Six (6) different Categories as indicated below. (Note: Category VII included in the Application Requirements, Contract Forms, was reviewed as part of the Minimum Submission requirements above). There are two steps to evaluating the Application. The first step is to assign each Application Category a rating using the following criteria:

Excellent (E) – The Application is comprehensive, feasible and appropriate. It satisfies all RFA requirements and exceeds many of the requirements. No weaknesses are identified. It demonstrates an excellent understanding of the services to be provided and the issues/barriers that a Contractor may need to address when providing services. It exceeds the needs of DMH.

Very Good (VG) – The Application is comprehensive, feasible and appropriate. It satisfies all RFA requirements and exceeds some of the requirements. Identified weaknesses, if any, are minor. It demonstrates a good understanding of the services to be provided and the issues/barriers that a Contractor may need to address when providing services. It exceeds the needs of DMH.

Good (G) – The Application is comprehensive, feasible and appropriate. It satisfies all the RFA requirements. If it has weaknesses they are minor. It demonstrates a reasonable understanding of the services to be provided and the issues/barriers that a Contractor may need to address when providing services. It meets the needs of DMH.

Fair (F) – The Application is not fully comprehensive, feasible or appropriate. It satisfies most, but not all of the RFA requirements. Weaknesses are identified; they may or may not be substantial. It demonstrates a reasonable understanding of the services to be provided and the issues/barriers that a Contractor may need to address when providing services. It does not meet the needs of DMH.

Poor (P) – The Application is not fully comprehensive, feasible or appropriate. It does not satisfy most of the RFA requirements. Weaknesses are identified and they are substantial. It does not demonstrate a reasonable understanding of the services to be provided and the issues/barriers that a Contractor may need to address when providing services. It is not responsive to the needs of DMH.

The second step is to give the Application an overall rating based on the ratings given to each Category and the level of importance (weight) assigned to each Category as indicated below.

Qualification: To qualify for the Master Agreement a Bidder must qualify for at least one Site Office (Mobile Only) or one Site Based Location (Site Only, Blended Capacity or Peer Respite) and it must receive a rating of “Good” or higher for its Application overall. To qualify for a Site Based location or Site Office it must receive a rating of “Good” or higher in both Categories II and V, for the Site Based location or Site Office.

Category Number and Title:

I. Bidder’s Background and Organizational Structure 25% Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

Requested Information
Comments

Base your comments on the evaluation criteria set forth above.

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations.

___ Bidder has a history and work experience that is relevant to providing Respite Services and which demonstrates its ability to perform the services required by this RFA and as described in its Application.

___ Bidder has relevant experience in providing recovery based services to individuals with serious mental illness and the type of services describe in this RFA.

___Preference will be given to bidders with 5 or more years of experience providing respite or services similar to Respite.

___Preference will be given to bidders with 5 or more years of experience in providing recovery based services to individuals with serious mental illness.

___ The staff capabilities, skills and trainings and/or approaches described by the Bidder are consistent with the requirements of the RFA and it is reasonable to believe the Bidder will be able to meet the requirements of the RFA, its response and the needs of individuals to be served and DMH.

___ The Bidder has a track record of success and it is reasonable to believe the organization is capable of taking on the requirements of the Master Agreement.

___ The Bidder understands that this service will be purchased on as needed and that it will be able to provide the services on that basis. The Bidder reasonable identifies the barriers to entering into Purchase Agreements and/or commencing services quickly and has a plan for how such barriers can be minimized.

___ The Bidder describes a mission and philosophy that is consistent with DMH and with the principles and goals of Respite Services. (Section 3 and Subsection 1.3, 1.4 and if applicable 7.3 )

___ Recovery, Trauma Informed Care, Person Centered and Strength based Services and Peer Support appear to be incorporated into the Applicant’s culture as demonstrated by its examples. (Subsection 1.3, and Section 3)

___Preference will be given to applicants that have incorporated recovery principles into their mission statements and policies and that submitted documentation of such as attachments to their responses.

___ It is reasonable to believe the Bidder’s has an organizational structure that will provide adequate oversight, consultation and support for the Respite Services the Bidder may supply as an MA contractor.

___ The Bidder has other qualifications that will benefit DMH, such as ____Review Committee to complete _______________________________, ____ N/A

___ The Bidder’s Risk Mitigation Protocol is appropriate for Respite Services and is consistent with the DMH Community Risk Policy. (Subsection, 6.14 or if applicable Subsection 7.10) ___ It is reasonable to believe the Bidder has the IT infrastructure to execute the requirements set forth in RFA Subsection 8.5 or has proposed a sound and reasonable plan to ensure the requirements will be met by the start of the Contract.

___ It is reasonable to believe the Bidder’s internal privacy and data security policies and procedures are appropriate for Respite Services. (Subsection 8.2)

___ Training on privacy and security is reasonable especially considering the applicable Service Model.

___ Nothing has occurred in the past five years that raises concerns about the bidder’s privacy practices.

___ Bidder demonstrates a reasonable understanding of HIPAA authorization requirements. (Subsection 8.2)

___ Bidder indicates its CAP or ARA status. If the Bidder is under a CAP/ARA, it is reasonable for DMH to believe that the Bidder can still successfully undertake the Contract. (Subsection 8.1)

___ Bidder’s proposed complaint process is in compliance with DMH Regulations. (Subsections 6.4 and 6.10, or if applicable, Subsections 7.7 and 7.10) For Peer Respite

___Bidder’s history and work experience is relevant to providing peer-driven recovery oriented services and Peer Respite Services.

___ Has relevant experience working with individuals with serious mental illness or have had substance issues.

___Preference will be given to Bidders who have five or more years or experience providing Peer Lead and Operated Services as defined in the RFR.

___ Reasonable assurances are provided that Peer Respite services will be administratively controlled and operated at the program level by Persons with Lived experience.

___ It is reasonable to believe that the bidder will be able to employ and utilize peer workers as needed to fulfil Purchase Agreements.

___Preference will be given to organizations that have Peer leadership and governance.

Category Number and Title:

II. Staff Positions, Qualifications, and Requirements 20% Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

If an Applicant wants to qualify for more than one location (Site-Based) or Site Office (Mobile) the Applicant needed to submit a different response to Category II for each location/Site Office for which it wants to be qualified. THE REVIEW COMMITTEE NEEDS TO COMPLETE THIS CATEGORY II WORKSHEET FOR EACH LOCATION/SITE OFFICE RESPONSE THE APPLICANT SUBMITTED AND GIVE EACH RESPONSE A CATEGORY II RATING.

Requested Information
Comments

Base your comments on the evaluation criteria set forth above.

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations. If applicable, identify points for contract negotiations.

A and B. Availability and Staff Positions:

___ Bidder’s proposed staffing is reasonable for the selected Service Model, location and expected capacity, based on titles and proposed roles and the number of FTEs, etc. (Subsections 5.1, 5.2, 5.3, 6.12, 7.1, 7.4 and 7.10 Sections 4, 5, 6 and 8)

___The Bidder has a reasonable plan for managing staff resources to ensure a degree of flexibility to be able to address the needs of Persons Served as they may change.

___Bidder response reflects an understanding of the service and the expected Persons Served.

___Bidder sufficiently addresses how it will meet the applicable requirements of Subsection 6.12 or Subsection 7.10 and it is reasonable to believe that they will be met.

___ Proposed job descriptions and qualifications are reasonable for the proposed positions.

___ Daily staffing needs are understood and contingencies are planned for sufficiently.

___ Staff will work as an integrated team for the benefit of Persons Served.

For Site Only, Blended Capacity and Mobile Only:

__ A multi-disciplinary team approach is reflected and the Applicant has a reasonable plan to ensure that there will be integration between staff serving Persons Served to ensure communication and appropriate care.

___ Bidder’s proposed staff positions are aligned with the clinical expectations of Respite Services, as set as addressed in Subsections 1.2; 5.1, 5.2, 5.5, 6.5 and 6.12.

___ The Bidder had a reasonable plan for ensuring the timely availability of clinical consultations (Subsection 5.1).

For Blended Capacity:

___ The Bidder adequately addresses both its mobile and site-based capacities.

___ It is reasonable to believe that the proposed staffing pattern will ensure the availability of Respite Services across the site-based and mobile settings (DMH Area) and the maximum capacity for the applicable rate model.

___ Position of Human Rights Officer is appropriately planned.

___The sample staffing schedule reflects the proposed staffing pattern, it is responsive to the needs of Persons Served, ensures the availability of Respite Services across the site-based and mobile settings, and reflects the requirements of the RFA.

For Peer Respite:

___ It is reasonable to believe that the Services Director and Direct Care staff will be Persons with Lived Experience. (Subsections 7.1, 7.4 and 7.10)

___ Response demonstrates a good working knowledge of the certification process for peers. It is reasonable to believe that the Peer Respite Services Director and Direct care staff will be certified Peer Specialist as required by the RFR. (Subsections 7.1, 7.4 and 7.10) Staff Deployment:

___ The sample staffing schedule reflects the proposed staffing pattern, will be responsive to the needs of Persons Served, ensures the availability of Respite Services across the site-based and mobile settings, and reflects the requirements of the RFA.

___ Position of Human Rights Officer is appropriately planned.

C. Staff Deployment:

___It is reasonable to believe that the proposed staff deployment will ensure that all applicable service components will be available as needed by Persons Served and that service standards will be met. (Subsections 5.9, 6.12.1, 6.12.2, 6.12.3, 7.10 and Sections 4, 5, 6 and 7)

Site Only, Blended Capacity and Mobile Only:

___The Bidder has a reasonable plan for ensuring that Peers are incorporated into the service model with clearly defined roles and the peers will be sufficiently supported and supervised. The roles of peers are clearly defined and meet DMH expectations. (Subsection 5.9)

D. Training and Supervision:

___ It is reasonable to believe that staff will be timely and appropriately trained on the applicable service model and the Bidder’s operation procedures (Subsections 6.12 and 7.10)

___ The supervision plan is reasonable based on the service model and the proposed staffing plan.

E. Organizational Chart:

____Proposed staffing organizational chart clearly depicts a staffing and supervision structure that supports the requirements of the RFA. (Subsections 1.2, 1.3, Section 4 and, as applicable, Sections 5 and 6 or 7.)

Category Number and Title:

III. Service Model and Service Delivery 20% Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

Requested Information
Comments

Base your comments on the evaluation criteria set forth above.

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations.

The following applies to Site Only, Blended Capacity and Mobile Only

A. Service Model:

___ The Bidder proposes a service model for Respite that will adequately assure that the components in Sections 5 and 6 will be available and provided as needed by Persons Served. In addition it is reasonable to believe that the Services will meet the service standards, Respite principles and goals. (Subsections 1.3 and 1.4, Sections 4, 5 and 6).

___ The Proposed service model describes how Respite Services will partner and coordinate with other stakeholders involved with Persons Served. (Subsections 1.2, 5.6, 5.10, 6.8 and 6.13)

___ Proposed service model will ensure Respite Services are available and accessible 24 hours/day, 7 days/weeks. (Subsection 6.1, 6.12.1)

___ For Blended Capacity Only: The Proposed service model will ensure Respite Services are available in both site-based and Mobile Settings.

B. Service Delivery:

___ The Bidder proposes a service delivery model which has the capacity to rapidly respond to Persons Served referred for Respite Services. (Subsection 6.4)

___ Proposed service delivery model reflects the time limited nature of Respite Services. (Subsection 6.4)

___ Service model is designed to be flexible to meet the needs of each person served. (Section 4)

___ The proposed service delivery model utilizes Evidence Based and Best Practices.

___The proposed service delivery model fully utilizes and integrates peer support. (Subsection 5.9, 1.3 and 5.3)

C. Referrals and Enrollment ___ Referral and Enrollment protocols meet the requirements of the RFA, including obtaining consent to participate. (Subsections 6.2, 6.3 and 6.4). It is reasonable to believe that required timeframes for enrollment will be met.

D. Assessments ___ Assessment protocols meet the requirements of the RFA, including the requirement that assessments are completed by or reviewed and signed by a respite service clinical Staff person (Subsection 6.5). It is reasonable to believe that assessments will be timely completed and will address the need for the referral.

___ The proposed assessment tools and other relevant forms support the above findings.

E. Community Service Plans ___ CSP protocols and CSP Form meet the requirements of the RFA. (Subsection 6.6)

F. Records ___ Records protocols meet the requirements of the RFA. (Subsection 6.10)

G. Discharge Planning ___Discharge planning protocols and Discharge Plan Form should ensure that the requirements of the RFA. (Subsection 6.7)

H. Medication ___ The implementation of the medication policies and procedures should ensure that the Medication requirements of Subsection 5.4 and 6.12 are met.

___ MAP staffing plan and training is reasonable and met RFA requirements.

The following applies to Peer Respite.

A. Service Model ___ The Bidder proposes a service model for Respite that will adequately assure that the components in Sections 7 will be available and provided as needed by Persons Served. In addition it is reasonable to believe that the Services will meet the service standards, Respite principles and goals. (Subsections 1.3 and Sections 4 and 7).

___ The Service Model is the IPS Model or a similar service delivery model. (Section 4 and Subsection 7.2)

___ The proposed service model describes how Respite Services will partner and coordinate with other stakeholders involved with Persons Served. (Subsections 1.2 and 7.4)

___ Proposed service model will ensure Respite Services are available and accessible 24 hours/day, 7 days/weeks. (Subsection 7.9)

B. Service Delivery

___ The Bidder proposes a service delivery model which has the capacity to rapidly respond to Persons Served referred for Respite Services. (Subsection 7)

___ Proposed service delivery model reflects the time limited nature of Respite Services. (Subsection 7)

___ Service model is designed to be flexible to meet the needs of each person served. (Sections 4 and 7)

C. Service Access ___ Eligibility determinations reflect the requirements of Subsections 7.4-7.7, specifies qualified staff for making the determinations and illustrates that the Bidder knows what the potential challenges will be in doing eligibility determinations and its approach as to how to address them is reasonable.

___ Plan for managing service when the Peer Respite Program is at capacity reflects an understanding of the population to be served and other resources that are available.

___ Plan for Services outside of the Peer Respite Program is reasonable considering the limited staff. It is practical to expect that the Bidder plan will ensure compliance with Subsection 7.4. It also demonstrates an understanding of the population to be served and the purpose of the Service.

___ Protocol for working with individuals determined not to be eligible should ensure that the Contractor will offer and will be able to refer individuals to other services or supports.

___ Length of Stay and hours of operation meet the requirements set forth in Subsections 7.8 and 7.9

___ The Bidder has a reasonable plan for emergency medical and psychiatric Services. ( Subsection 7.12)

___ It is reasonable to believe that eligibility determinations will be documented in accordance with the provisions of (Subsection7.6)

___Community Outreach Plan is feasible and organizations of key significance to the population to be served were included. (Subsection 7.4)

___ Plan for engaging individuals reflects the purpose and goals of Peer Respite Services and knowledge of the intended population to be served. (Subsections 7.3 and 7.4)

D. Entering the Peer Respite Program (Subsection 7.7)

___Orientation process and service description should provide individuals with the information they need to understand the service and their potential role and responsibilities. The process meets the requirements set forth in Subsection 5.4.

___ It is reasonable to believe that health and safety concerns will be identified and address immediately.

E. Goal Planning ___ Personal Goal Statement protocols meet the requirements of Subsection 7.7.

F. Records

___ Protocol for records meet the requirements of the RFR of Subsection 7.11.

G. Completion or Termination of Services ___Protocol for the completion or termination of services is reasonable and reflects the requirements set forth in Subsection 7.8.

Category Number and Title:

IV. SCENARIOS 10%

Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

THE REVIEW COMMITTEE NEEDS TO COMPLETE THIS CATEGORY IV WORKSHEET FOR EACH LOCATION/SITE OFFICE RESPONSE THE APPLICANT SUBMITTED AND GIVE EACH LOCATION/SITE OFFICE RESPONSE A SEPARATE CATEGORY IV RATING.

Requested Information

Comments

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations.

___ Applicant’s scenario(s) demonstrate a clear understanding of the Respite Services, its proposed service models and the expected Persons Served population.

___ Applicant’s response(s) to its scenario(s) and its responses to the Site Only, Blended Capacity and Mobile Only scenarios, if applicable, demonstrate a clear understanding of the Applicant’s Respite service model, especially as to its service components, specifications, principles and service goals as well as the resources available in the geographic area for which the Application was submitted.

Category Number and Title:

V. Site-Based Location(s) or Respite DMH Site Offices 20% Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

If an Applicant wants to qualify for more than one location (Site-Based) or Site Office (Mobile) the Applicant needed to submit a separate response to Category V for each location/Site Office for which it wants to be qualified. THE REVIEW COMMITTEE NEEDS TO COMPLETE a CATEGORY V WORKSHEET FOR EACH LOCATION/SITE OFFICE RESPONSE SUBMITTED BY THE APPLICANT AND GIVE EACH LOCATION/SITE OFFICE RESPONSE A SEPARATE CATEGORY V RATING.

Requested Information

Comments

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations.

Site Only; Blended Capacity and Peer Respite

Bidder’s proposed physical site:

___ As described, it is reasonable to believe the physical site will provide adequate space to accommodate Respite Services and meets the requirements of Subsections 6.11 and 6.13. (Site Only and Blended Capacity) and Subsection 4.1 and 7.9)

___ The site appears to be reasonably accessible.

___ Is DMH licensed or Bidder proposes a sound plan to obtain licensure.

___ If applicable, the site is DPH registered or Bidder proposes a sound plan to obtain certification.

For Blended Capacity:

___ The Bidder demonstrates it can reasonably provide mobile respite services Area wide and that it has collaborations and partnerships with entities throughout the Area that could benefit Persons Served.

Mobile Only:

DMH Site Offices:

___ It appears reasonable to believe that the Applicant knows the communities to be served and has experience provided services to these communities.

___ It is reasonable to believe that the Bidder will be able to provide the Respite service components and meet the service standards within the communities served by the applicable Site Office for which it is seeking to be qualified for under the RFA.

___ The collaboration and demonstrates both a knowledge of the communities to be served and the Respite services that are to be provided under the RFA.

Category Number and Title:

VI. Quality Management, Reporting Requirements 5% Rating: Excellent, Very Good, Good, Fair, Poor (Circle One)

Requested Information

Comments

Provide details. Be specific as to what was missing and/or how the Bidder failed to meet the specified requirement and/or how the Bidder exceeded requirements. It is not enough to say requirements were not met or were exceeded. If applicable, identify points for contract negotiations.

___ It is reasonable to believe the Bidder’s quality management practices and operations will successfully monitor and evaluate the effectiveness of Respite Services.

___ The Bidder’s proposed process for the collection and submission of data and reports meets the requirements of RFA Subsections 6.19, 6.20 or 7.4.

___ Bidder has a reasonable understanding of the potential issues which can arise impacting the Bidder’s ability to collect and submit data and a reasonable plan to address those issues.

APPLICATION RATING CONSOLIDATION

Application Category
Percentage
Rating

I. Bidder’s Background and Organizational Structure

25%

II. Staff Positions, Qualifications, and Requirements*
20%
III. Service Model and Service Delivery
20%
IV. Scenarios
10%
V. Site Based Locations And Mobile Respite DMH Site Offices *
20%
VI. Quality Management, Reporting Requirements
5%
Application Rating
100%

*Use the average score of all locations/Site Offices if more than one.

Site Office or Site Based Location:

Application Category
Rating

II. Staff Positions, Qualifications, and Requirements

V. Site Based Locations And Mobile Respite DMH Site Offices

Application Category
Rating

II. Staff Positions, Qualifications, and Requirements

V. Site Based Locations And Mobile Respite DMH Site Offices

Application Category
Rating

II. Staff Positions, Qualifications, and Requirements

V. Site Based Locations And Mobile Respite DMH Site Offices

Qualification: Bidders to qualify must qualify for at least one Site Office (Mobile Only) or one Site Based Location (Site Only, Blended Capacity or Peer Respite) and it must receive a rating of “Good” or higher for its Application overall. To qualify for a Site Based location or Site Office it must receive a rating of “Good” or higher in both Categories II and V, for the Site Based location or Site Office.

Committee’s recommendation regarding qualification:

SERVICE MODEL
LOCATION/SITE OFFICE
RECOMMENDED FOR MA YES OR NO

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